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291 ANAT > THORACIC WALL > Flashcards

THORACIC WALL Flashcards

1
Q

Special feature of 1st rib

A

grooves for subclavian artery and vein

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2
Q

True ribs attach to directly sternum via

A

costal cartilages

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3
Q

False ribs attach indirectly to sternum via

A

7th costal cartilage

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4
Q

Most common site of rib fractures

A

at angle of rib (sharpest part of curvature)

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5
Q

Are smaller or larger ribs most commonly associated with rib fractures?

A

larger

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6
Q

Major risk factor of rib fractures

A

May injure nearby structures (lungs/pleura/spleen/liver)

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7
Q

Intercostal Space

A

space between ribs

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8
Q

Contents of Intercostal Space

A

Intercoastal muscles (x3 - external, internal, innermost), intercostal VAN

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9
Q

Opposite from vertebral levels T2-T4

A

Manubrium (sternum)

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10
Q

Opposite from vertebral levels T5-T8

A

body of sternum

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11
Q

Opposite from T4/T5 vertebral disc

A

Sternal Angle

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12
Q

Why is sternal angle an important anatomical landmark?

A

o Marks start and endpoint of aortic arch
o Divides superior and inferior mediastinum
o Level of bifurcation of trachea
o Location of 2nd rib

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13
Q

Important clinical correlate for Sternum

A

Sternotomy in Heart Surgery (open the sternum)

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14
Q

Thoracic inlet

A

top “hole” of ribcage

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15
Q

Thoracic outlet

A

bottom “hole” of ribcage

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16
Q

Structures passing through THORACIC INLET

A

major arteries off aorta, major veins to SVC, trachea, esophagus, phrenic n., Vagus n.

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17
Q

Structures passing through THORACIC OUTLET

A

IVC, aorta, esophagus, sympathetic nn., Vagus nerve plexus

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18
Q

Parietal Pleura

A

thin CT forming deepest layer of thoracic wall

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19
Q

PARIETAL PLEURA is intimately associated with

A

Visceral Pleura on lungs

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20
Q

Costodiaphragmatic Recess

A

cavity along inferior margins of thoracic space

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21
Q

Costodiaphragmatic Recess is created by

A

dome of diaphragm protruding into thoracic space

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22
Q

Costodiaphragmatic Recess structure pattern

A

Shallow anteriorly getting progressively deeper as runs lateral then posteriorly

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23
Q

Pectoralis Major

A

Large fan-shaped muscle, running from humerus to sternal margin

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24
Q

Pectoralis Minor

A

small muscle immediately deep to pectoralis major, running from coracoid process to ribs

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25
Pectoralis Minor Nerves
Medial and Lateral Pectoral Nerves
26
External Intercostal Muscles
most superficial layer
27
External Intercostal Muscle fibers direction
inferoanterior direction (\\\\\\\ ///////)
28
External Intercostal muscles run...
from costovertebral to costochondral joint - replaced by external intercostal membrane
29
External Intercostal Membrane
starts ~7-10cm from sternum, thin/shiny CT layer
30
Internal Intercostal Muscles
below external intercostal membrane near sternum
31
Internal Intercostal Muscle fibers direction
run in inferoanterior direction (\\\\\\\ ///////)
32
Internal Intercostal Muscles run...
from sternocostal joint, ends ~ 5cm from costovertebral joint - replaced by internal intercostal membrane
33
Innermost Intercostal Muscles
deepest layer, on lateral aspect of thoracic cage, no pattern or membrane
34
Intercostal VAN
runs between Innermost and Internal Intercostals in costal groove
35
Subcostal Muscles
small strip of muscles (similar to transverse thoracic) on interior surface of posterior thoracic wall
36
Subcostal Muscles are found...
deep to innermost I/C, close to vertebrae
37
Subcostal Muscles span...
2 ribs levels
38
Transverse Thoracic Muscle
small strips of muscle on interior surface of anterior thoracic wall, running from sternal margin
39
Transverse Thoracic muscles are found...
deep to innermost I/C, close to sternum
40
Transverse Thoracic Muscles run...
superior-lateral direction
41
Transverse Thoracic Muscles span...
1 or 2 rib levels
42
INTERCOSTAL NEUROVASCULAR BUNDLE consists of
Intercostal VAN (found under costal grooves of each rib)
43
Anterior Intercostal VAN
very small, on interior surface of anterior thoracic wall, runs on inferior margin of each rib
44
Do the intercostal veins, arteries, or nerves lie most superior to costal grooves?
veins
45
Number of Posterior I/C veins on each side
11
46
Posterior I/C veins all drain into...
azygos system
47
Posterior I/C veins R SIDE
azygos vein
48
Posterior I/c veins L SIDE
hemiazygos vein
49
Anterior I/C veins drain into
internal thoracic vein
50
Where does the azygos system drain into?
SVC
51
Where does the internal thoracic vein drain into?
Brachiocephalic
52
Number of Posterior I/C arteries
1
53
Posterior I/C artery comes off the...
thoracic aorta
54
Number of Anterior I/C arteries
2 - pair
55
Anterior I/C arteries come off of...
internal thoracic artery
56
Size of Anterior I/C arteries
small
57
Internal Thoracic (Mammary) Artery
long artery on interior surface of anterior thoracic wall
58
Internal Thoracic (Mammary) Artery runs....
along lateral margin of sternum
59
Internal Thoracic (Mammary) Artery is accompanied by..
Internal Thoracic Vein
60
Number of nerves in thoracic wall
12
61
Nerves of thoracic walls come off of..
ventral roots of T1-T12
62
Nerves of thoracic wall supply..
motor (I/C muscles) and sensory/skin (thoracic dermatomes)
63
Nerves from T7-T12 supply...
abdominal structures
64
"Subcostal Nerve" comes off of...
T12
65
Main Clinical Correlate for Intercostal VAN
chest tube insertion/thoracocentesis
66
Anatomical consideration of Chest Tube Insertion/Thoracocentesis
Layers needle/scalpel pass through: - Skin - subcutaneous tissue, Ext. - I/C - Int. I/C - Innermost I/C - endothoracic fascia, parietal pleura – pleural space
67
Must avoid this when doing Chest Tube Insertion/Thoracocentesis
I/C VAN within costal groove
68
What thoracic wall VAN is the worst to hit? why?
costal artery - high pressure blood flow = excessive bleeding
69
Internal Thoracic Artery in CABG (Coronary Artery Bypass Graft)
dissected from post. sternum and attached to coronary artery – distal to obstruction

291 ANAT (8 decks)

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