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Gross II Unit 2 > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

Where a major site for red blood cell production (bone marrow) in the thoracic wall?

A

Sternum

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2
Q

What is the widest and thickest part of the sternum?

A

Manubrium

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3
Q

What does the upper border of the manubrium form?

A

Jugular notch

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4
Q

The body of the sternum articulates with what?

A

Second to seventh costal cartilages

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5
Q

Which costal cartilage articulates directly with the manubriosternal joint?

A

Of the second rib

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6
Q

What part of the sternum is sometimes broken during CPR?

A

Xiphoid process

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7
Q

Which part of the sternum is cartilaginous at birth & slowly ossifies throughout life?

A

Xiphoid process

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8
Q

What variation of the xiphoid process is fairly common?

A

Being bifid

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9
Q

Which variation of the xiphoid process is rarely present?

A

Xiphoid foramen

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10
Q

What is formed by the articulation of the manubrium with the body of the sterum?

A

Sternal angle

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11
Q

At what vertebral levels is the sternal angle found?

A

T4 and T5

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12
Q

What is “barrel chest”?

A

More pronounced sternal angles

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13
Q

Barrel chest is common among what condition?

A

Chronic Obstructive Pulmonary Disease (COPD)

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14
Q

What is another name for the thoracic inlet?

A

Superior thoracic aperture

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15
Q

What are the three boundaries of the superior thoracic aperture (thoracic inlet)?

A

Manubrium, first rib, and first thoracic vertebra

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16
Q

What is another name for the thoracic outlet?

A

Inferior thoracic aperture

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17
Q

What are the five boundaries of the inferior thoracic aperture?

A

Xiphoid process, costal margin, twelfth rib, distal end of the eleventh rib, twelfth thoracic vertebra

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18
Q

Which are the “true ribs”?

A

1-7

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19
Q

Where do the true ribs articulate?

A

Directly with the sternum through their own costal cartilages

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20
Q

Which are the “false ribs”?

A

8-12

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21
Q

Where do ribs 8-10 articulate?

A

Indirectly with the sternum by attaching to the costal cartilage of the rib above

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22
Q

Where do ribs 11 and 12 articulate?

A

They don’t articulate with the sternum at all :) Known as “floating ribs”

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23
Q

Which are “typical ribs”?

A

3-9

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24
Q

Which are “atypical ribs”?

A

1, 2, 10, 11, and 12

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25
Q

What shields the intercostal vein, artery, and nerve of a typical rib?

A

Costal groove

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26
Q

What are the three functions of the thoracic cage?

A

Protection of thoracic and upper abdominal organs, muscle attachments, and respiration

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27
Q

What is the second most important muscle for respiration?

A

External intercostal muscle

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28
Q

What is the origin of the external intercostal muscle?

A

Lower border of ribs 1-11

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29
Q

What is the insertion of the external intercostal muscle?

A

Upper border of ribs 2-12

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30
Q

What is the nerve supply of the external intercostal muscle?

A

Corresponding intercostal nerve

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31
Q

What is the function of the external intercostal muscle?

A

Elevates the ribs in inspiration

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32
Q

How do the fibers run in the external intercostal muscle?

A

Downward and forward (hands in pockets)

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33
Q

Where does the external intercostal muscle begin and end?

A

Begin at tubercle of rib, end at costochondral joint

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34
Q

What replaces the external intercostal muscle where it ends?

A

External intercostal membrane

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35
Q

What is the origin of the internal intercostal muscle?

A

The upper border of ribs 2-12

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36
Q

What is the insertion of the internal intercostal muscle?

A

The lower border of ribs 1-11

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37
Q

What is the nerve supply for the internal intercostal muscle?

A

Corresponding intercostal nerve

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38
Q

What is the function of the internal intercostal muscle?

A

Depresses the ribs in FORCED expiration

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39
Q

Where does the internal intercostal muscle begin and end?

A

Begin at sternum, end at the angle of the ribs

40
Q

What replaces the internal intercostal muscle where it ends?

A

Internal intercostal membrane

41
Q

How do the fibers run in the internal intercostal muscle?

A

Downward and backward

42
Q

What is the origin of the innermost intercostal muscle?

A

The upper border of ribs 2-12

43
Q

What is the insertion of the innermost intercostal muscle?

A

The lower border of ribs 1-11

44
Q

What is the nerve supply of the innermost intercostal muscle?

A

Corresponding intercostal nerve

45
Q

What is the function of the innermost intercostal muscle?

A

Depresses the ribs in FORCED expiration

46
Q

How do the fibers of the innermost intercostal muscle run?

A

Downward and backward

47
Q

What is the overall function of ALL intercostal muscles?

A

Preventing the pushing in or drawing out of the intercostal spaces during respiration

48
Q

What is the origin of the subcostalis muscle?

A

Inner surface of ribs near their angles

49
Q

What is the insertion of the subcostalis muscle?

A

Crosses a rib and inserts into the rib above that

50
Q

What is the nerve supply of the subcostalis muscle?

A

Intercostal nerve

51
Q

What is the function of the subcostalis muscle?

A

Depresses the ribs in FORCED expiration

52
Q

What other muscle is a part of the innermost costal layer?

A

Subcostalis

53
Q

Which intercostal muscle skips ribs?

A

Subcostalis

54
Q

What is the origin of the transversus thoracis muscle?

A

Posterior surface of the lower sternal body and xiphoid process

55
Q

What is the insertion of the transversus thoracis muscle?

A

Inner surface of costal cartilages 2-6

56
Q

What is the nerve supply for the transversus thoracis muscle?

A

Intercostal nerve

57
Q

What is the function of the transversus thoracis muscle?

A

Depresses the ribs in FORCED expiration

58
Q

What is the blood supply of the anterior aspect of the thoracic wall?

A

Internal thoracic artery and its branches

59
Q

What is the blood supply of the posterior aspect of the thoracic wall?

A

Supreme (Superior) intercostal artery, 3-11th posterior intercostal arteries, and subcostal artery

60
Q

What are the branches of the internal thoracic artery?

A

Pericardiacophrenic, anterior intercostal, musculophrenic, and superior epigastric arteries

61
Q

From where does the internal thoracic artery arise?

A

Subclavian artery

62
Q

Which branch of the internal thoracic artery accompanies the phrenic nerve?

A

Percardiacophrenic artery

63
Q

Which branch of the internal thoracic artery supplies the pleura, pericardium, and diaphragm?

A

Percardiacophrenic artery

64
Q

Which branch of the internal thoracic artery supplies the upper six intercostal spaces and the anatomose with the posterior intercostal arteries?

A

Anterior intercostal arteries

65
Q

Which branch of the internal thoracic artery is the lateral terminal branch?

A

Musculophrenic artery

66
Q

Which branch of the internal thoracic artery is the medial terminal branch?

A

Superior epigastric artery

67
Q

What is the purpose of anastomoses?

A

Enabling collateral circulation

68
Q

From where does the supreme (superior) intercostal artery arise?

A

Costocervical trunk

69
Q

What does the supreme (superior) intercostal artery branch into?

A

First and second posterior intercostal arteries

70
Q

From where do the 3-11 posterior intercostal arteries arise?

A

Directly from the thoracic aorta

71
Q

From where does the subcostal artery arise?

A

Thoracic aorta

72
Q

Where is the subcostal artery located?

A

Below the 12th rib

73
Q

What vein drains the anterior aspect of the thoracic wall?

A

Internal thoracic vein (into the brachiocephalic vein)

74
Q

What vein drains the posterior aspect of the thoracic wall?

A

Azygos system of veins

75
Q

What does azygos mean in Greek?

76
Q

Where is the internal thoracic artery located in reference to the internal thoracic vein?

A

Laterally (VAN)

77
Q

To which vein does the first posterior intercostal vein drain? (both sides)

A

Brachiocephalic vein

78
Q

What do the second and third posterior intercostal veins join together to form? (both sides)

A

Superior intercostal vein

79
Q

<p>To which vein does the superior intercostal vein (link between the second and third posterior intercostal veins) drain? (both sides)</p>

A

<p>Right side - azygos vein</p>

<p>Left side - left brachiocephalic vein</p>

80
Q

To which vein do the 4th-11th posterior intercostal veins and the subcostal vein drain directly? (both sides)

A

Azygos vein

81
Q

On which side of the body is the azygos vein?

82
Q

On which side of the body are the hemiazygos and accessory hemiazygos veins?

83
Q

Which veins join together to form the accessory hemiazygos vein?

A

4th-8th posterior intercostal veins

84
Q

Which veins joint together to form the hemiazygos vein?

A

9th-11th posterior intercostal veins

85
Q

The accessory hemiazygos and hemiazygos veins drain into which vein?

86
Q

The accessory hemiazygos and hemiazygos veins represent the continuation of which veins?

A

Right and left ascending lumbar veins

87
Q

What are the crossing areas of the azygos system called?

A

Superior and inferior right/left shunts

88
Q

What are the anterior primary rami of the first 11 thoracic spinal nerves called?

A

Intercostal nerves

89
Q

What is the anterior primary rams of the 12th thoracic spinal nerve called?

A

Subcostal nerve

90
Q

What is the function of the endothoracic fascia?

A

Preventing the innermost intercostal muscle from rubbing against the parietal pleura

91
Q

What is the thickening of the fascia over the apex of the lung called?

A

Suprapleural membrane

92
Q

What are the 12 layers (in order) of the thoracic wall?

A

Skin, superficial fascia, deep fascia, serratus anterior, external intercostal muscle, internal intercostal muscle, innermost intercostal muscle, endothoracic fascia, parietal pleura, pleural cavity, visceral pleura, lung

93
Q

The vascular structures of the thoracic wall lie between which layers?

A

Internal intercostal muscle and innermost intercostal muscle

94
Q

Which layer of the thoracic wall covers the lung directly?

A

Visceral pleura

95
Q

What is significant about the suprapleural membrane?

A

It prevents the puncturing of the lung during a rib or clavicle fracture

96
Q

What vascular structures does a typical intercostal space contain (superior to inferior)?

A

Intercostal vein, intercostal artery, intercostal nerve

97
Q

What partially shields the vascular structures of the intercostal space?

A

Costal groove of the rib

Gross II Unit 2 (10 decks)

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