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Biomedical Human Anatomy > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

Lines used based on surface anatomy of the thorax

A
  1. Anterior Median line
  2. Midclavicular line
  3. Anterior Axillary line
  4. Midaxillary line
  5. Posterior axillary line
  6. Posterior median line
  7. Scapular lines
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2
Q

Anterior medial line

A
  • midsternal

- median plane meets anterior thoracic wall

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3
Q

Midclavicular line

A

-midway through clavicle, parallel to AML

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4
Q

Anterior axillary line

A

-inferolateral margin of pectoralis major m. with upper limb raised

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5
Q

Midaxillary line

A

-vertical line from deepest portion of axilla, parallel to AAL

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6
Q

Posterior axillary line

A

-inferolateral margin of teres major and latissimus dorsi m. with upper limb raised, parallel to AAL and MAL

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7
Q

Posterior medial line

A

-vertical line along the spinous processes of the spine

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8
Q

Scapular lines

A

-vertical lines through the midline of the scapula

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9
Q

Pectoralis major m.

A
  • Innervation: lateral and medial pectoral nerves (C5-C8,T1)

- Action: arm flexion (clavicular head), rotates arm medially, adducts arm

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10
Q

Pectoralis minor m.

A
  • Innervation: medial pectoral nerves (C8, T1)

- Action: stabilize scapula

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11
Q

Serratus anterior m.

A
  • Innervation: long thoracic nerve (C5-7)

- Action: protract scapula, laterally rotate scapula

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12
Q

Serratus posterior superior m.

A
  • Innervation: 2-5th intercostal nerves

- Action: proprioception (rib elevation – in forced inspiration)

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13
Q

Serratus posterior inferior m.

A
  • Innervation: Anterior rami T9-12 thoracic spinal nerves

- Action: proprioception (rib depression – in forced experation)

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14
Q

External intercostals m.

A
  • Innervation: intercostal nerves

- Action: elevate ribs in forced inspiration

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15
Q

Internal intercostals m.

A
  • Innervation: intercostal nerves

- Action: between ribs - depress ribs; between cartilage - elevate ribs; active in forced respiration

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16
Q

Innermost intercostals m.

A
  • Innervation: intercostal nerves

- Action: between ribs - depress ribs; between cartilage - elevate ribs; active in forced respiration

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17
Q

Subcostal m.

A
  • Innervation: intercostal nerves

- Action: maybe similar to internal intercostals

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18
Q

Transversus thoracis m.

A
  • Innervation: intercostal nerves

- Action: depress ribs (kinda); proprioception

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19
Q

Diaphragm m.

A
  • Innervation: phrenic nerve (C3-5)

- Action: inspiration (flattens when contracted)

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20
Q

Diaphragmatic aperatures

A
  1. Caval opening= inferior vena cava
  2. Esophageal hiatus= esophagus
  3. Aortic hiatus= aorta
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21
Q

Innervation of thoracic wall

A
  • 12 pairs of thoracic spinal nerves

- ventral and dorsal rami

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22
Q

Ventral rami innervation of thoracic wall

A
  • T1-T11= intercostal nerves

- T12= subcostal nerve

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23
Q

Dorsal rami innervation of thoracic wall

A

-deep back muscles, skin, joints in thoracic region

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24
Q

Medial intercostal nerves

A

-between parietal pleura and the intercostal membrane

25
Q

Lateral intercostal nerves

A
  • after angle of rib
  • between internal intercostal and innermost intercostal m.
  • in/below costal groove
26
Q

Vessel and nerve postion in costal groove

A
  • Superior= vein
  • Middle= artery
  • Inferior= nerve
27
Q

5 branches of intercostal nerves

A
  1. Rami communicantes
  2. Collateral branch
  3. Lateral cutaneous branches
  4. Anterior cutaneous branches
  5. Muscular
28
Q

Rami communicantes

A
  • to sympathetic trunk via white ramus

- from symp. trunk via gray ramus

29
Q

Collateral branch

A
  • arise near angle of rib
  • to intercostal muscles and parietal pleura
  • superior margin of inferior rib
30
Q

Lateral cutaneous branches

A

-pierce intercostal m. to innervate the skin of the lateral thorax and abdomen at MAL

31
Q

Anterior cutaneous branches

A
  • parasternal
  • pierce intercostal m. to innervate the anterior thorax and abdomen
  • medial and lateral branches
32
Q

Muscular branches

A

-to the muscles

33
Q

3 arterial sources of the thoracic wall

A
  1. Thoracic aorta
  2. Subclavian a.
  3. Axillary a.
34
Q

Thoracic aorta branches

A
  • posterior intercostal a. (T3-T11)

- Subcostal a. (T12)

35
Q

Subclavian artery branches

A
  • internal thoracic a.

- costocervical trunk

36
Q

Internal thoracic a. branchrs

A

-anterior intercostal a.

37
Q

Costocervical trunk branches

A

-supreme intercostal a.–> posterior intercostal a. for T1 and T2

38
Q

Axillary artery branch

A
  • superior thoracic a. (1st branch)

- lateral thoracic a. (2nd branch of 2nd branch)

39
Q

Posterior intercostal a.

A
  • Right side must cross over vertebral bodies (aorta on left side of thorax)
  • anastomoses with the anterior intercostal a.
40
Q

Posterior intercostal a. supplies what:

A
  • intercostal muscles
  • skin
  • parietal pleura
41
Q

Dorsal branch of posterior intercostal a.

A
  • follows posterior rami to back

- Supplies: spinal cord, vertebral column, back muscles, skin

42
Q

Collateral branch of posterior intercostal a.

A

-to the superior margin of the inferior rib

43
Q

Internal thoracic artery

A
  • originated from the inferior side of the subclavian artery
  • behind the clavicle and 1st costal cartilage
  • phrenic nerve crossed behind it near its origin
  • internal surface of the thorax internal to transversus thoracis m.
44
Q

Internal thoracic artery supplies what:

A
  • intercostal muscles
  • skin
  • breast
  • pectoral muscle
45
Q

Anterior intercostal artery

A
  • T1-T6

- anastomoses with the posterior intercostal artery

46
Q

Internal thoracic artery splits into:

A
  • musculophrenic artery (T7-9)
  • anterior intercostal artery
  • superior epigastric artery
47
Q

Venous drainage of the htoracic wall

A
  • 11 posterior intercostal veins and 1 subcostal vein
  • anastomose with anterior intercostal vein (internal thoracic vein tributary)
  • no valves
  • T1-T4 veins are atypical
48
Q

Posterior intercostals end at either:

A
  • right side: azygos v.–> superior vena cava
  • left side: left superior intercostal vein–> left brachiocephalic vein; hemiazygos v./accessory hemiazygos v.–> azygos v.
49
Q

Breast location

A

-one top of pectoral fascia (2/3) and serratus anterior fascia (1/3)

50
Q

Retromammary space

A
  • potential space behind breast: loos CT

- allows movement on top of fascias

51
Q

(Cooper’s) Suspensory Ligaments

A

-anchor breast dermis to the deep fascia, separating lobules

52
Q

Innervation of the breast

A

-anterior and lateral cutaneous branches of intercostal n. (T4-6)

53
Q

Breast Arterial Supply

A
  • internal thoracic a.–> medial mammary and perforating a.
  • axillary a.–> lateral thoracic and thoracoacromial a.
  • posterior intercostal a. (T2-4)–> lateral cutaneous a.
54
Q

Venous drainage of breast

A
  • axillary vein–> main drain

- internal thoracic vein

55
Q

Lymphatic drainage of the breast

A

-subareolar lymphatic plexus

56
Q

Subareolar lymphatic plexus lymph nodes

A
  • axillary lymph nodes (ipsilateral; pectoral–>central–>apical)
  • infra- and supraclavicular lymph nodes
  • parasternal lymph nodes (ipsi- and contralateral)
  • inferior phrenic lymph noes
57
Q

Thoracotomy

A
  • posterior preferred–> 5th-7th intercostal space

- remove periosteum prior to cutting: add periosteum back to promote bone growth

58
Q

Chest paina

A
  • titanium plates for broken ribs
  • requires thoracotomy
  • 1 day hospital stay
  • not for all patients: if having problems with pain control, cannot breathe deeply or cough

Biomedical Human Anatomy (28 decks)

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