Thoracic Wall; Thoracic Cavity; Breast Flashcards
1
Q
Identify
A
Superior Thoracic Aperture: Opening to upper extremity and neck
- formed by T1, 1st ribs, manubrium
- Passing through: Trachea, esophagus, nerves (phrenic, vagus)
2
Q
Identify (green)
A
Inferior Thoracic Aperture
- Formed by: T12, ribs 11, 12; costal cartilages 7-10; xiphisternal junction
- Passing through: Aorta, esophagus, inferior vena cava
3
Q
What ribs are considered Vertebrocostal or “True” ribs
A
Ribs 1-7
4
Q
Which ribs are considered vertebrochondral or “False” ribs?
A
Ribs 8-10
5
Q
Which ribs are considered vertebral or “Floating” ribs?
A
Ribs 11-12
6
Q
Identify
A
Costal Cartilages
7
Q
Identify
A
Interchondral joints
8
Q
Identify
A
Costochondral joints
9
Q
Identify blue arrow
A
Head of rib
10
Q
Identify yellow arrow
A
Neck of rib
11
Q
Identify black arrow
A
Tubercle of rib
12
Q
Identify red arrow
A
angle of rib
13
Q
Identify light green arrow
A
Body of rib
14
Q
Identify Dark green arrow
A
Costal groove
15
Q
The two facets on the head of the rib articulate with what?
With what does the tubercle of rib articulate with?
A
- 2 vertebral bodies
- transverse process of vertebrae
16
Q
Identify
A
Xiphoid process (T10)
17
Q
Identify
A
Body (corpus) of sternum (T5-T9)
18
Q
Identify
A
Manubrium (T3-T4)
19
Q
Identify
A
Jugular notch (T2)
20
Q
Identify
A
Clavicular notches
21
Q
Identify
A
Costal notches
22
Q
Identify
A
Sternal angle (T4/5)
23
Q
Identify (red line)
A
Xiphisternal junction (T10)
24
Q
What happens to the thoracic wall during Forced Expiration
A
Muscle actions “shrink” thoracic cage to force air out of lungs
25
What happens to thoracic wall during forced inspiration?
Muscle actions "expand" thoracic cage to suck air into lungs
26
1. Identify black arrow.
2. Fiber direction?
3. Action
4. What innervates this muscle?
* Internal Intercostal muscle
* Fiber direction: Infero-lateral
* Most active during Forced Expiration
* non-muscluar membrane posteriorly
* Innervated by intercostal nerves (anterior rami)
27
1. Identify green arrow
2. Fiber Direction
3. Action
4. Innervation
* External Intercostal muscles
* Infero-medial fiber orientation ("hands in pockets")
* active during forced inspiration (elevate ribs)
* Non-musclar membrane anteriorly
* Innervation: Intercostal nn (anterior rami)
28
1. Identify red arrow
2. Action
3. Innervation
1. Innermost intercostal muscles
2. Active during forced expiration
3. Non-musclar membrane anteriorly and posteriorly
4. Innervation: Intercostal nn (anterior rami)
29
Identify red box
* Right crus: Larger (contains esophageal hiatus)
* Musculotendinous bundle arising from L1-L4
30
Identify black box
* Left crus: smaller
* Musculotendinous bundle arising from L1-L4
31
Abdominal Diaphragm
* Origin
* Insertion
* Action
* Innervation
* **Origin**: xiphoid process, costal cartilage, ribs 11-12, Crura
* **Insertion**: Central tendon
* **Action**: Contraction causes diaphragm to depress -\> increases volume of thoracic cavity -\> Decreases pressure -\> air rushes in
* **Innervation**:
* Motor: Phrenic nerves (C3-5)
* Central sensory: Phrenic nn
* Peripheral sensory: inferior intercostal nn
32
Identify red arrow
* Location
* What structure runs through?
* Caval Opening (T8)
* In central tendon
* IVC
33
Identify black arrow
* Location
* What structure runs through
* Esophageal hiatus (T10)
* In right crus
* Esophagus
34
Identify green arrow
* Aortic Hiatus
* Formed by left and right crura
* Aorta; Azygos vein; Thoracic duct
35
Identify
* Action?
* Transversus Thoracis
* Location: Between costal cartilages and sternum
* Action: Proprioception; weakly depress ribs
36
Anterior rami T1-T12 turn into what nerves?
* T1-T11: Intercostal nerves
* T12: Subcostal nerve
* run between internal and innermost intercostal mm
37
Identify
* Collateral branch
* Location: Branches off intercostal nn near rib angle and runs along superior margin of next inferior rib
* Run between internal and innermost intercostal mm.
38
Intercostal nerve block
* inject 7 cm lateral to midline
* Used for: Breast surgeries; Thoracotomies; pain relief from rib fx
39
Identify red box
Internal Thoracic Arteries
40
Identify black box
* Anterior Intercostal aa.
* Branches of internal thoracic a
* Anastomoses with posterior IC aa
41
Identify Green box
* Posterior Intercostal aa
* branches of thoracic aorta
* Course with costal groove
42
Identify black arrow
Superior Epigastric artery
* Inferior terminal branches of internal thoracic artery
43
Name the arteries that laterally come off the terminal branches of internal thoracic aa?
Musculophrenic aa
44
Anterior intercostal veins
* Run parallel to artery
* drain into brachiocephalic vv
45
Identify black box
Azygos vein
46
Cutaneous innervation of breast?
T3-T5
47
Identify
Retromammary space
* Potential space between breast tissue and pectoralis major
48
Identify (orange)
Axillary process (Axillary tail)
49
Identify (green)
Lactiferous ducts with sinuses
50
Identify
1. black arrow
2. red arrow
1. black: Suspensory ligament of Cooper
2. red: Mammary gland
51
Aterial supply of breast
1. Medial mammary branches (from internal thoracic a.)
2. Lateral mammary branches (from lateral thoracic aa and posterior intercostal aa)
52
Venous drainage of breast
* parallels arterial supply: Medial and lateral mammary vv
* drain mostly into axillary vein (some to internal thoracic v and some to posterior IC vv)
53
Identify
1. Red arrow
2. Black arrow
3. Blue arrow
1. Red: Parasternal nodes (25%)
2. Black: Subareolar plexus
3. Blue: Axillary nodes (75%)
54
Anatomical warning signs of breast cancer
* Recent asymmetry in breast size
* Discharge from nipple
* Redness of skin of breast
