Thoracic Wall/Diaphragm And Breast Flashcards
What is the vertebral level of the superior thoracic aperture?
T1
What is the border of the inferior thoracic aperture?
Follows costal margins and thoracic diaphragm. Separates the thoracic cavity to abdominal pelvic cavity
What is the palpable bony structure at T3
Jugular notch
What is the palpable bony structure at T4/5
Sternal angle. Also bifurcation of trachea
What is the palpable bony structure at T9/10?
Xiphisternal joint
At what level is the inferior border of scapula (different male and female)
Female: T6
Male: T7
What is the vertebral level of the most medial border of the scapula spine?
T3
What are the three main blood vessels of the thoracic wall?
- internal thoracic arteries
- anterior intercostal arteries
- posterior intercostal arteries
Why does each intercostal space have its own blood supply?
Because it helps with respiration
What is an anastomosis?
- two arteries form none direct connection and supply area
- advantage is that doesn’t matter if one artery is blocked off
How does the internal inferior surface accommodate for the VAN complex?
There is a costal groove on each internal inferior surface
What is the VAN complex?
- vein
- artery
- nerve
Always run in that order along each intercostal grove
What are the three main veins that drain into the superior vena cava?
- Azygos
- hemiazygous
- accessory hemiazygous veins
What are the tributes?
They are small veins coming into a larger vein
What is the body of the breast?
Base of the breast and apex
What is the axillary tail?
Extension of the base towards and into axillary
- formed by glandular tissue
What is the retromammary space?
Loose connective tissue plan between the breast and deep pectoral fascia
4 main internal features of the female breast?
- is drained by one major lactiferous ducts
- contains numerous lobules
- contains branches and sub-branches of a major lactiferous duct
- is separated by and contain varying amounts of adipose tissue and general connective tissue
What are the suspensory ligaments?
- fibrous connective tissue bands attaching between the skin and deep fascia of pectoralis major
- located between lobules
- denser superior to inferior
What is the diaphragm?
Muscular tissue often separating areas
Where is the summit of the left dome? (During expiration)
- 5th intercostal space
- T10
Where is the summit of the right dome? (During expiration)
- 4th intercostal space
- T9 (this side sits higher due to liver)
What are the parts of the thoracic diaphragm?
- central tendon
- right crus
- oesophageal hiatus
- left crus
- caval foramen
- aorta hiatus
What vertebral level is the right crus?
L1-L3
What vertebral level is the left crus?
L1-L2
What vertebral level is the caval foramen?
T8/9
- branches of phrenic nerves
What vertebral of the oesophageal hiatus?
T10
- vagus nerve
What vertebral level is the aortic hiatus?
T12
- thoracic duct
- inferior intercostal lymphatic trunk
- azygous and hemiazygos veins
How is the thoracic diaphragm innervated?
- phrenic nerves
- intercostal nerves
What passes through the superior thoracic aperture
- apex of lungs
- common carotid artery
- oesophagus
- trachea
- internal jugular veins
- subclavian vein and artery
