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ANAT0005 > Thorax walls > Flashcards

Thorax walls Flashcards

1
Q

What are the layers of the chest wall?

A
  1. Skin
  2. Superficial fascia - loose layer of fatty connective tissue that wraps other organs
  3. Limb muscle - pectoralis, latissimus, serratus
  4. Ribs and intercostal muscles
  5. Pleura - lines the chest wall
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2
Q

What is the superficial fascia?

A

Adipose tissue covering the chest and abdominal wall

Attached to the muscles by fibrous tissue

Within this layer you can find the glandular tissue and fatty connective tissue of the breast

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3
Q

What is the composition of breast tissue in non-lactating women?

A

50% fat

50% glandular tissue

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4
Q

What is the composition of breast in lactating women?

A

33% fat

67% glandular tissue

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5
Q

What is a unique presentation of breast cancer?

A

Orange peel

Cooper suspensory ligaments attach breasts to the chest wall

Invasion of these ligaments causes the characteristic dimpling effect seen in breast cancer

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6
Q

What are possible signs of breast cancer?

A 
Lumps 
Nipple discharge 
Dimpling 
Breast or nipple pain 
Nipple retraction or inversion 
Redness 
Changes to the skin's texture 
Lymph node changes 
Swelling
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7
Q

What structures do the lymph vessels from the breast drain to?

A

Axillary nodes

Opposite breast

Deep thoracic nodes in the stomach

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8
Q

During which occassions will the lymph node size increase?

A

Infection

Cancer metastasis

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9
Q

Which arteries supply the breast?

A

Arteries of the chest wall

Arteries of the arm

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10
Q

What are the two types of muscle in the thorax?

A

Limb muscles - muscles of the arm that are attached to the chest wall

Intercostal muscles - musculoskeletal core of the body

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11
Q

What are the 3 main limb muscles of the chest wall?

A

Pectoralis

Latissimus dorsi

Serratus anterior

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12
Q

What is the role of the pectoralis muscle?

A

Attaches the arm to the chest wall

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13
Q

What is the role of the Latissimus dorsi?

A

Attaches arm to the chest wall

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14
Q

What is the role of the serratus anterior?

A

Originates from the upper ribs and attaches to the back of the shoulder blade

Helps maintain the shoulder in its place, and stops the scapula from winging outwards

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15
Q

What is the function of the thoracic cage?

A

Protects the thoracic and upper abdominal contents (liver, lungs, spleen)

May be perforated if the ribs are broken

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16
Q

What are the components of the thoracic cage?

A

12 ribs

Sternum

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17
Q

What are the different types of ribs in the rib cage?

A

1 to 7 true ribs attached directly to the sternum

8 to 10 false ribs not directly attached to the sternum but to the cartilage that surrounds the sternum

11 to 12 are free ribs and is not attached to the sternum

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18
Q

What are the 3 parts of the sternum?

A

Manubrium - top part of the sternum, gap between clavicles

Body

Xiphisternum - cartilagenous end piece that becomes harder as it calcifies with age

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19
Q

What types of joints exist between the ribs and the sternum?

A

The joints betwwen the ribs and sternum are synovial

Except the joint between the manubrium and the body of the sternum = firbocartilaginous and allows flexion during breathing

20
Q

What is the joint between the manubrium and the body of the sternum called?

A

The manubriosternal joint

21
Q

Describe how intermembrane muscle become membranous?

A

External intercostal muscles become membranous anteriorly to form the external intercostal membrane

Internal intercostal muscles become membranous posteriorly to form the internal intercostal membrane

Therefore, when you look at the front of the lungs, you see the internal intercostal muscles first since they are seen through the external intercostal membrane

22
Q

What are ribs an example of?

A

Segmentation of the mesoderm

23
Q

What two arteries supply the intercostal muscles?

A

Posterior intercostal arteries

Anterior intercostal arteries

24
Q

What is the origin of posterior intercostal arteries?

A

Near the spinal cord

Branch from the aorta

25
Q

What is the origin of anterior intercostal arteries?

A

Near the sternum

Branch from the internal thoracic arteries (which are branches of the subclavian arteries)

26
Q

What can be found in the intercostal space?

A

Intercostal vein

Intercostal arteries

Intercostal nerve - from the spinal column supplying muscles in that space, as well as giving off branches of the skin to form the dermatome

These nerves send sensoy fibres to the parietal pleura internally and to the skin in a segmental pattern

27
Q

How are intercostal contents arranged within the space?

A

Vein

Artery

Nerve

28
Q

Explain the drainage system of the posterior thoracic wall

A

Posterior intercostal veins drain to azygous veins running down one side of the aorta, which drain to the superior vena cava

29
Q

What are hemiazygous veins?

A

Sometimes the azygous veins are paired

30
Q

What is the parietal pleura?

A

The serous lining of the rib cage

31
Q

Describe the shape of the thorax

A

Conical

  • the top is conical
  • the sides are formed by the ribs
  • the base is closed by the diaphragm
32
Q

Describe the shape of the diaphragm

A

Double-domed, musculotendinous tissue

33
Q

What is the origin of the muscular components of the diaphragm?

A

The diaphragm is formed by muscle slips that converge one a central tendon in a colver lead shape.

These muscle slips originate from:

  1. The ribs - costal ribs
  2. The lumbar vertebrae - crura
  3. Sternum - sternal slips
  4. Thick fascia over the muscles in the back (arcuate ligaments)
34
Q

What are the 3 openings of the diaphragm?

A
  1. Inferior vena cava + right phrenic nerve
  2. Oesophagus + right/left vagus nerve, esophageal branches of left gastric artery
  3. Aorta + thoracic duct/azygous vein
35
Q

At what level does the inferior vena cava enter the diaphragm?

A

Level T8

Through the central tendon

36
Q

At what level does the oesophagus enter the diaphragm?

A

Level T10

Through the crura

37
Q

At what level does the aorta enter the diaphragm?

A

Level T12

Passess behind the diaphragm

38
Q

How does congenital diaphragmatic hernia develop? `

A

Develops when component parts of the diaphragm fail to develop properly, leading to:

  • compressed lung
  • liver partially up into chest
  • small intestine in the left chest pushing heart and lungs to the heart
39
Q

Which nerve supplies the diaphragm?

A

Phrenic nerves

40
Q

What type of innervation does the phrenic nerve supply to the diaphragm?

A

Sensory to the central part of the diaphragm

Motor to all the diaphragm

41
Q

What type of nerve is the phrenic nerve?

A

Somatic

42
Q

What type of muscle is the diaphragm?

A

Skeletal muscle

43
Q

Apart from the diaphragm, what other structures does the phrenic nerve innervate?

A

Sensory to the pleura of the heart

Sensory to the parietal pleura

Peritoneum layer and underneath the diaphragm

44
Q

What is the serous membrane called in separate parts of the body?

A

Pleura in the thorax

Peritoneum in the abdomen

45
Q

What are the 4 main embryonic components of the development of the diaphragm

A
  1. Septum transversum - forms the central tendon to which all the other components come together
  2. Pleuroperitoneal folds - folds in to close the pericardioperitoneal canal
  3. Mesentery of the esophagus
  4. Muscle cells from the somites of the cervical region
46
Q

What is the septum transversum?

A

Sheet of fibrous tissue between the heart and liver

Gives rise to the central tendon of the diaphragm

47
Q

What explains the complicated innervation of the phrenic nerve?

A

Embryology

Skeletal muscle that makes up the diaphragm comes from myotomes in the neck

These invade the pleuroperitoneal membran and the esophageal mesentery

As they invade, they drag their nerve supply with them from the neck into the thorax

ANAT0005 (6 decks)

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