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anatomy (graces's) > Thorax 1 > Flashcards

Thorax 1 Flashcards

1
Q

The thorax is the…

A

…part of the trunk betweent the neck and abdomen.

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2
Q

The **thoracic skeleton **contains…

A
  • the thoracic cage (rib cage)

with the horizontal bars formed by ribs and costal cartilages

supported by the vertical sternum and thoracic vertebrae.

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3
Q

What makes up the floor of the thoracic cavity?

A

the diaphragm

deeply invaginated inferiorly (i.e., is pushed upward) by viscera of the abdominal cavity

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4
Q

the lower half of the thoracic wall surrounds and protects… ?

(what viscera?)

A

abdominal rather than thoracic viscera.

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5
Q

the **true thoracic wall **includes…

A
  • thoracic cage and the muscles that extend between its elements
  • the skin, subcutaneous tissue, muscles, and fascia covering its anterolateral aspect

(the same structures covering its posterior aspect are considered to belong to the back)

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6
Q

the **thorax **includes primary organs from what systems?

A

respiratory & cardiovascular

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7
Q

What are the compartments of the thoracic cavity?

A
  1. central compartment (or mediastinum):

= heart, great vessels, thalamus, esophagus, trachea, thoracic nerves

2&3. lateral compartments (R/L pleural cavities) :

= the lungs + right&left pleura

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8
Q

The majority of the thoracic cavity is filled by ____________.

Its function is to ________________________.

A

the lungs.

exchange of oxygen and carbon dioxide between air and blood.

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9
Q

The smaller thoracic compartment

contains structure responsible for _________________?

A

Conducting the **air and blood to and from the lungs. **

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10
Q

Nutrients traverse the thoracic cavity via the ______________ ,

passing from the ___________________ to the ________________________.

A

- esophagus

  • from the** intake organ (mouth)** to the** site of digestion and absorption (abdomen)**
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11
Q

The breasts & mammary glands…

A

… mammary glands lie within the subcutaneous tissue of the thoracic wall

… are mostly related to the reproductive system

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12
Q

chest pain is….

A

… the most important symptom of cardiac disease

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13
Q

chest pain can also occur from…

A

intestinal, gallbladder, and musculoskeletal disorders.

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14
Q

An examination of chest pain should focus on…

A

discriminating between serious conditions and the many minor causes of pain.

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15
Q

heart attack pain is usually described as…

A

severe sub-sternal pain (deep to the sternum) that does not disappear with rest.

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16
Q
A
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17
Q

What group of muscles are encountered in the thoracic wall and may be considered part of it?

A

anterolateral thoracoappendicular

(pectoralis major and serratus anterior)

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18
Q

thoracic cage functions:

A
  1. Protect vital thoracic & abdominal internal organs (most air or fluid filled) from external forces.
  2. Resist the negative internal pressures (elastic recoil of the lungs &inspiratory movements)
  3. Attachment for/support the weight of the upper limbs.
  4. Anchoring attachment (origin) of many of muscles that move/maintain the position of the upper limbs; attachments for muscles of the abdomen, neck, back, and respiration.
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19
Q

The joints, thinness and flexibility of the ribs allow…

A
  • absorbtion of many external blows and compressions without fracture
  • change of its shape repetitively/sufficiently as required for respiration
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20
Q

The thorax is one of the most dynamic regions of the body because…

A

… It contains the most important structures (heart, great vessels, lungs, and trachea) as well as its floor and walls, which are constantly in motion.

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21
Q

Which structures aid in the inhalation/exhalation motions?

A
  • muscles of the thoracic wall
  • the diaphragm
  • muscles of the abdominal wall
  • lung elasticity
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22
Q

What structures are active in INHALATION?

(lung volume increases)

A
  • the diaphragm (engaged)
  • external intercostals (forced inhalation, e.g. exercising)
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23
Q

What structures are active in EXHALATION?

(lung volume decreases)

A
  • diaphram (relaxed)
  • elactic recoil of lungs
  • internal intercostales (forced exhalation)
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24
Q

the thoracic skeleton forms the __________________

A

osteocartilaginous thoracic cage

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25
Q

The thoracis skeleton has:

___ pairs of ribs/costal cartilages?

____ thoracic vertebrae/intervertebral discs ?

and what other structure?

A
  • 12 pairs of ribs/costal cartilages
  • 12 thoracic vertebrae/intervertebral discs
  • sternum
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26
Q

RIBS

A
  • curved, flat bones that form most of the thoracic cage
  • lightweight yet highly flexible
  • has a spongy interior
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27
Q

What does the spongy bone in the ribs contain?

What does it produce?

A
  • contains bone marrow (hematopoietic tissue)
  • forms blood cells
28
Q

What are the 3 types of ribs?

A
  1. True ribs (vertebrocostal)
  2. False ribs (vertebrochondral)
  3. Floating ribs (vertebral, free)
29
Q

Describe true ribs

A

(1st - 7th ribs)

attach directly to the sternum through their own costal cartilages

30
Q

Describe false ribs

A

(8th, 9th, and usually 10th ribs)

cartilages are connected to the cartilage of the rib above them

indirect connection with the sternum

31
Q

Describe floating ribs

A

(11th, 12th, and sometimes 10th ribs)

do not connect even indirectly with the sternum

(instead they end in the posterior abdominal musculature)

32
Q

what are aspects of typical ribs

A

Head: wedge-shaped and has two facets

Neck: connects the head with the body at the level of the tubercle.

Tubercle: at the junction of the neck and body

Body (shaft): thin, flat, and curved–> most markedly at the costal angle; internal surface of the body has a costal groove

33
Q

What does the rib tuberacle articulate with?

A
  • smooth articular part = articulates with transverse process
  • fough non-articular part = attachment of the costotransverse ligament
34
Q

Where do the facets of the rib head articulate (typical ribs)?

A
  • vertebrae of the same number & the vertebrae superior to it (@ demifacet on ribs)
35
Q

Which ribs are atypical ribs?

A

1st rib

2nd rib

10th - 12th ribs

36
Q

What makes rib 1 atypical?

A

body is more broad, short, & sharply curved

single facet to articulate with T1

two transverse grooves (superior surface) for the subclavian vessels

scalene tubercle/ridge (seperates grooves ) the anterior scalene muscle attaches

37
Q

What makes the rib 2 atypical?

A

main atypical feature:

rough area on its upper surface, the tuberosity for serratus anterior, from which part of that muscle originates.

38
Q

What makes ribs 10-12 atypical?

A

ribs 10-12: one facet to articulate with a single vertebra

ribs 11-12: short and have no neck or tubercle.

39
Q

Why is costal cartilage important to the thoracic cage (clinically)?

A

they create elasticity and flexibility in the thoracic cage

  • helps prevent internal damage from impacts to thorax
  • allow movement in the thoracic walls (respiration)
40
Q

How does the length of costal cartliges change throughout the ribs?

A

increase in length through the first 7 ribs

and then gradually decrease

41
Q

How do the ribs/costal cartliages articulate to the sternum?

A

_ - 1-7 (sometimes 8th):_

attach directly and independently to the sternum

- 8th, 9th, and 10th:

articulate with the costal cartilages just superior to them, forming a continuous, articulated, cartilaginous costal margin

- 11th and 12th:

cartilages form caps on the anterior ends of these ribs and do not reach or attach to any other bone or cartilage

42
Q

costal cartliages of ribs 1-10 connect the ______________ to the ________________.

A
  • anterior end (tips) of the rib to the sternum

(limited movement)

43
Q

The posterior ends of the ribs rotate around _________________.

A

the transverse axis of the rib.

(elevation/depression of ribs)

44
Q

What separates the ribs and their costal cartilages from one another?

A

Intercostal spaces

(named according to the rib forming the superior border of the space)

45
Q

How many intercostal spaces and intercostal nerves are there?

A

11 intercostal spaces

11 intercostal nerves

46
Q

What is found within the intercostal spaces?

A
  • intercostal muscles and membranes
  • two sets (main and collateral) of intercostal blood vessels and nerves
47
Q

What is the space below rib 12 called?

A

subcostal space

(anterior ramus of spinal nerve T12 is the subcostal nerve)

48
Q

what action can widen the intercoastal spaces?

A

extension and/or lateral flexion of the thoracic vertebral column

(to the contratralateral side)

49
Q

Why is rib 1 rarely fractured?

A

… because of its protected position (it cannot be palpated)

50
Q

What can happen if rib 1 is fractured?

A

injury to the brachial plexus of nerves and subclavian vessels may occur.

51
Q

which ribs are most commonly fractured?

A

The middle ribs

52
Q

rib fractures are usually caused by ______________

A

…blows or from severe injuries

53
Q

What is the weakest part of the rib?

What can happen if a rib breaks?

A
  • weakest part of a rib is just anterior to its angle
  • broken ends may injure internal organs such as a lung and/or the spleen;

Lower rib fractures may tear the diaphragm (diaphragmatic hernia)

54
Q

What makes rib fracture so painful?

A

the broken parts move during

  • respiration
  • coughing
  • laughing
  • sneezing
55
Q

What is Flail Chest?

A

Multiple rib fractures

= a segment of the anterior and/or lateral thoracic wall to move paradoxically

56
Q

What is “Stove in Chest” also called?

What does it impair/affect?

A

Flail Chest

extremely painful injury;

impairs ventilation (affecting oxygenation of the blood)

57
Q

Thoracotomy

A

The surgical creation of an opening through the thoracic wall to enter a pleural cavity

(anterior thoracotomy may involve making H-shaped cuts through the perichondrium of one or more costal cartilages and then shelling out segments of costal cartilage)

58
Q

what are important sites for posterior thoracotomy incisions?

A

posterolateral aspects of the **5th - 7th intercostal spaces **

59
Q

How do you position a patient to gain the best access in a lateral thoracotomy?

A

patient lying on the contralateral side, the upper limb is fully abducted, placing the forearm behind the patient’s head

(elevates and laterally rotates the inferior angle of scapula, allowing access as high as the 4th intercostal space)

60
Q

How do ribs regenerate after a thoracotomy?

A
  1. strip the periosteum from the rib during the procedure, leaving it intact.
  2. missing pieces of ribs regenerate from the intact periosteum, although imperfectly.
61
Q

Supernumerary

A

(extra) ribs:

increased by the presence of extra cervical and/or lumbar ribs

decreased by failure of the 12th pair to form

62
Q

which type of ribs are more common in supernumeracy?

A

Cervical ribs are relatively common (0.5 - 2%)

63
Q

why can supernumeracy of the cervical ribs be bad?

A

may interfere with neurovascular structures exiting the superior thoracic aperture.

(cervical/lumber: may confuse the identification of vertebral levels in radiographs and other diagnostic images)

64
Q

Even with lack of fracture, what sould you check for in children with chest impact injuries?

A

chest compression may produce injury within the thorax

65
Q

what occurs in the costal cartileges of elderly people?

A
  • lose some of their elasticity and become brittle
  • may undergo calcification (making them radiopaque)

anatomy (graces's) (4 decks)

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