Topic 9: Bones, joints and muscles of the thoracic cage Flashcards

1
Q

How many pairs of ribs are there?

A

12

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2
Q

How many true ribs are there?

A

7

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3
Q

how many false ribs are there?

A

3

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4
Q

how many floating ribs are there?

A

2

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5
Q

What are the 3 parts of the sternum?

A
  1. manubrium
  2. body
  3. xiphoid
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6
Q

How many thoracic vertebrae?

A

12

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7
Q

what else makes up the bones of the thorax?

A

costal cartilages

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8
Q

What are the boundaries for the thoracic inlet?

A

Rib 1, T1, Manubrium, costal cartilages

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9
Q

What are the boundaries for the thoracic outlet?

A

inferior
costal cartilages, lower 3-4 thoracic vertebrae

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10
Q

What are the 2 joints of the sternum?

A
  1. manubriosternal
  2. xiphisternal
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11
Q

What are the 2 joints of the anterior ribs?

A
  1. sternocostal (1st & 2-7)
  2. costochondral
    * chondral = ribs
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12
Q

What are the 2 joints of the posterior ribs?

A
  1. costovertebral
  2. costotransverse
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13
Q

Classify the Manubriosternal joint

A

secondary cartilaginous- symphysis

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14
Q

how moveable is the manubriosternal joint?

A

slightly

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15
Q

classify the xiphisternal joint

A

secondary cartilaginous- symphysis

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16
Q

How moveable is the 1st sternocostal joint?

A

immovable (lots of imp structures around there)

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17
Q

how moveable is the xiphisternal joint?

A

slightly moveable but ossifies in middle age

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18
Q

Classify the 1st sternocostal joint

A

primary cartilaginous- synchondrosis

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19
Q

Classify the 2nd-7th sternocostal joints

A

synovial, multi-axial, plane

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20
Q

How moveable are the 2nd-7th sternocostal joints?

A

small range of twist & glide (for breathing)

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21
Q

Classify the costochondral joints

A

primary cartilaginous - synchondrosis

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22
Q

How moveable are the costochondral joints?

A

immovable

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23
Q

Classify the interchondral joints

A

synovial, multiaxial, plane (except 9&10- fibrous)

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24
Q

Which ribs have interchondral joints?

A

ribs 6-10

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25
Q

explain where the interchondral joints lie

A

between borders of costal cartilages of ribs 6-10 and lower border of cartilage above

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26
Q

What are the 3 bony landmarks on the ribs which articulate with the vertebrae?

A
  1. head
  2. neck
  3. tubercle
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27
Q

What bony landmark on the vertebrae does the head of the rib articulate with?

A

demi facets

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28
Q

What bony landmark on the vertebrae does the tubercle of the rib articulate with?

A

transverse processes

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29
Q

Classify the costovertebral joint

A

synovial, multi-axial, plane

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30
Q

What movements are allowed at the costovertebral joint?

A

small range of twist and glide

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31
Q

Classify the costotransverse joint

A

synovial, multi-axial, plane

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32
Q

what movements are facilitated at the costotransverse joint?

A

small range of twist and glide

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33
Q

articular surfaces of the costovertebral joints

A
  1. head of rib
  2. (demi) facet on the body of the thoracic vertebra
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34
Q

What thoracic vertebra does rib 1 articulate with in the costovertebral joints?

A

T1

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35
Q

Which thoracic vertebrae does rib 2 articulate with in the costovertebral joints?

A

T1 and T2

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36
Q

Which thoracic vertebrae does rib 9 articulate with in the costovertebral joints?

A

T8 & T9

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37
Q

Which thoracic vertebra does rib 10 articulate with in the costovertebral joints?

A

T10

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38
Q

Which thoracic vertebra does rib 11 articulate with in the costovertebral joints?

A

T11

39
Q

Which thoracic vertebra does rib 12 articulate with in the costovertebral joints?

A

T12

40
Q

Costotransverse joints- articular surfaces

A
  1. tubercle of rib
  2. facet on the transverse process of the thoracic vertebra
41
Q

Which ribs have no costotransverse jt and why?

A

ribs 11 &12 - no costal cartilage and transverse process articulation (floating)

42
Q

What are the 2 ligaments of the costovertebral joints?

A
  1. radiate
  2. intra-articular
43
Q

What are the 3 ligaments of the costotransverse joints?

A
  1. costotransverse
  2. lateral costotransverse
  3. superior costotransverse
44
Q

COSTOVERTEBRAL LIGAMENTS
Where does the radiate ligament span?

A

From the head of the rib – to the body of the vertebra above, the vertebra of the same number and the intervening IV disc

45
Q

Function of the radiate ligament

A
  • limit movement in all directions
  • attaches head of rib to vert
46
Q

Intra-articular ligament
Where does it go?

A

From the head of the rib– to the IV disc, divides the cavity into 2

47
Q

Function of the intra-articular ligament

A

keeps head of rib in place

48
Q

COSTOTRANSVERSE JT LIGAMENTS
1. superior costotransverse ligament
Where does it go?

A

From the neck of the rib to the transverse processes of the vertebra above

49
Q

What is the function of the superior costotransverse ligament

A

limits separation of the ribs

50
Q
  1. lateral costotransverse ligament
    Where does it go?
A

strong band between tip of transverse processes and the costal tubercle (same level)

51
Q

Function of the lateral costotransverse ligament

A

keeps rib & thoracic vert together

52
Q
  1. costotransverse ligament
    Length of fibres
A

short fibres

53
Q

where does the costotransverse ligament go?

A

from the back of the neck of the rib – to the front of the transverse process

54
Q

DIAMETERS OF THE THORAX
What happens to ALL dimensions of the thoracic cage (TC) with each inspiration?

A

increase

55
Q

DIAMETERS OF THE THORAX
What happens to the vertical diameter of the TC with each inspiration and how?

A

Increased by descent of diaphragm

56
Q

DIAMETERS OF THE THORAX
What happens to the antero-posterior diameter with each inspiration and how?

A

increased by movement of the sternum and anterior parts of ribs

57
Q

DIAMETERS OF THE THORAX
What happens to the lateral diameter with each inspiration and how?

A

increased by movements of the lateral parts of the ribs

58
Q

What are the 2 mechanisms for movement of the ribs?

A
  1. pump handle
  2. bucket handle
59
Q

Which ribs does the pump handle mechanism involve?

A

upper ribs 2-5

60
Q

What axis diameter does pump handle mechanism increase?

A

AP diameter

61
Q

What is the movement axis for pump handle mechanism?

A

along neck of rib

62
Q

Which ribs does the bucket handle mechanism involve?

A

lower ribs 8-10

63
Q

Where does the diameter increases in the bucket handle mechanism?

A

lateral

64
Q

what is the movement axis for the bucket handle mechanism?

A

through the costovertebral and sternocostal joints

65
Q

MUSCLES OF THE THORACIC CAGE:
1. diaphragm
What does it cover?

A

the thoracic outlet

66
Q

Attachments of the diaphragm

A
  1. bodies & intervening discs L1-L3
  2. inner surface of the ribs 7-12 and their costal cartilages (lat &ant)
  3. posterior surface of the xiphoid process of the sternum
  4. central tendon
67
Q

what is the prime role of the diaphragm

A

prime mover for inspiration

68
Q

What 2 areas does the diaphragm separate?

A

the thorax & abdo

69
Q

What happens to the thoracic cage when the diaphragm contracts?

A
  1. increase volume
  2. decrease pressure
70
Q

What happens to the abdo when the diaphragm contracts?

A
  1. decrease volume
  2. increase pressure
71
Q

What are the 3 apertures of the diaphragm?

A
  1. Abdominal aorta (T12)
  2. Oesophagus (T10)
  3. Inferior Vena Cava (T8)
72
Q

Where is the abdominal aorta aperture of the diaphragm located?

A

behind the diaphragm

73
Q

Is the abdominal aorta aperture affected by diaphragm contraction?

A

no

74
Q

Where is the oesophagus aperture located?

A

through the muscle of the diaphragm

75
Q

what happens to the oesophagus aperture when diaphragm contracts?

A

closed

76
Q

Where is the inferior vena cava aperture located?

A

through the central tendon

77
Q

What happens to the inferior vena cava aperture when diaphragm contracts?

A

opens

78
Q

OTHER MUSCLES OF THORAX
1. intercostals
where do they go?

A

from the lower border of one rib to the upper border of the rib below

79
Q

Three layers of intercostals:

A
  1. external
  2. internal
  3. innermost
80
Q

Role of the intercostals

A
  1. stiffen the space between the ribs
  2. role in breathing & in posture
81
Q

direction of external intercostal fibres?

A

hands in pockets

82
Q

direction of innermost & internal intercostal fibres?

A

opposite to hands in pockets

83
Q

What is an accessory muscle of inspiration?

A

any muscle attaching to the ribs from above can lift the ribs and increase thoracic volume (inspiration)

84
Q

e.g. of inspiratory muscles (upper limb)

A

serratus anterior, pec major & minor, sternocleidomastoid

85
Q

e.g. inspiratory muscles of the vertebral column

A
  1. scalenes group
  2. serratus posterior superior
86
Q

Are expiratory muscles largely active or passive in awake humans?

A

passive

87
Q

what happens with the diaphragm at the start of expiration?

A

contracts eccentrically for a short period to slow expiratory rate

88
Q

Muscles used in FORCED expiration

A
  1. abdominal muscles
  2. any other muscle that can pull the ribs down e.g. serratus posterior, QL
89
Q

What happens to the diameter of the rib cage in forced expiration

A

decreases

90
Q

4 phases of respiratory cycle

A
  1. quiet inspiration
  2. forced inspiration
  3. quiet expiration
  4. forced expiration
91
Q

Muscles responsible for quiet inspiration

A

diaphragm, external intercostals

92
Q

Muscles responsible for forced inspiration

A

diaphragm, pec maj & min, skelinis, sternoclydomastoid, serr ant, lat dorsi, ser post sup

93
Q

Muscles responsible for quiet expiration

A

diaphragm – eccentric initially – relaxes after

94
Q

Muscles responsible for forced expiration

A

abd muscles, serratus post, longissimus, lat dorsi, ext/int obliques, iliocostalis, transversus abdominus, serr post inf, QL