Thoracic wall muscles and anterior abdominal wall muscles

Question 1

which muscles attach to the inferior border of the rib and insert on the superior border of the rib below - and what do they do

Answer 1

external intercostals - elevates ribs

internal intercostals - elvates ribs ( upper 4 and 5) other depress ribs

Question 2

what nerves supply the intercostal muscles

Answer 2

intercostal nerves

Question 3

what muscle depresses the ribs and costal cartilages and attaches to the internal surface of the costal cartilages of 2-6 and posterior surface of the sternum

Answer 3

Transversus thoracics

Question 4

does the subcostal muscle elevate or depress the ribs

Answer 4

depress

Question 5

does the levator costarum elevate or depress the ribs

Answer 5

elevate

Question 6

where do you insert a catheter into the chest/pleural space

Answer 6

above the corresponding rib
This will avoid the blood vessels and nerves which run under the bottom of the rib. Listen for a decompression air rush (hissing sound) from the needle, or aspirate as much air as necessary to relieve the patient’s acute symptoms.

Question 7

where is a chest drain normally inserted

A chest drain is a tube inserted through the chest wall between the ribs and into the pleural cavity to allow drainage of air (pneumothorax), blood (haemothorax), fluid (pleural effusion) or pus (empyema) out of the chest

Answer 7

The 5th intercostal space in the mid-axillary line is generally used for most situations.

area known as the safe triangle
bordered by the anterior border of latissimus dorsi, the lateral border of the pectoralis major, a line superior to the horizontal level of the nipple and an apex below the axilla. The drain should be inserted just above the rib.

Question 8

aspiration

Answer 8

Aspiration means to draw in or out using a sucking motion. It has two meanings: Breathing in a foreign object (sucking food into the airway)

Question 9

what position should the patient be in for a chest drain

Answer 9

The most commonly used position are either with the patient lying at 45° with their arm raised behind the head to expose the axillary area or in a forward lean position. The procedure may also be performed with the patient lying on their side with the affected side uppermost.

trauma supine

Question 10

in the situation of an apical pneumothorax where should the chest drain be placed

Answer 10

apical pneumothorax, placement of a chest tube in the 2nd intercostal space should be considered.

Question 11

why is a catheter or chest drain placed above the rib

Answer 11

to avoid neurovascular bundles

Question 12

3 functions of the anterior abdominal muscles

Answer 12

compressing the abdominal wall and increasing the intraabdominal pressure, especially when lifting objects and during urination , childbirth or defecation
Assisitn diaphragm in forced expiration
help to flex and rotate the trunk
tensing abdominal wall

Question 13

function of the external abdominal oblique muscle

Answer 13

compresses and supports abdominal viscera and flexes and rotates the trunk

Question 14

function of internal abdominal oblique

Answer 14

compresses and supports abdominal viscera and flexes and rotates the trunk

Question 15

function of the transversus abdominus

Answer 15

compress and support abdominal viscera

Question 16

function of rectus abdominus

Answer 16

flexes trunk and compress abdominal viscera

Question 17

where does the rectus abdomens attach to

Answer 17

pubic symphysis and pubic crest and xiphoid process

Question 18

what nerves supply the anterior abdominal wall muscles

Answer 18

thoracic nerves ( anterior rami of inferior TN)

Question 19

what is the rectus sheath and what muscles are found in It

Answer 19

The rectus sheath is a tendon sheath (aponeurosis) which encloses the rectus abdominis and pyramidalis muscles. It is an extension of the tendons of the external abdominal oblique, internal abdominal oblique, and transversus abdominis muscles.

Question 20

what is the arcuate line

Answer 20

horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath

It is roughly positioned half way between the umbilicus and the pubic crest. Clinically, the arcuate line is important as the: site of entry of the inferior epigastric artery into the rectus sheath. site of weakness: site of Spigelian hernia.

Question 21

what abnormal outpourings of underlying structures due to a weakness of the wall occur on the anterior abdominal wall

Answer 21

hernias

umbilical - <3years and 40< years
linea alba hernias
incisional hernias from a previous scar
inguinal hernias