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anatomy lectures > thoracic wall > Flashcards

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
Q

12 ribs

A
  • true ribs: 1-7
  • false ribs: 8-12
  • floating ribs: 11, 12
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26
Q

true ribs

A

direct costal cartilage connected to sternum

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27
Q

false ribs

A

costal cartilage joins to adjacent costal cartilage (not sternum)

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28
Q

floating ribs

A

no costal cartilage

29
Q

which thoracic vertebrae are typical

A

T2-T8

30
Q

typical thoracic vertebrae features

A
  • heart shaped body
  • super and inferior demi-facets on both sides of body
  • costal facets on transverse processes
  • long downward slanting spinous processes
31
Q

which thoracic vertebrae are atypical

A

T1, T9-T12

32
Q

atypical thoracic vertebrae features

A
  • superior facet is costal (not demi)
  • no inferior demi facet
33
Q

which ribs are typical

A

2-9

34
Q

typical rib features

A
  • flat, curved, minorly twisted costal groove
  • blunt arrow-head shape
  • articular facet has a costal facet on transverse process
35
Q

costal groove on rib purpose

A

protects and holds artery, vein, nerve bundle

36
Q

atypical rib 1 features

A
  • shorter and wider
  • only one facet
  • superior surface allows subclavian vein and artery
37
Q

atypical rib 2 features

A
  • 2x length of rib 1
  • 2 facts
  • roughened superior surface
  • origin of serratus anterior muscle
  • insertion of posterior scalene muscle
38
Q

which ribs are atypical

A

1, 2, 10-12

39
Q

atypical rib 11, 12

A
  • 1 facet
  • no arrowhead
40
Q

thoracic joints

A
  • sternocostal joint (true ribs)
  • costochondral joint
  • interchondral joint
  • xiphisternal joint
  • manubriosternal joint (angle of Louis)
  • sternoclavicular joint
  • costovertebral joint
  • costotransverse joints
41
Q

sternocostal joint

A
  • rib 1: primarily cartilaginous
  • ribs 2-7: plane synovial
  • stabilized by sternocostal ligaments and thin capsule
  • slight gliding movements
42
Q

costochondral joint

A
  • primarily cartilaginous
  • no movement, hyaline cartilage
  • may inflame (costochondritis)
43
Q

interchondral joint

A
  • between 8th, 9th, 10th ribs
  • plane synovial joints
  • stabilized by interchondral ligaments and thin capsule
  • may inflame
44
Q

xiphisternal joint

A
  • secondary cartilaginous (symphysis)
  • usually ossifies later in life
45
Q

manubriosternal joint (angle of Louis)

A
  • secondary cartilaginous
  • 162 degrees
  • little movement
46
Q

sternoclavicular joint

A
  • synovial saddle joint
  • anteroposterior and verticular planes
  • minor rotation also occurs
  • stabilized by anterior and posterior sternoclavicular, interclavicular and costoclavicular ligaments
47
Q

costovertebral joint

A
  • 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
Q

costotransverse joints

A
  • 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
Q

which 2 joint movements are simultaneous

A
  • costovertebral joint
  • costotransverse joint
50
Q

primary respiration muscles (inhalation)

A
  • diaphragm
  • external intercostal muscles
51
Q

accessory respiration muscles (inhalation)

A
  • sternocleidomastoid muscle
  • scalene muscles
  • pectoralis minor muscle
  • serratus anterior muscle
52
Q

accessory respiration muscles (exhalation)

A
  • internal intercostal muscles
  • transverse thoracis muscle
  • external oblique muscle
  • rectus abdominis
  • internal oblique muscle
53
Q

intercostal muscles (outer to inner)

A
  • external intercostal
  • internal intercostal
  • innermost intercostal
54
Q

muscles in transverse thoracis group

A
  • subcostalis
  • transverse thoracis
  • innermost intercostal
55
Q

intercostal arteries enter the intercostal space anteriorly or posteriorly

A

both

56
Q

1st and 2nd intercostal space supplied by ? artery

A

superior intercostal artery

57
Q

superior intercostal artery origin

A

costocervical trunk

58
Q

intercostal spaces (excl. 1st and 2nd) are supplied by ?

A

descending aorta

59
Q

6 upper intercostals supplied by branches of the ?

A

internal thoracic artery

60
Q

intercostal spaces 7-9 supplied by ?

A

musculophrenic branch

61
Q

musculophrenic branch is a branch of ? artery

A

internal thoracic artery

62
Q

venous drainage

A

in each space there are one posterior and two anterior intercostal veins plus one collateral vein

63
Q

anterior vein drains into ?

A

musculophrenic and internal thoracic veins

64
Q

posterior veins drain into ?

A
  • azygos vein (right)
  • hemiazygos and accessory hemiazygos vein (left)
65
Q

lymphatic drainage pathway

A
  • thoracic wall drain to parasternal/intercostal and diaphragmatic nodes
  • parasternal drains to bronchomediasteinal
  • intercostal drains to thoracic duct
66
Q

thoracic wall layers (outer to inner)

A
  • 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
Q

simple clinical issues

A
  • costovertebral dislocation
  • transverse rib fracture
  • oblique rib fracture
  • overriding rib fracture
  • chondral fracture
  • costochondral seperation
  • chondrosternal seperation
  • sternal fracture
68
Q

complicated clinical issues

A
  • 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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