Thoracic wall Flashcards
list the types of vertebrae within the vertebral column:
- cervical
- thoracic
- lumbar
- sacral
- coccygeal
list how many vertebrae within each vertebral type:
- cervical C1-7
- thoracic T1-12
- lumbar L1-5
- sacral S1-5 (fused)
- coccygeal (3-4 fused)
typical features of thoracic vertebrae:
- costal facets on transverse process
- demi facets for rib articulation
atypical thoracic vertebrae/ features:
- T1 (superior costal facet for head of rib 1)
- T10 (single complete costal facet for head of rib 10)
- T11 (no costal facet on transverse process)
how many ribs and classify:
- 12 pairs
- R1-7 true
- R8-10 false
- R11-12 floating
atypical ribs:
R1-2, 10-12
typical ribs:
R3-9
typical ribs: features
- head w 2 articular demifacets
- neck
- tubercle w articular facet
- shaft w costal groove
atypical ribs: R1
- flat, short, broad
- head w singular articular facet
superior surface:
- scalene tubercle
- grooves for subclavian vein (ant) and artery (post)
atypical ribs: R2
flat but longer than R1
atypical ribs: R10
head only 1 articular facet
atypical ribs: R11/12
- head only 1 articular facet
- no tubercle or neck
costal cartilages; general features
- first 7 articulate directly w sternum
- 8-10th cartilage articular w cartilage superior
sternum: name parts
- manubrium
- body
- xiphoid process
sternal angle: importance
- separates superior/ inferior mediastinum
sternal angle: features
- beginning/ end of arch of aorta
- bifurcation of trachea
- entrance of superior vena cava to heart
- superior limit of pulmonary trunk
superior thoracic aperture: bones
- 1st thoracic vertebrae
- 1st pair of ribs
- manubrium
superior thoracic aperture: contents (8)
- oesophagus
- trachea
- common carotid arteries
- internal jugular veins
- vagus nn
- phrenic nn
- brachial plexus (roots)
- apices of lungs
superior thoracic aperture: subclavian v
btw ant scalene m and costoclavicular lig
superior thoracic aperture: subclavian aa and brachial plexus
btw ant scalene and middle scalene
eg. cervical ribs
- extra floating ribs found in neck
- 1% of population
- may compress neurovascular bundle
eg. thoracic outlet syndrome
- compression of structures within superior thoracic aperture (inlet)
- neurogenic
- arterial
- venous
list (5) anterior articulations in thorax
- manubriosternal joint
- xiphisternal joint
- sternocostal joints
- costochondral joints
- interchondral joints
classify joint: manubriosternal j
symphysis
classify joint: xiphisternal j
symphysis
classify joint: sternocostal j
- 1st: fibrocartilaginous
- 2-7th: synovial, planar
classify joint: costochondral j
synchondroses
classify joint: interchondral
synovial, planar
list posterior articulations:
- intervertebral discs
- zygapophyseal joints (btw sup/inf articular facets)
classify joint: intervertebral discs
symphyses
classify joint: zygapophyseal j
synovial, planar
costovertebral j: consists of
- head of rib (crest)
- superior/ inferior demifacets of 2 vertebra
- intervertebral disc in btw
costotransverse j: consists of
- transverse process of matching vertebra
- tubercle of rib
list costovertebral ligaments:
- superior costotransverse lig
- joint capsule (intra-articular lig within)
- costotransverse lig
- lateral costotransverse lig
thoracic wall movements:
anterior sternum:
- upwards and out
lateral side ribs:
- bucket handle
- flares outwards
list general: extrinsic thoracic wall muscles and meaning
- originate from elsewhere but attaches in thoracic wall
- neck mm
- anterolateral chest mm
- back mm
- anterolateral abdominal mm
list general: intrinsic thoracic wall muscles and meaning
- originate and attach within thoracic wall
- intercostals
- subcostales
- transverse thoracic mm
extrinsic thoracic wall muscles: list neck mm
- middle scalene
- anterior scalene
- post scalene
- sternocleidomastoid
extrinsic thoracic wall muscles: list anterolateral mm
- pec major
- pec minor
- subclavius
- serratus ant
extrinsic thoracic wall muscles: posterior mm
- serratus post inf
- serratus post sup
extrinsic thoracic wall muscles: abdominal mm
- ext oblique
- internal oblique
- transversus abdominis
- rectus abdominis
extrinsic thoracic wall muscles: list intercostal mm
- ext intercostals
- internal intercostals
- innermost intercostals
intrinsic thoracic wall muscles: subcostales features
- span multiple ribs
- more in lower post thoracic wall
intrinsic thoracic wall muscles: transverse thoracic mm origin
- xiphoid process and lower body of sternum
intrinsic thoracic wall muscles: transverse thoracic mm insertion
- costal cartilage R3-6
diaphragm: costal part
- internal surface of inf 6 ribs and costal cartilages
diaphragm: sternal part
- post aspect of xiphoid process
diaphragm: lumbar part
- median arcuate lig (most central, left/ right crus)
- medial arcuate lig
- lateral arcuate lig
diaphragm: list 4 openings
- caval opening
- oesophageal hiatus
- aortic hiatus
- lesser apertures in crura
diaphragm contents: caval opening
- inf vena cava
- right phrenic nn
diaphragm contents: oesophageal hiatus
- oesophagus
- left vagus nn
diaphragm contents: aortic hiatus
- abdominal aorta
- thoracic duct
- azygos vein
diaphragm contents: lesser apertures of crura
- greater/ lesser splanchnic nn
diaphragm: blood supply
- periocardiophrenic aa
- sup/ inf phrenic aa
diaphragm: innervation
motor:
- phrenic nn
sensory:
- phrenic nn (centrally)
- lower intercostal and subcostal nn (peripherally)
inhalation: accessory mm involved
- sternocleidomastoid (SCM)
- middle scalene
- ant scalene
- post scalene
inhalation: accessory mm function- SCM
elevate sternum
inhalation: accessory mm function- scalenes
elevate and fix upper ribs
inhalation: principal mm involved
- ext intercostals
- int intercostals (interchondral part)
- diaphragm
inhalation: principal mm function- ext intercostals
- elevate ribs
- increase width of thoracic cavity
inhalation: principal mm function- interchondral part of int intercostals
elevate ribs
inhalation: principal mm function- diaphragm
- domes descend
- increasing longitudinal dimension of thoracic cavity
- helps elevate lower ribs
exhalation: quiet breathing
expiration from passive recoil of lungs and rib cage
exhalation: active breathing mm involved
- internal intercostals (except interchondral part)
- rectus abdominis
- ext oblique
- int oblique
- transversus abdominis
exhalation: function- internal intercostals
- lower ribs decreasing width of thoracic cavity
exhalation: function- abdominals
- depress lower ribs
- compress ab contents -> pushing up diaphragm
