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CSF3-Exam I > Thoracic Wall- Dr. A > Flashcards

Thoracic Wall- Dr. A Flashcards

1
Q

The thoracic wall bounds the thoracic cavity and is formed by what types of tissues?

A

skin, bones, fascia, and muscle

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2
Q

What is the superior boundary of the thoracic wall?

A

vertebra T1, rib 1, manubrium

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3
Q

What is the inferior boundary of the thoracic wall?

A

vertebra T12, rib 12, costal margin, xiphoid process

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4
Q

What covers the thoracic wall transversely? What is it made up of?

A

thoracic cage which is the BONY portion of the thoracic wall

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5
Q

A stab wound below what rib level can pierce the abdominal cavity?

A

rib 5

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6
Q

T/F. Stab wound to the neck can pierce the lungs.

A

True!

The apex of the lung is in the superior thoracic aperture

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7
Q

What is the thoracic inlet of the thoracic cavity?

A

superior thoracic aperture

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8
Q

What is the thoracic outlet of the thoracic cavity?

A

inferior thoracic aperture

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9
Q

What is found in the superior thoracic aperture?

A
  • apex of the lungs
  • subclavian artery and vein
  • internal jugular vein
  • common carotid artery
  • esophagus
  • trachea
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10
Q

What two organs are found below the thoracic wall?

A

heart and lungs

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11
Q

What are the functions of the thoracic wall?

A
  • protect internal air- and fluid-filled organs
  • provide rigid exterior wall to prevent collapse of elastic lungs
  • provide for lung expansion
  • provide attachment and support to upper limbs
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12
Q

Where does the second rib attach?

A

sternal angle

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13
Q

What intercostal space is the nipple located at?

A

4th intercostal space

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14
Q

What important surface landmarks for clinical procedures (ECG, pericardial puncture, thoracoscope) are found on the anterior median (midsternal line)?

A
  • jugular (suprasternal) notch
  • sternal angle
  • manubrium
  • manubriosternal joint
  • body of sternum
  • xiphisternal joint
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15
Q

What marks the plane through T4-5 intervertebral disc separating the superior from the inferior mediastinum?

A

sternal angle

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16
Q

The sternal angle is used to ascertain the position of many landmarks in the body. What are they?

A
  • rib 2, for counting
  • marks the superior edge of the heart
  • marks the bifurcation of the trachea
  • marks the level of azygos arch
  • marks the plane through T4-5 intervertebral disc
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17
Q

What is the directional orientation of the ribs? Why is this orientation critical?

A

downward slope of the ribs is critical to its function as it needs to be pulled upward to increase in diameter anteriorly and posteriorly to allow for a greater volume for air to come in during breathing (inhalation)

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18
Q

The head of the ribs attaches where on the vertebrae?

A

demifacets

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19
Q

The costal tubercle of the rib attaches where?

A

transverse process

20
Q

What part of the rib shields the intercostal neurovascular bundle from impact?

A

costal facet

21
Q

What are the atypical ribs?

A

ribs 1, 2, 11, and 12

22
Q

What are the true ribs?

A

ribs 1-7

they all connect DIRECTLY to the sternum

23
Q

What are the false ribs?

A

ribs 8-12

they connect to the sternum INDIRECTLY

24
Q

What are ribs with costal cartilages?

A

ribs 8-10 as they connect to the sternum indirectly through costal cartilages

25
Q

Which ribs are floating?

A

ribs 11-12

26
Q

What is the importance of floating ribs?

A

to anchor the the rib cage by abdominal muscles

27
Q

How is the first rib similar and different from the other ribs?

A

same: neck, head, tubercle
different: scalene tubercle, groove for subclavian vein anteriorly, groove for subclavian artery posteriorly

28
Q

Which rib is the attachment of serratus anterior?

A

rib 1-8

have rib 2 in my notes for some reason

29
Q

What do vertebrae, sternum, and ribs all contain that is a source of blood cells?

A

red marrow

30
Q

Which facet on the thoracic vertebrae assists with elevation of the ribs?

A

costal facets on the transverse processes of the thoracic vertebrae that articulates with the costal tubercle of the rib

31
Q

The costal demifacets are located where on the thoracic vertebrae and what do they articulate with?

A

body of the thoracic vertebrae

articulate with the head of the rib

32
Q

The costovertebral joint refers to which facets? The costotransverse joints?

A

costovertebral joint: demifacets

costotransverse joint: costal facets

33
Q

Rib has the same number as the ________vertebrae and its transverse process.

A

inferior

Rib articulates with the demifacet above (rib 4) and below (rib 5) which has the transverse process (costal facet) where the costal tubercle of rib will attach.

34
Q

Which symphyses of the sternum ossify with age?

A

manubriosternal and xiphisternal symphyses

35
Q

The sternocostal joints are what type of joint?

A

rib 1: fibrocartilaginous

ribs 2-7: synovial

36
Q

The interchondral joints are what type of joint?

A

synovial

interchondral joints (in between the costal cartilages)

37
Q

Rib dislocation occur at what joint? Rib separation? Rib fracture?

A

Rib dislocation: sternochondral joint
Rib separation: costochondral joint
Rib fracture: usually just anterior to angle

38
Q

What occurs with flail chest due to multiple rib fractures?

A
  • paradoxical movement produces pain and impairs breathing
  • lose control of the intercostal muscles which stiffen and protect the integrity
  • cannot expand the age to full capacity and so lose sufficient oxygenation of blood
39
Q

What are the muscles of the upper limb that are considered accessory muscles of respiration?

A
  • pectoralis major
  • pectoralis minor
  • serratus anterior

they help with elevation of ribs especially in forced elevation (pectoralis m.) and during inspiration (serratus anterior m.)

40
Q

Which superficial muscles of the thoracic wall runs superomedially thus depressing the rib during exhalation?

A

internal intercostal muscles

41
Q

Which superficial muscles of the thoracic wall runs inferomedially thus elevating the rib during inhalation?

A

external intercostal muscles

42
Q

Where do the intercostal vein, artery, and nerve run?

A

in the subcostal groove between the internal intercostal and the innermost intercostal muscle

43
Q

Which deep muscle of the thoracic wall assists in depressing the ribs during exhalation?

A

subcostalis m.

44
Q

Where does the transversus thoracis m. originate?

A

originates from the lower 1/3 cartilage of the sternum

specifically the costal cartilages of last 3-4 true ribs, body of sternum and xiphoid process

45
Q

What is the primary muscle of inspiration?

A

diaphragm

46
Q

What is the major muscle of active forced expiration?

A

abdominal wall

47
Q

The diaphragm is innervated by what?

A

phrenic nerve (derived from C3, C4, C5)

CSF3-Exam I (9 decks)

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