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SHB > Thorax > Flashcards

Thorax Flashcards

1
Q

What forms the thoracic cage?

A

12 pairs of ribs
sternum
costal cartilages
12 thoracic vertebrae

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2
Q

What forms the thoracic wall?

A

cage + muscles and fascia

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3
Q

What is the function of the thoracic wall?

A

1) Protect thoracic cavity and upper abdominal
2) respiration
3) attachment for skin, fascia, muslces of neck, thorax, upper limbs, abdomen, back

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4
Q

What are the boundaries of the thoracic wall?

A

anterior: sternum, costal cartilages
laterally- ribs
posteriorly- thoracic vertebrae and IV discs

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5
Q

What are the special features of the thoracic vertebrae?

A

1) long, inferiorly angled spinous processes
2) costal facets on the transverse processes where ribs articulate (except last 2 or 3)
3) 2 demifacets on bodies T2-T9 for articulation with other ribs
- superior articulates with head of same rib number
- inferior articulates with head of inferior (higher number)

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6
Q

What does the inferior articular facet on the rib head articulate with?

A

vertebra of same number as rib

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7
Q

What does the superior articular facet of the rib head articulate with?

A

vertebra above (lower number)

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8
Q

What does the rib tubercle articulate with?

A

same number vertebra
attachment site for costotranserse ligaments
in neck

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9
Q

What are the true ribs?

A

1st-7th

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10
Q

What are the false ribs?

A

8th- 10th

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11
Q

What are the floating ribs?

A

11th and 12th

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12
Q

What are the atypical features of the first rib?

A

1) scalene tubercle

2) single facet for articulation with only the T1 vertebra

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13
Q

What are the atypical features of the 2nd rib?

A

tubercle for origin of serratus anterior muscle

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14
Q

What are the atyipcal features of the 10th rib?

A

only one faet for articulation with only one vertebra

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15
Q

What are the atypical features of the 11th and 12th ribs?

A

no necks or tubercles
free floating
articulate with only one vertebra

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16
Q

Where is the manubrium of the sternum?

A

level of T3 and T4 with jugular notch

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17
Q

Where is the body of the sternum?

A

T5-T9

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18
Q

Where is the xiphoid process of the sternum?

A

T10

19
Q

Where can the jugular (suprasternal) notch be felt?

A

palpated at T2 level

20
Q

Where can the sternal angle be felt?

A

palpated at the T4 level

21
Q

What are the boundaries of the superior thoracic aperture?

A

T1
1st ribs and cartilage
superior border of manubrium

22
Q

What passes through the superior thoracic aperture?

A

1 trachea
2 esophagus
3 nerves and blood vessels for head neck and upper extremities

23
Q

What binds the inferior thoracic aperture?

A 
T12
11th and 12th rib pairs
costal cartilages of ribs 7-10 
xiphisternal joint
closed by diaphragm
24
Q

What are the 3 openings to the inferior thoracic aperture?

A
  1. inferior vena cava hiatus (T8)
  2. esophageal hiatus (T10)
  3. aortic hiatus (T12)
25
Q

What are the four intercostal muscles of the thoracic cage?

A

external intercostal- raise ribs inspiration
internal intercostal - lowers ribs exspiration
innermost intercostal- raise ribs inspiration
transversus thoracis- w/ sternum

26
Q

Where do the thoracic fibers run?

A

anterior superior

posterior inferior

27
Q

What innervates the diaphragm?

A

phrenic nerve C3-5 cerivical plexus

Attached to: xiphoid process, lower 6 intercostal cartilages and L1-L3 vertebrae and converge into central tendon

functino: draw central tendn down and forward during inspiration

28
Q

What are the 3 major openings of the diaphragm>

A

1) inferior vena cava (T8)
2) esophagus (T10)
3. Aorta (T12)

I ate ten eggs at noon

29
Q

How does the thoracic cage move during breathing?

A

vertical diameter increases during inspiration as diaphragm decends

diaphragm ascent during expiration to return to size

transverse diameter = increases slightly when intercostals contract= BUCKET HANDLE motion

Anteroposterior diameter= movemnt of ribs 2-6 and sternal ends of ribs raise = PUMP HANDLE motion

sternum moves forward as lift chest= scalene and SCM can help with respiration to bring in 02 if struggling

30
Q

What is the neurovasculature of the throcic wall?

A

Intercostal vein
intercostal artery
interscostal nerve

nerve most exposed because most superficial
dont stick needed between ribs on up angle

31
Q

What is the blood supply to the posterior wall of the thoracic cage?

A

posterior intercostals

branches of aorta and costocervical trunk

32
Q

What is the blood supply to the anterior wall if the thoracic cage?

A

anterior intercostals

branches of internal thoracic and musculophrenic arteries

33
Q

Where do the intercostal veins drain?

A

azygos (right) vein then hemizygos veins (left)

deep and run opposite arterys

34
Q

What is the nerve supply to the thoracic wall?

A

intercostal muscles innervated by ventral rami of thoracic nerves

35
Q

What are the important dermatomes?

A 
C4 = clavical and jugular notch (supraclavicular)
T2= sternal angle
T4 = nipples

dermatomes usually drop 2 levels from posterior to anterior (T2 front = T4 back)

36
Q

What are the 2 divisons of the mediastinum?

A

superior mediastinum and inferior mediastinum

37
Q

What is in the superior mediastinum?

A

above sternal angle

1) thymus
2) brachiocephalic veins and superior vena cava
3) phrenic and vagus nerve (recurrent laryengeal)
4) aortic arch and branches
5) trachea
6) esophageous
7) thoracic duct

38
Q

What is the in the inferior mediastinum?

A

inferior to sternal angle superior to diaphragm

anterior mediastinum = thymus and sternopericardial ligs

middle mediastinum= pericardial cavity/heart, great
vessels, phrenic m, roots of lung

posterior mediastium= esophagous, descending aorta branches, azygos veins, thoracic duct, sympathetic chair and splanchnic nerve

39
Q

What is the most superficial structure against the ribs?

A

branches of interal thoracic vessels

in ant mediastinum

40
Q

Where is the aortic arch and branches?

A

superior mediastinum

brachiocephalic trunk
left common cartotid a
left subclavian a

41
Q

Where is the phrenic nerve?

A

on top of lungs

42
Q

Where is the vagus nerve?

A

with aortic arch behind heart- plexus

43
Q

Where is the recurrent largyngeal nerve?

A

in tracheoesophageal groove

44
Q

How do the lungs appear in a CT?

A

black hole = air

SHB (22 decks)

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