Thoracic Wall & Respiratory Muscles Flashcards by amelia k

What are the three subdivisions of the sternum?

Manubrium
Body of sternum
Xiphoid process

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Thoracic cage is made up of …

ribs

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What is another name for shoulder blade?

scapula

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Manubriosternal joint
- alternative name
- where
- vertebral level

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

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Xiphisternal joint
- where
- vertebral level

Between body of sternum and xiphoid process
T9 vertebral level

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Why do our ribs and vertebral levels not align?

Because ribs are not perfectly horizontal!

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How do we number intercostal spaces?

4th intercostal space would be below the 4th rib

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The nipple is an important landmark of…

the T4 dermatome

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

Adipose and glandular tissue

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Lobules in the breast can be in 2 states:

resting lobule
lactating lobule

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The areola surrounds the… and is a…

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

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What intercostal space does the nipple align with?

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

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Embryonic mammary crest is also called…

milk line

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Polymastia

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

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Polythelia

Presence of more than two nipples

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What is the role of glandular tissue in the breast?

Production of colostrum (first milk) and milk

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What is the indent at the top of the manubrium?

Sternal notch (aka jugular notch)

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

T2/T3 vertebral level

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Superior thoracic aperture follows…

the first (superior) thoracic rib

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Inferior thoracic aperture follows…

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

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Thoracic outlet syndrome

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

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How many rib pairs do we have?

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

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

Vertebrocostal ribs (1-7)
Ribs that attach directly to the sternum

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

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

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What are the "floating ribs" and what are they called

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

Define synarthrosis and synostosis

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)

Sternoclavicular joint

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

Why do we have a costal groove on our ribs?

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

What is a facet?

A point of articulation

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

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

What are demi-facets?

Articulation surfaces of vertebral bodies

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) 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

Rib number corresponds to...

the inferior vertebrae to which the ribs is attached to

Costovertebral joint

Articulation between the head of the rib and the vertebral body

Costotransverse joint

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

Costovertebral and costotransverse joints are examples of... (2)

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

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

Rotational movement Increases anteroposterior diameter of the thorax

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

Translational (gliding) movement Increases transverse diameter of thorax

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

Anterior: 1. Costochondral 2. Sternochondral 3. Interchondral Posterior 1. Costotransverse 2. Costovertebral

Costochondral joints Sternocostal joints Interchondral joints

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)

What is the dermatome?

Skin innervated by sensory fibres of a single spinal nerve

Intervertebral foramina

Holes between adjacent vertebrae through which spinal nerves pass

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

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

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

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

Do thoracic nerves cross the midline?

No! They do not cross the midline

What are the 3 types of intercostal muscles

External intercostal muscles Internal intercostal muscles Innermost intercostal muscles

External intercostal muscles function

Elevate the ribs when we breathe in

Internal intercostal muscles function

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

Innermost intercostal muscles function

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

Subcostal muscles

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)

Between which muscles is the neurovascular bundle?

Between the innermost and internal intercostal muscles.

Transversus thoracis muscles

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

What innervates al intercostal and subcostal muscles?

Intercostal nerves

Diaphragm attaches onto the ...

inferior thoracic aperture

Diaphragm shape and why

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

Which dome is higher than the other? Why?

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

What is the central attachment of the diaphragm?

Central tendon

Diaphragm forms the boundary between...

the thorax and abdomen

What innervates the diaphragm?

The phrenic nerve (C 3,4,5)

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

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

The inferior vena cava passes through the diaphragm via..

the cavial hiatus (T8 level)

The esophagus passes through the diaphragm via...

esophageal hiatus (T10 level)

The aorta passes through the diaphragm via...

the aortic hiatus (T12 level)

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

It increases (becomes more positive)

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

It decreases (becomes more negative)