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thoracic wall Flashcards

1
Q

thorax

A

upper part of the trunk, extending from the root of the neck to the abdomen

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2
Q

thorax basic boundaries

A
  • super ior thoracic aperature (roof)
  • inferior thoracic aperature (floor)
  • thoracic wall
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3
Q

thorax contents

A
  • heart
  • lungs
  • mediastinum
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4
Q

thorax functions

A
  • respiration
  • vital organ protection
  • conduit for structures passing to/from neck and abdomen
  • breast tissue support
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5
Q

respiration

A
  • movements of the thoracic wall increase/decrease intrathoracic volume
  • result in inspiration/expiration
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6
Q

thorax vital organs

A
  • heart
  • lungs
  • liver
    -spleen
  • kidneys
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7
Q

structures passing to/from neck and abdomen

A
  • nerves
  • blood vessels
  • lymphatics
  • trachea
  • esophagus
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8
Q

thoracic lines

A
  • anterior thoracic lines
  • axillary lines
  • posterior thoracic lines
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9
Q

sternal landmarks

A
  • suprasternal notch
  • sternal angle
  • xiphosternal joint
  • xiphoid process
  • infrasternal angle
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10
Q

erb’s point clinical importance

A

2nd heart sound (lub “dub”)

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11
Q

ekg lead placement names

A

V1, V2, V3, V4, V5, V6

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12
Q

V1 ekg place

A
  • 4th intercostal space
  • right side of sternum body
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13
Q

V2 ekg place

A
  • 4th intercostal space
  • left side of sternum body
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14
Q

V3 ekg place

A
  • 5th intercostal space
  • 50% distance of V2 and V4
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15
Q

V4 ekg place

A
  • 5th intercostal space
  • midclavicular
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16
Q

V5 ekg place

A
  • 5th intercostal space
  • anterior axillary
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17
Q

V6 ekg place

A
  • 5th intercostal
  • midaxillary
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18
Q

thoracic wall components

A
  • bones, muscle, fat
  • 12 thoracic vertebrae (typical and atypical)
  • 12 pairs of ribs with costal cartilage (typical and atypical)
  • sternum (manubrium, body, xiphoid process)
  • intercostal spaces
  • endothoracic fascia
  • parietal and visceral pleura
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19
Q

intercostal spaces

A
  • lie between ribs
  • contain. 3layers of muscles and neurovasculature bundle
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20
Q

sternum parts

A
  • manubrium
  • body
  • xiphoid process
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21
Q

endothoracic fascia

A
  • loose ct
  • deep to intercostal spaces and ribs, separates them from underlying pleura
  • outermost membrane of thoracic cavity
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22
Q

where and why does thoracic wall thicken

A
  • over top of each lung as suprapleural (sibson’s fascia) membrane
  • where it attaches to the internal border of first rib and transverse process of C7
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23
Q

skeletal structures of the thorax form ?

A

thoracic cage

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24
Q

thoracic cage components

A
  • 12 thoracic vertebrae
  • 12 ribs
  • sternum (manubrium, body, xiphoid process)
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25
12 ribs
- true ribs: 1-7 - false ribs: 8-12 - floating ribs: 11, 12
26
true ribs
direct costal cartilage connected to sternum
27
false ribs
costal cartilage joins to adjacent costal cartilage (not sternum)
28
floating ribs
no costal cartilage
29
which thoracic vertebrae are typical
T2-T8
30
typical thoracic vertebrae features
- heart shaped body - super and inferior demi-facets on both sides of body - costal facets on transverse processes - long downward slanting spinous processes
31
which thoracic vertebrae are atypical
T1, T9-T12
32
atypical thoracic vertebrae features
- superior facet is costal (not demi) - no inferior demi facet
33
which ribs are typical
2-9
34
typical rib features
- flat, curved, minorly twisted costal groove - blunt arrow-head shape - articular facet has a costal facet on transverse process
35
costal groove on rib purpose
protects and holds artery, vein, nerve bundle
36
atypical rib 1 features
- shorter and wider - only one facet - superior surface allows subclavian vein and artery
37
atypical rib 2 features
- 2x length of rib 1 - 2 facts - roughened superior surface - origin of serratus anterior muscle - insertion of posterior scalene muscle
38
which ribs are atypical
1, 2, 10-12
39
atypical rib 11, 12
- 1 facet - no arrowhead
40
thoracic joints
- sternocostal joint (true ribs) - costochondral joint - interchondral joint - xiphisternal joint - manubriosternal joint (angle of Louis) - sternoclavicular joint - costovertebral joint - costotransverse joints
41
sternocostal joint
- rib 1: primarily cartilaginous - ribs 2-7: plane synovial - stabilized by sternocostal ligaments and thin capsule - slight gliding movements
42
costochondral joint
- primarily cartilaginous - no movement, hyaline cartilage - may inflame (costochondritis)
43
interchondral joint
- between 8th, 9th, 10th ribs - plane synovial joints - stabilized by interchondral ligaments and thin capsule - may inflame
44
xiphisternal joint
- secondary cartilaginous (symphysis) - usually ossifies later in life
45
manubriosternal joint (angle of Louis)
- secondary cartilaginous - 162 degrees - little movement
46
sternoclavicular joint
- synovial saddle joint - anteroposterior and verticular planes - minor rotation also occurs - stabilized by anterior and posterior sternoclavicular, interclavicular and costoclavicular ligaments
47
costovertebral joint
- 2 plane synovial joints - articulations of the demifacets on the head of each rib with the bodies of its corresponding vertebra and the one above - 1st, 10th, 11th, 12th ribs have a single synovial joint with their corresponding vertebral bodies - gliding movements - stabilized by capsular, radiate, intra-articular ligaments
48
costotransverse joints
- 2 plane synovial joints formed by the articulations between facets on the rib tubercle and the transverse process of its vertebra - 1-10 ribs only - simple rotational and sliding motions - stabilized by capsular, inferior cotransverse, superior costotransverse, lateral costotransverse ligaments
49
which 2 joint movements are simultaneous
- costovertebral joint - costotransverse joint
50
primary respiration muscles (inhalation)
- diaphragm - external intercostal muscles
51
accessory respiration muscles (inhalation)
- sternocleidomastoid muscle - scalene muscles - pectoralis minor muscle - serratus anterior muscle
52
accessory respiration muscles (exhalation)
- internal intercostal muscles - transverse thoracis muscle - external oblique muscle - rectus abdominis - internal oblique muscle
53
intercostal muscles (outer to inner)
- external intercostal - internal intercostal - innermost intercostal
54
muscles in transverse thoracis group
- subcostalis - transverse thoracis - innermost intercostal
55
intercostal arteries enter the intercostal space anteriorly or posteriorly
both
56
1st and 2nd intercostal space supplied by ? artery
superior intercostal artery
57
superior intercostal artery origin
costocervical trunk
58
intercostal spaces (excl. 1st and 2nd) are supplied by ?
descending aorta
59
6 upper intercostals supplied by branches of the ?
internal thoracic artery
60
intercostal spaces 7-9 supplied by ?
musculophrenic branch
61
musculophrenic branch is a branch of ? artery
internal thoracic artery
62
venous drainage
in each space there are one posterior and two anterior intercostal veins plus one collateral vein
63
anterior vein drains into ?
musculophrenic and internal thoracic veins
64
posterior veins drain into ?
- azygos vein (right) - hemiazygos and accessory hemiazygos vein (left)
65
lymphatic drainage pathway
- thoracic wall drain to parasternal/intercostal and diaphragmatic nodes - parasternal drains to bronchomediasteinal - intercostal drains to thoracic duct
66
thoracic wall layers (outer to inner)
- skin - superficial fascia - serratus anterior muscle - external intercostal muscle - internal intercotal muscle - innermost intercostal muscle - intercostal vein, artery, nerve/collateral branches - endothoracic fascia - parietal pleura - pleural cavity - visceral pleura - lung
67
simple clinical issues
- costovertebral dislocation - transverse rib fracture - oblique rib fracture - overriding rib fracture - chondral fracture - costochondral seperation - chondrosternal seperation - sternal fracture
68
complicated clinical issues
- trauma to pleura of lung (pneumothorax, lung contusion, subcutaneous emphysema) - multiple rib fractures - hemothorax (tear of blood vessel) - compound by missile or puncture wound - injury to heart or great blood vessel

anatomy lectures (18 decks)

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