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Z N Anatomy > Thorax > Flashcards

Thorax Flashcards

1
Q

What is the thoracic cage part of?

A

The axial skeleton

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2
Q

What are the articulations of the thorax?

A
  1. the sternoclavicular joint (which is a saddle-type synovial joint with an articular disc)
  2. the sternocostal joints (which are synchondroses)
  3. the costochondral joints (which are primarily cartilaginous joints).
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3
Q

What is the opening at the top of the thoracic cage?

A

Superior thoracic aperture

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4
Q

What is the opening at the bottom of the cage?

A

the opening at the bottom of the cage is the inferior thoracic aperture, which is closed by the abdominal diaphragm

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5
Q

What are rib fractures?

A
  • Thoracic cage injuries result from trauma and often involve rib fractures
  • Ribs 1, 11, and 12 are the least fractured ribs.
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6
Q

What direction will rib fractures usually occur?

A

Rib fractures may occur in a transverse plane or an oblique plane or at multiple sites on the same rib, resulting in a free-floating segment (stove-in, or flail chest, injury)

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7
Q

Why are rib fractures really painful?

A

The pain is intense because of the continued expansion and contraction of the rib cage necessary during respiration

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8
Q

What dot he superior and inferior articular processes (facets) articulate and form?

A

plane synovial joints (zygapophysial joints)

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9
Q

What is each articulation surrounded by?

A

Each articulation is surrounded by a thin capsule

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10
Q

What do accessory ligaments do?

A

Accessory ligaments unite the laminae, transverse processes, and spinous processes

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11
Q

What do these articulations allow?

A

These articulations permit some gliding movements between adjacent vertebrae during flexion, extension, and limited lateral bending

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12
Q

What type of joints are costovertebral joints?

A

Costovertebral joints are plane synovial joints that occur between the head of a rib and the costal facets of a vertebra

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13
Q

Where do costotransverse plane synovial joints occur?

A
  1. Costotransverse plane synovial joints (ribs 1-10) occur between a tubercle of a rib and a transverse process of a vertebra
  2. Gliding movements occur at these joints.
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14
Q

Where could osteoarthritis affect?

A

Osteoarthritis is the most common type of arthritis and often involves erosion of the articular cartilage of weight-bearing joints, including the facet (zygapophysial) joints

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15
Q

Where do the external intercostal muscles arise from?

A

Each muscle arises from the lower border of a rib

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16
Q

Where do the external intercostal muscles insert?

A

Each muscle attaches to the upper border of the rib below its origin

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17
Q

What is the action of external intercostal muscles?

A

It is generally accepted that the external intercostal muscles are active during inspiration and that they elevate the ribs

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18
Q

What is the innervation of external intercostal muscles

A
  • Muscles are innervated by intercostal nerves, which are numbered sequentially according to the intercostal interspace.
  • The 4th intercostal nerve supplies muscles that occupy the 4th intercostal space, between the 4th and 5th ribs.
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19
Q

How many external intercostal muscles are there?

A

Because these muscles fill the intercostal spaces, there are 11 external intercostal muscles on each side of the thorax

20
Q

What do the intercostal muscles do?

A

All of the intercostal muscles keep the intercostal spaces rigid, preventing them from bulging out during expiration and being drawn in during inspiration

21
Q

Can the intercostal muscles assist the diaphragm?

A
  1. Whereas the diaphragm is the primary muscle of respiration (used almost exclusively in neonates and during quiet respiration)
  2. the intercostals do assist the diaphragm and, along with other accessory muscles of respiration (e.g., the scalene muscles)
  3. can become hypertrophied if a respiratory pathologic process occurs (e.g., in a chronic obstructive pulmonary disease such as emphysema).
22
Q

Where do the internal intercostal muscles arise from?

A

arise from a ridge on the inner surface of the inferior aspect of each rib and from the corresponding costal cartilage

23
Q

Where do the internal intercostal muscles insert?

A

Each muscle attaches to the upper border of the rib below its origin

24
Q

What is the action of the internal intercostal muscles?

A
  1. The portions of the upper 4 or 5 internal intercostal muscles that interconnect with the costal cartilages may elevate the ribs.
  2. The more lateral and posterior portions of the muscles, where the fibers run more obliquely, depress the ribs and are active during expiration
25
Q

What is the innervation of the internal intercostal muscles?

A

Intercostal nerves.

26
Q

What are the fibres like in the internal intercostal muscles?

A
  • In general, the fibers of the internal intercostals are roughly perpendicular to those of the external intercostal muscles
  • There are 11 pairs of internal intercostal muscles
27
Q

When will intercostal muscles hypertrophy?

A
  1. The intercostal muscles assist in respiration 2. can hypertrophy if a respiratory pathologic process develops (e.g., in a chronic obstructive pulmonary disease such as asthma or emphysema).
28
Q

Where does each innermost intercostal arise from?

A
  • arises from the lower border of a rib
  • The innermost intercostal muscles frequently are poorly developed and may be fused to the overlying internal intercostals
  • They are most prominent on the lateral thoracic wall.
29
Q

Where does the transverses throacis arise from?

A

arises from the posterior surface of the lower portion of the body of the sternum and the xiphoid process

30
Q

Where does each innermost intercostal attach?

A

to the upper border of the rib below its origin

31
Q

Where does the transversus thoracis attach?

A
  • attaches to the inner surfaces of costal cartilages 2-6

- The transversus thoracis muscle is variable in its attachments

32
Q

What does the innermost intercostals do?

A

The action of the innermost intercostals is controversial, but these muscles are thought to depress the ribs

33
Q

What do the transversus thoracis do?

A

The transversus thoracis muscle depresses the ribs

34
Q

What is the innervation of the innermost intercostals and transversus thoracis?

A

Intercostal nerves

35
Q

Where do you inject a local anaesthetic for chest trauma?

A
  1. Chest trauma can lead to very painful breathing
  2. Injection of a local anesthetic agent into the intercostal space (intercostal nerve block) can relieve this pain
  3. The intercostal neurovascular bundles course between the internal and innermost intercostal muscles in the costal groove of the ribs.
36
Q

Where does the serratus anterior muscle arise from?

A

arises by fleshy digitations from the outer surfaces and superior borders of the first 8 to 9 ribs

37
Q

Where do the serratus anterior muscle insert?

A

The serratus anterior muscle fibers pass backward, closely apply themselves to the chest wall, and insert on the ventral aspect of the vertebral (medial) border of the scapula

38
Q

What is the action of the serratus anterior muscle?

A
  1. Muscle pulls the medial border of the scapula anteriorly toward the thoracic wall (protraction)
  2. Preventing the bone from protruding (winging)
  3. Its fibers also rotate the scapula upward by laterally rotating the inferior angle
  4. This action helps abduct the arm at the shoulder
  5. Abduction above (above the horizontal) can be accomplished only by lateral rotation of the inferior angle of the scapula.
39
Q

What is the innervation of the serratus anterior muscle?

A

Long thoracic nerve (C5, C6, and C7)

40
Q

What is the serratus anterior particularly important in?

A
  • in rotation of the scapula so the deltoid muscle may fully abduct the arm
  • also is important in keeping the scapula flush against the thoracic wall.
41
Q

What could damage to the long thoracic nerve result in?

A
  • may lead to “winging” of the scapula, most evident when a patient pushes forward with the upper limb against resistance
  • In particular, the inferior angle of the scapula is elevated away from the thoracic wall
  • This type of nerve injury may occur from trauma to the lateral thoracic wall or from lateral flexion of the neck to the opposite side, causing a stretch injury to the nerve.
42
Q

What is the length of the oesophagus?

A

The esophagus is a muscular canal that extends from the pharynx to the stomach. Its muscular coat is organized into 2 planes

43
Q

What are the two planes in the oesophagus?

A
  1. an external plane of longitudinal fibers

2. an internal plane of circular fibers

44
Q

What muscle transitions are in the oesophagus?

A

transitions from skeletal to smooth muscle as it descends from the pharynx to the stomach

45
Q

Where are the 4 narrowed regions along its length where a swallowed object may become lodged or erode the mucosa as it passes?

A
  1. the pharynx becomes continuous with the proximal esophagus
  2. the aortic arch crosses the esophagus
  3. the esophagus is compressed by the left main bronchus
  4. the esophagus passes through the diaphragm (esophageal hiatus)
46
Q

What is GERD?

A

Gastroesophageal reflux disease (GERD) may occur at the level of the lower esophagus and present as dyspepsia, gas, heartburn, dysphagia, bronchospasm, or asthma

Z N Anatomy (35 decks)

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