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AFCP 1 FINAL > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

Thoracocentesis

A

Remove fluid between ICS 8 or 9 in midaxillary line to avoid lungs, superior to rib 9 or 10
Superior to upper border

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2
Q

Intercostal nerve block

A

In ICS, blood 2 adjacent nervesT

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3
Q

Thoracostomy

A

Remove fluid (down) or air (down) in ICS 4 or 5
Superior to upper border

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4
Q

Sternectomy

A

To access thorax

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5
Q

Sternum

A

Used for bone marrow graft

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6
Q

Pectus carinatum

A

Sternum protrudes

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7
Q

Pectus excavatum

A

Sternum caves in

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8
Q

Paradoxical movement of hemidiaphragms

A

Damage to phrenic nerve

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9
Q

Cervical supernumeral rib

A

C7 vertebrae
Can compress inferior trunk (C8-T1) or subclavian artery, causing ischemia

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10
Q

Lumbar supernumeral rib

A

Often misdiagnosed as L1 transverse process fracture

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11
Q

Flail chest

A

Caused by multiple rib fractures, paradoxical lung movement

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12
Q

True ribs

A

1-7

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13
Q

False ribs

A

Do not articulate directly with sternum, connected to seventh costocartilage at costochondral join
8-10

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14
Q

Floating ribs

A

11-12
Do not articulate with sternum at all

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15
Q

Ribs 1&2

A

Muscle attachment sites for ant & mid (1) and post (2) scalene muscle

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16
Q

Anterior scalene

A

Anterior = subclavian vein
Posterior = subclavian artery

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17
Q

Polymastia

A

Extra breasts

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18
Q

Amastia

A

Missing breast

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19
Q

Polythelia

A

Extra nipples

20
Q

Carcinoma effect on lymph nodes

A

Removal of axillary nodes to prevent spread of cancer BUT can lead to arm swelling

21
Q

Athelia

A

No nipples

22
Q

Sentinel lymph node biopsy

A

Done to prevent total removal of lymph nodes

23
Q

Sternal angle

A

Starts at second rib - T4
Divides superior and inferior mediastinum
Bifurcation of trachea into bronchi
Arch of aorta
Arch of azygos enters SVC
Thoracic duct crosses to left side

24
Q

Nerves of thoracic wall

A

ICN part of ventral rami
11 pairs plus subcostal nerve

25
Q

Typical IC nerves

A

3-6 btwn internal and innermost muscles

26
Q

Atypical IC nerves

A

1 part of brachial plexus
2 intercostal brachial n
7-11 thoracoabdominal n

27
Q

Blood supply of thoracic wall

A

Internal thoracic a
Post and ant intercostal arteries and veins

28
Q

Supreme intercostal arteries

A

1st and 2nd posterior intercostals coming off costocervical trunk

29
Q

Lymphatic drainage of thoracic wall

A

Thoracic duct on left receives all lymph except right thorax, arm, head and neck which goes to right lymphatic duct

30
Q

Breast

A

Glandular tissues, 15-20 lobules
Supported by suspensory ligament of Cooper
Retromammary bursa = posterior

31
Q

Breast location

A

Between ribs 2-6, nipple at 4, axillary tails extends

32
Q

Breast innervation

A

Internal thoracic, lateral thoracic and post intercostal a.
Nipple T4

33
Q

Diaphragm

A

Dome shaped muscle

34
Q

Diaphragm innervation

A

Innervated by phrenic nerve, peripherally by intercostal and subcostal

35
Q

Diaphragm openings

A

Caval = IVC, r. phrenic (T8)
Esophageal hiatus = esophagus, vagal trunk (T10)
Aortic hiatus = aorta, thoracic duct, azygos (T12)

36
Q

Superior thoracic aperture

A

T1, rib 1, manubrium
Contains carotids and subclavian

37
Q

Inferior thoracic aperture

A

T12, ribs 11-12, xiphisternal joint

38
Q

External intercostals

A

Hands in pocket

39
Q

Internal intercostals

A

Hands to chest

40
Q

Herpes zoster

A

Invades spinal ganglion and affects thoracic wall dermatomes

41
Q

Posterior intercostal arteries

A

3-11 come off descending thoracic aorta
1-2 come off supreme intercostal a

42
Q

Anterior intercostal arteries

A

1-6 come off internal thoracic
7-9 come off musculophrenic

43
Q

Azygos vein

A

Unpaired on right side

44
Q

Inspiratory muscles

A

EI, II
Deep breathing - diaphragm
Accessory - sternoclediomastoid and scalenes

45
Q

Expiratory muscles

A

Quiet breathing - recoil of muscles
Forced - innermost, abs

46
Q

Parietal pleura

A

Sensitive to pain, innervated by intercostal nerves
Must be anesthetized

47
Q

Anterior and posterior intercostal arteries

A

Anastomose, can be collateral

AFCP 1 FINAL (9 decks)

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