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Anatomy > Thoracic Wall: Osteology & Muscles > Flashcards

Thoracic Wall: Osteology & Muscles Flashcards

1
Q

what is thorax?

A

the part of the body between the neck and the abdomen, including the cavity enclosed by the ribs, sternum, and dorsal vertebrae, and containing the chief organs of circulation and respiration; the chest

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2
Q

mediastinum

A

central compartment

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3
Q

L/R pleural compartments are separated by the

A

mediastinum

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4
Q

what shape does the thoracic skeleton take the shape of? (3)

A

a dome, birdcage or truncated cone

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5
Q

where is the thoracic cavity narrowest?

A

superiorly, with the circumference increasing inferiorly

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6
Q

the floor of the respiratory diaphragm is — superiorly

A

convex

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7
Q

are the walls of the thoracic wall thick or thin?

A

relatively thin

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8
Q

what are the four functions of the thoracic cavity?

A

protect vital thoracic/abdominal organs from external forces
resist the negative internal pressure created by the elastic recoil of the lungs
provide attachments for and support the weight of the upper limbs
provide the origin for some upper limb muscles and attachments for muscles of the abdomen, neck, back, and respiration

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9
Q

true ribs

A

1-7
attach vertebrae to the sternum
(costal cartilage) from the sternal end to the sternum/breastbone

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10
Q

false ribs

A

8-10 have cartilages attached to the cartilages of ribs superior
(don’t have a cartilage of their own, join the intrasternal angle)

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11
Q

floating ribs

A

11-12 have cartilages ending in the posterior abdominal wall musculature

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12
Q

what are cartilages of 7-10 are joined to form the

A

infrasternal angle

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13
Q

ribs and costal cartilages are separated by an

A

intercostal space

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14
Q

what is the superior thoracic aperture (thoracic outlet and inlet) bounded by?

A

1st thoracic vertebra, 1st pair of ribs, and superior border of the manubrium

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15
Q

inferior thoracic aperture is closed by the

A

diaphragm

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16
Q

structures must pass through the inferior thoracic aperture – it

A

behind

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17
Q

what do the facets of the head of the ribs articulate with?

A

inferior and superior costal facets of the adjacent thoracic vertebrae

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18
Q

where does the tubercle of the ribs articulate with?

A

the costal facet of the transverse process of vertebrae of the same number

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19
Q

what is the number of ribs increased by? what is it decreased by?

A

increased by the presence of cervical and/or lumbar ribs

decreased by failure of the 12th pair to form

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20
Q

how common are cervical ribs?

A

fairly common

.5-2%

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21
Q

what do cervical ribs interfere with?

A

neuromuscular structures exiting the superior thoracic aperture

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22
Q

what is the clinical significance of supernumerary (extra) ribs

A

confusion in radiological diagnosis

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23
Q

thoracic outlet syndrome (TOS)

A

a group of disorders that occur when there is compression, injury, or irritation of the brachial plexus and/or subclavian vessels in the lower neck and upper chest

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24
Q

the manubriosternal and xiphisternal joints can fuse and become a

A

synostosis in older persons

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25
Q

failure of fusion between halves of the sternal bars during development can result in

A

sternal cleft or sternal foramen

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26
Q

cardiac/pericardial tamponade

A

a type of pericardial effusion in which fluid, put, or gas accumulates in the pericardium (the sac in which the heart is encodes) results in slow or rapid compression of the heart

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27
Q

5-4 year old patient suffering from a chest wall sarcoma that necessitated the removal of his sternum as well as a portion of his rib cage. once removed,

A

these bones would have been replaced with a titanium implant, which creased a new set of problems that needed to be addressed. creating the implant with 3D printing offered the advantage of the ability to completely customize the implant, dose relatively quickly, and to create a design that would counter some of the problems historically present in flat titanium implant design

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28
Q

precuts carinatum

A

abnormal development causing the sternum to protrude. can be evident at both; adolescent males during growth spurt (most common). it may occur as a solitary congenital abnormality or in association with other genetic disorders or syndromes

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29
Q

prevalence of PE

A

1 in 500-1000 children

3x in males

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30
Q

cause of PE

A

unknown

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31
Q

Poland

A

absent pectorals major

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32
Q

ectopia cordis

A

heart is on the outside of the thoracic cavity

failure of sternum to fuse

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33
Q

scoliosis

A

lateral curvature of the spine

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34
Q

congenital scoliosis

A

Caused by a bone abnormality present at birth

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35
Q

neuromuscular scoliosis

A

A result of abnormal muscles or nerves. Frequently seen in people with spina bifida or cerebral palsy or in those with various conditions that are accompanied by, or result in, paralysis

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36
Q

degenerative scoliosis

A

This may result from traumatic bone collapse, previous major back surgery, or osteoporosis

37
Q

idiopathic scoliosis

A

The most common type of scoliosis, idiopathic scoliosis, has no specific identifiable cause. There are many theories, but none have been found to be conclusive. There is, however, strong evidence that idiopathic scoliosis is inherited

38
Q

upper ribs (1-7) — at the costotransverse joints

A

rotate

39
Q

lower ribs (8-10) — at the costotransverse joints

A

glide

40
Q

ribs 11 and 12 do not articulate with

A

transverse processes

41
Q

costochondral joints

A

primary cartilaginous joints and they usually do not experience movement

42
Q

interchondral joints (2)

A

some are plane synovial joints (between costal cartilages 6-9)
some are fibrous (between cartilages 9 and 10)

43
Q

sternocostal joints (2)

A

1st joint is cartilaginous

joints 2-7 are synovial plane joint

44
Q

the intercostal muscles occupy the intercostal spaces and function during respiration, both by

A

moving the ribs and by helping to keep the intercostal spaces rigid

45
Q

the intercostal muscles include (5)

A 
external intercostal
internal intercostal
innermost intercostal
subcostal
transversus thoracis
46
Q

external intercostals

A

attach superiorly to the inferior border of the rib above and inferiorly to the superior border of the rib below

47
Q

what direction do external intercostal fibers run

A

anteriorly

48
Q

function of external intercostals

A

elevate the ribs during forced inspiration

49
Q

internal and innermost intercostals attach

A

superiorly to the rib above and inferiorly to the superior rib below
fibers run inferoposteriorly

50
Q

interosseous part functions to

A

depress the ribs during forced respiration

51
Q

internal intercostals and innermost intercostals are separated by the

A

intercostal neuromuscular bundle

52
Q

external intercostal
breathing in
breathing out

A

contract

relax

53
Q

internal intercostal/innermost
breathing in
breathing out

A

relax

contract

54
Q

subcostalis attach

A

superiorly to internal surfaces of lower ribs near their angles and inferiorly to superior borders of ribs 2 or 3 levels below

55
Q

subcostalis fibers

A

run in the same orientation and blending with internal and innermost intercostals

56
Q

subcostalis function

A

probably the same as the internal intercostals

57
Q

transversus thoracis attach

A

superiorly on the posterior sternum and inferiorly on costal cartilages 2-6

58
Q

function of transversus thoracis

A

depress the ribs

59
Q

levator costae
O:
I:
A:

A

O: transverse processes
I: rib below between tubercle and angle
A: elevate the ribs

60
Q

serratus posterior superior
O:
I:
A:

A

O: spines of C7-T3
I: ribs 2-4
A: elevate ribs

61
Q

serratus posterior inferior
O:
I:
A:

A

O: spines of T11-L2
I: ribs 8-12
A: depress ribs

62
Q

in the thoracic region, the ventral rami are in the form of

A

intercostal nerves

63
Q

roots carry

A

sensory or motor

64
Q

rami carry

A

both sensory and motor, mixed

65
Q

dermatome

A

area of the skin supplied by nerves from a single spinal root

66
Q

sensory impairment for a specific dermatome is related to the

A

level of spinal cord injury

67
Q

thoracotomy

A

surgical opening through the thoracic wall to access the lungs, heart, esophagus, and the thoracic vertebrae

68
Q

thoracentesis

A

a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest

69
Q

nerve root block

A

selective nerve root block primarily used to diagnose the specific source of nerve root pain and secondarily, for therapeutic relief of low back pain and or leg pain

70
Q

thoracic epidural steroid injections are most commonly used to reduce the pain associated with

A

herpes zoster (shingles)

71
Q

such blocks may reduce the risk of developing persistent

A

postherpetic neuralgia

pain that persists long after the shingles skin eruption has healed

72
Q

muscles raise the ribs during

A

inspiration

73
Q

buckle handle movement

A

the lateral-most parts of the ribs are elevated and the transverse diameter of the thorax increases

74
Q

the ribs are also elevated at the

A

neck (especially ribs 2-6) results in an increase in the AP diameter of the thorax pump handle movement

75
Q

Boyles law

A

increase in volume, decrease in pressure

air comes in with less effort

76
Q

pump handle movement:

bucket handle movement:

A

pump handle movement: elevation of the ribs, increase in the anteroom-posterior diameter of the thoracic cavity
bucket handle movement: elevation of ribs, increase in lateral diameter of the thoracic cavity

77
Q

the primary blood supply to the thoracic wall is derived from branches of the

A

aorta and the subclavian arteries

78
Q

internal thoracic artery

A

descends into thorax 1.2 cm lateral to edge of sternum, and ends at the sixth costal cartilage by dividing musclophrenic and superior epigastric arteries

79
Q

anterior intercostals 7-10 come from

A

the musclophrenic arteries

arises from the subclavian artery near its origin

80
Q

intercostal veins will drain back to the (2)

A

musclophrenic or internal thoracic veins

81
Q

internal thoracic vessels give off anterior intercostal arteries to the

A

first six intercostal spaces

82
Q

anterior intercostal arteries anastomose with

A

posterior intercostal arteries (from the descending thoracic aorta) in the intercostal space

83
Q

companion veins accompany the

A

arteries

84
Q

two of the posterior intercostal arteries branch off the

A

superior intercostal artery in the first two intercostal spaces

85
Q

the remaining posterior intercostal Arties are branches of the

A

descending thoracic aorta

86
Q

most of the posterior intercostal veins return blood to the

A

azygous and hemiazygos veins

87
Q

posterior intercostal vein exception

A

left superior intercostal

88
Q

thoracentesis

A

insertion of the needles just superior to the rib should avoid injuring the intercostal nerve and Bessel

89
Q

VAN

A

vein
artery
nerve

Anatomy (29 decks)

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