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Thoracic Wall and Cavities Flashcards

1
Q

List the boundaries of the superior thoracic aperture

A

T1 vertebral segment, paired 1st ribs and superior manubrium

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2
Q

Superior Thoracic Aperture

A

communication between thorax and neck

-Contains trachea and esophagus, nerves and blood supply to head, neck and upper extremities

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3
Q

List the boundaries of the thoracic aperture

A

T12 vertebral segment, 11th and 12th ribs, 7th through 10th costal cartilages and xiphisternal joint

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4
Q

Inferior Thoracic Aperture (Thoracic Outlet)

A
  • irregular communication between thorax and abdomen

- esophagus, inferior vena cava, aorta

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5
Q

Describe the three parts of the sternum

A

Manubrium,Body of Sternum

Xiphoid Process

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6
Q

Manubrium boundaries

A
  • Suprasternal angle: top of manubrium
  • Sternal angle: junction of manubrium and body
  • Clavicular notch: articulates with clavicle
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7
Q

Body of Sternum

A
  • Xiphoid/sternal joint attaches xiphoid to sternum

- Articulates with second to seventh costal cartilages

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8
Q

Costal Cartilages:

A
  • 1-7:connect ribs to sternum

- 8-10: articulate with cartilage above them before connecting to sternum

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9
Q

Typical Ribs: (3-9)

A

-head, neck, body, tubercle

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10
Q

Atypical Ribs

A
  • First Rib
  • Second rib
  • Tenth Rib
  • Eleventh Rib
  • Twelfth Rib
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11
Q

-First Rib

A

Head, scalene tubercle for insertion of scalene muscle, groove for subclavian V and A, broadest and shortest

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12
Q

-Second rib

A

longer than first, two articular facets to articulate with bodies of first and second thoracic vertebrae

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13
Q

-Tenth Rib

A

head with articular facet to articulate with 10th thoracic vertebrae

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14
Q

-Eleventh Rib

A

no head and neck, facet on head (false rib)

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15
Q

-Twelfth Rib

A

no head and neck, facet on head(false rib)

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16
Q

Most commonly fractured Ribs?

A

middle Ribs, at their weakest locus, just anterior to the Costal Angle. Rib fracture can damage internal organs and produce severe pain with respiration, coughing, laughing and sneezing

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17
Q

Supernumerary Ribs

A

Extra Ribs either in the Cervical region or Lumbar region

Cervical Ribs typically produce no symptoms; however, can produce neural and circulatory problems with based on their proximity to the Brachial Plexus and Subclavian A. Lumbar Ribs also often produce no symptoms; however, can result in confusion when reading radiographs and other diagnostic images.

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18
Q

three layers of intercostal muscles

A

External Intercostals,Internal Intercostals,Innermost Intercostals

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19
Q

External Intercostals

A
  • Most superficial layer, extends from tubercles of ribs to junction of costal cartilages with bony ribs
  • elevated upon contraction, fibers with inferomedial orientation
  • An external intercostal membrane passes from the anterior margin of this muscle to the lateral border of the sternum
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20
Q

Internal Intercostals

A
  • Middle layer of muscles, extends from sternum to mid axillary line
  • An internal intercostal membrane passes from the lateral margin of this muscle to the region of the vertebral column to fuse with the superior costotransverse ligaments
  • Upon contraction,ribs depressed, inferolateral orientation
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21
Q

Innermost Intercostals

A
  • Deepest layer, extends from angles of ribs to anterior of mid axillary line
  • An innermost intercostal membrane passes from the anterior border of this muscle to the lateral border of the transversus thoracis muscle
  • The fibers have the same orientation and function as the internal intercostal
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22
Q

Transversus Thoracis

A
  • Not a real intercostal muscle
  • It extends from the posterior surface of the lower half of the body of the sternum and the xiphoid process to the costochondral junction of ribs 3-6
  • Muscle functions to depress ribs
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23
Q

Nerves of thoracic wall and cavities

A
  • Intercostal nerves, ventral primary rami of T1-T11
  • cutaneous branches provide sensory innervation to the skin on the lateral and anterior surfaces of the thorax
  • Intercostal nerves T1-T7 have branches that continue into the abdominal wall to provide both motor and cutaneous branches to the muscles and skin in this region
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24
Q

Posterior Intercostal arteries

A
  • located between two deepest layers of intercostal muscles in intercostal spaces 3-11
  • These arteries have muscular branches which supply the intercostal, pectoral and serratus anterior muscles.
  • In intercostal spaces 3-5 their lateral branches supply the breasts in females.
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25
Supreme Thoracic arteries:
- Supply intercostal spaces 1-2 | - branches from axillary
26
Supreme Intercostal arteries:
- Supply intercostal spaces 1-2 | - branches from costocervical trunk
27
Anterior Intercostal Arteries:
- branches of internal thoracic, intercostal spaces 1-6 | - supply skin, intercostal muscles, breasts and thymus gland
28
Musculophrenic Artery:
-provides anterior intercostal arteries to spaces 7-9
29
Describe the attachments and action of the transversus thoracis muscle
Not an intercostal muscle. It extends from the posterior surface of the lower half of the body of the sternum and the xiphoid process to the costochondral junction of ribs 3-6. This muscle functions to depress the ribs
30
The Thoracic Cavity is surrounded by an Osteocartilaginous Thoracic Cage (give details)
contains three primary divisions: two Pulmonary Cavities, located laterally which contain the Lungs and Pleurae, and the Mediastinum, located centrally containing the Heart, Thoracic Great Vessels, Trachea, Thoracic Esophagus and Thymus.
31
Thoracentisis
Insertion of a hypodermic needle through the Intercostal musculature between ribs to obtain a fluid sample or drain small amounts of blood or fluid from the Pleural Cavity. The needle is inserted between ribs inferior to the Intercostal neurovascular bundle, but superior to the collateral branches
32
Insertion of Chest Tube
Insertion of a tube to remove large amounts of air, fluid, blood or pus from the Pleural Cavity. Tube is typically inserted in the 5th or 6th Intercostal Space.
33
Thoroscopy
Insertion of a Thoroscope into the Pleural Cavity through small incisions for visualizing and biopsying the space inside the Pleural Cavity
34
Dislocation vs separation of ribs
Dislocation of ribs refers to a dislocation at the Sternocostal joint. Separation of ribs refers to a separation at the Costochondral joint
35
Two forms of movement occur at the Costovertebral Joint
both function to increase the Thoracic Volume, thereby decreasing Thoracic Pressure producing Inspiration Bucket Handle Movement Pump Handle Movement
36
Bucket Handle Movement:
Elevation of the lateral most portion of the Rib, | increasing the transverse diameter of the Thorax
37
Pump Handle Movement:
Elevation of the Sternal End of the Rib, increasing | the anterior to posterior diameter of the Thorax
38
Three types of joints
Synovial Joint (Diarthrosis; united by an articular capsule) Fibrous Joint (Synarthrosis; united by fibrous tissue) ``` Cartilaginous Joint (Amphiarthrosis; united by Hyaline Cartilage or Fibrous Cartilage) ```
39
Planar
Flat, arthroidal, non-axial gliding movement, synovial
40
Ginglymus
synovial, (Hinge, uniaxial
41
Trochoid
synovial, Pivot, unixial, rotation
42
Condylar
one or two concave surfaces articulating with one or two | convex surfaces, biaxial, synovial
43
Sellar
Saddle, both surfaces are convex and concave, biaxial, synovial
44
Spheroidal
synovial, ball and socket
45
Compound Synovial
synovial, combination of multiple joints
46
Sutures
Interlocked bone, fibrous
47
Schindylesis
Tongue-In-Groove, fibrous
48
Gomphosis
Peg-In-Socket, fibrous
49
Syndesmosis
Bone-Ligament-Bone, fibrous
50
Synchondrosis
Primary Cartilagenous Joints, characterized by temporary cartilagenous unions of Hyaline Cartilage, usually between the Diaphysis and Epiphysis of growing bone), cartilagenous
51
Symphysis
Secondary Cartilagenous Joints, characterized by strong | slightly moveable joints united by Fibrocartilage, cartilaginous
52
Boundaries of Inferior Thoracic Aperture
T12 vertebral segment, 11th and 12th ribs, 7th through 10th costal cartilages and xiphisternal joint
53
xiphoid process boundaries
- lies at level of T10 vertebra - Xiphisternal joint lies at T9 - attached via its pointed caudal end to linea alba
54
Sternoclavicular joint:
saddle type synovial joint: only attachment between appendicular and axial skeletons
55
Sternocostal joint:
Articulation of sternum with first 7 cartilages
56
Costochondral joints:
ribs articulate with their respective cartilages
57
Costovertebral joints:
joints of head of ribs with corresponding vertebral bodies
58
Costotransverse joint:
synovial plane joint that attached tubercle of rib with corresponding vertebra
59
Interchondral joint:
synovial plane joints between costal cartilages of ribs
60
Superior Gastric Artery
-supplies rectus abdominis and anastomoses with inferior epigastric artery
61
Pericardiophrenic Artery:
-accompanies phrenic nerve between pleura and pericardium to diaphragm, supplies pleura, pericardium and upper diaphragm
62
Musculophrenic Artery:
- provides anterior intercostal arteries to spaces 7-9 | - supplies pericardium and muscles of abdominal wall
63
Anterior Intercostal Arteries:
- branches of internal thoracic, upper and lower borders of intercostal spaces 1-6 - supply skin, intercostal muscles, and thymus gland - Perforating Branches supply breasts
64
Supreme Intercostal arteries:
- Supply intercostal spaces 1-2 | - branches from costocervical trunk
65
Supreme Thoracic arteries:
- Supply intercostal spaces 1-2 | - branches from axillary
66
Posterior Intercostal arteries:
- located between two deepest layers of intercostal muscles in intercostal spaces 3-11 - These arteries have muscular branches which supply the intercostal, pectoral and serratus anterior muscles. - In intercostal spaces 3-5 their lateral branches supply the breasts in females.
67
Internal Thoracic Artery:
-comes from first part of subclavian, gives rise to two anterior intercostal arteries

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