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Anatomy Exam 2 > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

Where is the thorax?

A

between the neck and abdomen

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2
Q

What is included in thorax?

A

thoracic cavity, ribs, sternum, and thoracic vertebral column
lungs, heart, esophagus, and thoracic portion of descending aorta

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3
Q

What structure is at the inferior opening of thoracic cavity?

A

diaphragm

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4
Q

functions of the thorax:

A

-protect internal organs
-resist negative pressure created by elastic recoil of lungs
-attach and support upper limbs
-origins for groups of muscles to upper limbs, abdomen, back, neck and head
-include the muscles of breathing

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5
Q

How many sets of ribs are there?

A

12

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6
Q

Ribs 1-7 are known as:

A

true ribs
-attach directly to sternum

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7
Q

Ribs 8-10 are known as:

A

false ribs
-attach to cartilage of ribs superior to them

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8
Q

Ribs 11 and 12 are:

A

floating ribs
-do not have an anterior attachment

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9
Q

Ribs 7-10 form:

A

the infrasternal angle

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10
Q

space between ribs and costal cartilages:

A

intercostal space

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11
Q

Borders of thoracic cavity:

A

superior: 1st thoracic vertebra, 1st pair of ribs, and superior border of manubrium

inferior- diaphragm

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12
Q

Head of rib

A

articulates with inferior and superior costal facets of adjacent thoracic vertebrae

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13
Q

neck of rib

A

attach head to body

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14
Q

Tubercle of rib

A

articulates with costal facet of transverse process of vertebrae

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15
Q

Supernumerary ribs

A

extra ribs that are not normally seen
-rudimentary
-fused with first thoracic rib
-fully developed
can cause thoracic outlet syndrome

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16
Q

thoracic outlet syndrome

A

compression caused by supernumerary ribs in the lower cervical region can cause irritation or injury to the vessels and nerves supplying the shoulder and upper limb

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17
Q

Manubrium of sternum

A

contains attachment site for rib 1
-superior portion of sternum

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18
Q

body of sternum

A

notches for attachment of ribs 3-6

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19
Q

sternal angle

A

at manubriosternal joint

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20
Q

Xiphoid process becomes completely ossified by what age?

A

40

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21
Q

Types of scoliosis

A

-congenital scoliosis
-neuromuscular scoliosis
-degenerative scoliosis
-idiopathic scoliosis

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22
Q

What is one cause of sternal malformation?

A

Failure of fusion between halves of the sternal bars during development

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23
Q

Costovertebral joints

A

head of rib to bodies of adjacent vertebrae

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24
Q

sternocostal joints

A

sternum to costal cartilage
1- cartilaginous
2-7 are synovial plane joints

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25
Q

Costotransverse joint

A

tubercle of rib to transverse process of vertebrae
-1-7 rotate here
-8-10 glide here
11 and 12 do not articulate

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26
Q

Costochondral joint

A

rib to costal cartilage

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27
Q

interchondral joints

A

between adjacent costal cartilage
6-9 are synovial
9 and 10 can be fibrous

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28
Q

Teitze syndrome

A

autoimmune disease that causes symptoms similar to costochondritis

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29
Q

Costochondritis

A

inflammation of the sternocostal joints
-sharp pain and tenderness

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30
Q

Intercostal muscles

A

external, internal, and innermost intercostals, subcostal muscles, and transversus thoracis

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31
Q

external intercostals

A

attach superiorly to inferior border of rib above and inferiorly to superior border of rib below
-run inferio-anteriorly
-elevate ribs

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32
Q

Internal and innermost intercostals

A

attach superiorly to the inferior border of the rib above and inferiorly to the superior border of the rib below
-run interio-posteriorly
- interosseous part depresses the ribs
-interchondral part elevates the rib
-intercostal neurovascular run between internal and innermost intercostal

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33
Q

subcostal muscles

A

attach superiorly to internal surfaces of lower ribs near their angles and inferiorly to superior borders of ribs 2 or 3 levels below
-run in same orientation

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34
Q

Transverus thoracis

A

attach inferiorly on posterior sternum and superiorly on costal cartilages 2-6
-depress ribs

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35
Q

Levatores costrum (origin, insertion, and action)

A

O- transverse processes
I- rib below between tubercle and angle
A- elevate ribs

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36
Q

Serratus posterior superior (origin, insertion, and action)

A

O- spines of C7-T3
I-Ribs 2-4
A- elevate ribs

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37
Q

Serratus posterior inferior (origin, insertion, and action)

A

O- spines of T11-L2
I- ribs 8-12
A- depress ribs

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38
Q

Anterior and Middle scalenes (origin, insertion, and action)

A

O- transverse processes of cervical vertebrae
I- 1st rib
A-elevate 1st rib during forced or labored inspiration

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39
Q

Posterior Scalenes (origin, insertion, and action)

A

O- transverse processes of cervical vertebrae
I- 2nd rib
A-elevate 2nd rib during forced or labored inspiration

40
Q

Muscles that elevate the ribs

A

-External intercostals
-Interchondral part of internal intercostals
-levatores costrum
-serratus posterior superior
-scalene muscles

41
Q

Muscles that depress the ribs

A

-internal intercostals
-innermost intercostals
-subcostal muscles
-transversus thoracis
-serratus posterior inferior

42
Q

Nerves the innervate upper limb

A

T1 and T2

43
Q

What nerves supply the trunk?

A

T2-T12

44
Q

What is a thoracotomy?

A

surgical opening through the thoracic wall to access the lungs, heart, esophagus, diaphragm, and the thoracic aorta

45
Q

What is a thoracentesis?

A

Procedure to remove fluid from the space between the lining of the outside of the lungs and the wall of the chest
-do not want to hit a nerve

46
Q

Order of neurovascular bundle in intercostal space

A

superior to inferior
vein
artery
nerve

47
Q

What occurs during inspiration?

A

expansion of ribs move sternum upward and outward
-chest wall and lungs expand

48
Q

What occurs during expiration?

A

ribs and sternum depress
-chest cavity and lungs contract

49
Q

Arterial sources of intercostal arteries?

A

aorta and subclavian

50
Q

Internal thoracic artery

A

arise from the subclavian artery
-intercostal arteries 1-6 come from this
-descend into thorax and end at 6th costal cartilage (divide into musculophrenic and superior epigastric arteries)

-

51
Q

What do the musculophrenic arteries give rise to?

A

intercostal arteries 7-10

52
Q

Posterior intercostal arteries

A

two of the posterior intercostal branch off the superior intercostal arteries in the first two intercostal spaces
-remaining are branches from the descending aorta

53
Q

Posterior intercostal veins

A

most return blood to azygous vein on the right and hemiazygous/accessory hemizygous on the left
-left superior intercostal drain into subclavian vein

54
Q

What type of joints are costotransverse joints?

A

synovial

55
Q

Where do ribs 2-10 articulate with the vertebral column?

A

Between two adjacent vertebral bodies

56
Q

Where does the intercostal neurovasculature run compared to intercostal muscles?

A

inbetween the internal and the innermost intercostals

57
Q

What are intercostals nerves branches off of?

A

Ventral rami of spinal nerves

58
Q

What are the lateral and anterior cutaneous branches of ventral rami?

A

Branches that provide sensory innervation to the skin around the thoracic cavity

59
Q

Another name for t2 nerve:

A

Intercostobrachial nerve

60
Q

What nerve is responsible for the referred pain down the arm that is felt during a heart attack?

A

T2: intercostobrachial nerve

61
Q

Angle needle is inserted during a nerve block in thoracic region

A

45 degrees

62
Q

During thoracentesis do you enter above or below a rib and why?

A

Above. The intercostal neurovascular bundle is right below so you do not want to hit that

63
Q

Where do you insert a needle for a nerve block in the ribs?

A

Right under a rib so you can get into the neurovascular stuff

64
Q

Inhalation causes the ribs to do what?

A

Move outward due to muscle contraction
-give more room in the chest cavity for air

65
Q

Upper ribs move like what?

A

Pump handle

66
Q

Ribs 6-10 move like what?

A

Bucket handle

67
Q

How do ribs 11 and 12 move?

A

Like calipers

68
Q

What gives off anterior intercostal arteries?

A

Subclavian

69
Q

What gives off posterior intercostal arteries?

A

Descending aorta

70
Q

Where does the superior intercostal vein drain into?

A

Left subclavian vein

71
Q

what structure is this?

A

head of rib

72
Q

what structure is this?

A

tubercle of rib

73
Q

what structure is this?

A

neck of rib

74
Q

what structure is this?

A

shaft of rib

75
Q

what structure is this?

A

sternal end of rib

76
Q

what structure is this?

A

costal groove

77
Q

what structure is this?

A

angle of rib

78
Q

what structure is this?

A

jugular notch

79
Q

what structure is this?

A

manubrium

80
Q

what structure is this?

A

sternal angle

81
Q

what structure is this?

A

transverse ridges

82
Q

what structure is this?

A

body of sternum

83
Q

what structure is this?

A

xiphoid process

84
Q

what muscles are these?

A

internal intercostals

85
Q

what muscles are these?

A

external intercostals

86
Q

what muscles are these?

A

innermost intercostals

87
Q

what muscles are these?

A

subcostal muscles

88
Q

what muscles are these?

A

transversus thoracis

89
Q

what muscles are these?

A

serratus posterior superior

90
Q

what muscles are these?

A

serratus posterior inferior

91
Q

what muscles are these?

A

levatores costarum

92
Q

what muscle is this?

A

middle scalene

93
Q

what muscle is this?

A

posterior scalene

94
Q

what muscles are these?

A

anterior scalenes

95
Q

what artery is this?

A

anterior intercostal a.

96
Q

what artery is this?

A

internal thoracic a.

97
Q

what artery is this?

A

posterior intercostal a.

Anatomy Exam 2 (6 decks)

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