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Anatomy (Karen) > Thoracic walls > Flashcards

Thoracic walls Flashcards

1
Q

Breast tissue extends from

A
  • 2-6th rib
  • lateral border of sternum to mid-axillary line
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2
Q

Base of the breast overlies

A

pec major and serratus anterior

*base is concave in shape

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3
Q

What is the sub/retromammary space?

A

between breast tissue and pec major & serratus anterior

contains loose areola CT

where breast implants are inserted

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4
Q

What is the blood supply of the breast?

A

shares arterial, venous, and lymphatic drainage with the thoracic wall and the upper limb

axillary atery laterally

internal thoracic artery medially

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5
Q

Thoracic cage consits of

A

12 thoracic vertebrae & IV discs

12 pairs of ribs

manubrium and sternum

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6
Q

Which costal cartilages articulate directly with the manubriosternal complex?

A

upper 7

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7
Q

Which costal cartialges articulate with the one above it?

A

on ribs 8, 9, and 10

forms the costal margin

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8
Q
A
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9
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A
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10
Q
A
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11
Q

What are the thoracic three?

A

features that identify a thoracic vertebrae:

  • demi facets (body)
  • transverse facets (transverse process)
  • spinous process)
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12
Q

What are the two articulations between the ribs and thoracic vertebra posteriorly?

A
  • costovertebral joint
    • superior articular facet on head of rib with IV disc and inferior demi-facet on vertebra above; inferior articular facet of rib with superior demi-facet on vertebral body
    • covered by radiate ligament
  • costotransverse joint
    • tubercle of rib body with facet of transverse process
    • supported by costotransverse ligament
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13
Q

The supeior aperture is reduced by

A

the suprapleural membrane

attaches ti the internal surface of the (flat) first rib

houses lung, pleural cavity, allows passage of mediastinum

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14
Q

What closes the inferior aperture?

A

diaphragm

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15
Q

What is the origin of the diaphragm?

A
  • circumferential:
    • xiphloid process
    • costal margin
    • tips of 11th and 12th ribs
    • arcuate ligaments
    • lumbar vertebral column
    • R & L crus
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16
Q

What forms the arcuate ligaments?

A

fascia overluing quadratus lumborum and psoas major

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17
Q

What are the borders of the R crus?

A

anterior L1-L3

because dome of R diaphragm is higher (over the liver), longer than L crus

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18
Q

What are the borders of the L crus?

A

anterior L1-L2

(shorter than R bc L hemidiaphragm sits lower)

19
Q

What is the insertion of the diaphragm?

A

central tendon

20
Q

Where does the IVC enter the diaphragm?

A

caval orifice: T8, R of midline, through central tendon

21
Q

Where does the oesophagus enter the diaphragm?

A

oesophageal hiatus: T10, L of midline, through muscle

22
Q

Where does the aorta enter the diaphragm?

A

T12, midline, along the vertebral column between the crurae

23
Q

Where does the R phrenic nerve enter the diaphragm?

A

at T8 through the caval orifice with the IVC

24
Q

Where does the left phrenic nerve enter the diaphragm?

A

pierces the left hemidiaphragm

25
Q

Contraction of the diaphragm results in

A

central fibres pulling towards the margins

central tendon goes down

inspiration

26
Q

What direction are the fibres of the external intercostals?

A

“hands in front pockets”

anteroinferior fibres

27
Q

What is the function of the external intercostals?

A
  • muscles of inspiration
  • contraction pulls rib below up and out, expanding the ribcage laterally (decreases pressure)
28
Q

What is the path of the external intercostal muscles?

A

extend over whole of rib space from posterior to costochondral junction

replaced with external intercostal membrane here

29
Q

What direction are the fibres of the internal intercostal muscles?

A

“hands in back pockets”

posteroinferior fibres

30
Q

What is the function of the internal intercostal muscles?

A

contraction pulls ribs down and in

theoretically expiratory but serve more of a splinting role w/innermost ICMs

31
Q

What is the path of the internal intercostals?

A

extends anterior to posterior

replaced with internal IC membrane

32
Q

What direction are the fibres of the innermost intercostals?

A

“hands in back pockets”

posteroinferior fibres

(follow internal intercostals)

33
Q

What is the function of the innermost intercostals?

A

splinting

34
Q

What is the path of the innermost intercostals?

A

discontinuous

35
Q

Where does the neurovascular bundle run?

A

in the costal groove

between innermost and internal ICMs

36
Q

What is the order of the intercostal neurovascular bundle from top to bottom?

A

Vein

Artery

Nerve

37
Q

What gives rise to the nerve supply of the intercostal neurovascular bundle?

A
  • thoracic spinal nerve exits through intervertebral foramen
  • gives off dorsal ramus that innervates the back muscles and skin
  • gives off ventral ramus that slips in between the innermost and internal ICMs
    • runs posterior to anterior
    • supplies muscles, cutaneous branches anterior and laterally to overlying skin (dermatomes)
38
Q

Where does the arterial supply to the intercostal neurovascular bundle arise?

A

posterior:

  • intercostal artery comes off dorsal aorta, splits into dorsal intercostal artery and posterior intercostal artery

anterior:

  • internal thoracic artery next to the sternum becomes the anterior intercostal artery which anastamoses with the posterior intercostal artery laterally in the thoracic cage
39
Q

What gives the venous supply to the intercostal neurovascular bundle?

A
  • intercostal veins follow the intercostal arteries
  • anterior intercostal vein in each intercostal space running opposite alongside arteries
  • azygous vein receives all posterior intercostal veins
40
Q
A
41
Q

What alters the vertical dimensions of the intra-thoracic space?

A
  • movement of the diaphragm:
    • down (contraction) increases thoracic space
    • up (relaxation) decreases thoracic space
42
Q

What alters the lateral dimensions of the thoracic cage?

A
  • elevation and depression of the lower ribs (8-12)
    • bucket handle movement
  • elevation of the lateral ribs increases the diameter
  • depression decreases the diameter
43
Q

What alters the anteroposterior dimensions of the thoracic cavity?

A
  • elevation of the upper ribs
    • pump handle movement
  • upper ribs 1-7 (attached to sternum) push sternum forward on elevation
    • increases AP diameter
44
Q

What are the accesory muscles of respiration?

A
  • any muscle that attaches to the ribs
  • scalenes & sternocleidomastoid in the neck
    • elevate upper ribs
  • abdominal muscles
    • pull rib cage down and in

Anatomy (Karen) (16 decks)

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