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SF3- Exam 1 > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

What are the component of the thoracic wall?

A

Skin

Bone

Fascia

Muscles

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2
Q

What are the boundaries of the thoracic wall?

A

Superior:

  • vertebra T1, rib 1, manubrium

Inferior

  • vertebra T12, rib 12, costal margin, xiphoid process

Transversely

  • thoracic cage
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3
Q

What are the borders of the thoracic cavity?

A

Superior border of the liver

Inferior borders of the lungs

Inferior border of pleura

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4
Q

A stab wound below rib _ can pierce the abdominal cavity.

A

5

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5
Q

Stab wound in the ______ can pierce the lungs.

A

neck

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6
Q

Label

A
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7
Q

What are the functions of the thoracic wall?

A
  • Protects internal air and fluid-filled organs
  • Provide rigid exterior wall to prevent collapse of elastic lungs
  • Provides for lung expansion
  • Privides attachment and support to upper limbs
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8
Q

What are the reference lines of the thoracic wall?

A
  • Jugular (suprasternal) notch
  • Sternal angle
  • Anterior median (midsternal) line
  • Midclavicular lines
  • Axillary fossa
  • Anterior axillary line
  • Midaxillary line
  • Posterior axillary line
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9
Q

What are the surface landmarks of the thoracic wall?

A

Jugular notch

Clavicle

Anterior axillary fold

Manubrium

Sternal angle and manubriosternal joint

Body of sternum

Xiphisternal joint

Infrasternal (subcostal) angle

Costal margin

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10
Q

What is the significance of the sternal angle?

A
  • used to ascertain the position of rib 2
  • Marks plane through T4-5 intervertebral disc
  • Marks the superior edge of the heart
  • Marks the bifurcation of the trachea
  • Marks the level of azygos arch
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11
Q

What is the signiicance of the orientation of the ribs?

A

Downward slope of ribs is critical to function

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12
Q

Label

A
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13
Q

Label

A
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14
Q

Which part of the rib articulates with the vetebrae above?

A

Articular facet

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15
Q

Which part of the rib articulates with the numerically corresponding vertebrae?

A

Tubercle

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16
Q

Which part of the rib is for the intercostal vein, artery, and nerve?

A

Costal groove

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17
Q

Which ribs are considered “atypical”?

A

1,2, 11, and 12

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18
Q

Which muscles articulates with the first rib?

A

Levator costae

Scalenus medius

Serratus anterior

Scalenus anterior

Subclavius

*NOTE: The costaclavicular ligament also articulates with the 1st rib

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19
Q

Label

A

1st rib

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20
Q

Which ribs are considered true ribs?

A

Ribs 1-7

*True ribs are ribs that are attached directly to the sternum by costal cartilage

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21
Q

Which ribs are considered false ribs?

A

Ribs 7-12

*False ribs do not attach to the sternum directly but are attached to the 7th rib by cartilage

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22
Q

Which ribs are considered floating ribs?

A

Ribs 11-12

*Floating ribs are important or anchoring of rib cage by abdominal muscles.

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23
Q

Vertebrae, sternum and ribs contain ____________ marrow; a source of blood cells.

A

red

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24
Q

The thoracic vertebrae have two different articulations: intervertebral and costal. What does each articulation allow for?

A

Intervertebral: slight rotation of the trunk

Costal (costal facts of transverse processes): Elevation of ribs

*The discs found in between each vertebrae allows for weight bearing

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25
Demi facets are found on __________ of the thoracic vertebrae.
Body
26
Rib has same number as the _________ (superior/inferior) vertebra and its transverse process.
Inferior
27
As ribs rotate and elevate along ___________ joint, thorax expands both laterally and anteriorly.
**costovertebral**
28
Label
Sternum
29
Label
30
List the 4 sternal joints
•**Sternocostal**: * rib 1 (fibrocartilaginous) * ribs 2-7 (synovial) * **Interchondral**: synovial * **Manubriosternal**: symphysis * **Xiphisternal**: symphysis **NOTE: Symphsis and costal cartilage _ossify_ with age**
31
If multiple rib fractures produce an isolated segment, get \_\_\_\_\_\_\_\_\_\_\_\_\_: paradoxical movement produces pain and impairs breathing.
flail chest
32
Rib dislocation
an injury where one or more of the ribs are moved from their normal location in the chest cavity
33
Where do rib separations occur?
At the costochondral joint
34
Where do rib fractures usually occur?
Just anterior to the angle
35
Label
36
Label
37
Label
38
The internacostal vein, artery and nerve run between which two muscles?
Internal intercostal Innermost intercostal **NOTE:** These muscles are numbered by the superior rib
39
Label
40
Label
41
What are the attachment point for transversus thoracis?
The inferior attachment of the transversus thoracis muscle is on the **sternum** and its superior attachments are on **costal cartilages 2 to 6.**
42
What is the function of transversus thoracis?
The transversus thoracis muscle **depresses the ribs.**
43
Label
Proprioceptive muscles
44
What are the major muscles of inspiration and expiration respectively?
**Inspiration:** Diaphragm **Expiration:** Abdominal wall muscle
45
What is the major function of intercostal muscles?
Stiffen wall to resist elastic forces
46
What actions are involved in quiet inspiration?
1. Diaphragm contracts 2. External intercostal muscles pull rib up and out
47
What actions are involved in forced inspiration?
1. Sternocleiodomastoid elevates sternum 2. Pectoralis minor elevates rib 3. Diaphragm contracts more (than in quiet inspiration)
48
What actions are involved in quiet expiration?
Abdominal organs recoil and press diaphragm upward
49
What actions are involved in forced expiration?
1. Posterior internal intercostal muscles pull ribs down and inward 2. Abdominal organs force diaphragm higher 3. Abdominal wall muscles contract and compress abdominal organs
50
What are the accessory respiratory muscles?
Trapezius Scalenus Sternocleidomastoid \*People with **dyspnea** (asthma, emphysema, heart failure, etc.) fix the pectoral girdle and use accessory respiratory muscles
51
Where does the intercostal nerve arise from?
Anterior rami of the spinal nerves of T1 to T11
52
Intercostal nerves arise from the ___ nervous system.
Somatic
53
Posterior ramus of the intercostal nerve supplies what?
Skin of back
54
The intercostal enrves primarily supply which structures?
Motor to intercostal muscles Sensory to overlying skin and parietal pleura
55
Which intercostal nerves are considered atypical? Which are considered typical?
**Atypical:** 1,2, and 7-11 **Typical:** 3-6
56
Which branch of the first intercostal nerve joins the brachial plexus?
The superior part
57
What are the branches of the second intercostal nerve? What are it's functions?
**Intercostobrachial nerve** (lateral cutaneous branch) **Functions:** Supplies skin of axilla and communicates with medial cutaneous nerve
58
The seventh to eleventh intercostal nerve cross costal margin and become the ______________ nerves of the anterior abdominal wall.
Thoracoabdominal
59
What is the course of the intercostobrachial nerve?
1. **T2** exits anterior armpit 2. Courses over to humerus as it goes thru axilla under **pectoralis muscles** 3. Splits into **intercostobrachial nerve** branches near bottom-most crease of axilla.
60
Label
61
Thoracentesis
an invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes
62
Where should a thoracocentesis be performed?
**midaxillary line**, in the eighth, ninth, or tenth intercostal space
63
What arteries supply the thoracic wall?
1. Costocervical trunk * **​Superior intercostal aa.** * **​Posterior intercostal aa.** (1st and 2nd) 2. **internal thoracic aa.** * **Anterior intercostal aa.** **​**3. Aorta * **Posterior intercostal aa.** (3-11)
64
Why does shingles affect a single dermatome?
Shingles is a herpes zoster infection of a **spinal ganlion** that is **transported along axons,** so it affects a single dermatome.
65
Why are the right posterior intercostal arterieslonger than the left ones?
Becuase they cross over the vertebral bodies
66
Thoracic aorta runs along the _______ (left/right) side of the vertebral bodies.
Left
67
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ arteries run along the posterior and anterior roots of the spinal nerves and supply them with blood.
**Radicular** **\***Radicular arteries are branches of posterior intercostal arteries. A blood clot here could result in infarction of the spinal cord
68
The ___________ artery supplies the first and second intercostal spaces.
Superior intercostal
69
Label
70
What is the clinical signifance of the internal thoracic artery?
* used for by-pass * Important to avoid during pericardiocentesis
71
The internal thoracic artery birfurcates into which two arteries?
Superior epigastric artery Musculophrenic artery
72
Label
73
There are 9 anterior intercostal arteries. From where does each artery arise?
**Internal thoracic artery:** 1-6 **Musculophrenic artery:** 7-9 **NOTE:** The anterior intercostal artteries are absent from the 10th and 11th intercostal spaces
74
Label
75
The medial mammary branches are branches of the ___________ artery, while the lateral mammary branches are branches of the ___________ artery.
Internal thoracic; lateral thoracic
76
Where do intercostal veins drain?
**Internal thoracic veins** * Then drain in to **brachiocephalic vein** **​Azygos veins** * Then drain into the superior vena cava
77
What is the clinical significance of the azygos vein?
It is an alternate route back to the heart when IVC or SVC are blocked
78
The _________ vein provides alternate circulation when there is liver disease.
Thoracoepigastric vein
79
The ventromedial portion of somites develop into __________ and \_\_\_\_\_.
Vertebrae and ribs \*This is the **sclerotome**
80
The dorsolateral portion of somites develop into \_\_\_\_\_\_\_\_\_- and \_\_\_\_\_\_\_\_\_\_\_.
**Dermatome** (skin and subcutanenous) **Myotome (**muscles)
81
How is the sternum formed?
1. Sternal bars form from somatic mesoderm in the ventral body wall 2. Sternebrae fuse at puberty
82
Sternebrae are supposed to fuse at puberty. What happens if this does not occur?
Failure to fuse results in bifid or perforated sternum

SF3- Exam 1 (26 decks)

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