Thoracic Wall Flashcards

1
Q

How many pairs of ribs do we have and what do they all articulate with

A

12 and they all articulate with the thoracic vertebrae

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2
Q

What does the thoracic cage contain

A
  1. Ribs and costal cartilage
  2. Sternum
  3. Thoracic vertebrae
  4. Pectoral girdle
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3
Q

What are the boundaries of the superior thoracic aperture

A
  1. Body of T1
  2. 1st pair of ribs and costal cartilages
  3. Superior body of the manubrium
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4
Q

What are the boundaries of the inferior thoracic aperture

A
  1. Body of T12
  2. 11th and 12th pairs of ribs
  3. Costal cartilages of ribs 7-10 (costal margin)
  4. Xiphisternal joint
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5
Q

What vertebra/vertebrae does the head of the 7th rib articulate with

A

T6 and T7

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6
Q

What vertebra/vertebrae does the tubercle of the 7th rib articulate with

A

T7

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7
Q

What are the true ribs and describe their connection to the sternum

A

1-7 and they connect directly via their own costal cartilage

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8
Q

What are the false ribs and describe their connection to the sternum

A

8-10 and they connect indirectly via costal cartilage of the ribs above

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9
Q

What are the floating ribs and describe their connection to the sternum

A

11 and 12 and they have no connection

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10
Q

What are the typical ribs

A

3-9

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11
Q

What are the atypical ribs

A

1, 2, and 10-12

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12
Q

Describe the appearance of a typical rib head

A

Wedge shaped; contains 2 articular facets separated by crest

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13
Q

What does the head of a rib articulate with

A

Body of its own vertebra and of the vertebra above, and with the IV disc via the crest

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14
Q

What does the tubercle of a rib articulate with

A

Transverse process of their own vertebra

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15
Q

What is the costal angle

A

The most curved part of the body of the rib

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16
Q

Where is the costal groove located and what does it provide

A

Inferior and posterior part of the bone; provides protection for neurovascular structures

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17
Q

Describe the common difference in the 1st, 10th, 11th and 12th ribs

A

Contain a single facet as they only articulate with one vertebra each

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18
Q

What is a difference in the 2nd rib

A

Contains a tuberosity for the serratus anterior muscle

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19
Q

Describe the difference in just the 11th and 12th ribs

A

They are short with no neck or tubercle

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20
Q

What are the 3 parts of the sternum

A
  1. Manubrium
  2. Body
  3. Xiphoid process
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21
Q

What are the joints in the sternum

A
  1. Manubriosternal (sternal angle)

2. Xiphisternal

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22
Q

What rib attaches at the sternal angle

A

2nd

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23
Q

What rib attaches at the xiphisternal joint

A

7th

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24
Q

What joint forms between the vertebral bodies and what does it allow

A

A secondary cartilagenous joint; allows bodies to move against one another (IV disc)

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25
Q

What joint forms between the articular facets of the vertebra and what does it allow

A

A synovial plane joint (zygapophysial joint); allows for a lot of lateral rotation

26
Q

Describe the different sternocostal joints

A
  1. Primary cartilagenous joint in rib 1

2. Synovial plane joints in ribs 2-7

27
Q

Describe the different interchondral joints

A
  1. Synovial plane joints between ribs 6&7, 7&8 and 8&9
  2. Fibrous joint between ribs 9&10
28
Q

What are the different respiratory movements in the ribs, and which ribs complete which movement

A
  1. Ribs 1-6 = pump handle movement

2. Ribs 7-12 = bucket handle movement

29
Q

Describe the movement of the upper ribs

A

Happens anteriorly at the distal end of the ribs, anterior to the sternum; ribs move up and out

30
Q

Describe the movement of the lower ribs

A

Occurs more laterally; ribs flare outwards

31
Q

Describe the changes in dimension of structures during respiratory movement

A
  1. Sternum moves anteriorly and superiorly
  2. Lower ribcage moves laterally
  3. Diaphragm descends
32
Q

What are the main thoracic wall muscles involved in respiratory movements

A
  1. Intercostal
  2. Subcostal
  3. Transversus thoracis
33
Q

What are the secondary muscles involved in respiratory movements

A
  1. Scalene

2. Serratus posterior (superior and inferior)

34
Q

What are the superficial muscles involved in respiratory movements

A
  1. Pectoral
  2. Serratus anterior (attachment to the 2nd rib)
  3. External oblique
  4. Rectus abdominis
35
Q

Name the 5 upper limb and anterior abdominal wall muscles

A
  1. Pectoralis major
  2. Pectoralis minor
  3. External oblique
  4. Serratus anterior
  5. Rectus abdominis
36
Q

Describe the attachment of the pectoralis major

A

Very broad attachment along the sternum and the ribs; distal attachment to the humerus

37
Q

Describe the attachment of the pectoralis minor

A

Attaches to some of the ribs and the coracoid process of the scapula

38
Q

Name the 5 posterior thoracic wall muscles

A
  1. Anterior scalene
  2. Middle scalene
  3. Posterior scalene
  4. Serratus posterior superior
  5. Serratus posterior inferior
39
Q

What are the 3 layers of intercostal muscle (starting with the most superficial)

A
  1. External intercostal
  2. Internal intercostal
  3. Innermost intercostal
40
Q

Describe the orientation of the external intercostal muscles and where they attach

A
  1. Fibres pass downwards and forwards

2. Attach to tubercles of ribs to costochondral junction

41
Q

What is the function of the external intercostal muscles

A

They raise the ribs in inspiration

42
Q

Describe the orientation of the internal intercostal muscles and where they attach

A
  1. Fibres pass downwards and backwards

2. Attach from the sternum to the angle of the ribs

43
Q

What is the function of the internal intercostal muscles

A
  1. Interosseous part depresses the ribs

2. Interchondral part raises the ribs

44
Q

Describe the orientation of the innermost intercostal muscles and where they are located

A
  1. Fibres pass downwards and backwards

2. Deep to the lateral part of the internal intercostal muscles

45
Q

Where are the subcostal muscles located and how far do they span

A
  1. Near the angle of the ribs

2. Spans 1 or 2 intercostal spaces

46
Q

Where does the transversus thoracis muscle span

A

Radiates from the sides of the sternum to costal cartilages 2-6

47
Q

Where is the neurovascular plane located between the ribs

A

Between the internal and innermost muscles

48
Q

What is the arrangement of vessels and nerves in the intercostal space

A
Intercostal
1. Vein (superior)
2. Artery
3. Nerve (inferior)
run in the costal groove
49
Q

Where do the posterior intercostal arteries originate from

A

The thoracic aorta; apart from 1 and 2

50
Q

What does the anterior thoracic arteries supply and where does it originate from

A
  1. The anterior region of the thoracic cavity

2. The internal thoracic artery

51
Q

Describe where the first 2 posterior intercostal arteries originate from

A

The supreme intercostal artery; branch of costocervical trunk from the subclavian artery

52
Q

What does the superior epigastric artery supply

A

The anterior abdominal wall

53
Q

Describe the anterior venous drainage system

A

Anterior intercostal veins -> internal thoracic vein -> brachiocephalic vein

54
Q

Describe the posterior venous drainage system

A

Posterior intercostal veins -> azygous venous system -> superior vena cava

55
Q

Where does the breast tissue anchor on the thoracic wall

A

At the connective tissue of the overlapping pectoral muscle

56
Q

What nodes does the majority (75%) of lymph drain to from the breast

A

Axillary lymph nodes

57
Q

Where does less than 25% of lymph drain to from the breast

A

Parasternal nodes and some to the abdominal nodes

58
Q

Describe the venous drainage in the breast

A

Through the medial and lateral mammary veins

59
Q

What vessels originate from the lateral thoracic artery that supply the breast

A

Lateral mammary branches

60
Q

What vessels originate from the internal thoracic artery that supply the breast

A

Medial mammary branches