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BLOCK B - RESPIRATION > Thoracic Wall & Respiratory Muscles > Flashcards

Thoracic Wall & Respiratory Muscles Flashcards

1
Q

What are the three subdivisions of the sternum?

A

Manubrium
Body of sternum
Xiphoid process

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2
Q

Thoracic cage is made up of …

A

ribs

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3
Q

What is another name for shoulder blade?

A

scapula

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4
Q

Manubriosternal joint
- alternative name
- where
- vertebral level

A
  • Manubriosternal joint - sternal angle
  • Between the manubrium and body of sternum
  • T4/T5 vertebral level (2nd rib)
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5
Q

Xiphisternal joint
- where
- vertebral level

A
  • Between body of sternum and xiphoid process
  • T9 vertebral level
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6
Q

Why do our ribs and vertebral levels not align?

A

Because ribs are not perfectly horizontal!

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7
Q

How do we number intercostal spaces?

A

4th intercostal space would be below the 4th rib

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8
Q

The nipple is an important landmark of…

A

the T4 dermatome

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9
Q

Breasts contain a lot of what kind of tissue? (2)

A

Adipose and glandular tissue

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10
Q

Lobules in the breast can be in 2 states:

A

resting lobule
lactating lobule

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11
Q

The areola surrounds the… and is a…

A

The aureola surrounds the nipple and is a visual and tactile target for the infant during breastfeeding.

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12
Q

What intercostal space does the nipple align with?

A

With the space between rib 4 and rib 5 (4th intercostal space)

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13
Q

Embryonic mammary crest is also called…

A

milk line

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14
Q

Polymastia

A

Presence of more than two mammary glands (may include presence of extra breast tissue)

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15
Q

Polythelia

A

Presence of more than two nipples

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16
Q

What is the role of glandular tissue in the breast?

A

Production of colostrum (first milk) and milk

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17
Q

What is the indent at the top of the manubrium?

A

Sternal notch (aka jugular notch)

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18
Q

What vertebral level does the sternal/jugular notch align with?

A

T2/T3 vertebral level

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19
Q

Superior thoracic aperture follows…

A

the first (superior) thoracic rib

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20
Q

Inferior thoracic aperture follows…

A

the inferior border of our thoracic cage (infrasternal/subcostal angle + costal margin)

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21
Q

Thoracic outlet syndrome

A

Condition resulting from pressure on blood vessels and nerves between the collarbone and first rib.

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22
Q

How many rib pairs do we have?

A

12 rib pairs (corresponding to 12 pairs of thoracic nerves)

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23
Q

What are the “true ribs” and what are they called

A
  • Vertebrocostal ribs (1-7)
  • Ribs that attach directly to the sternum
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24
Q

What are the “false ribs” and what are they called

A
  • Vertebrochondral ribs (8-10)
  • Connect to sternum indirectly through the costal cartilage of the 7th rib
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25
Q

What are the “floating ribs” and what are they called

A
  • Vertebral/free ribs (11-12)
  • Do not attach to the sternum at all, only to the vertebrae in the back
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26
Q

Define synarthrosis and synostosis

A

Synarthrosis: Joint has little to no movement (e.g. manubrosternal joint and xiphisternal joint)

Synostosis: Fusion of bones (e.g. manubriosternal and xiphisternal joint often fuse in late adulthood)

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27
Q

Sternoclavicular joint

A

Only true joint that attaches our limbs to our axial body.

28
Q

Why do we have a costal groove on our ribs?

A

It is where the intercostal neurovascular bundles (VAN) travel.

29
Q

What is a facet?

A

A point of articulation

30
Q

How many facets do our typical ribs have?
How many facets on rib 1?
How many facets on ribs 10-12?

A

Typical ribs: 3 articular facets
Atypical ribs:
* rib 1: 2 facets
* rib 10-12: 1 facet

31
Q

What are demi-facets?

A

Articulation surfaces of vertebral bodies

32
Q

A) The superior facet on the head of the rib articulates with…
B) The inferior facet on the head of the rib articulates with the…
C) The articular facet on the tubercule of the rib articulates with the…

A

A) the inferior demi-facet of the vertebral body
B) superior demi-facet of the vertebral body
C) transverse costal facet on the transverse process of the vertebra

33
Q

Rib number corresponds to…

A

the inferior vertebrae to which the ribs is attached to

34
Q

Costovertebral joint

A

Articulation between the head of the rib and the vertebral body

35
Q

Costotransverse joint

A

Articulation between the tubercle of the rib and the transverse process of the vertebral body

36
Q

Costovertebral and costotransverse joints are examples of… (2)

A

Synovial joints: Joint contains sinovial fluid, allowing for a wide range of movement
Diarthrosis: Articulation that permits free movement

37
Q

Articulations between ribs 1-7 have what type of movement? What does it result in?

A

Rotational movement
Increases anteroposterior diameter of the thorax

38
Q

Articulations between ribs 8-10 have what type of movement? What does it result in?

A

Translational (gliding) movement
Increases transverse diameter of thorax

39
Q

What are the 3 types of anterior costal joints?
What are the 2 types of posterior costal joints?

A

Anterior:
1. Costochondral
2. Sternochondral
3. Interchondral

Posterior
1. Costotransverse
2. Costovertebral

40
Q

Costochondral joints
Sternocostal joints
Interchondral joints

A

Costochondral: Joint between rib and hyaline (costal) cartilage

Sternocostal: Joint between hyaline (costal) cartilage and sternum

Interchondral: Joint between two hyaline (costal) cartilage regions (e.g. between ribs 8-10 and rib 7)

41
Q

What is the dermatome?

A

Skin innervated by sensory fibres of a single spinal nerve

42
Q

Intervertebral foramina

A

Holes between adjacent vertebrae through which spinal nerves pass

43
Q

In the thoracic region, nerves are numbered according to which vertebra?
a) inferior
b) superior

A

b) superior (e.g. T6 vertebra is above the T6 nerve)

44
Q

Name the structures associated with the following dermatomes.
T2:
T4:
T6:
T10:

A

T2: sternal angle
T4: nipples
T6: xiphoid process
T10: umbilicus

45
Q

Do thoracic nerves cross the midline?

A

No! They do not cross the midline

46
Q

What are the 3 types of intercostal muscles

A

External intercostal muscles
Internal intercostal muscles
Innermost intercostal muscles

47
Q

External intercostal muscles function

A

Elevate the ribs when we breathe in

48
Q

Internal intercostal muscles function

A

Depress the ribs (pull them down) during deep or forced expiration

49
Q

Innermost intercostal muscles function

A

Probably function similarly to internal intercostal muscles (depress ribs during expiration)

50
Q

Subcostal muscles

A

Involved in the depression of ribs
Span between more than 1 rib (longer than intercostal muscles)
Attach on the angle of the ribs (in the back)

51
Q

Between which muscles is the neurovascular bundle?

A

Between the innermost and internal intercostal muscles.

52
Q

Transversus thoracis muscles

A

Involved in the depression of ribs
Found on the posterior surface of the inferior sternum

53
Q

What innervates al intercostal and subcostal muscles?

A

Intercostal nerves

54
Q

Diaphragm attaches onto the …

A

inferior thoracic aperture

55
Q

Diaphragm shape and why

A

Dome shaped (sticks up into thorax) due to presence of abdominal organs.

56
Q

Which dome is higher than the other? Why?

A

The right dome is slightly higher than the left dome due to the presence of the liver on that side.

57
Q

What is the central attachment of the diaphragm?

A

Central tendon

58
Q

Diaphragm forms the boundary between…

A

the thorax and abdomen

59
Q

What innervates the diaphragm?

A

The phrenic nerve (C 3,4,5)

60
Q

Structures spanning between the thorax and abdomen pass through or behind the diaphragm through 3 major openings:

A
  1. Caval hiatus in the central tendon
  2. Esophageal hiatus in muscle
  3. Aortic hiatus
61
Q

The inferior vena cava passes through the diaphragm via..

A

the cavial hiatus (T8 level)

62
Q

The esophagus passes through the diaphragm via…

A

esophageal hiatus (T10 level)

63
Q

The aorta passes through the diaphragm via…

A

the aortic hiatus (T12 level)

64
Q

What happens to the intra-abdominal pressure when the diaphragm muscular components contract?

A

It increases (becomes more positive)

65
Q

What happens to the intra-thoracic pressure when the diaphragm muscular components contract?

A

It decreases (becomes more negative)

BLOCK B - RESPIRATION (31 decks)

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