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Anatomy > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

what is the thorax and what is its location

A

the chest cavity
-between neck and abdomen, enclosed by the ribs, sternum, and dorsal vertebrae

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2
Q

what are the 3 parts of the thorax

A

mediastinum and left and right pleural compartments

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3
Q

describe the shape of the thoracic cavity

A

shaped like a dome, birdcage or truncated cone

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4
Q

what is the floor of the thoracic cavity

A

diaphragm, convex in shape

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5
Q

describe the walls of the thoracic cavity

A

thin

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6
Q

what is a barrel chest characteristic of

A

emphysema

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7
Q

what are the functions of the thorax

A

-protect vital thoracic/abdominal organs
-resist the negative internal pressure created by the elastic recoil of the lungs
-provide attachments for and support the weight of the upper limbs
- provide the origin for some upper limb muscles and attachments for muscles of the abdomen, neck, back and respiration

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8
Q

what are the 3 types of ribs

A

true ribs, false ribs, and floating ribs

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9
Q

describe the true ribs

A

1-7 attach vertebrae to sternum. have cartilage at the ends

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10
Q

describe the false ribs

A

8-10 have cartilages attached to the cartilages of ribs superior, costal cartilage

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11
Q

describe floating ribs

A

11-12 have cartilages ending in the posterior adbominal wall musculature

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12
Q

what is the infrasternal angle

A

cartilages of ribs 7-10 join to form this

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13
Q

what is the intercostal space

A

separation between ribs and between cartilage

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14
Q

what is the superior thoracic aperture bound by

A

bound by 1st thoracic vertebra, 1st pair of ribs, and superior border of manubrium

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15
Q

what seals the inferior thoracic aperature

A

the diaphragm

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16
Q

what do the articular facets of the head of the rib articulate with

A

the superior facet articulates with the vertebrae above the rib, the inferior facet articulates with the corresponding vertebra to that rib

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17
Q

where is the neck of the rib

A

in between the head and the tubercle

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18
Q

what does the tubercle of the rib articulate with

A

the articular facet of the tubercle articulates with costal facet of the transverse process of the vertebrae of same number

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19
Q

what does the sternal end of the rib do

A

connects to sternum to the cartilage of the rib

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20
Q

what runs in the costal groove

A

intercostal vessesl

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21
Q

where can supernumerary ribs occur

A

cervical ribs or lumbar ribs

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22
Q

what is thoracic outlet syndrome

A

a group of disorders that occur when there is compression, injury, or irritation of the brachial plexus and/or subclavian vessels in the lower neck and upper chest

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23
Q

what is the manubrium

A

the top part of the sternum

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24
Q

what are the notches in the manubrium

A

jugular notch, clavicular notch and notch for 1st costal cartilage

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25
what does the body of the sternum do
has notches for costal cartilage
26
what is the xiphoid process of the sternum
the inferior portion of the sternum
27
what is a sternal foramen
failure of fusion between halves of the sternal bars during development
28
what are some chest wall deformities as a result of an abnormal sternum
pectus carinatum, pectus excavatum, cleft sternum, poland syndrome, ectopia cordis
29
what is pectus carinatum and when does it occur
abnormal development causing the sternum to protrude. can be at birth or adolescent males during growth spurts, can be congenital or genetic
30
what is pectus excavatum
abnormal development of the rib cage in which the sternum grows inward, cause is unknown, more common in males
31
what is congenital scoliosis
caused by a bone abnormality present at birth
32
what is neuromuscular scoliosis
a result of abnormal muscles or nerves, seen in spina bifida or cerebral palsy
33
what is degenerative scoliosis
may result from traumatic bone collapse, previous major back surgery or osteoporosis
34
what is idiopathic scoliosis
most common, no identifiable cause, may be inherited
35
what do upper ribs do at costotransverse joints
rotate
36
what do lower ribs do at costotransverse joint
glide
37
which ribs do not articulate with transverse processes
11 and 12
38
what are costochondral joints
primary cartilaginous joints and they usually do not move
39
what are intercondral joints
between costal cartilages 6-9 synovial joints between cartilages 9 and 10, fibrous joint
40
explain sternocostal joints
1st joint is cartilaginous - joints 2-7 are synovial joints
41
which rib joints have the most movement involed
costotransverse joints
42
where are the intercostal muscles located and what is their function
occupy intercostal spaces and function during respiration by moving the ribs and keeping the intercostal spaces rigid
43
what are the 3 layers of intercostal musclrs
external intercostal, internal intercostal, and innermost intercostal
44
describe the attachments of the external intercostal muscles
attach superiorly to the inferior border of the rib above and inferiorly to the superior border of the rib below. fibers run infero-anteriorly
45
what is the function of the external intercostal muscles
elevate the ribs during forced inspiration, pull up on ribs
46
describe the attachments of the internal and innermost intercostal muscles
they attach superiorly to the inferior border of the rib above and inferiorly to the superior rib below. fibers run inferoposteriorly
47
what is the function of internal and innermost intercostals
functions to depress the ribs during forced respiration
48
what separates the internal intercostal muscle from the innermost intercostal muscle
the intercostal neurovascular bundle
49
describe the actions of the intercostal muscles during inspiration (breathing in)
external intercostals contract internal intercostals relax
50
describe the actions of the intercostal muscles during expiration
external intercostals relax and internal intercostals contract
51
what direction internal and innermost intercostal muscles run
downward and outward
52
where does the subcostalis attach
superiorly to internal surfaces of lower ribs near their angles and inferiorly to superior borders of ribs 2 or 3 levels below
53
what direction do subcostalis muscles run
same orientation and blending with internal and innermost intercostals
54
what is the function of subcostalis muscles
help breathe out and pull down on ribs
55
where does the transversus thoracis attach
inferiorly on the posterior sternum and superiorly on costal cartilages 2-6
56
what is the function of the transversus thoracis
depress ribs, involved in expiration
57
what is the origin, insertion, and action of the levator costae
origin: transverse processes insertion: rib below between tubercle and angle action: elevate ribs
58
what is the origin, insertion, and action of the serratus posterior superior
origin: spines of C7-T3 insertion: ribs 2-4 action: elevate ribs
59
what is the origin, insertion, and action of the serratus posterior inferior
origin: spines of T11-L2 insertion: ribs 8-12 actions: depress ribs
60
what is a dermatome
an area of the skin supplied by nerves from a single spinal root
61
what are some important markers of the dermatome
nipples are at T4 and umbilicus is at T10
62
what is a thoracotomy
surgical opening through the thoracic wall to access the lungs, heart, esophagus, diaphragm and the thoracic aorta
63
what is a thoracentesis
a procedure to remove fluid from the space between the lining of the outside of the lungs and the wall of the chest
64
where is the needle inserted in a thoracentesis and why
above the ribs to avoid nerves and vessels
65
what is an intercostal nerve block
injection to block sensory pain
66
what is a nerve root block
selective nerve root block primarily used to diagnose the specific source of nerve root pain and secondarily for therapeutic relief of low back pain and/or leg pain
67
what type of injections are used for shingles
thoracic epidural steroid injections
68
what is the order of the vessels and nerves from superior to inferior
vein, artery, nerve
69
describe what happens in the thorax during inspiration
-ribs raise - increased volume leads to decreased pressure
70
what is the result of the pump handle movement in inspiration
elevation of ribs, increase in antero-posterior diameter of thoracic cavity
71
what is the result of the bucket handle movement in inspiration
elevation of ribs, increase in lateral diameter of thoracic cavity
72
what muscle is responsible for passive breathing
the diaphragm
73
what are the principle muscles of inspiration
-external intercostals -diaphragm
74
what are the principle muscles of forced expiration
internal intercostals and abdominals
75
what is the primary blood supply of the thoracic wall derived from
aorta and subclavian arteries
76
what branches from the aorta
posterior intercostals
77
what branches from the subclavian
internal thoracic (left and right)
78
where is the internal thoracic artery located
descends into the thorax lateral to the edge of the sternum and ends at the 6th costal cartilage by dividing musculophrenic and superior epigastric arteries
79
what comes off of the internal thoracic artery
anterior intercostal 1-6
80
what arteries do anterior intercostals 7-10 come off of
musculophrenic arteries
81
what do intercostal veins drain back into
musculophrenic or internal thoracic veins
82
what do anterior intercostal arteries anastomose with
posterior intercostal arteries in the intercostal space
83
what do the posterior intercostal arteries branch off of
two of the arteries branch off of the supreme intercostal artery in the first two intercostal spaces. the remaining arteries branch off the descending thoracic aorta
84
where do the posterior intercostal veins drain into
the azygous and hemiazygous/accessory veins
85
which side are the azygous veins on
right side
86
which side are the hemiazygous veins on
left side
87
what is the exception to posterior intercostal veins
left superior intercostal

Anatomy (27 decks)

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