Thorax Flashcards

1
Q

What are the numbers of the typical ribs?

A

3-9

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2
Q

Where do the ribs connect on the vertebrae?

A

The rib has 2 facets that connect to the superior facet of the same number rib and the transverse process of that same vertebrae

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3
Q

Describe the first ribs articulation

A

The 1st rib is wide, flat, and small and it only articulates with T1

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4
Q

What are the components of the sternum?

A
  • Manubrium
  • Jugular Notch
  • Sternal angle
  • Body
  • Xiphoid process
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5
Q

Describe the sternal angle

A

Where the manubrium meets the sternum at the 2nd costal cartilage

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6
Q

What is the last rib to have costal cartilage?

A

7th rib

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7
Q

How many pairs of true ribs are there?

A

7 pairs

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8
Q

Where does the superior portion of the diaphragm attach?

A

The xiphoid process (at the inferior limit of the thoracic cavity)

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9
Q

Describe the xiphoid-sternal joint

A

Connects the xiphoid process with the body of the sternum

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10
Q

What are the false ribs?

A

8, 9, 10

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11
Q

Where do the false ribs attach?

A

To the costal cartilage right above it

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12
Q

What is the costal cartilage that is connected to the false ribs called?

A

The costal margin

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13
Q

What are complications of a rib fracture?

A

-Puncture the pleura, lung, spleen, diaphragm

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14
Q

What is a median sternotomy?

A

-Surgical splitting down the middle plane

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15
Q

What are the floating ribs?

A

Ribs 11 and 12

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16
Q

Where do the floating ribs articulate?

A

Only articulate posteriorly

-anteriorly they just end up in muscle

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17
Q

What is protected by ribs 11 and 12

A

Superior parts of the kidney

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18
Q

What travels in the recess of the ribs?

A

Neurovascular bundles

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19
Q

What are the 4 joints of the thoracic wall?

A
  • Costovertebral
  • Costotransverse
  • Costochondral
  • Sternocostal
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20
Q

Describe the costovertebral joint

A

The head of the rib with the body of the vertebrae

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21
Q

What type of joint is the costovertebral

A

-Synovial–> planar

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22
Q

What types of joint are all the joints of the thoracic wall?

A

They are all different

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23
Q

Describe the costotransverse joint

A

These are between 7 and 8

-Pivot joints

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24
Q

Describe the costochondral joints

A

-only ribs 1-10

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25
Q

What type of joints are the costochondral

A
  • primary cartilaginous joints
  • synchondroses
  • stay cartilage throughout life
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26
Q

What type of joint is the sternocostal joint?

A
  • The 1st rib has a synchondroses

- All the rest are synovial planar

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27
Q

What is the goal of inspiration

A

increase volume so pressure drops

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28
Q

What determines your longitudinal increase?

A
  • Diaphragm
  • Contraction of the diaphragm makes the area longer or shorter
  • Breath in= diaphragm goes down
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29
Q

What controls the medial and lateral increase in size?

A
  • The bucket handle
  • Used for lower ribs 8-10
  • Gliding occurs on the tubercle of the first rib and the transverse processes of the vertebrae
  • (lifting the handle more towards the side increases the medial and lateral diameter)
30
Q

What is responsible for the anterior and posterior increase in size?

A
  • The pump handle
  • The costotransverse ligaments of ribs 4-7
  • They rotate so this is why they are pivot joints
  • The tubercle is the main moving part
31
Q

What does rotation at the middle thorax allow?

A

-For the AP to increase

32
Q

Describe the sternoclavicular joint

A
  • Synovial (saddle)
  • Functions like a ball and socket tho
  • Contains an articular disc
33
Q

What are the ligaments of the sternoclavicular joint?

A
  • Anterior
  • Posterior
  • Interclavicular
34
Q

Describe the superior thoracic aperature

A
  • Almost in a horizontal plane
  • Along the first rib and the costal cartilage and T1 vertebrae, manubrium
  • Nicknamed the thoracic inlet
35
Q

Describe the inferior thoracic aperature

A
  • Covered by the diaphragm
  • T11, T12, costal margin, costosternal joint, ALL,deep surface of xiphoid-sternal joint
  • Not in a plane
  • Nicknamed the thoracic outlet
36
Q

Describe thoracic outlet syndrome

A
  • Manifestation of the upper thorax
  • T1 nerve is compressed
  • Blood and nerve impairment
  • Ischemia, numbness, tingling
37
Q

This is the musculotendoneous sheath that covers seperates the thorax from the abdomen

A

Diaphragm

38
Q

Where is the hemi-diaphragm?

A

-5th rib and 5th costal cartilage

39
Q

During breathing, where does your liver rise?

A

5th rib

40
Q

Where does your spleen rise?

A

-Costal cartilage

41
Q

Describe external intercostals

A
  • Run supralaterally

- start at the vertebral bodies but do not do all the way to the sternum

42
Q

How many intercostalis are there total?

A

22

43
Q

What splits the innermost intercostalis?

A

-Split by the neurovascular structures

44
Q

What are the internal, external, and innermost intercostalises intervated by?

A

Intercostal nerve

45
Q

What is the main job of the intercostal muscles?

A
  • Maintain tone and space
  • So we don’t collapse or explode
  • Can move ribs with increased respiration need
  • Reflexive
46
Q

What are the anterior axioappendicular muscles?

A
  • Pec major and minor
  • Subclavius
  • Serratus anterior
47
Q

Describe the significance of paralysis of the serratus anterior

A
  • Nerve lies on the surface so it is vulnerable

- Winged scapula and lack of full abduction result

48
Q

Describe the action of transverse thoracic muscle

A
  • Don’t have uniform action bc they are at different angles

- Mainly there for proprioception

49
Q

Describe the subcostal muscle

A
  • spans more than 1 intercostal space

- always ALWAYS on the posterior wall

50
Q

Where does the diaphragm sit mostly

A

-On the costal margin

51
Q

This is a musculotendonous division

A

Diaphragm

52
Q

All the muscle fibers of the diaphragm attach to this

A

-The central tendon

53
Q

What are the 3 components of the muscular part of the diaphragm?

A
  • Sternal Part
  • Costal Part
  • Lumbar Part
54
Q

What bony landmark is included in the sternal part

A

The xiphoid process

55
Q

What bony landmarks are included in the costal part?

A

-The inferior 6 costal cartilages and ribs

56
Q

What bony landmarks are included in the lumbar part?

A
  • Bodies of all lumbar vertebrae

- AKA CRURA

57
Q

What provides motor innervation to the diaphragm?

A

-Phrenic nerve

58
Q

Does the phrenic nerve have sensory input?

A

-Yes- for the pleura and the lining of the pericardium (central parts)

59
Q

Where do the peripheral parts receive innervation from?

A

-Sensory from intercostal nerves

60
Q

Describe the right crus

A
  • Around the esophagus hiatus
  • Not a circular muscle
  • External structure that is part of the diaphragm that acts kinda like an sphincter
61
Q

Describe the left crus

A
  • Smaller and tighter

- Wraps around the aortic hiatus

62
Q

What rib level is the caval hiatus found?

A

T8 and 9

63
Q

What structure sits on top of the caval hiatus?

A
  • The right atrium

- The pericardium is anchored here

64
Q

What holds the heart to the diaphragm?

A

-Pericardial phrenic ligaments

65
Q

Where does the right crus arise from?

A

-First 3 or 4 lumbar vertebrae

66
Q

Where does the left crus arise from?

A

-The first 2 or 3 lumbar vertebrae

67
Q

What 3 things form the aortic hiatus?

A
  • Median arcuate ligament
  • Right crus
  • Left crus
68
Q

This is fibrous and connects the right and left crura

A

The median arcuate ligament

69
Q

This is a thickening of the fascia that covers the psoas major
-Spans between the lumbar vertebral bodies and the tip of the transverse processes of L1

A

Medial arcuate ligament

70
Q

Where does the lateral arculate ligament span?

A

-L 12 transverse process to the tip of the 12th rib