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Clinical Anatomy > Thorax I > Flashcards

Thorax I Flashcards

1
Q

anterior posterior dorsal ventral lateral medial proximal distal

All body planes

A
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2
Q

True Ribs

A

1-7

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3
Q

False Ribs

A

8-10

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4
Q

Floating Ribs

A

11-12

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5
Q

The Thoracic Cage

A
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6
Q
A
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7
Q
A
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8
Q
A
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9
Q

Inferior Thoracic Aperture

A
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10
Q

Posterior Anterior of Thoracic vertebrae

A
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11
Q

Lateral View of Vertebrae

A
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12
Q

Costovertebral joint

A
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13
Q

Features of Typical Ribs

A
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14
Q

Which of the ribs is atypical?

A

Ribs 1, 2, 10 11 and 12

Note how all contains the numbers 1, 2

1 is important clinically because of its close relationship to lower nerves of the brachial plexus and main vessels of arm

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15
Q

True & False Ribs

How do all ribs articulate? and with what structure?

A

All ribs articulate posteriorly with the thoracic vertebrae

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16
Q

What can happen if the first rib/clavicle is damaged…

A

The nerves of the brachial plexus can be compressed between the first rib and clavicle which can cause pain in the forearm, hand, wrist and can comprimise circulation in the upper limb

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17
Q

Where are fractures most likely to occur in the ribs?

A

The weakest point in adult ribs vulnerable to fractures is the angle

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18
Q

Clinical case: Cervical Rib

A

A rib arising from anterior tubercle of transverse process (TP) of C7

Can cause pressure on lower brachial plexus or subclavian artery

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19
Q

The black boxes are fibres

Muscles of the chest wall: Pectoralis Major

A
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20
Q

Deltoids _____ arm

Pectoralis Major ______ arm

A

Deltoids abduct arm

Pectoralis Major adducts arm

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21
Q

Muscles of the chest wall: Pectoralis Minor

Function?

A

Depression of Scapula

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22
Q

Muscles of the chest wall: Serratus anterior

Function?

A

Protraction and rotation of scapula

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23
Q

Intercostal muscles

A
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24
Q

Intercostal Membranes

A
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25
Q

Intercostal muscle fibre direction

A
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26
Q

Subcostalis

A

Internal surface of one rib to internal surface of another

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27
Q

Transversus thoracis

A

From xiphoid process and lower body of sternum to lower border of CCs 3-6

(costal cartilages?)

28
Q

Functions of intercostal muscles

A

•External intercostal muscles most active during inspiration (A)

•Interchondral portion of internal intercostal also involved (C)

o Elevate ribs and sternum

•Internal intercostal muscles most active during expiration (B)

o Interosseous portion - the portion between the ribs

o Depress ribs and sternum

Most activity of intercostal muscle is to maintain tone in the intercostal space: ‘isometric’

29
Q

The Diaphragm & structure

A

Most important muscle of respiration

Thin muscular & tendinous septum

Separates the thoracic cavity above & the abdominal cavity below

Dome shaped

30
Q

Diaphragm consists of…

A

Peripheral muscular part & Centrally placed tendon

31
Q

On contraction the diaphragm…

A

pulls down its central tendon & increases the vertical diameter of the thorax

32
Q

Diaphragm Structure question

A

Answer in Picture

33
Q

There are three main apertures in the diaphragm:

A

Vena Caval foramen (T8)

Oesophageal hiatus (T10)

Aortic hiatus (T12) (not a true aperture)

34
Q

Mechanism of respiration

A
  • Two phases of Inspiration & Expiration
  • Alternate increase & decrease of capacity of thoracic cavity
  • As there is only a single entrance (trachea), an increase in capacity of the thoracic cavity, results in air moving into the lungs under atmospheric pressure
35
Q

Vertical diameter

Changes in thoracic cage diameter

A

changes are achieved through the diaphragm

36
Q

Anteroposterior diameter

Changes in thoracic cage diameter

A

Downward sloping ribs raised at sternal end

First rib is fixed, intercostals contract bringing ribs closer together

External intercostals & interchondral part of internal intercostals and innermost intercostals

37
Q

Transverse diameter

Changes in thoracic cage diameter

A
  • Ribs articulate in front with the sternum & behind with vertebral column
  • Curve downward & resemble bucket handles
38
Q

The interchondral joints

A

small articulations between the apposed costal cartilages of the ribs 7-10.

39
Q

The intercostal artery, vein & nerve (the neurovascular bundle) run along between the…

Intercostal neurovascular bundle

A

Internal & innermost intercostal muscles

Protected by the costal groove of the superior rib

V - Vein

A - Artery

N - Nerve

40
Q

How many intercostal spaces are there?

A

11 intercostal spaces: name according to the rib superior

41
Q

Intercostal nerve enters space between

Intercostal nerves

A

parietal pleura & internal intercostal membrane

42
Q

Intercostal nerves originates segmentally from…

Intercostal Nerves

A

Anterior Rami T1-T11 of spinal nerve:

  • 1-6 intercostal spaces
  • 7-9 pass deep to Costal Cartilages to enter anterior abdominal wall
  • 10-11 pass directly to anterior abdominal wall
43
Q

‘Subcostal nerve’

Intercostal nerves

A

T12 intercostal nerve

44
Q

T1 intercostal nerve has branch that joins to..

Intercostal nerves

A

Brachial Plexus

It also has:

No lateral cutaneous branch

No anterior cutaneous branch

45
Q

Intercostal Nerve Diagram question

A
46
Q

Blood supply via the anterior & posterior intercostal arteries originate from…

Intercostal arteries

A

…the internal thoracic artery (branch of the subclavian - anterior) & descending thoracic aorta (posterior) respectively

47
Q

Each intercostal artery gives off branches to the…

A

…muscles, skin, parietal pleura & in the region of the breast in the female. The branches to the superficial structures are particularly large

48
Q
A
49
Q
A
50
Q

Intercostal Artery & Vein Diagram

A
51
Q

The azygous and hemi-azygous system of veins drains…

Intercostal veins

A

the intercostal spaces, as well as the pericardium & parts of the posterior abdominal region

52
Q

Posterior intercostal veins drain into…

Intercostal veins

A

the azygous & hemi-azygous systems

53
Q

Main azygous vein on _____

Superior (accessory) & Inferior hemiazygous (proper) on _____

Intercostal veins

A

Main azygous vein on right,

Superior (accessory) & Inferior hemiazygous (proper) on left

54
Q

Azygous & Hemi-zygous veins are also important as they can be an…

Intercostal Veins

A

anastomotic pathway for venous return if IVC becomes blocked

55
Q
  • Azygous formed by union of right ______ _____& right ______ ____
  • Inferior hemiazygous formed by union of left ______ _____ & left _____ ____

Intercostal Vein

A
  • Azygous formed by union of right ascending lumbar & right subcostal veins
  • Inferior hemiazygous formed by union of left ascending lumbar & left subcostal veins
56
Q
A
57
Q
A
58
Q

Breast structure, where it overlies and parts rest

A
  • Overlies the 2nd–6th rib
  • Two-thirds of it rests on pectoralis major, one-third on serratus anterior
  • Lower medial edge just overlaps the upper part of the rectus sheath
59
Q

Structure of the Breast (go over lecture in this bit)

A
  • Modified sweat gland
  • It is conical in shape
  • It lies in superficial fascia of the front of chest
  • It has a base, apex and tail (axillary tail)
  • It extends from the lateral margin of the sternum to the midaxillary line
  • It has no capsule
60
Q

Blood supply to the Breast (Arterial)

A

Arterial

From the axillary artery, principally via its lateral thoracic and acromiothoracic branches:

  1. Perforating branches of internal thoracic (internal mammary) artery
  2. Mammary branches of lateral thoracic artery
  3. Mammary branches of Intercostal arteries
61
Q

Blood supply to the Breast (Venous)

A

Venous

  1. Circular venous plexus are found at the base of nipple.
  2. Veins of this plexus drain into axillary & internal thoracic veins.
62
Q

Diagram

A
63
Q

The largest lymph nodes are located where….

Breast Lymphatics

A

peripheral lymphatics connect with the trunk , such as the groin, axillae and base of the neck

64
Q

Particular importance to the lymph nodes in the axilla…

Breast Lymphatics

A
  1. Frequent development of cancer in the mammary gland
  2. Subsequent dissemination of the malignant cells along lymph vessels to the nodes
65
Q

5 breast lymphatic groups which lie in the axillary fat:

Breast lymphatic

A
  1. Pectoral (Anterior) group: which lies on Pectoralis Major along lateral thoracic vessels
  2. Subscapular (Posterior) group: which lies on posterior wall of axilla on lower border of subscapularis along subscapular vessels
  3. Brachial (Lateral) group: lies on lateral wall of axilla along the axillary vessels
  4. Central group: lies in at the Center (base of axilla)
  5. Apical group: lies at apex of axilla
66
Q

Subclavian lymph trunk is formed by union of…

Breast lymphatic

A

…efferent lymph vessels of apical group.

  • It usually opens in subclavian vein.
  • On the left side it usually opens into thoracic duct.

Clinical Anatomy (7 decks)

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