THORAX Flashcards
Location of the sternum
Anterior aspect of thorax, in the midline
Shape of sternum, function
T shaped flat bone , protects internal thoracic viscera(heart, lungs, esophagus)
Structure of eternal body
Flat, elongated, lots of articulate facets for 3-6 ribs. Demifacets for 2,7 ribs
What is the level of xophoid process
T10
Xiphoid process sometimes connects
7 rib
Heart is behind
Xiphoid process
Describe structure of manubrium
Most superior part of sternum with trapezoid shape, jugular notch.
Concave superior aspect of manubrium with depression called
Jugular notch
Which joint associated with manubrium
Sternoclavicular joint
Facet of manubrium is for
Demifacet of manubrium is for
1 rib
2nd rib
Inferiorly, the manubrium articulates with the body of the sternum, forming the
Sternal angle
Inferiorly, the manubrium articulates with the body of the sternum, forming the sternal angle. This can be felt as
transverse ridge of bone on the anterior aspect of the sternum. The sternal angle is commonly used as an aid to count ribs, as it marks the level of the 2nd costal cartilage
Which structure palpate trachea, lower border of body of T2 vertebrae
Suprasternal notch
Stern Al angle locates
5 cm below suprasternal notch
The ribs are counted from this level downwards , the … ends at this level. The arch of the aorta begins and also ends at this level. The descending aorta begins at this level. The trachea divides into two principal bronchi.
Sternal angle
Typically, the sternum will break into several pieces – this type of fracture is classified as
Comminuted fracture
Most common site of fracture in sternum is
the manubriosternal joint – where the manubrium meets the body of the sternum.
Despite the degree of damage to the sternum, the fragments are not usually displaced due to the attachment of the
Pectoralis muscles
They articulate with the vertebral column …., and terminate … as cartilage (known as costal cartilage).
Posteriorly
Anteriorly
The typical rib consists of
Head, neck, body
Describe head of typical ribs
wedge shaped, and has two articular facets separated by a wedge of bone. One facet articulates with the numerically corresponding vertebrae, and the other articulates with the vertebrae above.
Describe neck of typical rib
contains no bony prominences, but simply connects the head with the body. Where the neck meets the body there is a roughed tubercle, with a facet for articulation with the transverse process of the corresponding vertebrae.
Describe the body of typical rib
flat and curved. The internal surface of the shaft has a groove for the neurovascular supply of the thorax, protecting the vessels and nerves from damage.
Costal groove location
On the body, posterior aspect
Which ribs are atypical
1, 2, 10 11 and 12
1 rib shape is
is shorter and wider than the other ribs.
Describe facet of 1st rib
only has one facet on its head for articulation with its corresponding vertebrae (there isn’t a thoracic vertebra above it)
Superior surface of 1st rib is
marked by two grooves, which make way for the subclavian vessels.
Shape, facets of second rib
Rib 2 is thinner and longer than rib 1, and has two articular facets on the head as normal.
Upper surface of 2nd rib
has a roughened area on its upper surface, from which the serratus anterior muscle originates.
Rib 10 is atypical because of
only has one facet – for articulation with its numerically corresponding vertebrae.
Rib 11,12 are atypical because
have no neck, and only contain one facet, which is for articulation with their corresponding vertebrae.
Costotransverse joint is between
Between the tubercle of the rib, and the transverse costal facet of the corresponding vertebrae.
Costovertebral joint – Between the
head of the rib, superior costal facet of the corresponding vertebrae, and the inferior costal facet of the vertebrae above.
Ribs 11 and 12 do not have an … attachment and end in the … musculature. Because of this, they are sometimes called ‘floating ribs’.
Anterior
Abdominal
Ribs 8-10 attach
To the costal cartilages superior to them
Ribs 1-7 attach
Sternum
Rib fractures most commonly occur in the
Middle ribs
Nflail chest is a condition when
If two or more fractures occur in two or more adjacent ribs, the affected area is no longer under control of the thoracic muscles. It displays a paradoxical movement during lung inflation and deflation
During inspiration pressure in thorax
decreases below atmospheric pressure, and air rushes in through the trachea, rib cage out
In glial chest the injured part
The flail segment will be pulled in with the decrease in pressure while the rest of the rib cage expands.
Spinous process locates
Posteriorly
Transverse process location, articulation
extend laterally and posteriorly from the vertebral body. In the thoracic vertebrae, the transverse processes articulate with the ribs.
Pericles function
connect the vertebral body to the transverse processes.
Lamina function
connect the transverse and spinous processes.
Articulate processes form joints between
one vertebra and its superior and inferior counterparts. The articular processes are located at the intersection of the laminae and pedicles.
Long ligaments that run the length of the vertebral column, covering the vertebral bodies and intervertebral discs.
Anterior and posterior longitudinal ligaments
Which ligament
Ligamentum flavum
L,L
Which ligament Connects the spinous processes of adjacent vertebrae.
Interspinous ligament
Which ligament Connects the tips of adjacent spinous processes.
Supraspinous ligament
In the cervical spine, the interspinous and supraspinous ligaments
thicken and combine to form the NUCHAL ligament
Cervical vertebrae contain main distinguishing features
Bifurcation spinous process - distal end
Transverse foramina- vertebral arteries
Triangular vertebral foramen in the middle
Bifid spinous process – c1,c7
C1 (no spinous process) and C7 (spinous process is longer than that of C2-C6 and may not bifurcate).
Triangular vertebral foramen - c1, c2
C1 and C2 (called the atlas and axis respectively), are specialised to allow for the movement of the head.
Costal facets present only in T
T1-T10
Superior and Inferior Costal Facets in thoracic vertebrae
Location, articulation
The superior and inferior costal facets are located on the sides of each vertebral body. They consist of cartilage lined depressions, which articulate with the heads of the ribs. The superior facet articulates with the head of the adjacent rib, and the inferior facet articulates with the head of the rib below
In the majority of the vertebrae (T2-T9) these facets are …. There are some atypical vertebrae that possess whole facets.
Demi-facets
T1, t19, t11, t12 is atypical because
Superior facet is not demifaset
Between vertebral bodies – adjacent vertebral bodies are joined by intervertebral discs, made of fibrocartilage. This is a type of cartilaginous joint, known as a …..
Symphisis
Between vertebral arches – formed by the articulation of superior and inferior articular processes from adjacent vertebrae. It is a …. type joint.
Synovial
Each costovertebral joint consists of the head of the rib articulating with:
Superior costal facet of the corresponding vertebra
Inferior costal facet of the superior vertebra
Intervertebral disc separating the two vertebrae
The costotransverse joints are formed by the articulation of
transverse processes of a thoracic vertebra and the tubercle of the adjacent rib. They are present in all vertebrae except T11 and T12.
Radiate ligament of head of rib locates
outwards from the head of the rib to the bodies of the two vertebrae and intervertebral disc.
Costotransverse ligament
Connects the neck of the rib and the transverse process.
Lateral costotransverse ligament – Extends
from the transverse process to the tubercle of the rib.
Superior costotransverse ligament –
Passes from the upper border of the neck of the rib to the transverse process of the vertebra superior to it.
During inspiration diaphragm
contracts and flattens, increasing the vertical diameter of the thoracic cavity.
During exspiration diaphragm
the diaphragm passively relaxes and returns to its original dome shape. This reduces the volume of the thoracic cavity.
Peripheral attachments of diaphragm
Lumbar vertebrae and arcuate ligaments.
Costal cartilages of ribs 7-10 (attach directly to ribs 11-12).
Xiphoid process of the sternum.
The parts of the diaphragm that arise from the vertebrae are tendinous in structure, and are known as the right and left crura
right and left crura
Right crus – Arises from … and their intervertebral discs. Some fibres from the right crus surround the oesophageal opening, acting as a physiological sphincter to prevent reflux of gastric contents into the oesophagus.
L1-L3
Left crus – Arises from … and their intervertebral discs.
The muscle fibres of the diaphragm combine to form a central tendon. This tendon ascends to fuse with the inferior surface of the fibrous pericardium.
L1-L2
Caval hiatus (T8) include
Inferior vena cava
Terminal branches of right phrenic nerve
Oesophageal Hiatus (T10) contain
Oesophagus
Right and left vagus nerves
Oesophageal branches of left gastric artery/vein
Aortic Hiatus (T12) has
Aorta
Thoracic duct
Azygous vein
The halves of the diaphragm receive motor innervation from the
Phrenic nerve
Each phrenic nerve is formed in the neck within the … …and contains fibres from spinal roots …
Cervical plexus
C3-C5
The majority of the arterial supply to the diaphragm is delivered via the … phrenic arteries
Inferior
the inferior phrenic arteries, which arise directly from the
Abdominal aorta
