Thoracic Wall Anatomy Flashcards
what are is the post boundary and ant boundary for the thoracic wall?
what are the superior and floor boundaries?
post: vertebral column
ant: sternum
superior: 1st rib
floor: diaphragm (separates abs from thoracic cavity)
what is the anterior sternum divided into
manubrium
body of sternum
xyphoid process
what is the thoracic inlet?
upper border of the thoracic cavity (T1 vertebra) and follows the contour of rib 1 which articulates w/ the manubrium of sternum
why can’t rib 1 be palated (touched)
bc it is under the clavicle
what does thoracic outlet syndrom refer to?
what happens during this
what would a typical TOS pt look like
what is a typical treatmetn
refers to something going on in the thoracic inlet
- compression of vessel and nerves in region of brachial plexus (btwn 1st rib and clavicle)
- long thin women w/ drooping shoulders and long neck
- physical treatment
wehre is the thoracic outlet
what does it separate
line starting from bottom of T12 and follows the contour of the lower edge of the ribs
- follows inf costal margin
- floor contains diaphragm
- separates thorax above from abdomen below
- where is rib 2 at
- what is the most prominent vertebral spine you can feel
- which ribs contact the sternum directly
- which ribs attach to costal cartilage
- which ribs are floating rib
sternal angle C7 first 7 ribs 8-10 11 and 12
what are costal cartilagse
- what do the first 7 pairs connect with?
- what are the next 3 articulted with?
- what do the last 2 have
bars of hyaline cartilage that prolong the ribs forward and contribute to the elasticity of the thoracic wall
- sternum
- w/ the lower border of the cartilage of the preceding rib
- last two have pointed extremities, which end in the wall of the abdomen
where is open heart surgery performed
through the sternum
where do these costal cartilages artifulate rib 1 rib 2 rib 3-7 rib 8-10 rib 11-12 rib 8-12
- manubrium
- sternal angle
- sternum
- articulate w/ cartilage of preceding rib
- pointed ends (floating ribs)
- false ribs
what are the 3 categories of joints?
what are their subcategories and examples?
fibrous
- fibrous: ex suture. dense collagenous tissue
- syndesmosis: ex fibrous sheet that allows bones to work together and rotate
- comphosis: ex joint in gums which allows the root of the tooth to connect into the cxt tissue of gum
cartilaginous
- synchondrosis: hyaline cartilage. present in the spiphysial plate of long bone
- symphyses: fibrocartilage. ex. fibro disc present throughout the spinal column and elsewehre
synovial-space btwn articulated bones has fluid that lubricates and nourishes joint
- present at membrane which caps 2 adjoining bones
- cells secrete a fluid which allows for movement of joints (cuts down friction)
what is synchondrosis
what is symphysis
what is synovial
articulation of the 1st rib and the manubrium and xiphisternal joint
-hyaline cartilagionous linkage
fibrocartilaginous joints (the intervertebral discs int he back)
sterno-clavicular joint. allows for greatest degree of mevement. membrane lines the space btwn tibia and femur. cells lining the space btwn produce fluid allowing for movement of the joint
the rib makes 2 contacts with the vertebra, where are they?
1 on the transverse process
1 on the body
what is free movement due to? what does it maximize?
synovial joints
potential movement of ribs, relative to sternum and vertebral column during inhalation and exhalation
articulation of ribs 2-10 w/ sternum or preceding rib is via what?
synovial joint
costa-vertebral join
costo-transverse joint
waht ist he thoracic wall supplied by?
what do they run in
internal thoracic (aka internal mammary artery -branch of subclavian) and posterior intercostal arteries (branch off descending aota)
- intercostal vein, artery, and nerve run in costal groove
- this is dorsal to ventral
- the lateral cuntaneous branch of the nerve is ____ to the vessels
- what is the main branch of the spinal nerve
parallel ventral ramus (the intercostal nerve in VAN which travels in the groove of a rib)
what are dermatomes
what does it mirror the distribution of?
the cutaneous distribution of a spinal nerve
intercostal nerve-the nerve doesn’t just innervate muscle, but the skin which runs above
what is referred pain
pain from a malfunctioning or diseased body area is perceived in another area, often far from the origin
ex. pain in the left shoulder radiating down the arm-a sig symptom of heart attack
ex. appendix pain in the bottom right of the abdomen
- when the appendix is inflamed but not yet hitting the body wall, the referred pain gets transferred to the umbilicus
what is the visceral layer
what is the pareital layer
what is the pleural space
covers organs-insensitive, has to do w/ the organ in questions
- on the body wall-sensistive
- space between them, is airtight. when intact, this allows the lungs to stay at an overall negative pressure-needed in order to maintain the lungs in their healthy position and inhalation
where does the cupola extend
extends above the level of the thoracic inlet, into the neck
extends above the 1st rib
-higher up on right than left bc right lung extends higher than left
what is a classic horner’s scenerario
a long term smoke w/ a growth on the right lung (behind cupola) impacts sympathetic innervation heading up to superior cervical ganglion in the neck
what are some symptoms of horner’s syndrome
unilateral miosis-bc sympathetic is down/para rules
facial anhydrosis-dryness from lack of sweating
ptosis - failure to stimulate Muller’s muscle
what is congenital horner’s
heterochromia (diff colored eyes) -sympathetic system plays a role in the pigmentation of the iris
what is the most imoprtant respiratory muscle
diaphragm
what do external intercostal muscles do
head medialy and inf to the rib below
-when they contract, they help elevate the ribs for inspiration
what is expiration primarily due to
what plays a role
waht plays a role in forced expiration
due to elastic recoil of the lung and thoracic cage
- internal intercostals
- external intercostals, scalene, abdominal muscles
