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Anatomy > Thorax 1 > Flashcards

Thorax 1 Flashcards

1
Q

What is the structure of the thoracic wall?

A

skin–>fascia–>muscles–>bones and cartilage, blood vessels and nerves

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2
Q

What are the functions of the thoracic wall?

A

-Protects thoracic and some abdominal viscera
-Provides the mechanical function of breathing
-Provides attachment for the upper limb, neck back
muscles

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3
Q

What does the thoracic wall consist of?

A

-Sternum
-12 pairs of ribs and costal cartilages(CCs)
-12 thoracic vertebrae

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4
Q

How many intercostal spaces does the thoracic wall have?

A

Intercostal spaces ( 11)

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5
Q

What are the boundaries of the superior thoracic opening?

A

T1 Vertebra,
first rib,
manubrium

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6
Q

What are the boundaries of the inferior thoracic opening?

A

T12 vertebra,
11th& 12thribs,
7th-10th CCs,
xiphisternal joint

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7
Q

What is the sternum?

A

Flat, vertically elongated bone

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8
Q

What forms the sternum?

A

Forms the middle anterior part of the thoracic cage

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9
Q

What is the sternal angle also known as?

A

The manubriosternal joint
(angle of Louis)

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10
Q

What is the anatomical location of the sternal angle?

A

Opposite to the 2nd costal cartilage:
At the level of the T4-T5 disc

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11
Q

What are the 3 types of ribs and there vertebrae level?

A

-True ribs (1st-7th): vertebro-sternal
-False ribs(8th-10th): vertebro-chondral
-Floating(11th and 12th): Free

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12
Q

What are the features of typical ribs?

A

ØAnterior costal end articulate with its CC
ØShaft/body
ØPosterior vertebral end (head, neck and tubercle)

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13
Q

What ribs are considered typical

A

3rd– 9th ribs are considered typical

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14
Q

What is the superior margin of typical ribs like?

A

Smooth

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15
Q

What is the inferior margin of typical ribs like?

A

Sharp

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16
Q

What do typical ribs articulate with?

A

articulate with 2
vertebrae

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17
Q

What do non-typical/atypical ribs articulate with?

A

Non-typical/ Atypical:
articulate with its own
vertebra.

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18
Q

What ribs are atypical?

A

Atypical ( 1, 2,10,11,12)

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19
Q

What is the first rib like?

A

Highest, shortest, strongest, flattest,most curved, most fixed rib

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20
Q

Where is the scalene tubercle on the first rib?

A

Scalene Tubercle; on the inner border for insertion of scalene anterior muscle

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21
Q

What are the grooves for in the first rib?

A

Grooves for the subclavian vein in front of it , and behind it for subclavian artery , and lower trunk of brachial plexus.

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22
Q

Where do ribs fracture in adults?

A

*In adults ribs fractures at the weakest point i.e. at the angle

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23
Q

Where does thoracic outlet syndrome impact?

A

On the superior thoracic opening
(anatomical inlet)

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24
Q

What occurs in thoracic outlet syndrome?

A

Compression of brachial plexus,
subclavian artery and/or subclavian vein

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25
Q

What are the symptoms of thoracic outlet syndrome?

A

Pale colour & coldness on the skin of the
upper limb

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26
Q

What are the causes of thoracic outlet syndrome?

A

Causes: trauma, anatomical defect like
cervical rib

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27
Q

What happens to radial pulse in thoracic outlet syndrome?

A

Diminished radial pulse

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28
Q

What is a cervical rib?

A

A rib arising from
the anterior
tubercle of TP of C7

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29
Q

What can a cervical rib cause?

A

Can cause pressure
on the lower
brachial plexus or
subclavian vessels

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30
Q

What do deltoid muscles do?

A

Abduct arm

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31
Q

What do the clavicular fibres assist in the deltoid with?

A

Clavicular fibers assist in arm flexion

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32
Q

What do posterior fibres assist in the deltoid with?

A

Posterior fibers assist in arm extension

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33
Q

What does the pectoralis major do?

A

Adducts arm

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34
Q

What does the pectoralis major medially rotate?

A

Medially rotates
humerus

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35
Q

What does the pectoralis major extend?

A

Extends flexed
arm

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36
Q

What is the origin of the clavicular part of the pectoralis major?

A

anterior surface of medial half of clavicle

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37
Q

What is the origin of the sternocostal part of the pectoralis major?

A

anterior surface of sternum, Costal cartilages of ribs 1-6

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38
Q

What is the origin of the abdominal part of the pectoralis major?

A

Anterior layer of rectus sheath

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39
Q

Where is the insertion of the pectoralis major?

A

Crest of the greater tubercle of the humerus

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40
Q

What is the function of the pectoralis minor?

A

Depression of scapula

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41
Q

Where is the origin of the pectoralis minor?

A

Anterior surface, costal cartilages of ribs 3-5

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42
Q

Where is the insertion of the pectoralis minor?

A

Coracoid process of scapula

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43
Q

What is the function of the serratus anterior?

A

Protraction and rotation of scapula

44
Q

What is the origin of the superior part of the serratus anterior?

A

Ribs 1-2, intercostal fascia

45
Q

What is the origin of the middle part of the serratus anterior?

A

Ribs 3-6

46
Q

What is the origin of the inferior part of the serratus anterior?

A

Ribs 7-8/9/10 and the external oblique muscle

47
Q

What is the insertion of the superior part of the serratus anterior?

A

Anterior and posterior surface of superior angle of scapula

48
Q

What is the insertion of the middle part of the serratus anterior?

A

Anterior surface of entire medial border of scapula

49
Q

What is the insertion of the inferior part of the serratus anterior?

A

Anterior and posterior surface of inferior angle of scapula

50
Q

What is the origin of the external intercostal muscle?

A

Inferior border of ribs

51
Q

What is the insertion of the external intercostal muscle?

A

Superior border of immediate rib below

52
Q

What is the origin of the internal intercostal muscle?

A

Costal groove of ribs

53
Q

What is the insertion of internal intercostal muscle?

A

Superior border of immediate rib below

54
Q

What is the origin of innermost intercostal miscle?

A

Costal groove of ribs

55
Q

What is the insertion of the innermost intercostal muscle?

A

Superior border of immediate rib below

56
Q

What is the direction of the external intercostal muscle fibre?

A

-Downward and forwards
-‘Hands in pockets’

57
Q

What is the direction of the internal and innermost intercostal muscle fibre?

A

-‘Upwards and forwards’
-‘Hands on shoulders’

58
Q

What is the direction of the internal intercostal muscle fibres?

A

-‘Upwards and forwards’
-‘Hands on shoulders’

59
Q

What is the subcostalis?

A

Internal surface of one rib to internal surface of another

60
Q

What are the transverse thoracis?

A

From xiphoid process and lower body of sternum to lower border of CCs 3-6

61
Q

What intercostal muscles are most active during inspiration?

A

External intercostal muscles

62
Q

What do interchondral portions of the internal intercostal elevate during inspiration?

A

Elevate ribs and sternum

63
Q

What intercostal musclesa re most active during expiration, what portion and what do they do to the ribs and sternum?

A

Internal intercostal muscles
-Interosseous portion
-Depress ribs and sternum

64
Q

What does the diaphragm seperate?

A

Separates the thoracic cavity
above and the abdominal
cavity below

65
Q

What shape was the diaphragm?

A

Dome shaped

66
Q

What does the diaphragm consist of?

A

Consists of:
-Peripheral muscular part
-Centrally placed tendon

67
Q

What nerve innervates the diaphragm?

A

Phrenic nerve

68
Q

What is the shape of the diaphragm during inspiration?

A

Contracted and flattened

69
Q

What is the shape of the diaphragm during expiration?

A

Relaxed and elevated

70
Q

What do changes in the anteroposterior and lateral dimensions result from?

A

Changes in the anteroposterior and lateral dimensions result from
elevation and depression of the ribs

71
Q

How does the anteroposterior diameter of the thoracic cage represent the pump-handle effect?

A

When intercostal muscles contract:
-Upper ribs rise upwards and outwards in a similar fashion to a pump handle
-This increases anteroposterior diameter of thorax, drawing air into lungs

72
Q

How does the transverse diameter of the thoracic cage represent bucket-handle effect?

A

-Ribs articulate in front with the sternum and behind with vertebral column
-Curve downward and resemble bucket handles

73
Q

How is the intercostal neurovascular bundle arranged?

A

VAN:
Vein –> Artery –> Nerve

74
Q

Where is the intercostal neurovascular bundle found between?

A

Found between the internal and innermost intercostal muscles

75
Q

What is the intercostal neurovascular bundle protected by?

A

Protected by the costal groove of the superior rib

76
Q

What does the intercostal nerve branch into?

A

Branches into:
-Posterior ramus
-Lateral cutaneous branch

77
Q

What does the lateral cutaneous branch of the intercostal nerve branch into?

A

-Posterior branch
-Anterior branch

78
Q

What does the collateral branch of the intercostal nerves give off?

A

Gives off muscular branches

79
Q

What does the anterior cutaneous branch of the intercostal nerve repersent?

A

Termination of intercostal nerve

80
Q

Where do the anterior rami of the intercostal nerves, T1-T6 pass by?

A

-1-6 intercostal spaces

81
Q

Where do the anterior rami of the intercostal nerves, T7-T9 pass by?

A

Pass deep to CCs to enter the anterior abdominal wall

82
Q

Where do anterior rami of the intercostal nerves, T10-T11 pass by?

A

10-11 pass directly to the anterior
abdominal wall

83
Q

What is the intercostal nerve at T12 also known as?

A

Subcostal nerve

84
Q

What are intercostal nerves joined to at T1?

A

Joined to brachial plexus

85
Q

What branches do intercostal nerves not have at T1?

A

-No lateral cutaneous branch
-No anterior cutaneous branch

86
Q

What intercostal arteries does each intercostal space have apart from which 2 spaces?

A

-Large posterior intercostal artery
-Small anterior intercostal arteries
-Apart from the 10th and 11th space

87
Q

What intercostal arteries are present in the posterior thoracic cage?

A

-Superior intercostal artery (1st, 2nd spaces)
-Descending aorta (3-12 spaces)

88
Q

What intercostal arteries are present in the anterior thoracic cage?

A

-Internal thoracic artery(1-6 spaces)
-Musculophrenic artery(7-9 spaces)

89
Q

What intercostal vein does each intercostal space have?

A

-Large posterior intercostal vein
-Small anterior intercostal veins

90
Q

What intercostal vein does the posterior thoracic cage have?

A

Azygos vein and hemiazygos vein

91
Q

What intercostal vein does the anterior thoracic cage have

A

Internal thoracic vein and musculophrenic vein

92
Q

What intercostal vein does the right brachiocephalic vein receive from and via what veins?

A

Receives anterior intercostal veins via internal thoracic and musculophrenic veins

93
Q

What intercostal veins does the azygous vein receive from?

A

receives lower 8 right posterior intercostal
veins, right superior intercostal vein and
hemiazygous veins

94
Q

What does the left superior intercostal vein drain and what does it drain into?

A

drains 2-3rd left posterior intercostal veins
-Drains into the left brachiocephalic vein

95
Q

What intercostal vein does the superior (accessory) hemiazygos vein receive from?

A

receives 4-8th left posterior intercostal veins

96
Q

What intercostal vein does the inferior hemiazygos vein receive from?

A

Receives 9-11th left posterior intercostal
veins

97
Q

What do both superior and inferior hemiazygos vein drain into?

A

Drain into azygous vein

98
Q

What does the Left ascending lumbar vein branch into?

A

Branches into left subcostal vein and inferior hemiazygos vein

99
Q

What is the breast also a modified version of?

A

Modified sweat gland

100
Q

Where does the breast lie?

A

It lies in the superficial fascia of the front of the
chest

101
Q

What is the shape of the breast like

A

Conical

102
Q

Where does the breast extend from?

A

It extends from the lateral margin of the
sternum to the midaxillary line

103
Q

What ribs does the breast overlie?

A

Overlies the 2nd-6th rib

104
Q

What muscle does the breast rest on?

A

-2/3 of it rests on pectoralis major
-1/3 rests on serratus anterior

105
Q

What are the 3 main sources of arterial blood to the breast?

A
  1. Perforating branches of the internal thoracic (internal mammary) artery
  2. Mammary branches of the lateral thoracic artery
  3. Mammary branches of intercostal arteries
106
Q

What is the venous supply of breasts?

A

-Circular venous plexus are found at the base of nipple
-Finally veins of this plexus drain into axillary and internal thoracic veins

Anatomy (12 decks)

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