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Foundations of health and disease > thoracic wall > Flashcards

thoracic wall Flashcards

1
Q

What are the boundaries of the thorax?

A

The thorax is a skewed cylinder with openings superiorly and inferiorly.

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2
Q

What structures are located superiorly to the thorax?

A

Superiorly, the thorax is continuous with the neck.

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3
Q

What structures are located inferiorly to the thorax?

A

Inferiorly, the thorax is closed by the abdomen, specifically the diaphragm.

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4
Q

What structures are located laterally to the thorax?

A

The upper limbs are located laterally to the thorax.

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5
Q

What structures are located anteriorly to the thorax?

A

The breast is located anteriorly to the thorax.

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6
Q

What is contained within the thorax?

A

The thoracic cavity contains the pleural cavities (right and left) and the mediastinum.

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7
Q

What are the functions of the thorax related to respiration?

A

The thorax is involved in respiration through the lungs, diaphragm, intercostal muscles, and accessory respiratory muscles.

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8
Q

What structures in the thorax are responsible for protection?

A

The thorax provides protection for the heart, lungs, great vessels, and abdominal viscera such as the liver, stomach, spleen, and kidneys.

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9
Q

What structures in the thorax act as conduits?

A

The thorax contains important conduits such as the oesophagus, trachea, thoracic aorta, superior and inferior vena cavae, phrenic nerves, vagus nerves, thoracic duct, and autonomic splanchnic nerves.

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10
Q

What are the bones of the thorax?

A

The bones of the thorax include T1-T12 vertebrae, 12 pairs of ribs, the manubrium, body of the sternum, and the xiphoid process.

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11
Q

How many pairs of ribs are found in the thorax?

A

12

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12
Q

What are the soft tissues of the thorax?

A

The soft tissues of the thorax include the three flat intercostal muscles.

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13
Q

: Which region of the sternum is located superiorly?

A

The manubrium is the superior region of the sternum.

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14
Q

What is the name of the bony structure at the inferior end of the sternum?

A

The xiphoid process is the bony structure at the inferior end of the sternum.

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15
Q

What is the significance of the sternal angle?

A

The sternal angle is located at the vertebral level T4/5 and is the articulation point of the 2nd rib costal cartilage. It has several important clinical and anatomical implications.

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16
Q

What structures are associated with the sternal angle?

A

The sternal angle is associated with the bifurcation of the trachea (carina), the drainage of the azygos vein into the superior vena cava (SVC), and it serves as a boundary between the superior and inferior mediastinum. Additionally, it marks the origin and end of the arch of the aorta, and the SVC pierces the pericardium at this level.

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17
Q

What are the boundaries of the superior thoracic aperture?

A

The superior thoracic aperture is formed by the T1 vertebra, 1st rib, and the manubrium of the sternum. It is an oblique plane that allows the transit of neurovascular and visceral structures between the neck and thorax, as well as between the thorax/neck and the upper limb.

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18
Q

What are the boundaries of the inferior thoracic aperture?

A

The inferior thoracic aperture is formed by the T12 vertebra, the 12th rib, the 11th rib, the costal cartilage of ribs 7-10, the costal margin, and the xiphoid process. It is an oblique plane.

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19
Q

What is the function of the inferior thoracic aperture?

A

The inferior thoracic aperture allows the transit of structures from the thorax to the abdomen. However, in order to pass through, these structures must go through or posteriorly to the hiatuses of the diaphragm.

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20
Q

What are the layers of the thoracic wall related to the skin?

A

The layers include the skin, superficial fascia, and fat.

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21
Q

What is the deep fascia associated with the thoracic wall?

A

The deep fascia in this region is known as the pectoralis fascia.

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22
Q

What are the muscles found in the thoracic wall?

A

The muscles in this area include the pectoralis major and minor, serratus anterior, and intercostal muscles.

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23
Q

What is the endothoracic fascia?

A

The endothoracic fascia is a layer located deep to the muscles of the thoracic wall.

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24
Q

What is the parietal pleura?

A

The parietal pleura is the outer layer of the pleura that lines the thoracic cavity.

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25
Q

What is the pleural space?

A

The pleural space is the small, fluid-filled gap between the parietal pleura and visceral pleura.

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26
Q

What are the visceral pleura and lungs?

A

The visceral pleura is the inner layer of the pleura that covers the surface of the lungs.

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27
Q

What nerves innervate the thoracic wall?

A

The thoracic wall is innervated by intercostal nerves (T1-T11) and the subcostal nerve (T12).

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28
Q

What are the types of branches associated with thoracic wall innervation?

A

The innervation includes lateral and anterior cutaneous branches as well as collateral branches.

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29
Q

What modalities are covered by thoracic wall innervation?

A

The innervation provides somatic motor, somatic sensory, and autonomic sympathetic functions.

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30
Q

What are the major arteries supplying the thoracic wall?

A

The thoracic wall is supplied by the anterior intercostal arteries (T1-11) and the posterior intercostal arteries (T1-11).

31
Q

True or False: True ribs directly articulate with the sternum through their own costal cartilage.

A

True. True ribs (ribs I-VII) directly articulate with the sternum through their own costal cartilage.

32
Q

True or False: False ribs indirectly articulate with the sternum through conjoined costal cartilage or have no articulation with the sternum.

A

True. False ribs (ribs VIII-X) either indirectly articulate with the sternum through conjoined costal cartilage or have no articulation with the sternum.

33
Q

What are floating ribs?

A

Floating ribs (ribs XI-XII) are a type of false rib that have no articulation with the sternum.

34
Q

What is the intercostal space (ICS)?

A

The intercostal space refers to the space between the ribs that is filled with soft tissue structures.

35
Q

What are the main features of a typical rib?

A

The main features of a typical rib include the head, articular facets, neck, tubercle, shaft, angle, and costal groove.

36
Q

What is the function of the head of a rib?

A

The head of a rib articulates with the vertebral column.

37
Q

Where are the articular facets of a rib located and what do they articulate with?

A

The articular facets are found on the head of the rib, with the superior facet articulating with the vertebra above and the inferior facet articulating with its own vertebra.

38
Q

What is the purpose of the tubercle on a rib?

A

The tubercle of a rib articulates with the transverse process of a vertebra and serves as a site of ligament attachment.

39
Q

What is the costal groove?

A

The costal groove is a feature on the internal surface of the rib that protects the neurovascular bundle.

40
Q

Which ribs are considered atypical and why?

A

Ribs I, II, X, XI, and XII are considered atypical ribs due to specific characteristics of their shape or articulations.

41
Q

What are some unique features of atypical ribs?

A

Rib I is flat and broad, articulates with vertebra T1, and has scalene tubercle, anterior groove (subclavian vein), and posterior groove (subclavian artery). Ribs II, XI, and XII lack a tubercle or neck. Rib X articulates with vertebra T10.

42
Q

What is the name of the joint between the rib head and the vertebral body?

A

The joint between the rib head and the vertebral body is called the costovertebral joint. It is a synovial joint.

43
Q

What is the name of the joint between the rib tubercle and the transverse process?

A

The joint between the rib tubercle and the transverse process is called the costotransverse joint. It is also a synovial joint.

44
Q

What type of joint is formed between the rib and the sternum via the costal cartilage?

A

The joint between the rib and the sternum via the costal cartilage is called the sternocostal joint. For ribs I-VII, it is a fibrocartilaginous (secondary cartilaginous) joint. Rib I forms a synovial joint, while ribs II-VII have a direct cartilaginous connection to the sternum.

45
Q

What is the name of the joint between the manubrium and the body of the sternum?

A

The joint between the manubrium and the body of the sternum is called the manubriosternal joint. It is a symphysis joint, specifically a secondary cartilaginous joint.

46
Q

What is the name of the joint between the xiphoid process and the body of the sternum?

A

The joint between the xiphoid process and the body of the sternum is called the xiphisternal joint. It is also a symphysis joint, specifically a secondary cartilaginous joint.

47
Q

What is the name and orientation of the intercostal muscle that has an inferomedial orientation?

A

The external intercostal muscle has an inferomedial orientation.

48
Q

What is the name and orientation of the intercostal muscle that has a superomedial orientation?

A

The internal intercostal muscle has a superomedial orientation.

49
Q

What is the name and orientation of the innermost intercostal muscle?

A

The innermost intercostal muscle also has a superomedial orientation.

50
Q

What is the attachment of the external intercostal muscle?

A

The external intercostal muscle attaches to the inferior margin of the rib above and the superior margin of the rib below.

51
Q

Which intercostal nerves innervate the external intercostal muscle?

A

The external intercostal muscle is innervated by the intercostal nerves T1-T11.

52
Q

When is the external intercostal muscle most active and what is its role?

A

The external intercostal muscle is most active during passive inspiration. It supports the intercostal space and moves the ribs superiorly.

53
Q

What is the attachment of the internal intercostal muscle?

A

The internal intercostal muscle attaches to the lateral edge of the costal groove of the rib above and the superior margin of the rib below, deep to the attachment of the related external intercostal muscle.

54
Q

Which intercostal nerves innervate the internal intercostal muscle?

A

The internal intercostal muscle is innervated by the intercostal nerves T1-T11.

55
Q

When is the internal intercostal muscle most active and what is its role?

A

The internal intercostal muscle is most active during active expiration. It supports the intercostal space and moves the ribs inferiorly.

56
Q

What is the attachment of the innermost intercostal muscle?

A

The innermost intercostal muscle attaches to the medial edge of the costal groove of the rib above and the internal aspect of the superior margin of the rib below.

57
Q

Which intercostal nerves innervate the innermost intercostal muscle?

A

The innermost intercostal muscle is also innervated by the intercostal nerves T1-T11.

58
Q

What is the role of the innermost intercostal muscle?

A

The innermost intercostal muscle acts together with the internal intercostal muscles.

59
Q

What are the components of the tri-component bundle in the intercostal spaces?

A

The tri-component bundle in the intercostal spaces consists of the intercostal vein, artery, and nerve, arranged in a superior to inferior orientation.

60
Q

Where is the tri-component bundle located?

A

The tri-component bundle is located within the costal groove of the rib.

61
Q

What is the relationship of the tri-component bundle with the internal and innermost intercostal muscles in the intercostal space?

A

The tri-component bundle is situated between the internal and innermost intercostal muscles in the intercostal space.

62
Q

What are the collateral branches in the intercostal spaces?

A

The collateral branches consist of the collateral intercostal nerve, artery, and vein, arranged in a superior to inferior orientation.

63
Q

Where are the collateral branches located?

A

The collateral branches are situated in the inferior aspect of the intercostal space.

64
Q

What is the relationship of the collateral branches with the internal and innermost intercostal muscles in the intercostal space?

A

The collateral branches are located between the internal and innermost intercostal muscles in the intercostal space.

65
Q

What are the arteries that supply the anterior intercostal spaces (1-6 ICS anteriorly)?

A

The anterior intercostal arteries in the thorax are supplied by the paired internal thoracic arteries.

66
Q

Which arteries supply the posterior intercostal spaces (3-11 ICS)?

A

The posterior intercostal arteries in the thorax are supplied by branches of the thoracic aorta.

67
Q

How does the supreme intercostal artery arise and which intercostal spaces does it supply?

A

The supreme intercostal artery arises from the costocervical trunk, which branches off from the subclavian arteries. It supplies the 1st and 2nd intercostal spaces posteriorly.

68
Q

Where does the internal thoracic artery bifurcate and what are its branches?

A

The internal thoracic artery bifurcates at the 6th costal cartilage. Its branches include the musculophrenic artery and the superior epigastric artery.

69
Q

Which nerves innervate the intercostal spaces in the thoracic region?

A

The intercostal spaces in the thoracic region are innervated by the intercostal nerves, specifically T1-T11.

70
Q

Which nerve innervates the 12th intercostal space in the thoracic region?

A

The 12th intercostal space in the thoracic region is innervated by the subcostal nerve, which originates from the T12 spinal nerve.

71
Q

What are the branches of the intercostal nerves that provide cutaneous innervation?

A

The intercostal nerves give rise to lateral and anterior cutaneous branches, which provide sensory innervation to the skin in their respective regions.

72
Q

Besides the main intercostal nerves, are there any additional branches involved in innervation?

A

Yes, collateral branches also contribute to the innervation of the thoracic region.

73
Q

What modalities of innervation are associated with the intercostal nerves in the thoracic region?

A

The intercostal nerves provide somatic motor innervation (motor control to muscles), somatic sensory innervation (sensory perception from the skin and muscles), and autonomic sympathetic innervation (regulation of involuntary functions) in the thoracic region.

Foundations of health and disease (45 decks)

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