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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
Q

Pectoralis Minor Nerves

A

Medial and Lateral Pectoral Nerves

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26
Q

External Intercostal Muscles

A

most superficial layer

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27
Q

External Intercostal Muscle fibers direction

A

inferoanterior direction (\\\\ ///////)

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28
Q

External Intercostal muscles run…

A

from costovertebral to costochondral joint - replaced by external intercostal membrane

29
Q

External Intercostal Membrane

A

starts ~7-10cm from sternum, thin/shiny CT layer

30
Q

Internal Intercostal Muscles

A

below external intercostal membrane near sternum

31
Q

Internal Intercostal Muscle fibers direction

A

run in inferoanterior direction (\\\\ ///////)

32
Q

Internal Intercostal Muscles run…

A

from sternocostal joint, ends ~ 5cm from costovertebral joint - replaced by internal intercostal membrane

33
Q

Innermost Intercostal Muscles

A

deepest layer, on lateral aspect of thoracic cage, no pattern or membrane

34
Q

Intercostal VAN

A

runs between Innermost and Internal Intercostals in costal groove

35
Q

Subcostal Muscles

A

small strip of muscles (similar to transverse thoracic) on interior surface of posterior thoracic wall

36
Q

Subcostal Muscles are found…

A

deep to innermost I/C, close to vertebrae

37
Q

Subcostal Muscles span…

A

2 ribs levels

38
Q

Transverse Thoracic Muscle

A

small strips of muscle on interior surface of anterior thoracic wall, running from sternal margin

39
Q

Transverse Thoracic muscles are found…

A

deep to innermost I/C, close to sternum

40
Q

Transverse Thoracic Muscles run…

A

superior-lateral direction

41
Q

Transverse Thoracic Muscles span…

A

1 or 2 rib levels

42
Q

INTERCOSTAL NEUROVASCULAR BUNDLE consists of

A

Intercostal VAN (found under costal grooves of each rib)

43
Q

Anterior Intercostal VAN

A

very small, on interior surface of anterior thoracic wall, runs on inferior margin of each rib

44
Q

Do the intercostal veins, arteries, or nerves lie most superior to costal grooves?

A

veins

45
Q

Number of Posterior I/C veins on each side

A

11

46
Q

Posterior I/C veins all drain into…

A

azygos system

47
Q

Posterior I/C veins R SIDE

A

azygos vein

48
Q

Posterior I/c veins L SIDE

A

hemiazygos vein

49
Q

Anterior I/C veins drain into

A

internal thoracic vein

50
Q

Where does the azygos system drain into?

A

SVC

51
Q

Where does the internal thoracic vein drain into?

A

Brachiocephalic

52
Q

Number of Posterior I/C arteries

A

1

53
Q

Posterior I/C artery comes off the…

A

thoracic aorta

54
Q

Number of Anterior I/C arteries

A

2 - pair

55
Q

Anterior I/C arteries come off of…

A

internal thoracic artery

56
Q

Size of Anterior I/C arteries

A

small

57
Q

Internal Thoracic (Mammary) Artery

A

long artery on interior surface of anterior thoracic wall

58
Q

Internal Thoracic (Mammary) Artery runs….

A

along lateral margin of sternum

59
Q

Internal Thoracic (Mammary) Artery is accompanied by..

A

Internal Thoracic Vein

60
Q

Number of nerves in thoracic wall

A

12

61
Q

Nerves of thoracic walls come off of..

A

ventral roots of T1-T12

62
Q

Nerves of thoracic wall supply..

A

motor (I/C muscles) and sensory/skin (thoracic dermatomes)

63
Q

Nerves from T7-T12 supply…

A

abdominal structures

64
Q

“Subcostal Nerve” comes off of…

A

T12

65
Q

Main Clinical Correlate for Intercostal VAN

A

chest tube insertion/thoracocentesis

66
Q

Anatomical consideration of Chest Tube Insertion/Thoracocentesis

A

Layers needle/scalpel pass through:
- Skin
- subcutaneous tissue, Ext.
- I/C
- Int. I/C
- Innermost I/C
- endothoracic fascia, parietal pleura – pleural space

67
Q

Must avoid this when doing Chest Tube Insertion/Thoracocentesis

A

I/C VAN within costal groove

68
Q

What thoracic wall VAN is the worst to hit? why?

A

costal artery - high pressure blood flow = excessive bleeding

69
Q

Internal Thoracic Artery in CABG (Coronary Artery Bypass Graft)

A

dissected from post. sternum and attached to coronary artery – distal to obstruction

291 anat (8 decks)

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