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gross anatomy unit 2 > thoracic wall > Flashcards

thoracic wall Flashcards

1
Q

thorax location

A

between the neck and diaphragm muscle

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2
Q

thorax shape

A

a barrel that is narrow at the top and wider at the bottom

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3
Q

components of the thoracic cavity

A

contains the thymus, heart, lungs, trachea, esophagus, nerves and vessels

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4
Q

components of the thoracic wall

A

surrounds contents of the thoracic cavity

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5
Q

posterior boundary of the thoracic wall

A

T1 through T12 vertebral bodies and their intervening intervertebral discs

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6
Q

lateral boundary of the thoracic wall

A

12 pairs of ribs and their costal cartilages

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7
Q

anterior boundary of the thoracic wall

A

sternum

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8
Q

superior boundary of the thoracic wall

A

“thoracic inlet”

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9
Q

thoracic inlet

A

a small opening bounded by T1 vertebral body, inner margins of ribs 1 and their costal cartilages, and the manubrium of the sternum

slopes obliquely downward from posterior to anterior; forms a plane; apices of the lungs rise through this inlet to the roots of the neck

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10
Q

inferior boundary of the thoracic cavity

A

“thoracic outlet”

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11
Q

thoracic outlet

A

demarcatd by the diaphragm muscle, a parachute-shaped muscle that arises from the inner margins of the thoracic cage, T12 vertebra, and ribs 12

the diaphragm separates the thoracic cavity from the abdominal cavity. because the diaphragm arises partly from ribs 12 and domes upward at a steep angle, it is lower posteriorly than anteriorly

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12
Q

manubrium

A

has a jugular notch, clavicular notches for articulation iwth the clavicles,and articulates with the costal cartilages of ribs 1 and 2. the first sternocostal joints are primary cartilaginous joints in which cartilage is fused to bone, allowing no movement

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13
Q

body of the sternum

A

articulates with the manubrium at the sternal angle; the sternal angle is located at the manubriosternal joint (a secondary cartilaginous joint that allows some movement); costal cartilages of ribs 2 articulate at the sternal angle, and the costal cartilages of ribs 3-7 articulate with the sternum inferior to the sternal angle; stenocostal joints 2-7 are all synovial joints and are all moveable

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14
Q

xiphoid process

A

articulates with the body at the xiphisternal joint

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15
Q

sternal angle

A

forms a horizontal palpable ridge of the chest and is a landmark for counting ribs and counting intercostal spaces

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16
Q

counting ribs

A

begin with ribs 2 at the sernal angle and move inferiorly, counting each successive rib

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17
Q

counting intercostal spaces

A

there are 11 intercostal spaces and each is named by the number of rib above

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18
Q

transverse thoracic plane

A

marks the level of the intervertebral disc between T4 and T5 vertebrae, the bifurcation of the trachea, and the beginning and end of the aortic arch

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19
Q

true ribs

A

ribs 1-7; articulate directly with the sternum

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20
Q

false ribs

A

ribs 8-10; articulate indirectly witht he sternum; each costal cartilage joins the one immediately above; costal cartilages of ribs 7-10 form a costal margin on each side of the thoracic cage

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21
Q

floating ribs

A

ribs 11&12 - no articulation with the sternum

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22
Q

typical ribs coponents

A

head
neck
articular tubercle
shaft

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23
Q

head of ribs

A

articulates with vertebral bodies (of the same number and the one above) and the intervening intervertebral disc at the costoverterbal joint (synovial joint)

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24
Q

neck of ribs

A

between the head and tubercle

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25
articular tubercle
articulates with the transverse process of the vertebra (of the same number) at the costotransverse joint (synovial joint)
26
shaft of the ribs
thin and curved; maximum curvature occurs at the angle; internal surface has a costal groove along its inferior border for passage of intercostal nerve and vessels forward; ends in a depression for articulation with the costal cartilage
27
atypical ribs
ribs 1, 2, 10, 11, 12 lack one or more features of a typical rib
28
inspiratory movements
increase thoracic cavity size and lower its pressure so air can flow down the respiratory passages into the lungs
29
main inspiratory movement
contraction of the diaphragm; the diaphragm drops on contraction, increasing the vertical dimension of the thoracic cavity
30
pump handle movement
forced inspiration elevation of upper ribs moves the sternum up and forward, increasing the anteroposterior dimension of the thoracic cavity
31
bucket handle movement
forced inspiration elevation of lower ribs increases the transverse dimension of the thoracic cavity, "bucket handle" movement
32
expiratory movements
opposite to inspiratory movements
33
intercostal muscles
muscles of the thoracic wall
34
location of the intercostal muscles
intercostal spaces between the ribs
35
function of the intercostal muscles
keep the intercostal space taut, preventing it from being sucked in on inspiration and bulging out on expiration
36
arrangement of intercostal muscles
3 thin layers
37
external intercostal muscles
superficial layer; arise from the rib above and insert on the rib below; fibers run downward and medially like fibers when hands are in the front pockets; anteriorly are replaced by external intercostal membranes; raise the ribs in forced inspiration
38
internal intercostal muscles
middle layer; fibers are at right angles to those of the external intercostals; lower the ribs on forced expiration
39
innermost intercostal muscle group
deep layer; consists of 3 muscle groups interconnected by membrane; includes transversus thoracis mm (anterior group), innnermost intercostal mm (lateral group), and subcostal mm (posterior group), lower the ribs in forced expiration
40
neurovascular plane location
between the internal intercostal and innermost intercostal mm.
41
neurovascular plane contents
anterior and posterior intercostal veins, anterior and posterior intecostal arteries, and intercostal nerve as they run in an intercostal space sheltered by the costal groove of a rib (a "VAN" arrangement, from superior to inferior)
42
nerves of the throacic wall
intercostal nerves
43
intercostal nerves
ventral rami of spinal nerves T1-T11
44
branches of the intercostal nerves
each nerve typically gives off muscular branches, a lateral cutaneous branch, and an anterior cutaneous branch; intercostal vessels accompany the intercostal nerve and its branches along their course
45
function of intercostal nerves
motor fibers innervate intercostal muscles sensory fibers receive sensation from a discrete dermatome sympathetic fibers supply blood vessels and sweat glands (THERE IS NO PARASYMPATHETICSUPPLY TO THE BODY WALL)
46
7th-11th intercostal nerves
thoracoabdominal nerves because they leave the thoracic neurovascular plane and enter the neurovascular plane between the internal abdominal oblique and transversus abdominis muscles; these nervres transmit motor, sensory, and sympathetic fibers to the thoracic and abdominal walls
47
posterior intercostal arteries
supply most of the thoracic wall; most are branches of the descending aorta; anastomose with the smaller anterior intercostal artiers
48
anterior intercostal arteries
arise from an internal thoracic (internal mammary) artery or branch of it, the musculophrenic artery (follows the costal margin); each internal thoracic artery is a branch of the subclavian artery
49
anterior intercostal veins
empty into the musculophrenic and internal thoracic veins; each internal thoracic vein drainsinto the brachiocephalic vein on its respectiveside
50
posterior intervostal veins
drain most of the thoracic wall; most drain into veins on each side of the vertebral column; empty into the accessory hemiazygos and hemiazygos veins on the left and the azygos vein on the right; accessory hemiazygos and hemiazygos veins cross the midline to drain into the azygos vein; the azygos vein drains into the superior vena cava
51
compartments of the thorax
2 lateral compartments | 1 central compartment
52
2 lateral compartments of the thorax
each contains a lung surrounded by its pleural sac; are separate from each other and occupy the majority of the thoracic cavity
53
1 central compartment of the thorax
the mediastinum
54
superior mediastinum
lies between the thoracic inlet and the transverse throacic plane
55
inferior mediastinum
lies between the transverse thoracic plane and the diaphragm; is subdivided into anterior, middle, and posterior mediastina
56
visceral pleura
covers the lung; firmly adheres to its surfaces and dips into its fissures
57
parietal pleura
remaining portion; is continuous with the visceral pleura at the hilum of the lung (where lung root structures enter and exit the lung)
58
pleural cavity location and contents
space between visceral and parietal layers of the pleural sac; contains only a thin film of pleural fluid
59
plueral fluid functions
lubrication allows visceral and parietal pleura to slide past each other without friction surface tension keeps visceral pleura close to parietal pleura during breathing movements
60
cervical pleura
extends the lung apex
61
costal pleura
lines the inner surface of the throacic cage
62
mediastinal pleura
lies against the meidastinum; also surrounds the lung root as the "pleural seeve: and continues inferiorly as a thin fold, the "pulmonary ligament"
63
diaphragmatic pleura
lies on the upper surface of the diaphragm
64
lines of pleural reflection
abrupt lines along whihc the parietal pleura changes direction from one wall of the pleural cavity to another
65
sternal lines of reflection
located anteriorly where costal pleura meets mediastinal pleura
66
costal lines of reflection
located inferiorly where costal pleura meets diaphragmatic pleura
67
sternal reflection lines
both (right and left) descend to 4th costal cartilage; left runs laterally then down to the 6th costal cartilage; on the left, note that an area of pericardium covering the heart, the "bare area," is not covered by parietalpleura; this allows surgical access to the heart without incising the left pleural sac
68
costal reflection lines
both run laterally and inferiorly from the 6th costal cartilages
69
pleural recesses
slit-like spaces of the pleural cavity not occupied by lungs during expiration
70
costomediastinal recesses
located posterior to sternum, where costal pleura is closely apposed to mediastinal pleura
71
costodiaphragmatic recesses
located inferiorly, where costal pleura is closely apposed to diaphragmatic pleural
72
after exhaling, the visceral pleura and basal lung surface are
2 ribs above the extent of the pleural cavity
73
visceral pleura and basal lung surface extend as low as rib ___ in the mid-clavicular (sagittal line midway through clavicle)
6
74
visceral pleura and basal lung surface extend as low as rib ___ in the mid-axillary line (sagittal line midway through axilla)
8
75
visceral pleura and basal lung surface extend as low as rib ___ in the scapularline (sagittal line through inferior angle of scapula)
10
76
parietal pleura and basal lung surface extend as low as rib ___ in the mid-clavicular (sagittal line midway through clavicle)
8
77
parietal pleura and basal lung surface extend as low as rib ___ in the mid-axillary line (sagittal line midway through axilla)
10
78
parietal pleura and basal lung surface extend as low as rib ___ in the scapularline (sagittal line through inferior angle of scapula)
12
79
how deep is the costodiaphragmatic recess
about 2 intercostal spaces deep
80
prior to inspiration
parietal pleura lying against ribs and on the surface of the diaphragm are closely apposed and exclude lung and visceral pleura; net is a 2 rib difference between visceral and parietal pleura within the costodiaphragmatic recess with lungs at rest
81
at rest
diaphragm drops on contraction, lowering the "closed angle" between costal and diaphragmatic parietal pleura inside the costodiaphragmatic recess; lung and its covering of visceral pleura rush into this space; result is the 2 rib difference now diminishes
82
pneumothroax
presence of air in the pleural cavity; it is commonly caused by a bullet wound to the chest; the bullet punctures the thoracic wall and parietal pleura, admitting air into the pleural cavity; the lung and visceral pleura may also be penetrated, admitting air into the pleural cavity. as a result, surface tension between parietal and visceral pleura is lost and the lung collapses; treatmentis insertion of a chest tube
83
tube thoracotomy
a skin incision is made in an intercostal space parallel to the rib; tube is inserted upward over the upper border of the rib above (avoids the intercostal VAN running along the costal groove), through the intercostal space, and into the pleural cavity; tube is advanced upward in the pleural cavity and air is evacuated to re-inflate the lung

gross anatomy unit 2 (8 decks)

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