Thoracic wall Flashcards
thoracic wall framework
thoracic cage
posterior boundary of thorax
thoracic part of verteb column
anterior boundary of thorax
sternum and costal cartilage
lateral boundary of thoras
ribs and intercostal cartilage
superior border of thorax
suprapleural membrane
inferior border of thorax
diaphragm
sternum is divided into 3 parts
manubrium
body
xiphoid
manubrium articulates with body at what
manubriosternal joint
manubriosternal joint found at what level
T3-4 vertabra
manubrium articulates with what
body
clavicle
1st costal cartialge
upper of 2nd costal
body articulates with xiphoid at what
xiphisternal joint
xiphisternal joint found at what level
T9
found at each side of body of sternum
2nd to 7th costal cartialge
no ribs or cartilage attached to it
xiphoid process
formed by the articulation of the ,anubrium and body
angle of Louis (sternal angle)
this lies at the level of the 2nd costal cartilage
transverse ridge
sternal ngle found at what level
between T4-5 vertebra
alin ang true ribs
1-7
alin ang false ribs
8 9 10
alin ang floating ribs
11 12
aling part ng rib ang sharp and thin
inferior border
aling part ng rib ang rounded and smooth
superior border
itsura ng typical rib
long, twisted flat bone
part of the ribs that accomodates the intercostal nerves and vessels
costal groove
parts of ribs
head neck tubercle shaft angle
saan ang costal groove taas o baba
baba border
alin ang dumidikit sa vertebra
head ng rib
clinical importance of 1st rib
close to subclavians
what crosses anterior to scalenus anterior
subcla vein
what crosses posterior to scalenus anterior
subclav artery and lower trunk for bachial plxus
cartilages of 11 and 12 rib end in
abdominal musculature
in old age, costal cartilages lose elasticity due to
superficial calcification
connects rib head to intervertebral disc
intraarticular ligament
articulates via transverse process of the corresponding vertebra
tubercle
articulate with one another along their borders by small synovial joints
6-10th costal
joint type of sternoclavicular joint
synovial double plane joint
articular disc of the sternoclav joint
flat fibrocartilaginous disc
accesory ligaments of the sternoclav joint
costoclavicular ligament
this is formed from junction of 1st rib with the 1st costal to the inferior surface of sternal end of clavicle
costoclavicular ligament
nerve supply to sternoclav joint
supraclav nerve and nerve to subclavius
lies opposite the lower border of T2 vertebra and felt between prominent medial ends of clavicles
suprasternal notch
this rib lies deep to the clavicle and cannot be palapted
1st rib
can be used to identify a particular rib by counting from below
12th rib
position of nipples in male
4th intercostal space, 4 inches from midline
vertebra prominens
C7
line drawn bet. sternal border and midclav line
parasternal line
vertical line along transverse processes
paraverterbral line
origin of intercostal muscles
inferior border of rib
insertion of intercostal muscles
super border of rib below
innervation of intercostal muscles
intecostal nerves
origin and insertion of innermost intercostal muscle
adjacent rib
action of ext. intercostal muscle
raises rib during inspi
increases diameter bsajfkdfbjdhfjaljgksd
action of internal intercost muscles
lowers rib during expi
action of innermost intercost muscles
assist inter and external intercost
origin of diaphragm
xiphoid process
lower 6 costal cartilages
1st 3 lumbar vertebrae
insertion of diaphragm
central tendon
action of diaphragm
muscle of inspi
increase diameter of thorax
raises lower ribs
origin of levatores costarum
tip of transverse process of C7 T1-11
insertion of levatores costarum
rib below
action of levatores costarum
raises rib
inspi msucles
origin of serratus posterior superior
lower cervical and upper thoracic spines
insertion of srratus posterior superior
upper ribs
origin of serratus posterior inferior
upper lumbar and lower thoracic spines
insertion of serratus posterior inferior
lower ribs
contained within the intercostal space
innermost, internal and external intercostal muscles
lines the innermost intercostal muscle, lined internally by the parietal pleura
endothoracic fascia
arrangement of neurovascular structures above to below
vein
artery
nerve
(VAN)
saang nagrrun ung VAN
between intermediate and deepest layers muscles
the intercostal muscles are replaced by the corresponding
anterior or posterior intercostal membrane
the innermsost intercostal muscle corresponds to th
transversus abdominis muscle
this rib is fixed during inspiration
1st, fixed by scalenus anterior
this rib is fixed during expiration
12th, fixed by quadratus lumborum and oblique muscles
supplies the first 2 posterior intercostal spaces
costocervical trunk of subclaian artey
supplies the first 6 anterior spaces
internal thoracic artery
supplies the lower 9 posterior spaces (3-12)
descending thoracic aorta
supplies the lower 6 anterior spaces
musculophrenic (7-9)
superior epigastric artery (10-12)
posterior intercost veins drain into
azygous or hemiazygous veins
anterior intercost veins drain into
internal thoracic and musculophrenic vein
1st posterior intercostal vein drains into
vertebral or brachiocephalic vein
2-3rd posterior intercostal vein drains unite to form
superior intercostal vein
4th-11th posterior intercostal veins drain into
azygous (right side)
hemiazygous (left side)
1-3rd anterior intercostal drain into
internal thoracic vein
4-9th anterior intercostal drain into
musculophernic vein
joins with the superior epigastric vein to drain into internal thoracic vein at 3rd space
musculophrenic vein
musculophrenic vein joins the _____________ to drain into ______ at ______________
superior epigastric vein
internal thoracic vein
3rd intercostal space
3 fibers of the intercotal nerves
motor
sensory
sympathetic
san galing intercostal nerves
anterior rami of 1st 11 thoracic spinal nerves
comes from the anterior ramus of the 12th thoracic nerve
subcostal nerve
saan pwesto ng subcostal nerve
lies in abdomen
runs forward in abdominal wall
sensory fibers innervate the
parietal pleura
cutaneous areas
sympahetic fibers innervates the
smooth muscles around blood vessels
secretory fibers to glands in the skin
intercost nerves enters thru or where
enters intercostal space in subcostal groove between innermost intercostal and internal intercostal
where are first 6 nerves distributed
intercostal spaces
where are 7-9th nerves distributed
leave the angterior ends of the spaces by passing deep to costal cartilages and enters abdominal wall
where the 10-11th merves distributed
pass directly into abdominal wall
branches of the intercostal nerves
rami communicantes collateral branch lateral cutaneous anterior cutaneous muscujlar branches pleural sensory peritoneal sensory
connects intercostl nerves to a ganglion of sympathetic trunk
rami communicantes
gray ramus joins balakakfkas
runs forward inferiorly to main nerve on upper border of rib below
collateral branch
reaches skin on side of the chest
lateral cutaneous
terminal protion of the main trunk, reaches skin near midline
anterior cutaneous
nerve that runs to the intercostal muscles
muscular branch
nerves that goes to the parietal pleura
pleural sensory
nerves tht go to the peritoneal pleura
peritoneal sensory
the peritoneal sensory nerves include only the
7-11th intercostal nerves only
the 1st intercostal nerve is joined to _____________ by a large branch equal to lateral cutaneous branch of typical intercostal nerves
brachial plexus
joined to brachial plexus by a large branch equal to lateral cutaneous branch of typical intercostal nerves
1st intercostal nerve
2nd intercostal nerve is joined to _____________ via the ________________
medial cutaneous
intercostobrachial nerves
thoracic wall nerve that supplies the skin of the armpit and upper medial side of the arm
2nd intercostal nerve
