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Anatomy 3001 > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

What are the basic functions of the thorax (6)

A
  • Protection
  • Rigidity and elasticity
  • Provides attachement for certain muscles required for upper limb movement
  • Haematopoiesis
  • Resists negative intra-thoracic pressure (works in partnership with diaphragm and abdominal muscles)
  • Connections with the neck, upper limbs and abdomen.
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2
Q

What is the shape of the thorax?

A

The shape of a truncated cone

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3
Q

What makes up the components of the rib cage?

A
  • Sternum
  • 12 pairs of ribs (plus their costal cartilages)
  • 12 thoracic vertebrae (plus their intervertebral discs)
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4
Q

What makes up the components of the thoracic wall?

A
  • Thoracic cage
  • Skin
  • Subcutaneous tissue
  • Thoracic muscles + fascia
  • 3 layers of muscles extending between ribs (intercostal space)
  • Mammary gland/breast tissue
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5
Q

What are the three classifications for ribs?

A
  • True ribs (1-7)
  • False ribs (8-10)
  • Floating ribs (11-12)
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6
Q

Where is the costal groove located?

A

On the inner surface and close to the inferior border for the intercostal nerves

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7
Q

What lies in the grooves of the first rib?

A

(anterior to posterior)

  • Groove for subclavian vein
  • Scalene tubercle (attachment for anterior scalene muscle)
  • Groove for subclavian artery and the inferior trunk of the brachial plexus
  • There is no costal groove
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8
Q

What muscle attaches to the tuberosity on the 2nd rib?

A

Serratus anterior

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9
Q

Where can bone marrow aspiration be done in the thorax?

A

The sternum

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10
Q

What level is the solar plexus region at?

A

T6

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11
Q

Which ribs do not articulate with the superior costal facet of its corresponding vertebra and the inferior costal facet of the vertebra above?

A

ribs 1, 11 and 12

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12
Q

What type of joint is the costovertebral joint?

A

Synovial, supported by a capsule with ligaments

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13
Q

What articulates on the costotransverse joint?

A

The tubercle of the rib (except 11 and 12) and the transverse process of the corresponding vertebra.

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14
Q

How are the facets shaped on the 1st to the 7th costotransverse joints?

A

They are curved to allow for rotatory movements

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15
Q

How are the facets shaped on the 8, 9 and 10th costotransverse joints?

A

They have flat facets which allow for gliding movements

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16
Q

What kind of joint is the costochondral/costosternal joint?

A

A primary cartilaginous joint

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17
Q

How far does the apex of the lung extend above the anterior part of the 1st rib and clavicle?

A

2-3 cm

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18
Q

What is the thoracic inlet bound by?

A

The T1 vertebra, 1st rib, costal cartilage and manubrium.

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19
Q

What structures pass between the thorax and neck?

A
  • Vessels that supply and drain the head and neck
  • Trachea
  • Oesophagus
  • Vagus and recurrent laryngeal nerves
  • Phrenic nerves
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20
Q

What structures pass between the thorax and the upper limb? (lie on 1st rib)

A
  • Subclavian artery
  • Subclavian vein
  • Inferior trunk of the brachial plexus
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21
Q

What is the thoracic outlet (inferior thoracic aperture) bounded by?

A
  • T12 vertebra
  • 11th and 12th ribs
  • Costal cartilages of ribs 7-10 (costal margin/arch)
  • Xiphoid process
  • Closed incompletely by the diaphragm
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22
Q

What is Thoracic Outlet Syndrome?

A
  • Subclavian artery, subclavian vein or nerves of the brachial plexus become compressed by either the clavicle, scalene triangle or between coracoid process and pec minor.
  • Occurs at thoracic inlet
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23
Q

What are montgomery tubercles?

A

Visible portions of areolar glands on the skin surface, within the areola

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24
Q

What are sebaceous glands?

A

Microscopic exocrine glands in the skin that secrete an oily or waxy mixture called sebum, to lubricate and waterproof the skin.

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25
What are areolar (Montgomery) glands?
Sebaceous glands
26
Where are the breasts located in adult females?
- Between the levels of the 2nd - 6th rib - From the lateral border of the sternum to the mid-axillary line - The upper lateral section may extend towards the axilla - Found between the superficial and deep layers of superficial fascia.
27
What is the name given to connective tissue which condenses to form ligaments in the breasts?
Suspensory (Cooper's) ligaments
28
What is the purpose of the suspensory (Cooper's) ligaments in the breasts?
- Connect deep fascia to the dermis of the skin | - Support the breast
29
What is the retromammary space?
A layer of loose connective tissue between the deep layer of superficial fascia and the deep fascia. Provides some degree of movement over underlying structures
30
What arteries supply the breasts?
- Mammary branches from the internal thoracic artery - anterior intercostal arteries from the internal thoracic artery - Lateral thoracic and thoraco-acromial branches of axillary artery
31
What veins drain the breasts?
Veins follow the arteries and drain mainly to axillary and internal thoracic veins
32
How is the breast divided?
Into 5 areas - areola nipple complex (nac) - Upper medial - Lower medial - Upper lateral - Lower lateral
33
What lymph nodes do the nac and lateral quadrants of the breast drain into?
Axillary lymph nodes
34
What lymph nodes do the upper and lower medial quadrants of the breast drain into
Parasternal lymph nodes, they may cross the mid line and metastisise on the other side.
35
What lymph nodes can inferior quadrants occasionally drain into?
Inferior phrenic lymph nodes
36
What is the function of the external intercostal muscles?
They raise the ribs and prevent indrawing during insiparion
37
What is the function of the internal intercostal muscles?
They prevent indrawing during inspiration and aid elastic recoil by moving ribs inferiorly in expiration
38
What are the muscle fibres of the internal intercostal muscles replaced by posteriorly?
The internal intercostal membrane
39
What are the muscle fibres of the external intercostal muscles replaced by anteriorly?
The external intercostal membrane.
40
What is the function of the innermost intercostal muscles?
They act with the internal intercostal muscles but there function is almost negligable. They cover the intercostal neurovascular bundle.
41
Where are the innermost intercostal muscles located
Posterior to the intercostal nerves and vessles.
42
Where is the transversus thoracis muscle located?
- Posterior to the sternum | - Internal aspect of ribs and costal cartilages 3 to 6, to sternum, xiphisternum and costal margin.
43
Where is the subcostalis muscle located and what is its function?
- It lies on the posterior wall. | - It lowers the ribs, internal surface, near angle down to inner surface of 2 to 3 ribs below.
44
How do the intercostal vessels and nerves arrange themsleves?
Superiorly the vein then artery then the intercostal nerve lies inferiorly at the bottom
45
What is the intervertebral foramen?
The space between the pedicle, articular process, vertebral body and IV disc.
46
What can cause spinal (intercostal) nerve compression?
Arthritis, fracture and disc prolapse
47
What do the anterior rami of the thoracic spinal nerves become?
Intercostal nerves
48
What thoracic nerves form plexuses?
T1 and the lateral cutaneous branch of T2
49
What thoracic nerve is reffered to as subcostal?
T12
50
What branches off the intercostal nerve before it travels in the costal groove?
The lateral cutaneous branch
51
What do the intercostal nerves supply?
The intercostal muscles and the skin (plus parietal pleura)
52
What does the intercostal nerve become parasternally?
Anterior cutaneous branch
53
What cervical nerves descend over the clavicle as far as the 2nd rib?
C3 and C4
54
What is the large lateral cutaneous branch of T2 called?
The intercostobrachial nerve
55
What does the intercostobrachial nerve supply?
The thorax wall in axilla and the upper and medial part of the upper limb
56
What thoracic nerves supply the skin and muscles of the abdominal wall?
T7(8)- T12
57
What nerve is at risk during breast surgery?
Intercostobrachial nerve
58
What arteries supply the thoracic wall?
Mostly aorta and branches from it. Subclavian artery. Branches of the subclavian artery; vertebral artery (supplies CNS), thyrocervical trunk, costocervical trunk and the internal thoracic artery.
59
Describe the pathway of the internal thoracic artery?
- It arises from the subclavian artery - It is a paired artery with one running along each side of the sternum. - It runs deep to the external oblique but superficial to the vagus nerve - After passing the 6th intercostal space it becomes the musculophrenic and the superior epigastric artery.
60
What are the names of the parietal branches of the thoracic aorta?
- 3rd -11th posterior intercostal artery + subcostal artery | - Superior phrenic artery
61
What intercostal arteries arise from the descending aorta?
3rd - 11th posterior intercostal arteries
62
What does the supreme intercostal artery give off?
The 1st and 2nd posterior intercostal artery
63
How many anterior intercostal arteries are there?
10
64
What intercostal arteries are branches of the musculophrenic artery?
7 - 10th anterior intercostal artery
65
What do the anterior intercostal veins drain into?
The internal thoracic vein then the brachicephalic vein
66
What do the posterior intercostal veins drain into?
Either the brachiocephalic vein or the SVC via the azygos system
67
What posterior intercostal vein(s) do not drain via the azygos?
The 1st right posterior intercostal vein and the 1-4 left intercostal vein.
68
What does the azygos system drain?
The posterior wall of the thorax and part of the posterior abdominal wall
69
Where does the hemiazygos vein cross to the right side
T9 (joins azygos)
70
Is the accessory hemiazygos vein superior or inferior to the hemiazygos vein?
Superior
71
Where does the accessory hemiazygos vein descend from?
The 4th intercostal space
72
What ribs are most commonly fractured?
Ribs 3 - 10
73
What lymph nodes drain the thoracic wall anteriorly?
- Parasternal nodes | - Bronchomediastinal trunks
74
What lymph nodes drain the thoracic wall posteriorly
- Intercostal nodes | - Thoracic duct (inferiorly) or the bronchomediastinal trunks superiorly)

Anatomy 3001 (14 decks)

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