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Anatomy > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

Describe the sagittal anatomical plane

A

Divides into left and right

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1
Q

Describe the median sagittal/midsagittal anatomical plane

A

Sagittal plane divided at the midline

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2
Q

Describe the parasagittal anatomical plane

A

Divides the body into uneven left and right, so NOT at the midline

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2
Q

Describe the coronal/frontal anatomical plane

A

Divides the body into anterior and posterior portions

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2
Q

Describe the transverse/axial anatomical plane

A

Divides the body into superior and inferior portions

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2
Q

What point of view is utilized when looking at the transverse/axial plane?

A

From the patients feet, looking up towards their nose

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3
Q

What does the axial skeleton consist of?

A

The skull, vertebral column, ribs, and sternum

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4
Q

What does the appendicular skeleton consist of?

A

The bones of the limbs, including the shoulder girdle and hip bones

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5
Q

Define fascia

A

A layer of fibrous connective tissue that wraps around and supports different structures of the body

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6
Q

What does the superficial fascia consist of?

A

Found directly under the skin, consists of loose connective tissue, blood vessels, and nerves

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7
Q

What is deep fascia?

A

Fascia that surrounds bones, muscles, some nerves, and some blood vessels

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8
Q

What is the thorax?

A

The anatomical region inferior to the neck and superior to the abdomen

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9
Q

What is the thoracic wall comprised of?

A

The skin, fascia, nerves, vessels, muscles, cartilage, and bones

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10
Q

What is the function of the thoracic wall?

A

Protect underlying viscera and to provide attachments for muscles

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11
Q

What does the thoracic skeleton consist of?

A

12 thoracic vertebrae and intervertebral discs, 12 pairs of ribs and costal cartilage, the sternum

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12
Q

What are costal facets?

A

Points where the ribs articulate with the costal vertabrae and form synovial joints

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13
Q

What do the articular facets of typical ribs articulate with? (Non-specifically)

A

With the costal facets of the thoracic vertebrae

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14
Q

What does the tubercle facet of typical ribs articulate with?

A

With the costal facets of the transverse process of thoracic vertebrae

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15
Q

Which ribs are deemed to be “atypical ribs”

A

Ribs 1, 11, and 12

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16
Q

What is costal cartilage?

A

Cartilage comprised of hyaline cartilage that connects the ribs to the sternum. Contributes to the elasticity of the rib cage

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17
Q

Where are the sternocostal joints located?

A

Between the sternum and the costal cartilage (these are synovial joints)

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18
Q

What is the costal margin?

A

The medial margin formed by the cartilage of ribs 7-10

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19
Q

Which ribs are deemed to be “True ribs”?

A

Ribs 1-7 (attached to the sternum directly via their own costal cartilage)

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20
Q

Which ribs are deemed to be “False ribs”?

A

Ribs 8-10 (attached to the sternum indirectly via the costal cartilage of superior ribs)

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21
Q

Which ribs are deemed to be “Floating ribs”?

A

Ribs 11 and 12 (do not attach to the sternum)

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22
Q

Which ribs does the manubrium of the sternum articulate with?

A

Ribs 1 and 2

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23
Q

Which ribs does the body of the sternum articulate with?

A

Ribs 2-7

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24
Q

Which ribs does the xiphoid process of the sternum articulate with?

A

None (trick question!)

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25
Q

What is the superior-most notch of the sternum called?

A

Jugular or suprasternal notch

26
Q

What is the sternal angle?

A

The point at which the manubrium and body of the sternum articulate. Found at the level of the T4/T5 intervertebral disc space

27
Q

What is the xiphisternal joint?

A

Where the body of the sternum and the xiphoid process articulate. Found at the level of the T10 vertebrae

28
Q

What marks the inferior limit of the thoracic cavity?

A

The xiphisternal joint

29
Q

Name the muscles of the thoracic wall

A

Pectoralis major, pectoralis minor, and serratus anterior

30
Q

Describe the intercostal muscles

A

3 layers of muscle found within the intercostal spaces that help stabilize the ribcage during respiration. Muscle fibers of each layer run in different directions for added strength (layers are thin)

31
Q

Name the 3 intercostal muscles from superficial to deep

A

External intercostal, internal intercostal, innermost intercostal

32
Q

What are intercostal neurovascular bundles?

A

A bundle consisting of an intercostal vein, intercostal artery, and intercostal nerve (listed from superior to inferior) that supplies the muscles and overlying skin

33
Q

Where are intercostal neurovascular bundles located?

A

In the costal grove in between the internal and innermost intercostal muscles

34
Q

Intercostal nerves are the ventral rami of what spinal nerves?

A

Intercostal nerves are ventral rami of the T1-T11 spinal nerves (T12 is the subcostal nerve)

35
Q

What is the subcostal nerve?

A

The ventral ramus from the T12 spinal nerve (there are only 11 intercostal spaces)

36
Q

What is meant by the collateral branch with respect to intercostal nerves?

A

Each intercostal nerve gives off a collateral branch that travels along the superior boarder of the rib below it (so each intercostal space has 2 neurovascular bundles)

37
Q

What types of fibers are found in the intercostal &
subcostal nerves?

A

Somatic motor nerves (intercostal muscles), somatic sensory nerves (skin, joints, muscles), and sympathetic nerves (targets in skin)

38
Q

What dermatome landmark is located at the nipple line?

A

T4

39
Q

What dermatome landmark is located at the umbilicus?

A

T10

40
Q

What is the anatomical relationship between dermatomes and myotones?

A

Myotomes are found deep to dermatomes (the 2 do not perfectly align with one another!)

41
Q

If you were going to remove a mole from the skin between Ribs 5 & 6, where would you inject your patient with anesthesia, and why?

A

1) Inferior to Rib 5 to anesthetize the 5th intercostal nerve travelling in the costal groove
2) Superior to Rib 6 to anesthetize the collateral branch from the 5th intercostal nerve
3/4) Superior to Rib 5 & Inferior to Rib 6 to anesthetize adjacent areas in consideration of overlapping dermatomes

42
Q

Describe the thoracic aorta

A

a large, singular vessel located posteriorly that supplies blood to the posterior intercostal arteries and their collateral branches

43
Q

Describe the internal thoracic arteries

A

A pair of 2 vessels located anteriorly (just deep of the ribcage) that supplies blood to the anterior intercostal arteries

44
Q

Describe the flow of blood from the thoracic aorta to the thoracic wall

A

Thoracic aorta > posterior intercostal arteries > collateral branches

45
Q

Describe the flow of blood from the internal thoracic arteries

A

Internal thoracic arteries > anterior intercostal arteries (there are usually only 2 anterior intercostal arteries in each intercostal space)

46
Q

Describe the relationship between the anterior intercostal arteries and the posterior intercostal arteries

A

They anastomose (connect) with one another

47
Q

How is venous drainage achieved within the thoracic wall?

A

Via the anterior intercostal veins and the posterior intercostal veins (they too anastomose with one another)

48
Q

Describe the flow of venous drainage from the posterior intercostal veins

A

Posterior intercostal veins > azygos system > superior vena cava (SVC)

49
Q

Describe the flow of venous drainage from the anterior intercostal veins

A

Anterior intercostal veins > Internal thoracic veins > brachiocephalic veins > superior vena cava (SVC)

50
Q

If the left internal thoracic artery was removed for a coronary bypass, how would oxygen rich blood get to the affected intercostal spaces?

A

Via the anastomosis’ between the internal thoracic artery and the thoracic aorta

51
Q

A patient suffered a stab wound that severed the proximal end of the T10 intercostal nerve. Which answer best describes how the patient would present?

A) Anesthesia of the lateral & anterior aspects of the T10 dermatome

B) Anesthesia of the lateral & anterior aspects of the T10 myotome

C) Lack of sweating in the lateral & anterior aspects of the T10 dermatome

D) A&B

E) A, B, & C

A

E

52
Q

Each intercostal nerve gives off a _____________ that travels along the superior border of the rib below

A

Collateral branch

53
Q

What what level is the sternal angle?

A

T4/T5

54
Q

At what angle is the the xiphoid process at?

A

T10

55
Q

Define ipsilateral

A

Meaning on the same side

56
Q

Define contralateral

A

On opposite sides

57
Q

What is known as the weakest part of the rib?

A

The angle (most common location of rib fractures)

58
Q

What are the visible and/or palpable features of the thoracic wall?

A

Jugular notch, clavicles, sternal angle, costal margin, xiphoid process, etc.

59
Q

From superior to inferior, list the structures found in an intercostal neurovascular bundle

A

Intercostal vein, intercostal artery, intercostal nerve

59
Q

In the costal grove, the intercostal neurovascular bundles travel between what 2 layers of intercostal musculature?

A

The internal and innermost intercostal muscles

59
Q

All 3 layers of the intercostal muscles are supplied by what (nerve and vasculature)

A

Intercostal neurovascular bundles

60
Q

The intercostal neurovascular bundles are responsible for supplying what structures?

A

The muscles and overlying skin

61
Q

What type of nerve fibers are found in the intercostal and subcostal nerves?

A

Somatic motor (intercostal muscles), somatic sensory (skin, joints, and muscles), and sympathetic (targets in the skin such as sweat glands, arrector pili muscles, and blood vessels)

62
Q

Posterior intercostal veins drain into what?

A

The azygous system

63
Q

The azygous system drains into what structure?

A

The superior vena cava (SVC)

64
Q

The anterior intercostal veins drain into what?

A

Internal thoracic veins

65
Q

Internal thoracic veins drain into what?

A

Brachiocephalic veins

66
Q

Brachiocephalic veins drain into what?

A

The superior vena cava (SVC)

Anatomy (5 decks)

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