Thorax Anatomy 1 + Medical Imaging Flashcards
What is the clinical name for the thoracic aperture?
Superior thoracic aperture :
Thoracic Outlet
What are the boundaries of the thoracic outlet
Anterior: Manubrium
Posterior: T1 Spinous verterbrate
Lateral: 1st Rib
What are the palpatable bony landmarks?
Clavicle (Prevents 1st rib palpation)
Manubrium
Jugular notch
Manubriosternal Joint
Costal Ridge
At what level is the manubriosternal joint?
At the T4 / T5 level
What is the area above the T4/T5 level called?
Superior Mediastinum
What are anterolateral joints which concern the ribs called and classify:
Costochondral -> Primary Cartilagenous
Sternochondral -> Synovial Planar
What are the common chest deformities and what are they caused by?
- Barrel Chest -> Emphysema
- Scoliosis -> Idiopathic or congenital
- Pectus Carinatum -> Congenital
- Pectus Excavatum -> Congenital
- Kyphosis -> Compression Fracture (thoracic lordosis)
What can occur due to strain or previous respiratory infection?
Chostocondritis
What are the common symptoms of chostochondritis
Imflamed and painful costochondral joints which can be associated with “Tietze syndrome”
Sometime mistake as cardiac pain
What is the main function of the chest during breathing?
To provide a rigid surrounding to the pleural cavity so the diaphragm can work
What is the secondary function of the chest?
to move and assist in breathing
Explain the movement of the ribs?
Ribs 2-7 will elevate and increase the dimension of the thorax using a pump handle mechanism
Lower ribs will elevate and also increase the dimension of thorax using a bucket handle mechanism
Explain the concept of flail chest:
Flail chest is free moving of the chest wall which may occur due to external injury. For example a fracture of the ribs will cause a paradoxical movement:
Inspiration will call intact chest wall to expand and the site of the fracture to be sucked in and depress.
Expiration will cause the intact chest wall to depress and site of the fracture to exert air and expand.
What are the palpable surface of the posterolateral thorax?
Spine of C7 -> Vertebra Prominens
Root of the Spine of Scapula -> T3 Spinous
Inferior angle of scapula -> T7
Explain how you could map the fissures of the right lung :
**From an abducted arm postion: **
Oblique fissure: T4 spinous to rib 6 anterioly
Horizontal Fissure: T4 spinous to 5th rib mid axillary line then 4th rib
Explain the concept of Shovelers Fracture:
Force from the upper limb is transmitted via the scapular which is held onto the thorax via the muscles which attach to the spine.
Excess force which is held by the trapezius or rhomboids can cause an avulsion fracture of the lower cervical or upper thoracic spinous processes (C7)
Label
Where is the common fracture point of the rib?
The body which is anterior to the angle
What is a common occurrence due to a fractured rib?
Can puncture pleural cavity: Pneumothorax
Can also puncture abdominal organs
Compare and Open vs tension Pneumothorax
Open pneumothorax occurs due to a perforation in lung which causes air to enter and exit.
Tension pneumothorax occurs due to perforation in lung which causes air to enter but not exit. This creates a buildup in pressure of the lung which compresses the heart onto the adjacent lung as well as pushing the trachea.
Explain how to process a percutaneous liver biopsy:
A needle is inserted into the 7th -10th intercostal space in the mid/anterior axillary line.
This is done during held expiration to reduce the size of the diaphragmatic recess and hence be able to puncture the liver.
