Thorax 1 Flashcards
(119 cards)
1
Q
Name the bones of the thorax.
A
- 12 Thoracic vertebrae
- 12 pairs of ribs
- Sternum
2
Q
How is it described how the vertebra, attached ribs, and sternum in the thorax?
A
closed system
3
Q
What is found in between the osseous bone of the rib and osseous sternum?
A
costal cartilage
4
Q
What type of cartilage are costal cartilage?
A
hyline cartialge
5
Q
How are all the ribs oriented?
A
angles downward 30 degrees from posterior to anterior on the transverse plane
6
Q
Where is the 1st rib found?
A
Anteriorly inferior the clavicle
Laterally/posteriorly deep to the trapezius
7
Q
What are the three parts of the sternum?
A
manubrium
body
xiphoid process
8
Q
The union between the manubrium and the body of the sternum is what? and aka?
A
Manubriosternal joint aka Sternal Angle
9
Q
What type of joint is the manubriosternal joint?
A
Symphysis joint which is a cartilaginous which is amphiarthrosis
10
Q
When do you see movement of the manubriosternal symphysis joint?
A
In respiration for deep respiration involving the upper ribs
11
Q
What is the upper notch on the manubrium called?
A
Jugular notch
12
Q
What is the joint found in between the sternal body and the xiphoid process?
A
Xyphisternal joint
13
Q
What kind of joint is the xyphisternal joint?
A
synchondrosis joint- contains hyaline cartilage in between the bones therefore it’s a amphiarthrosis joint
14
Q
What is the developmental course of the xyphisternal synchondrosis joint?
A
early in life it has much hyaline cartilage in between the xiphoid process and the sternal body. As we grow the hyaline cartilage ossifies
15
Q
The 1st rib’s costal cartilage will articulate with what?
A
Manubrium
16
Q
The 2nd rib’s costal cartilage will articulate with what?
A
the joint between the manubrium and the body which is also known as the level of the sternal angle
17
Q
Which number of rib’s costal cartilage will articulate with the body of the sternum?
A
3-7 ribs
18
Q
When ribs 8-10 costal cartilage merge with the 7th costal cartilage what is that structure called?
A
costal arch
19
Q
Which ribs are typical ribs?
A
2-10 ribs
20
Q
Which ribs are distinct?
A
1, 11-12 ribs
21
Q
Which rib is very short and very flat?
A
1st rib
22
Q
What are true ribs and false ribs?
A
True ribs will have their own costal cartilage(1-7)
False ribs will not (8-12)
23
Q
What can ribs 11 and 12 be considered besides false ribs?
A
floating ribs bc it doesn’t articulate with the costal cartilage
24
Q
What is the joining of the osseous rib and costal cartilage called?
A
costochondral joints
25
What is the joining of the costal cartilage and osseous sternum called?
sternocostal joint
26
What are the costochondral joints of ribs 1-7 classified as?
synchondroses
27
What are the sternocostal joints of 1st, 6th, and 7th ribs classified as?
synchondroses
28
What are the sternocostal joints of 2-5 ribs classified as?
plane synovial joints
29
What is the angle between the two costal arches called?
infrasternal angle
30
Males/Females have a larger infrasternal angle.
Males
31
What pathology will lead to a larger infrasternal angle? and why?
emphysema or COPD. The elasticity of the lung diminished, they can inspire fine, they just can't recoil out naturally.
32
The large infrasternal angle is known as what?
barrel chest
33
What is the opening on the superior aspect of the thorax known as?
Superior Thoracic Aperture
34
What are the boundaries of the superior thoracic aperture?
superiorly- manubrium
posteriorly- T1 vertebrae
laterally- 1st rib and clavicle
35
What travels through the superior thoracic aperture?
Phrenic nerve
Trachea
Vagus nerve
Internal Jugular
Common carotid artery
Esophogus
36
What What is the large opening formed by the costal arch and the last two ribs?
Inferior Thoracic Aperture
37
What structure lines most of the Inferior Thoracic aperture?
Diaphragm
38
What regions does the diaphragm divide?
Thorax from the abdomen
39
What openings does the diaphragm have?
Esophogeal hiatus- for the esophagus
Aortic hiatus- for descending aorta
Caval hiatus- Inferior vena cava
40
How are the diaphragm hiatuses oriented?
Esophogeal hiatus is in the middle
Aortic hiatus is more on the left
Caval hiatus is more on the right
41
What is the portion of the rib where it's posterior and medial?
the head of the rib
42
What is the narrow point lateral to the head?
the neck of the rib
43
What is the bump lateral to the neck of the rib?
Tubercle of the rib
44
What is the rounded portion of the rib?
angle of the rib
45
What is the indentation on the underbelly of the rib?
Costal groove
46
What transmits in the costal groove?
intercostal nerves
| intercostal artery/vein
47
What muscle insertion in the angle of the rib?
Iliocostalis
48
How are the dermatomes oriented in the thorax?
strips correlating to the nerves in the ribs from the anterior ramus
49
Where does the head of rib articulate with the thoracic vertebrae?
costal facets, sup/inf costal facets on the body of the vertebra
50
Where does the tubercle of the rib articulate with the thoracic vertebrae?
transverse process of the thoracic vertebra
51
What is two head of rib and vertebral articulating joints called?
costovertebral joints
52
What is the tubercle of the rib and transverse process of the thoracic vertebrae joint called?
costotransverse joints
53
What type of joints are the costovertebral and costotransverse joints?
plane synovial joints
54
What vertebra(es) does first rib articulate with?
T1
55
What vertebra(es) does 11th and 12th ribs articulate with?
T11 and T12 respectively
56
What vertebra(es) does the 2nd rib articulate with?
Head of the rib will articualte with the bodies of T1 and T2. The tubercle will articulate with transverse process of T2
57
What vertebra(es) does the 5th rib articulate with?
the head will with T4 and T5 body. and tubercle on the T5 transverse process
58
Between the anterior head of the rib and the anterior vertebral bodies are held together by what?
Radiate Ligament
59
What is the Radiate Ligament?
Primary ligamentous supporting structure between the head of the rib to the costal facets of the vertebral body. also known as the costovertebral joint
60
What is the primary ligamentous supporting structure for the costotransverse joint?
Superior costo-transverse ligament
Lateral costo-transverse ligament
Inferior costo-transverse ligament
61
What are the two general movements of the ribs?
Elevation and Depression
62
What is Bucket handle motion?
Movement of the false ribs, ribs 11-12 in the coronal plane, allowing for medial lateral expansion
63
What is Pump handle motion?
Movement of the upper ribs. As we inhale the sternal moves anterior/posterior and superior in the sagittal plane allowed by the manubriosternal joint's movility
64
What other aspect of the ribs also help to facilitate the Pump hand motion?
ribs 30 degree angulation
65
Why is it difficult to palpate the 1st rib?
it sits behind the clavicle and in front of it sets the thick pectoralis major.
66
Where does the diaphragm's fibers converge and merge called?
Central Tendon
67
What innervates the diaphragm and how is it innervated?
phrenic nerve
| two, one on each side right and left
68
What sort of muscle is the diaphragm?
skeletral muscle
69
How is the Central tendon unique?
It doesn't attach to bone
70
What is the position of the diaphragm at rest?
It is elevated, therefore when it contracts in move inferiorly
71
What nerve roots innervate the diaphragm
C3, C4(most important), C5
72
Can you control the diaphragm from one side?
Yes due to the two phrenic nerves
73
What lines the actual inner surface of the thorax and diaphragm?
Parietal pluera
74
What lines the lung itself?
Visceral Pluera
75
What is found in between the visceral and parietal pleura?
Serious fluid
76
What is the function of Serious Fluid?
- Reduces friction due to constant lung movement
| - Increases surface tension to keep the two layers together
77
What law governs the respiration?
Boyel's Law- Inversely paportionate law of pressure and volume
78
What are the key facts when the diaphragm contracts? volume, pressure, and pressure gradient in the thorax, then inhale/exhale?
Diaphragm goes from it's upward domed natural state to descending downward. Volume in the thorax increases, pressure decreases, therefore a negative pressure gradient, higher barometric pressure, causing inspire.
79
Which is active and which is passive: inspire, expire?
Inspire- active
| Expire- passive process bc diaphragm will recoil to original position
80
What type of volume is being moved during resting breathing?
Tidal breathing/volume
81
What are the attachment sites for the diaphragm?
- back of the sternum
- inside of the costal arch
- tip of the 11th and 12th rib
- T12, L1 vertebra
82
What is the primary muscle of respiration?
Diaphragm
83
The diaphragm will emerge from fascia which overlies what two posterior abdominal wall muscles?
Quadratus lumborum
| Psoas Major muscle
84
What is Quadratus lumborum's attachments?
12th rib
Transverse processes of L1-L5
Iliac Crest
85
What is the Iliopsoas commonly known as?
Hip flexor muscles
86
What is the origin point for the Iliopsoas muscle?
Vertebral body, transverse processes, and IV joints of T12-L5
87
What body parts does the Iliopsoas effect?
Hip and Lumbar spine
88
What nerve is just lateral to the phrenic nerve ?
Vagus nerve
89
The phrenic nerve if often found anterior to what muscle?
Anterior scalene
90
Where is the Vagus nerve often found in, in the neck region?
in between the common carotid artery and internal jugular vein in the carotid sheath
91
What are two rib related muscles that are involved in inspiration?
External Intercostals and the Scalene muscles
92
What does a muscle have to attach to, to be involved in respiration?
Ribs
Manubrium
Clavicle
93
What are the most superficial intercostal muscles?
External Intercostal muscles
94
What are the Scalene muscles?
Posterior
Middle
Anterior
95
Which scalenes attach to the 1st rib?
Anterior
| Middle
96
What does the posterior scalene attach to distally?
2nd rib
97
Since the Scalene muscles either attach to the 1st or 2nd rib they are involved in what movement and what action of respiration?
Rib elevation
| Inspiration
98
What other muscle near the scalene is involved in respiration?
Sternocladomastoid
99
What are the attachments of SCM?
mastoid process to medial 1/3 of clavicle and manubrium of sternum
100
How is SCM involved in respiration?
elevates the attached sites and assists in inspiration
101
How do scalenes look in people with COPD?
enlarged to the constant forced inspiration due to the overuse of the scalene muscles in the pumphandle motion of the ribs due to lack of diaphram's strength
102
Where are intercostal muscles located and how many are there?
```
in between ribs
3
external intercostal
internal intercostal
inner most intercostal
```
103
How are the layers of the intercostal muscles oriented?
External- run inferior medially (pocket)
Internal- perpendicular to external, superior medially
Inner most- perpendicular to external, superior medially
104
As the external intercostals contract what occurs?
elevates and anterior motion the ribs below, allowing for inspiration
105
What innervates the intercostals?
anterior rami,
| Intercostal nerves
106
What else are innervated by the intercostal nerves?
Serratus posterior inferior
| Serratus posterior superior
107
What are the serratus posterior muscles involved in?
proprioception of the ribs
| secondary muscles of respiration
108
What does the inner most and internal intercostal muscles do?
depress the ribs
109
What muscles result in forced expiration?
internal intercostal
| inner most intercostal
110
What muscles are involved in 'deep respiration"
scalenes
111
What is the enlarged internal and inner most intercostal muscles that are on the inner portion of the vertebral bodies?
Subcostals. only found in the inside and in the back.
112
What anterior/inferior sets of muscles are also involved in forced expiration?
abdominal
113
What is the most superficial layer of the muscles of the abdominal wall? and what is it's fiber orientation?
Rectus Abdominis muscles
| -vertical superior to anterior
114
What is the layer deep to the Rectus abdominis muscles and what is it's fiber orientation?
External Oblique
| - runs like the external intercostal muscles inferior medially
115
What is the layer deep to the External oblique muscles and what is it's fiber orientation?
Internal Oblique
- runs like the internal intercostal muscles
inferior laterally
perpendicular to external oblique
116
What is the layer deep to the internal oblique and the deepest abdominal wall and what is it's fiber orientation?
Transversus abdominis
| -runs transversly
117
What are the functions of abdominal wall muscles?
When they contract they move the trunk and compress inward, and compress the abdominal viscera.
118
What happens when abdominal wall contract?
- Increases intra-abdominal pressure
- forces the diaphragm up
- results in decreased intra-pleural volume
- expires
119
What is one of the important functions of the abdominal wall muscles related to powerful breathing?
related to powerful forced expiration in cough or sneeze
