Thoracic Wall and Pectoral Region Flashcards

1
Q

Inferior thoracic aperture

boundaries:

A
– 12th thoracic vertebra
– 11th and 12th pair of ribs
– Costal cartilages of ribs
7
th – 10th (costal margin)
– Xiphisternal joint
– Closed by the diaphragm
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2
Q

Superior thoracic aperture-Boundaries:

A

Body of 1st thoracic vertebra
– 1st ribs and their costal cartilages
– Jugular notch

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3
Q

Superior thoracic aperture-Structures passing through

A

Left Subclavian artery
– Subclavian (or SCV) vein
– Brachiocephalic trunk

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4
Q

Thoracic wall-Bones

A

Vertebrae, ribs, sternum

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5
Q

Thoracic wall-Muscles

A

Diaphragm, intercostal, pectoral, serratus

anterior, latissimus dorsi

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6
Q

Thoracic wall-Nerves and blood vessels

A

– Intercostal neurovascular bundle

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7
Q

Sternum-three portions:

A

– Manubrium
– Body
– Xiphoid process

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8
Q

Sternum-Articulates with:

A

– Clavicle

– Costal cartilages I-VII

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9
Q

Jugular notch

A

Small indentation on the superior

border of the manubrium

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10
Q

Manubriosternal joint

A
Anterior boundary of the
transthoracic plane
– Corresponds to:
β€’ T4/5 intervertebral disc
β€’ 2nd costal cartilage
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11
Q

Atypical ribs

A

(1, 2, 10, 11, 12)

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12
Q

Thoracic vertebrae

A

-Small heart shaped body
β€’ Round vertebral foramen
β€’ Downward slanting spinous process
β€’ Two demifacets on body for articulation with the head of the rib
β€’ A facet on the transverse process for articulation with the tubercle of the rib

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13
Q

COSTOVERTEBRAL Joints

A

Synovial joints between rib and

vertebrae

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14
Q

STERNOCOSTAL Joints

A

Synovial joints between costal
cartilage and sternum
(1st is fibrocartilaginous)

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15
Q

True ribs (1-7)

A

attach to sternum via

own costal cartilage

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16
Q

False ribs (8-10) -

A

attach to costal cartilage of

rib above

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17
Q

Floating ribs

A
  • no attachment anteriorly
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18
Q

Intercostal muscles-Neurovascular bundle

A

– intercostal artery, vein, nerve
– between internal and innermost
-Innervation is segmental from intercostal nerves**

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19
Q

Intercostal muscles-Action:

A

Elevation and depression of ribs
and maintaining the intercostal space
during respiration

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20
Q

Intercostal muscles

A
  • External intercostal-Fibers – down and medial
  • Internal intercostal-Fibers – down and lateral
  • Innermost intercostal-same as internal
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21
Q

Transversus thoracis muscle- loction

A

Radiates out from the

sternum”

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22
Q

Subcostal muscles

A

Found posteriorly near the
angles of the ribs and
span 1 or more
intercostal spaces

23
Q

Pectoralis major

A

medial & lateral
pectoral n.
Shoulder adduction, flexion
& medial rotation of humerus

24
Q

Subclavius

A

nerve to
subclavius
depresses clavicle

25
Q

Pectoralis minor
(in clavipectoral
fascia)

A

medial pectoral n.
depresses shoulder,
protracts
scapula

26
Q

Serratus anterior

A

long thoracic n.

upward rotates scapula

27
Q

Rib movement during respiration-pump handle

A
increases AnteriorPosterior (AP)
dimensions
28
Q

Rib movement during respiration-β€œbucket handle”

A

increases lateral dimension

29
Q

Viscera Pleura

A

– lines/adhered to the lungs

30
Q

Parietal Pleura

A

lines/adhered to the thoracic cage

31
Q

Pleura-innervation

A

-Costal; intercostal nerves
– Mediastinal; phrenic nerve
– Diaphragmatic; phrenic and intercostal
– Cervical

32
Q

Surface landmarks for pleura-*At rest (relaxed)
Inferior border of lung
(visceral pleura)

A

Midclavicular-Rib 6
Midaxillary-Rib 8
Paravertebral-TV10

33
Q

Surface landmarks for pleura-*At rest (relaxed)-Inferior edge of parietal
pleura

A

Midclavicular-Rib 8
Midaxillary-Rib 10
Paravertebral-TV12

34
Q

Thoracocentesis

A

pleural tap” to sample fluid from pleural space

35
Q

Thoracostomy

A

Chest tube inserted to drain fluid or air from

pleural cavity

36
Q

Ventral rami of spinal nerves (intercostal

nerves):

A

Motor innervation to muscles
– Sensory innervation to ribs, costal
cartilages, skin, costal pleura and
peritoneum (T7-12)

37
Q

Dermatomes-T4 –

A

Nipple

38
Q

Dermatomes-T7

A

Tip of xiphoid

39
Q

Dermatomes-T10

A

Umbilicus

40
Q

Dermatomes-T12

A

Suprapubic region

41
Q

Dermatomes-L1

A

– Inguinal region

42
Q

Internal thoracic A

A

Gives anterior intercostal arteries and
terminates into musculophrenic and
superior epigastric

43
Q

Anterior intercostal a.

A

Follows the inferior border of the rib and
anastomoses with the posterior intercostal
arteries

44
Q

Musculophrenic a

A

continues along the costal margin
supplies diaphragm, anterior and
lateral walls

45
Q

Superior epigastric a

A

continues onto the anterior
abdominal wall and anastomoses
with inferior epigastric a

46
Q

Posterior intercostal

artery

A

Runs in costal groove

47
Q

Descending

Thoracic Aorta

A

Supplies posterior

intercostal arteries

48
Q

Subclavian A

A

Gives internal thoracic a.
Vertebral a.
Costocervical trunk

49
Q

Costocervical trunk

A

Supplies the first 2

posterior intercostal spaces

50
Q

Diaphragmatic Parietal pleura -nerve innervation

A

supplied by superior phrenic arteries

51
Q

Mediastinal Parietal pleura -nerve innervation

A

supplied by pericardiacophrenic artery

52
Q

Venous drainage of thoracic wall

A
The veins from the
upper 2 intercostal
spaces posteriorly join
together and may drain
into the azygos and
accessory hemiazygos
or directly into the
brachiocephalic vein
53
Q

Lymphatic drainage of the thoracic

wall

A

Anteriorly to parasternal nodes
– Posteriorly to intercostal nodes
– Inferiorly to diaphragmatic
nodes

-Most lymph nodes from thorax
eventually drain into thoracic duct
-Upper part of right thorax into
right bronchomediastinal trunk