thorax Flashcards
• Atypical feature:
tuberosity for serratus anterior (rough) (found in lateral side)
1,2 10, 11, or 12 ?
2nd atypical rib
atypical rib with 2 transverse groove separated by scalene tubercle
- broadest, shortest, more curved
1, 2, 10 or 12 ?
1st rib
what are the typical ribs ?
3-9
what are the atypical ribs ?
1,2, 10-12
how many pairs of bone does ribs have ?
other name for rib
12 pairs
costae
3 classifications of rib
true (vertebrocostal) 1-7 - connected to sternum
false (vertebrochondral) 8-10 - connected to cartilage
free / floating (10-12) - connected to thoracic vertebrae
broadest and shortest atypical rib with 1 facet and 2 transverse groove (separated by scalene tubercle)
1st atypical rib
- primary organs of the respiratory & cardiovascular system
thorax or lungs
thorax
- broadest superiorly part of the trunk
- with pectoral girdle
thorax or chest ?
chest
pectoral girdle is formed by?
clavicle (collar bone) and scapulae
truncated cone shaped wall
narrowest superiorly
Thoracic cavity or thoracic wall ?
Thoracic cavity
origin for the central and lateral compartment of thoracic cavity
LATERAL IS PULMONARY CAVITIES . CENTRAL IS ?
central: mediastinum (heart)
lateral: pulmonary cavities
sternum and costal cartilage articulates 1st – 7th costal cartilages.
- 1ST Rib: fibrocartilaginous
• 2nd – 7th: synovial
- Sternoclavicular joint (SC) or - Sternocostal (sternochondral) joints ?
- Sternocostal (sternochondral) joints
Movement: ball-and-socket joint.
Provides bony attachment between appendicular and axial skeletons
Sternoclavicular joint (SC) or - Sternocostal (sternochondral) joints ?
Sternoclavicular joint (SC)
o domed shape for rigidity
- Osteocartilaginous thoracic / rib cage
1st -7th ribs
o Attached to STERNUM.
o Has own independent costal cartilage
True (vertebrocostal)
False (vertebrochondral)
Floating (vertebral, free)
True (vertebrocostal)
8th, 9th & usually 10th ribs)
o Connected to cartilage (as union of 3 ribs)
o Forms articulated, cartilaginous costal margin
True (vertebrocostal)
False (vertebrochondral)
Floating (vertebral, free)
False (vertebrochondral)
11th-12th, 10th
Connected ONLY to thoracic vertebra
True (vertebrocostal)
False (vertebrochondral)
Floating (vertebral, free)
Floating (vertebral, free)
• Small articular junction
head, tubercle or shaft ?
tubercle
for attachment and support
typical or atypical ?
atypical
(1st – 7th ribs; anteriorly)
o Contribute to the elasticity of the thoracic wall
Costal cartilages
concave internal surface
Where intercostal nerve/vessel pass (VEIN, ARTERY, NERVE)
made it ROUGH
• costal angle “posterior” or • costal groove (inferior)
• costal groove (inferior)
atypical rib with 1 facet
• Xiphoid process is located
1,2,10,11 or 12 ?
10th
11 Intercostal spaces with 2 sets of IC Blood vessel and nerves refers to the..
THORACIC CAGE ONLY
best way to palpitate intercostal spaces
start from anterior “clavicle” 3rd – 4th then to lateral
posterior, anterior and lateral of superior thoracic inlet of thoracic aperture
• Posterior – T1 vertebra
• Lateral - 1st pair of ribs
Anterior - superior border of manubrium
size of thoracic inlet
(6.5 cm A-P / 11 cm Transverse)
- Posterior - T12 vertebra
- Posterolateral - 11th & 12th pair of ribs
- Anterolateral - 7-10 ribs & costal cartilages
- Anterior - xiphisternal joint
inferior outlet or superior inlet
inferior outlet
sternocostal joint: what pair of cartilage
symphysis” manubrium & body of sternum (manubriosternal)
2nd pair of cartilage
sternocostal joint: what pair of cartilage
manubrium only
1st pair of cartilage
sternocostal joint: what pair of cartilage
“symphysis” body of sternum & xiphoid process (xiphisternal)
7th pair of cartilage
o flat, elongated bone that forms the middle of the anterior part of the thoracic cage
o shorter and thinner in female
sternum / chest
o common site for bone marrow biopsy
o protects mediastinal viscera and heart.
sternum / chest
part of sternum
- trapezoidal bone
- widest and thickest
- jugular notch
- clavicular notch
manubrium, body or xiphoid process ?
manubrium
part of sternum
Articulates with 2nd – 7th costal cartilages and xiphoid process
T5 -T9 vertebrae level
transverse ridges (lines of fusion-synostosis)
body
o junction between manubrium and sternum
o location:
second ribs articulate with the sternum.
sternal angle or xiphoid process?
sternal angle
xiphoid process
- flat, cartilaginous process at birth
- Attached to linea alba.
landmark: xiphisternal joint (T9)
an interpleural space (area between the pleural cavities) in the thorax
manubrium or mediastinum
mediastinum
- contents: Thymus, great vessels
With arch of the azygos vein
Lies between the right and left pleural cavities
inferior or middle pericardium
middle pericardium
flat, cartilaginous process at birth
- Attached to linea alba.
landmark: xiphisternal joint (T9)
xiphoid process
o Separates the thoracic and abdominal cavities
o Primary muscle of inspiration: most important function
diaphragm
At cricoid cartilage (C6) as continuation of LARYNX
has 16 to 20 incomplete hyaline cartilaginous rings
Has CARINA
larynx or trachea ?
trachea
o Forms keel-like ridge (separates bronchi openings)
o Examined with bronchoscope
o Immobile by bronchogenic carcinoma and is associated with cough reflex.
carina
differentiate right and left bronchus
right:
under the arch of the azygos vein
3 lobar
left:
Runs at the arch of the aorta
divides into 2 lobar or secondary bronchi
• Covering of thoracic wall
pleural cavity
o Location:
• cage, muscles, skin, subcutaneous tissue, fascia
o Main function:
• To help in our breathing (INSPIRATION OR RESPIRATION)
true thoracic wall
anterolateral aspect
- Connected wither to clavicle, sternum, scapula, superior part of the humerus)
- Best seen in posterior view
THORACO-APPENDICULAR MUSCLE
o transverse process of C7 & T1 vertebrae TO T12
connected to ribs
vertebral movement
serratus posterior, levatores costarum or intercostal muscle ?
levatores costarum muscle
Origin: Nuchal ligament to spinous process C6 or C7
Passes T2 or T3 vertebrae – then elevates 2nd -5th ribs superior border during respiration (insertion)
SPP or SPI
SPP
• Serratus posterior superior
Spinous process last 2 thoracic, 11th – 12th lumbar spinous spine
Origin: thoracolumbar fascia
o inferior 3 or 4 ribs inferior border (insertion)
Pulls down the last 3-4 ribs
SPP or SPI
SPI (INFERIOR)
separates intercostal nerves & vessels
INTERNAL or INNERMOST ?
INNERMOST INTERCOSTAL MSCLE
Below 12th rib in posterior aspect
depress ribs
origin: Internal
subcostal
thoraco-appendicular
• Origin:
o 4th or 5th ribs attach posteriorly to the xiphoid process, inferior part body of the sternum & adjacent costal cartilages
• Insertion:
o 3rd -6th costal cartilages
TRANSVERSE OR POSTERIOR
transverse (anterior)
o located in between the parietal and visceral
o where air goes in
pleural cavity
- origin of all nerves
Thoracic Spinal Nerves – 12 pairs (mixed)
- Supplies Myotome (group of muscles)
- Innervates the joints, muscles and skin of the back
anterior or posterior
o Posterior ICS 3RD – 6TH nerves
in ATYPICAL Intercostal nerve,
thoracoabdominal nerve (anterior abdominal wall)
o 7th-11th IC nerves
What are the typical Intercostal nerve
3-6 nerve
what are the Atypical Intercostal nerve?
1,2,7-11
• Origin of all posterior intercostal & subcostal arteries
descending thoracic aorta
• Origin of all anterior (1st branch) internal thoracic & supreme intercostal artery
o Subclavian artery / internal
o Origin of artery: musculophenic artery (an extension of internal thoracic
10TH AND 11TH supplied by 2 arteries (2 posteriors intercostal)
supplied by 3 arteries (2 posterior, 1 anterior)
- 1st -9th, 12th
ANTERIOR INTERCOSTAL ARTERIES from internal thoracic artery.
3-6 OR 7-9 ICS?
3-6 ICS
ANTERIOR INTERCOSTAL ARTERIES from Musculo-phrenic nerve
3-6 OR 7-11 ICS?
7-11 ICS
Supplies rectus abdominis muscle and anastomoses with the inferior epigastric artery
SUPERIOR OR POSTERIOR EPIGASTRIC ARTERY
Superior epigastric artery
o the dome of the pleura.
o Reinforced by SIBSON’S FASCIA (thickened portion of the endothoracic fascia)
parietal or visceral ?
cervical pleura (cupula) in parietal area
supplied by bronchial arteries, but its venous blood is drained by pulmonary veins.
insensitive to pain but is sensitive to stretch
parietal or visceral
visceral (pulmonary)
o nourished by the bronchial arteries and drained by the bronchial veins for the larger subdivisions and pulmonary veins for the smaller subdivisions
lungs
o Lingula (tongue-shaped portion) o 2 lobes & 8-10 segmental bronchi
right or left bronchus
left
right
Has 3 lobar (secondary) bronchi and 10 segmental (tertiary) bronchi.
o the anatomic, functional, and surgical unit (subdivision) of the lungs.
BRONCHOPULMONARY SEGMENT
o Elevated ribs and sternum following contraction of diaphragm
o Intercostal muscle contraction and elevation of the ribs (BUCKET HANDLE)
o PUMP HANDLE
Elevation of the ribs in connection with the sternum
inspiration or expiration?
inspiration
o Relaxed diaphragm and elastic recoil of the lungs. (QUIET BREATHING
inspiration or expiration
expiration