Thorax Overview Flashcards
How many ribs are classified as true, false, and “floating” ribs?
true= 7 - directly attach to sternum
false = 3 - articulate with costal arch (not with sternum)
2 = floating ribs
At what Thoracic level will the following structures be found
- Manubrium - Suprasternal Notch
- Sternal Angle
- Xiphoid Process/ Xipersternal Joint
- T2
- T4 - T5
- T9-10
What rib will one fond the Sternal Ange/Angle of Louis?
2nd Rib
The thoracic inlet is bounded by what 3 structures?
- 1st rib
- T1 vertebrae
- MANUBRIUM
The thoracic outlet is bounded by what 3 structures?
- 12th Rib
- Costal Arch
- Xiphoid Process
- closed off by the DIAPHRAGM
What are the four intercostal muscles and in what direction to they project?
- External Intercostal - project inferomedially (hands in pockets)
- Internal Intercostal - 90 degrees
- Innermost Intercostal - up and down
- Transversus Thoracis - on the BACK of the costal cartilage project to the sternum
What structure closes the thorax off from the abdominal cavity?
Diaphragm
What is the blood supply to the anterior wall of the Thorax?
What are they a branch of?
Anterior Intercostal Arteries
- branch of Internal Thoracic & Musculophrenic Arteries
&supreme thoracic
What is the blood supply to the POSTERIOR wall of the Thorax? What are they a branch of?
Posterior Intercostal Arteries
- branch of the AORTA & costacervical trunk
What is the venous drainage of the thorax?
Braciocephalic vein (long and moves to the left- in the body)
- Azygos veins
What is the area between the right and left pleural cavities?
Mediastinum
The pleura is continuous, true or false? What is the innermost pleura called? Outermost?
TRUE
inner = Visceral outer = Parietal
What are the contents of the Superior Mediastinum? (there are 11) What is it bounded by?
- Aortic Arch
- Braciocephalic Trunk
- Left Common Carotid A.
- Left subclavian A.
- Superior Vena Cava
- Braciocephalic V.
- Thymus
- Trachea & Esophogus
- Vagus & Phrenic
- Recurrent Laryngeal N.
- THoracic Duct
BOUNDED BY THORACIC INLET AND STERNAL ANGLE (2nd rib/ T4)
* GREAT VESSELS OF THE HEART
What are the contents of the Middle Mediastinum? (there are 4) it is the area ______ the heart.
- Pericardium
- Heart & great vessels
- root of lungs
- Phrenic Nerves
Area AROUND the heart
What are the contents of the Anterior Mediastinum? (there are 2) it is the area ______ the heart.
in FRONT of the heart
- Areolar Tissue
- Lymph Nodes
What are the contents of the Posterior Mediastinum? (there are 6). It is the area ______ the heart.
BEHIND the heart
- Descending Aorta
- Azygos/Hemizygos
- Esophogus
- Vagus
- Thoracic Splanchnic
- Thoracic Duct
What is the pleural cavity?
Closed sac that invests each lung
- contains serrous fluid for LUBRICATION
What pleura covers the
lungs?
VISCERAL Pleura
What is a pleural recess? What are 2 important ones?
Between the PARIETAL and VISCERAL pleura forming potential spaces
- allow MAX EXPANSION of the lung (during forced ventilation)
- Costodiaphragmatic Recess
- Costomediastinal Recess
Which side of the aorta contains the braciocephalic trunk? What two structures come DIRECTLY off the Aorta?
- RIGHT = braciocephalic trunk
2. LEFT = Left Common Carotid Artery + Left Subclavian Artery
The radiology oncologist explains to you that your patients tumor is at the T3 level
and is compressing an artery. Which artery might be involved?
A: Descencing Aorta B: Ascending Aorta C: Braciocephalic D: Right subclavian E: Musculophrenic
C: Braciocephalic
Patient is a 25 year old male that was mugged. He was shot in the chest. The bullet entered just below the sternal angle and lodged in a vertebra posteriorly. Which vertebrae? A: T2 B: T3 C: T4 D: T5 E: T6
D: T5
Patient has a fracture of the costal cartilage of the 4th rib. You could localize this by:
A: counting down 2 ribs from the sternal angle (sternal angle is at 2nd RIB
Your patient has an osteocarcoma on the anterior surface of the T6 vertebral body. Which artery would be most affected?
B: Right posterior Intercostal A.
What ribs does the transverse thoracis muscle attach to?
Ribs 2-6
-behind sternum, attaching to the body of the ribs
Which artery comes directly off the aorta?
POSTERIOR INTERCOSTAL
How many intercostal nerves are there? What is the nerve under the 12th rib called?
11!!! only 11 intercostal spaces
VAN - vein artery nerve
the last nerve is the SUBCOSTAL
When entering the intercostal space with a needle, should one go above or below the rib?
ABOVE
- since nerve is found directly below
Which vein has a longer course to reach the superior vena cava?
LEFT Braciocephalic Vein is longer
Where does the trachea begin to divide?
TRACHEA WILL DIVIDE AT THE STERNAL ANGLE - T4 – T5 at 2nd rib
How does the Vagus nerve reach the abdominal cavity (from the thorax)?
- from thorax to abdominal cavity via:
ESOPHOGUS
- carries PARASYMPATHETICS
