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Anatomy of thorax > Thoracic wall > Flashcards

Thoracic wall Flashcards

1
Q

Which are true ribs

A

1-7

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2
Q

Which are false ribs

A

8-10

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3
Q

which are floating ribs

A

11+12

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4
Q

What are typical ribs and what do they have

A

3-9

  • Head of rib which has two facets separated by crest of the head
  • Neck of rib
  • Tubercle of rib
  • Body of rib
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5
Q

What does the tubercle of the rib have

A

Smooth articular facet that connects with corresponding transverse process of vertebra (via synovial joint)

Rough non articular facet to the process via the costotransverse ligament

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6
Q

What does the costotransverse ligament connect

A

Non articular part of rib to the spinous process

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7
Q

What is the scalene tubercle

A

Separates the grooves on the 1st rib which is for the subclavian vessels

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8
Q

What mm attach to the second rib

A

Serratus anterior and posterior scalene muscles

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9
Q

which ribs have no necks or ribs

A

11+12

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10
Q

What are joints between costal cartilages called

A

Interchondral joints

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11
Q

What are joints between ribs and costal cartilages called

A

Costochondral

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12
Q

What is a thoracotomy

A

Creating an opening through the thoracic wall to enter the pleural cavity

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13
Q

What is involved in an anterior thoracotomy

A

H shaped cuts through the perichondrium of one or more costal cartilages and then shelling out segments of the costal cartilage to gain access to thoracic cavity

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14
Q

Where are important sites for a posterior thoracotomy

A

postolateral aspects of the 5th to 7th intercostal spaces

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15
Q

How is a posterior thoracotomy performed

A

Patient lying on side and the upper limb is fully abducted, placing the forearm beside the patient’s head (allows higher access by moving scapula)

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16
Q

What are sternal biopsies used to obtain

A

Specimens of bone marrow for transplantation and for detection of metastatic cancer

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17
Q

What is median sternotomy

A

Sternum split in middle and retracted (e.g. for coronary artery bypass grafting)

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18
Q

What is lateral thoracotomy used for

A

Provides wide access to the pulmonary cavity (and is done through intercostal spaces)

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19
Q

What is is minimally invasive thoracic surgery fir

A

Allows access to the thorax through small intercostal incisions for many intrathoracic procedures

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20
Q

What are the symptoms of costoclavicular syndrome

A

Pallor and coldness of skin of upper limb and diminished radial pulse as a result of compression of subclavian artery between clavicle and 1st rib

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21
Q

What is a rib dislocation the dissociation of

A

Dislocation of costal cartilage from sternum

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22
Q

What is a rib separation?

A

Dislocation of costochondral junction between the rib and its costal cartilage

23
Q

What usually happens in the separation of the 3rd-10th ribs and what is the result of this

A

Tearing of the perichondrium and periosteum (rib may move superiorly, overriding the rib above and causing pain)

24
Q

What muscles act as accessory muscles of respiration

A

Pec muscles
Inferior part of serratus anterior
Scalene muscles

25
Q

What is the origin of the internal thoracic artery

A

Subclavian artery

26
Q

What is the course of the internal thoracic artery

A

Passes inferiorly, lateral to sternum, between the costal cartilages and internal intercostal muscles to divide into the epigastric and muscolpphrenic arteries

27
Q

What does the internal thoracic artery divide into

A

Musculophrenic

Epigastric

28
Q

What does the internal thoracic artery supply

A

Anterior intercostals to ics1-6

Musculophrenic arteries ics 7-9

29
Q

Where does the lateral thoracic artery originate from

A

Axillary artery

30
Q

What is the course of the lateral thoracic artery

A

Inferiomedially along the inferior border of pectorals minor to the anterior surface of the serratus anterior

31
Q

What does the lateral thoracic artery supply

A

Lateral structures of the breast and thorax

32
Q

Where does the acromiothoracic artery originate from

A

Axillary artery

33
Q

What does the acromiothoracic artery supply

A

Pec minor + major

Anterior part of deltoid

34
Q

What are the origins of the posterior intercostal arteries

A 
Supreme intercostal arteries (ics 1+2)
Thoracic aorta (remaining ics)
35
Q

What are the courses of the anterior and posterior intercostal arteries

A

Between internal and innermost intercostal muscles

36
Q

What are the origins of the anterior intercostals

A

internal thoracic arteries (ics1-6) and Musculophrenic arteries (ics 7-9)

37
Q

How many intercostal veins are there on each side of the thoracic wall

A

11 posterior intercostals

1 subcostal vein

38
Q

Where do most posterior intercostal veins end in

A

Azygos/hemiazygos venous system (which goes to superior vena cava)

39
Q

What does the medial pectoral nerve innervate

A

Pec minor and sternocostal portions of the pec major

40
Q

What does the lateral pectoral nerve innervate

A

Pec major

41
Q

What do the intercostal nerves supply

A

Thoracic wall, pleura and peritoneum

42
Q

What is the root value for the intercostal nerves

A

T1-11

43
Q

Origin of the internal thoracic artery

A

Subclavian artery

44
Q

Origin of the internal thoracic vein

A

Arises from superior epigastric and terminates as brachiocephalic vein

45
Q

What is the arterial supply of the breast

A
  • Medial mammary branches of anterior intercostals from internal thoracic arteries
  • Lateral thoracic from axillary arteries
  • Thoraco-acromial from axillary arteries
  • Posterior intercostals from thoracic aorta
46
Q

Where does all lymph from breast go into

A

Sub-areolar plexus

47
Q

Where does all the breast lymph from the sub-areolar plexus drain into

A

Axillary (75%) [drain into infra/supra clavicular nodes then into subclavian lymph trunk]
Parasternal (opposite breast)
Abdominal

48
Q

Where do the parasternal lymph nodes drain into

A

Bronchomediastinal trunks

49
Q

What are the different axillary lymph nodes

A 
Pectoral 
Humeral
Subscapular 
Central
Apical
50
Q

What is the pec major innervated by (and root values)

A

C6-8 Lateral and medial pectoral nerves

51
Q

Innervation of the pectoralis minor and root value

A

Medial pectoral nerve (C8-T1)

52
Q

Innervation of the serratus anterior and root value

A

C5-7

53
Q

Where are anterior intercostal arteries from

A

Internal thoracic aorta

54
Q

Where does the anterior intercostal vein drain into

A

Internal thoracic vein

Anatomy of thorax (7 decks)

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