Thoracic Wall Flashcards
which ribs are true ribs?
1-7
what determines a true rib?
attaches directly to sternum via costal cartilage
which ribs are false indirectly attached ribs?
8-10
which ribs are false floating ribs?
11-12
ribs are what type of bone?
curved flat bones
heads of ribs 2-9 articulation
Sup facet: vertebral body above Inf facet: vertebral body below Crest - projection between articular facets
what is found in the costal groove?
intercostal blood vessels, nerve, and muscles
what part of the rib forms the costochondral joint?
cup for the costal cartilage
T2-T9 articulate with ribs where?
bilaterally demifacets on sup/inf surfaces
plane of articular processes allows T vert to do what?
rotate and ab-/adduct but not FL/EX
joint type for manubrium and 1st rib
synchondrosis
Costovertebral joint type
articulations are planar but overall joint is condyloid
Costovertebral joint, # of articulations
typically 3 (ribs 2-9)
Costovertebral joint ligaments
1). strong capsule 2). intra-articular ligament 3). radiate ligament
collective movements at the Costovertebral joints?
pump/bucket handle – each articulation rotates a little which collectively elevates/depresses the sternum
how many articulations does a costotransverse joint have?
1 articulation per rib
where does the costotransverse joint articulate?
transverse process of the inferior vertebrae
Costotransverse joint type
planar
ribs 1-6 costotransverse joints
slightly convex (rib) with concave (transverse process) – allow rotation = pump handle
ribs 7-10 costrotransverse joints
flat planar - allow gliding = bucket handle
Costotransverse joint ligaments
weak capsule, lateral and superior costotransverse ligaments
Sternocostal joints
1). rib 1 - synchondrosis 2). ribs 2-10 have costochondral and sternochondral joints
costochondral joint type
synchondrosis (rib to cartilage)
sternochondral joint type
synovial planer (cartilage to sternum)
sternochondral joint rib 1
syncondrosis
sternochondral joint ribs 2-10
synovial planar/gliding
superior aperture borders
1). post - T1 body 2). lat - rib 1 3). ant - manubrium
superior aperture contents
esophagus, trachea, nerves (vagus, sympathetic trunk, cervical plexus), blood vessels (carotids, subclavian, vertebral, jugular)
inferior aperture borders
1). post - T12 body 2). lat post - 11 & 12 ribs 3). lat ant - costal cartilage ribs 7-10 4). ant - xiphosternal joint
what is the inferior aperture covered by?
respiratory diaphragm
inferior aperture contents
esophagus, nerves (vagus, sympathetic chain), blood vessels (inf vena cava, descending aorta), internal thoracic arteries
what are the internal thoracic arteries called as they pass the diaphragm?
superior epigastric arteries
subdivisions of thoracic cavity
R/L Pleural cavity, mediastium
what is in the mediastium?
pericardial cavity, esophagus, trachea, great vessels, nerves
Muscles of the thoracic cavity
1) . Serratus posterior (S/I)
2) . Levator Costarum
3) . External intercostals
4) . Internal intercostals
5) . innermost intercostals
6) . subcostal
7) . transversus thoracis
Serratus posterior superior, origin
S: spinous processes C7-T3
Serratus posterior superior, insertion
ribs 2-4
Serratus posterior superior, innervation
intercostal nerves
Serratus posterior superior, action
proprioception for respiration control
Serratus posterior inferior origin
spinous processes T11-L2
Serratus posterior inferior insertion
ribs 9-12
Serratus posterior inferior, innervation
intercostal nerve
serratus posterior inferior, action
proprioception for respiration control
Levator costarum origin
transverse processes of C7-T11
Levator costarum insertion
rib below
Levator costarum innervation
dorsal rami
Levator costarum action
elevate ribs for inspiration
external intercostals origin
superior rib
external intercostals insertion
inferior rib
external intercostals innervation
intercostal nerve
external intercostals action
elevate adjacent rib for inspiration
internal intercostals origin
inferior rib
internal intercostals insertion
superior rib
internal intercostals innervation
intercostal nerve
internal intercostals action
depress adjacent rib for expiration
innermost intercostals origin
inferior rib
innermost intercostal insertion
superior rib
innermost intercostal innervation
intercostal nerve
innermost intercostal action
depress adjacent rib expiration
subcostal origin
inferior rib
subcostal insertion
superior rib 2 or 3 above
subcostal innervation
intercostal nerve
subcostal action
depress ribs for expiration
transversus thoracis origin
sternum
transversus thoracis insertion
costal cartilage
transversus thoracis innervation
intercostal nerve
transversus thoracis action
proprioception for respiration control
ventral rami T1-11
intercostal nerve
what are the intercostal nerves further divided to?
S/I collateral branches and Lat/Ant cutaneous
ventral rami T12
subcostal nerve
sympathetic chain ganglia
connected to ventral rami by rami communicants; located on either side of vertebral bodies forming thoracic vertebral column
blood supply to Ant and Ant/lat thoracic wall
R/L subclavian arteries -> internal thoracic artery -> ant intercostals arteries -> ant and lat intercostals spaces of ribs 1-10
blood supply to post and post/lat thoracic wall
descending abdominal aorta -> paired post intercostal arteries -> post and post/lat intercostals spaces of ribs 4-11
Anterior intercostal veins
internal thoracic veins -> brachiocephalic vein
posterior intercostals veins
azygos/hemiazygos system -> superior vena cava
lymph flow
blood plasma -> capillary filtration -> ECF -> lymph capillary -> lymph fluid -> lymph vessel -> lymph nodes -> lymph trunk -> lymph duct
2 lymph ducts
Right Lymphatic Duct and Thoracic Duct
what does the Right lymphatic duct drain?
right side of head, arm, and thorax
what does the Thoracic duct drain?
left side head, arm, thorax, and entire abdomen, pelvis, legs
structural components of the mammary gland
1) . glandular tissue
2) . lactiferous ducts/sinus
3) . nipple
4) . areola
5) . fat
6) retro-mammary space
7) . pectoralis fascia
8) . suspensory (Cooper’s) ligaments
anterior arterial blood flow to the mammary glands
anterior intercostal -> medial mammary branches
axillary arterial blood flow to the mammary glands
axillary artery -> lateral thoracic and thoracoacromial -> lateral breast
posterior arterial blood flow to the mammary glands
posterior intercostals artery -> deep structures