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ANATOMY CARDIO PULM > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

Jugular notch

A

level of T2 vertebra; trachea is palpable

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2
Q

Sternal angle

A

sight of articulation of rib 2; level of T4 vertebra

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3
Q

Nipple

A

marks T4 dermatome; approximate location of dome of diaphragm

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4
Q

Xiphoid process

A

inferior aspect of sternum; anterior attachment point of diaphragm

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5
Q

Sternum 3 parts

A

manubrium, body, xiphoid process

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6
Q

Name ribs

A

12 pairs
1. True ribs (1-7) attach directly to sternum
2. False ribs (8, 9, usually 10) indirect attachment to sternum via cartilage above
3. Floating ribs (sometimes 10, 11, 12) end in abdominal mm

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7
Q

Superior thoracic aperture

A

Consists of:
- body of t1 vertebra
- first pair of ribs & costal cartilages
- manubrium of sternum

Structures passing through:
- trachea
- esophagus
- nerves & vessels to head, neck, & upper limbs

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8
Q

Thoracic outlet syndrome

A

impact to subclavian artery and brachial plexus
- compression of structures
-can be due to inflammation, common in pregnant women
- BOTH the nerve and blood supply affected
-S/S: swelling

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9
Q

Inferior thoracic aperture

A

Consists of: body of T12 vertebra, rib pairs 11 & 12, costal margins, xiphisternal joint
-Closed in life by diaphragm

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10
Q

Costochondral joint

A

lateral end of costal cartilage with sternal end of rib
-Cartilaginous

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11
Q

Interchontral joint

A

Costal cartilages of 6 & 7, 7 & 8, and 8 & 9 ribs
-Synovial- plane

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12
Q

Sternocostal joint

A

1st costal cartilage & manubrium; 2-7 pairs costal cartilages & sternum
-1st: synchondrosis (ossified as we age)
-2-7: synovial- plane (allows for slight gliding action)

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13
Q

Intervertebral joint

A

Adjacent vertebral bodies
-symphysis

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14
Q

Costovertebral

A

Joints of head of rib: head of rib with sup. & inf. demi facets of vertebral body

Costotransverse: tuberacle of rib w. transverse process

Synovial; plane

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15
Q

Upper 6 rib movement

A

pump-handle movement
-Transverse axis for rib rotationR

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16
Q

Ribs 7-10 movement

A

Bucket-handle movement
- Costotransverse joint allows for elevation and depression (sliding action)

17
Q

External intercostal mm.

A

“hands into pockets”
Inn: intercostal nn. (T1-T11)
Function: elevate rib during forced inspiration

18
Q

Internal intercostal mm.

A

Inn: intercostal nn.
Function:
-Interosseous part- depress
-Interchondral part- elevate
-During forced respiration

19
Q

Innermost intercostal mm.

A

Inn: intercostal nn.
Function: likely acts with internal intercostal (depresses ribs)

20
Q

Subcostal mm.

A

Inn: intercostal nn.
Function: similar to internal intercostal (depresses weakly)

21
Q

Transversus thoracis mm.

A

Inn: intercostal nn.
Function: weakly depresses ribs

22
Q

Inspiration

A

Main muscle= diaphragm
- moves down causing a decrease in intrathoracic pressure, increase in space
- air is drawm in

23
Q

Expiration

A
  • diaphragm moves up
  • passive, elastic recoil of lungs
  • muscles relax causing an increase in intrathoracic pressure (decreased space)
    -Air rushes out
    -Intra-abdominal pressure decreased
24
Q

Subclavian Artery branches

A

First part
1) vertebral a.
2) thyrocervical trunk
3) internal thoracic aa.
Second part
4) costocervical trunk
Third part
5) Dorsal scapular (anatomical variation)- to rhomboids and levator scapulae

25
Q

Posterior intercostal aa.

A

Supreme a. (to intercostal spaces 1&2)
- Costocervical trunk of subclavian a.
- 9 pairs from thoracic aorta

26
Q

Anterior intercostal a

A

from internal thoracic artery off subclavian a.
- Anastamosis–> collateral branch
-Anastamosis location can vary
- inferior border of rib above

27
Q

Collateral aa.

A

branches of intercostal aa.
-superior boarder of rib below

28
Q

Superior thoracic a.

A

First branch of axillary a.

29
Q

Lateral thoracic a.

A

Axillary a. branch

30
Q

Internal thoracic aa. terminal branches

A
  1. Superior epigastric a.
  2. Musculophrenic a. –> blood supply to diaphragm
31
Q

Intercostal vv.

A
  • drain posteriorly into the azygos system which drains into the superior vena cava

-drains anteriorly into the internal thoracic v. which brains into the brachiocephalic vv. –> come together to form SVC

Right–> azygos
Left –> accessory (above t6-t8) + hemizygous (below t6-t8)
- Go into azygous–> SVC

32
Q

Intercostal nerves

A

Ventral rami of spinal nn. t1-t11
Branches:
- lateral cutaneous branch
- anterior cutaneous branches
Ventral ramus t12 spinal n.= subcostal n. (part of lumbar plexus)

33
Q

Clinical correlation: Herpes Zoster

A

Classic dermatomally distributed skin lesion-shingles
-viral disease of spinal ganglia
-usually a reactivation of varicella-zoster or chickenpox virus
-S/S: sharp burning pain in the dermatome, skin becomes red, vesicular eruptions and possible muscle weakness in the same myotome

34
Q

Intercostal spaces

A

Contains:
-intercostal mm: external, internal, innermost
-intercostal n.
-Intercostal aa.
-intercostal vv.
-Lymphatics

Top to bottom: VAN NAV

35
Q

Clinical correlation- intercostal nerve block

A

Rib fracture patients, after thoracic surgery

Percutaneous procedures: insertion of chest tubes, thoracentesis, pericardiocentesis

-Intercostal bundle located along inferior boarder of superior rib
-Collateral bundle located along superior boarder of inferior rib

36
Q

Pleural cavities

A

Superiorly extend above rib 1 into the root of neck

inferiorly extend to jsut above costal margin

medial wall is mediastinum

contain lungs

37
Q

Mediastinum

A

Superior
Inferior: anterior, middle, posterior

38
Q

Serous membranes of thoracic viscera

A

Viscera covered with serous membrane
1. Parietal layer- lines walls of cavity
2. Visceral layer- adheres to surface of organ

Small layer of serous fluid between parietal and visceral layer–> reduces friction

ANATOMY CARDIO PULM (2 decks)

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