Thoracic Wall Flashcards
Characteristics of thoracic vertebrae
- Long, inferiorly pointing spinous processes
- Heart shaped vertebral bodies
- Superior/Inferior articular facets - Oriented in coronal place
- Costal facets on transverse processes of ribs
Three parts of the sternum
Manubrium, Body, Xiphoid process
Jugular notch (Sternal notch)
- Notch on superior part of manubrium
- Separates R/L Sternoclavicular joints
Notches on manubrium where SC joint articulates
Clavicular notches
What ribs (costal cartilages) does the manubrium articulate with
Costal cartilages 1 and 2
Manubriosternal joint
- Articulation between inferior manubrium and the body of the sternum
- Cartilaginous, symphysis joint
What ribs (costal cartilages) does the body of the sternum articulate with?
Costal cartilages 2-7
Sternal angle
- Marks fusion of manubrium and body
- Palpable spot
- Horizontal plane through sternal angle marks:
- T4-T5 IV disk, division of mediastinum into superior and inferior regions, bifurcation of trachea, origin and termination of aortic arch
Xiphisternal joint
- Articulation between xiphoid process and the body of the sternum
- Cartilaginous, synchondroses
What are the two types of cartilaginous joints and what are they made of?
- Primary cartilaginous - Synchondroses joints - hyaline cartilage (ossify)
- Secondary cartilaginous - Symphysis joints - fibrocartilage - don’t ossify
Ribs 1-7
- True ribs
- individual costal cartilages of ribs 1-7 articulate with sternum
Ribs 8-10
- False ribs
- Indirect articulation between costal cartilages connected to superior costal cartilages
Ribs 11-12
- Floating ribs
- Don’t articulate with sternum
Costochondral joints
- Articulation between costal cartilages of ribs 1-10 and the bony segment of the rib
- Cartilaginous, synchondroses
Sternocostal joints
- Articulation between costal cartilages of ribs 1-7 and (costal notches) on sternum
- Rib 1 - Cartilaginous, synchondroses
- Ribs 2-7 - Synovial, plane
Costotransverse joints
- Articulation between costal tubercle on rib and costal facets on the transverse processes of the vertebrae
- Synovial, plane
Costovertebral joints
- Ribs 2-10: articulation between the head of rib and the costal facet on adjacent vertebrae and on the demifacet of the superior vertebrae
- Ribs 1,11,12: articulation between the head of the rib and the costal facet on adjacent vertebrae
- Synovial, plane joints
Name and describe the boundaries for the thoracic apertures
- Superior Thoracic Aperture
- bounded by manubrium of sternum, 1st rib, T1 vertebrae
- open thorax superiorly to neck - Inferior Thoracic Aperture
- bounded by xiphoid process of sternum, 11th and 12th ribs, T12 vertebrae, costal margin
Interchondral joint
- Between costal cartilages
- Synovial, plane
Sternoclavicular joint
- Articulation between clavicular notches on manubrium and sternal end of clavicle
- Synovial, saddle
Intervertebral joint
Ask
Right and left crura
- Extensions of the posterior diaphragm
- attach to lumbar vertebral bodies
- Right crus is slightly longer than left crus
What happens to the diaphragm during expiration/inspiration
During inspiration, the diaphragm depresses increasing the room in the thoracic cavity.
During expiration, the diaphragm elevates to the 4th or 5th rib level
Which side of the diaphragm is slightly higher
Right
What are the three apertures (openings) in the diaphragm that allow for passage of structures between the thorax and abdomen
- Caval aperture (hiatus )
- Esophageal aperture (hiatus)
- Aortic aperture (hiatus_
Caval aperture (hiatus)
- Passageway for inferior vena cava
- at T8 level, through central tendon of diaphragm
Esophageal aperture (hiatus)
-Passageway for esophagus
(R/L gastric artery/vein, ant/post vagal trunks)
-T10 vertebral level
-Formed by the right (sometimes left) crura
-Crura constrict and form a sphincter around the esophagus
Aortic aperture (hiatus)
- Behind T12 level
- In between right and left crura
- Passage for aorta (thoracic duct, azygos/hemiazygos veins)
List the neurovasculature of the diaphragm
Arteries - mainly supplied by the inferior phrenic arteries (branch of abdominal aorta)
-also supplied by superior phrenic, pericardiophrenic, musculophrenic
Veins
-venous blood drains into azygos vein (from posterior intercostal and superior phrenic veins)
What innervates the diaphragm
Phrenic nerve (C3,4,5)
What is the breast composed of
Mammary gland (modified sweat gland +supporting fat/fibrous tissue)
Where is the breast located in females
Lateral sternum to midaxillary line (over ribs 1-6, pec major and serratus anterior muscles)
Retromammary space
- Loose C.T. that creates a space between the breast and underlying pectoralis major fascia
- Allows for movement on thoracic wall
Highest prominence of the breast
- Nipple
- T4 level
- Smooth muscle fibers
Areola
- pigmented skin surrounding nipple
- contains sebaceous glands that lubricate the area during nursing
What are the two components of the mammary gland
Parenchyma and stroma
What are the parts of the parenchyma
- Lobes
- Lobes divide into 15-20 lobules
- Lobules contain sacs of alveoli (hollow, with secretory cells)
- Lactiferous ducts - drain lobules, open at nipple
- Lactiferous sinus - small dilation of ducts, stores small amount of milk in lactating women
What is the stroma of the breast composed of/function
- Fibrous network of the mammary gland
- Separates lobules/supports lobes
What attaches the stroma of the mammary gland to overlying dermis
Suspensory (cooper) ligaments
-especially strong superiorly
Neurovasculature of the breast
Arteries - anterior intercostal and medial mammary arteries (branches of internal thoracic)
Veins - venous blood drains into axillary vein
Lymph - 75% lymph drains into axillary nodes
What makes up the thoracic cage
T1-T12 vertebrae, Ribs 1-12, Sternum
