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Regional Anatomy 1 > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

what forms lateral walls of thoracic cage

A

12 pairs of ribs

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2
Q

anteriorly the ribs articulate with what

A

midline sternum

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3
Q

are the scapula and clavicle part of the thoracic cage

A

no

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4
Q

posteriorly ribs articulate with what

A

12 thoracic vertebrae

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5
Q

what are the boundaries of the superior thoracic aperture (inlet)

A

body of T1 posteriorly
1st pair of ribs and costal cartilages (laterally)
superior border of manubrium (anteriorly)

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6
Q

what are the boundaries of the inferior thoracic aperture (outlet)

A

body of T12 posteriorly
ribs 11 and 12 and costal cartilages of ribs 7-10 (costal margin) laterally and anteriorly
xiphysternal joint anterior midline

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7
Q

transverse process of vertebrae allows what

A

allows muscle attachment and articulation with ribs

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8
Q

the head of the 7th rib will sit above/below T7

A

above - head of the 7th rib will sit between T6 and T7

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9
Q

what are the parts of the vertebrae called that articulate with the heads of the ribs

A

superior and inferior demifacets

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10
Q

what part of the rib articulates with the transverse process

A

tubercle

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11
Q

the tubercle of rib 7 will articulate with the transverse process of

A

T7

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12
Q

what are the true ribs

A

1-7

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13
Q

what are the false ribs

A

8-10

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14
Q

what are the floating ribs

A

11 and 12

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15
Q

how do true ribs connect with sternum

A

directly via own cartilage

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16
Q

how do false ribs connect with sternum

A

indirectly via cartilage of ribs above - costal cartilage fuses with costal cartilage of rib above

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17
Q

how do floating ribs connect with the sternum

A

no connection - end on musculature of posterior abdominal wall

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18
Q

what are the 2 classifications of ribs based on their bony features

A

typical - 3rd - 9th
atypical 1st 2nd and 10-12

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19
Q

describe the head of a typical rib

A

wedge shaped with 2 articular facets separated by a crest

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20
Q

the head of a typical rib articulates with what

A

articular facets articulate with own vertebra and vertebra above
crest articulates with IVD

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21
Q

typical rib : the tubercle articulates with what

A

transverse process of own vertebrae

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22
Q

typical rib : what are the non-articular parts of the tubercle for

A

costotransverse ligament

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23
Q

typical rib : what attaches the head and body at the tubercle

A

neck

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24
Q

what is the most curved part of a typical rib

A

costal angle

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25
Q

where is the costal groove of a typical rib

A

on the internal surface of inferior border of body

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26
Q

what does the costal groove protect

A

intercostal vessels and nerves

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27
Q

what is different about the head of the first rib

A

only has 1 facet on head

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28
Q

why does rib 1 only have one facet on its head

A

articulates with T1 only as C7 doesn’t have costal facets

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29
Q

the 1st rib has grooves on superior surface for what

A

subclavian vessels

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30
Q

what separates the subclavian grooves on the first rib

A

scalene tubercle for attachment of anterior scalene muscle

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31
Q

what else makes rib 1 atypical

A

highly curved

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32
Q

rib 2 has a tuberosity for the attachment of what

A

serratus anterior

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33
Q

rib 2 has a rough area where

A

upper surface

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34
Q

describe the heads of ribs 10-12

A

single facet on head as they only articulate with single vertebra

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35
Q

describe ribs 11 and 12

A

short with no neck or tubercle

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36
Q

what are the 3 parts of the sternum

A

manubrium
body
xiphoid process

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37
Q

what are the 2 joints of the sternum

A

sternal angle (manubriosternal joint)
xiphisternal joint

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38
Q

how many notches does the sternum have on lateral border

A

7 for articulation of costal cartilages of ribs

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39
Q

where does the 1st rib articulate with the sternum

A

with manubrium adjacent to clavicular notch

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40
Q

where does the 2nd rib articulate with the sternum

A

with sternal angle

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41
Q

where does the 7th rib articulate with the sternum

A

at xiphisternal joint

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42
Q

the joints between adjacent vertebrae are intervertebral joints and they are

A

secondary cartilaginous joints

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43
Q

what kind of joints are between articular facets of vertebrae

A

synovial plane joints

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44
Q

the synovial plane joints between articular facets in vertebra are called

A

zygopophysial joints

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45
Q

can rotational movement occur between vertebrae of the thoracic region of vertebral column

A

yes - due to the orientation of articular facets

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46
Q

what are sternocostal joints

A

joints between sternum and costal cartilages of ribs

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47
Q

the sternocostal joint between rib 1 and manubrium is what kind of joint

A

primary cartilaginous joint (synchondrosis)

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48
Q

the sternocostal joints between ribs 2-7 and body of sternum are what kind of joints

A

synovial plane joints

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49
Q

what are interchondral joints

A

joints between adjacent costal cartilages

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50
Q

interchondral joints are what kind of joints

A

synovial plane
- between 6-7-8-9
fibrous
- between 9 and 10

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51
Q

costovertebral joints are what kind of joints

A

synovial plane joints

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52
Q

describe the axis of movement of the costovertebral joints

A

movement will occur at joints formed by the head and tubercle at the same time so rib will move around an axis that runs through both of these joints
- elevation and depression of rib

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53
Q

what are the participants in the costovertebral joint of head of rib

A

body of vertebra superior to rib
IVD
head of rib - 2 facets and crest
body of vertebra of same number as rib

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54
Q

what are the participants in the costotransverse joint

A

transverse process of vertebra of same number as rib
tubercle of rib

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55
Q

upper ribs (1-6) have an axis which is angled more _____

A

laterally

56
Q

lower ribs (7-12) have an axis that is angled more ____

A

posteriorly

57
Q

upper ribs (1-6) have their greatest degree of movement at the _____ aspect

A

anterior

58
Q

upper ribs (1-6) have a movement called

A

pump handle

59
Q

lower ribs (7-12) have their greatest degree of motion at the _____ aspect

A

lateral

60
Q

lower ribs (7-12) have a movement called

A

bucket handle

61
Q

how is the rib cage expanded in the AP dimension

A

sternum and upper ribs move anteriorly and superiorly

62
Q

how is the rib cage expanded laterally

A

lower ribs flare out laterally

63
Q

how is the rib cage expanded vertically

A

diaphragm descends as it contracts and flattens

64
Q

what is the primary muscle of inspiration at rest

A

diaphragm

65
Q

what are the groups of muscles of the thoracic wall

A

respiratory - true muscles of thoracic wall
accessory respiratory
superficial - assoc. with upper limb or abdominal wall

66
Q

what are the true muscles of the thoracic wall

A

intercostal muscles
subcostal and transversus thoracis

67
Q

what are the secondary muscles of respiration

A

scalene muscles of the neck
serratus posterior (superior and inferior) of back

68
Q

what are the superficial muscles assoc. with the upper limb and anterior abdominal wall

A

pectoral muscles
serratus anterior
external oblique
rectus abdominis

69
Q

nerve supply of pec major

A

medial (C8,T1) and lateral (C5-7) pectoral nerves

70
Q

nerve supply of pec minor

A

medial pectoral nerve (C8,T1)

71
Q

nerve supply of serratus anterior

A

long thoracic nerve (C5-7)

72
Q

nerve supply of external oblique

A

anterior rami T7-T12

73
Q

nerve supply of rectus abdominis

A

anterior rami T7 - T12

74
Q

nerve supply of serratus posterior superior

A

2nd - 5th intercostal nerves

75
Q

nerve supply of serratus posterior inferior

A

anterior rami T9-12

76
Q

nerve supply of anterior scalene

A

anterior rami C3-7

77
Q

nerve supply of middle scalene

A

anterior rami C4-7

78
Q

nerve supply of posterior scalene

A

anterior rami C5-7

79
Q

where do scalene muscles attach proximally

A

transverse process of cervical vertebrae

80
Q

where do anterior and middle scalene attach distally

A

first rib

81
Q

where does posterior scalene attach distally

A

second rib

82
Q

what is the function of the scalene muscles

A

primarily involved in neck movement but when neck is fixed can act as accessory respiratory muscles by raising 1st and 2nd ribs

83
Q

serratus posterior superior extends downwards from what to what

A

spinous process of C7-T3
to upper borders of ribs 2-4

84
Q

serratus posterior inferior extends upwards from what to what

A

spinous process of T11-L2 towards the lower borders of ribs 8-12

85
Q

what is the main function of serratus posterior superior and inferior

A

proprioception but may assist in raising/lowering ribs respectively

86
Q

what are the 3 layers of intercostal muscles

A

external
internal
innermost

87
Q

fibres of external intercostal muscles run in what directoin

A

anteriorly and inferiorly from lower border of upper rib to upper border of lower rib
- inferomedial, hands in pockets

88
Q

fibres of external intercostal muscles run from where to where

A

tubercles of ribs to costochondral junction

89
Q

what are the external intercostals replaced with anteriorly

A

external intercostal membrane that extends between costal cartilages to lateral border of sternum

90
Q

where are the external intercostals most obvious

A

posteriorly and laterally

91
Q

what is the function of the external intercostal muscles

A

raise ribs in inspiration

92
Q

what way do fibres of the internal intercostal muscles run

A

posteroinferiorly (down and back) - 90 degree angle to external intercostal

93
Q

from where to where do fibres of internal intercostal muscles run

A

sternum to angle of ribs

94
Q

what are internal intercostal muscles replaced with posteriorly

A

internal intercostal membrane

95
Q

what is the function of the internal intercostal muscles

A

interosseous part - depresses ribs on expiration
interchondral part - raises ribs on inspiration

96
Q

the fibres of the innermost intercostal muscles run in the same direction as what

A

internal intercostal muscle fibres

97
Q

is the innermost intercostal muscle layer continuous

A

no, very thin often incomplete

98
Q

what are the deepest muscles of the thoracic wall

A

subcostal and transversus thoracis

99
Q

the internal thoracic vessels that run on either side of the sternum lie _____ to the transversus thoracis muscle

A

superficial

100
Q

where are the subcostal muscles found

A

near angle of ribs

101
Q

fibres of subcostal span ____ ribs and may blend with fibres of ____

A

span 1-2 ribs
may blend with innermost intercostal

102
Q

where is the neurovascular plane of the intercostal space

A

between internal and innermost layers

103
Q

describe the neurovascular bundle in the ICS from superior to inferior

A

VAN
vein
artery
nerve

104
Q

the vein artery and nerve run where

A

costal groove

105
Q

describe the nerve bundle of the ICS

A

intercostal nerve that will supply musculature of the ICS
- also give lateral and anterior branches that pierce through the muscle layers into skin to supply sensory innervation

106
Q

describe the arterial supply of the ICS

A

most via posterior intercostal arteries, most of which will come directly from aorta
PIA will also give a cutaneous branch to pass through muscle walls and out to supply skin

107
Q

anterior part of each ICS is supplied by what

A

anterior ICA - will branch out to supply skin

108
Q

anterior ICA usually branch directly from

A

internal thoracic artery

109
Q

the internal thoracic artery is a branch of what

A

subclavian artery

110
Q

PICA supplying spaces 3-11 and subcostal (inferior to rib 12) originate as posterolateral branches of

A

thoracic aorta

111
Q

PICA supplying 1st and 2nd ICS arise from

A

supreme intercostal artery

112
Q

the supreme intercostal artery is a branch of

A

costocervical trunk from subclavian artery

113
Q

AICAs for 1-6 come directly from

A

internal thoracic artery

114
Q

internal thoracic artery runs

A

either side of sternum the bifurcates to form superior epigastric artery and musculophrenic artery

115
Q

AICAs supplying ICS 7-9 come from

A

musculophrenic artery

116
Q

the anterior intercostal veins drain to the

A

internal thoracic vein

117
Q

the internal thoracic vein runs with the

A

internal thoracic artery

118
Q

on the right, the 1st PICV drains to the

A

right brachiocephalic vein

119
Q

on the right the 2-11 PICVs + subcostal drain to the

A

azygous vein

120
Q

on the left, the 1-4 PICVs drain to the

A

left brachiocephalic vein

121
Q

on the left, the 5-8 PICVs drain to the

A

accessory hemiazygous vein

122
Q

on the left the 9-11 PICVs + subcostal drain to

A

hemiazygous vein

123
Q

nipple dermatome

A

T4

124
Q

belly button dermatome

A

T10

125
Q

glandular tissue in the breast is organised into

A

lobules

126
Q

lobules of the mammary gland will open at the nipple via

A

lactiferous ducts

127
Q

how is support for the glandular tissue provided

A

fibrous tissue which is organised into a number of thick fibrous glands - suspensory ligaments

128
Q

what is the function of the suspensory ligaments

A

support the breasts and anchor breasts at dermis of skin

129
Q

what is the arterial supply of the breast

A

lateral and medial mammary branches

130
Q

lateral mammary branches come from

A

lateral thoracic artery from axillary artery

131
Q

medial mammary branches come from

A

internal thoracic artery

132
Q

venous drainage of the breast goes to

A

medial and lateral mammary veins

133
Q

what is the name of lymphatic plexus in the breast

A

subareolar lymphatic plexus

134
Q

> 75% of lymph of breast goes where

A

axillary nodes

135
Q

remainder of lymph from breast goes where

A

parasternal nodes and some may go to abdominal nodes

Regional Anatomy 1 (30 decks)

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