Unit 2 Thoracic wall, pleural cavity and lungs Flashcards
thoracic cage also called
rib cage
floor =
respiratory diaphragm
thoracic inlet also known as
superior aperture
thoracic outlet also known as
inferior aperture
true ribs
1-7
have their own coastal cartilages
false ribs
8-10
indirect attachment to sternum
floating ribs
11 and 12
no sternal attachment
embed in abdominal oblique
three line that makes the thorax
midsternal line
parasternal line
midclavicular line
2 clavicular space
supraclavicular space
infraclavicular space
right lungs
- 3 valves
- 3 cm above clavicle in midclavicular line
- follow inferior along parasternal line to 6th rib
- follow lateral to midclavicular line
- continue laterally to 8th rib and posterity to 10th rib
left lung
2 valves
- 3cm above midclavicualr line
-follow inferior along parasternal line
- follow along the curvature of the heart to the 6th rib (the heart occupies more space on the left side)
- follow lateral to midclavicular line
- continue laterally to 8th ride and posterity to 10th rib
costochondral joint
- sternal end of rib with lateral end of costal cartilage
- Primary cartilaginous (synchondrosis -no movement here)
- strengthened by periosteum surrounding bone and cartilage
dislocation
- rib separation
- usually 3-7 (tends to lift)
sternocostal joint
-costal cartilages with sternum
- primary cartilaginous joint (1st rib)
-synovial plane joint (ribs 2-7)
- strengthened by radiate sternocostal ligaments
costovertebral joint complex
- two joint
- costovertebral joint
- costotransverse joint
- plane / gliding
- strengthened by radiate ligament
costovertebral joint
head of rib with costal facets of vertebrae
cosotransverse joint
tubercle of rib with traverse process of vertebrae
what allows bucket handle movement
middle 1/3 of ribs 7-10 are lower than the sternal or vertebral ends. this allows for movement of the rib to shaft laterally
what allows pump handle movement
elevation of ribs 1-6 move the sternum superiorly and anteriorly
diaphragm
- involuntary and voluntary muscles
- origin: costal part, lumbar part, sternal part
- insertion: central tendon
inn: phrenic nerve (c3-c5) - openings - naval opening, esophageal hiatus, aortic hiatus
costal part
inferior border of the ribs (7-12)
lumbar part
vertebral bodies L1-L3, ALL, arcuate ligament
sternal part
posterior surface of xiphoid process
openings of diaphragm
caval opening
esophageal
hiatus
aortic hiatus
insertion of diaphragm
central tendon
what innervates the diaphragm
phrenic nerve
c3-5
caval opening
IVC, phrenic nerve branches
esophageal hiatus
esophagus
vagal trunks
aortic hiatus
descending aorta
thoracic duct
what keeps the diaphragm alive
C 3,4, and 5 keeps the diaphragm Alvie
blood supply for diaphragm
superior and inferior phrenic arteries, musculophrenic artery
muscles of the thoracic wall - accessory muscles of respiration
external intercostals
internal intercostals
innermost intercostals
transversus thoracis
subcostal muscle
lavatories costar
inspiration muscles
lavatores costarum
external intercostal
expiration muscles
internal intercostal
innermost intercostal
subcostal muscle
transversus thoracis
External intercostals
internal intercostals
innermost intercostals
O: inferior border of ribs
I: superior border of ribs
Inn: intercostal nerves
Blood: intercostal arteries
external intercostal muscles
- fibers move in an inferomedial direction (anterior view)
- elevates the ribs during force inspiration
provides support for the thoracic age during respiration
internal intercostal muscles
- fibers move in a posterior inferolateral direction (anterior view)
- depress the ribs during force expiration
- provide support for the thoracic cage during respiration
- intercondral portion of muscle contributes to elevation of ribs
innermost intercostal muscles
-fibers move in a posterior inferolateral direction (anterior/lateral view)
- occupy middle 2/4 of the rib
- depress the ribs during force expiration (work with internal intercostals)
- provides support for the thoracic cage during respiration / increased muscle tone and rigidity
serratus posterior - superior
O: nuchal ligament - spinous process C7-T2
I: Superior border of ribs 2-5
Inn: intercostal nerves
Blood: PIA
Serratus Posterior - inferior
O: spinous process of T11-L2
I:Inferior border of ribs 9-12
Inn: intercostal nerves
Blood: PIA
what muscles are proprioceptive feedback to the brain?
serratus posterior - respiratory muscles
subcostal muscle
O: internal surface of lower ribs
I: superior border (internal surface) of ribs 2-3 inferior to origin
Inn: intercostal nerves
Blood: PIA and musculophrenic artery
- depress the ribs during expiration
-provides support for thoracic cage during respiration
transversus thoracis
O: posterior sternum body and xyphoid process, costal cartilages 4-7
I:internal surface of costal cartilage 2-6
Inn: intercostal nerves
Blood: branches of internal thoracic arteries
- depress - expiration
- support for the intercostal spaces and thoracic cage during respiration
levatores costtarum
O: c7-t11 transverse processes
I:adjacent rib
Inn: dorsal rami C8-T11
Blood: PIA
- elevate - inspiration
-contributes to rotation of the thoracic spine
muscles of inspiration action
contraction of diaphragm, intercostal muscles increases diameter of thoracic cage
accessory muscles for inspiration
- sternocledomastoid (elevates the sternum)
- scalene muscles (elevate upper ribs)
- lavatories costarum (elevate rib)
- muscles of back and upper limb (trap, pec)
muscles of expiration action
passive recoil of lungs and thoracic cage; intercostal muscles decrease diameter of thoracic cage
accessory muscles for expiration
-abdominal muscles (depress lower ribs and compress abdominal contents)
-subcostal muscles (depress ribs)
-transversus thoracis (depress ribs)
what nerves supply the thoracic wall
spinal nerves T1-T11
What forms the intercostal nerves
ventral (anterior) rami T1-T12
what forms the thoraco abdominal nerve
T7-T11 only
Subcostal nerve is made up of
T12 - anterior ramus
Dorsal (posterior) rami supply what region?
thoracic region (joints, back muscles and skin)
this connects each intercostal nerve to the sympathetic trunk?
rami communicantes
what is the job of sympathetic nerve fibers?
can use spinal nerves to reach vessels and glands in thoracic wall
dermatomes of the thorax is from?
posterior ramus and cutaneous branches of anterior ramus
another name for shingles
herpres zoster infection
Dermatome distribute skin lesion may occur when
varicella zoster virus is reactivated (dorsal root ganglion)
true or false: posterior and anterior intercostal arteries communicate via anastomoses
true
3 intercostal arteries
- posterior -branch from aorta
- anterior branch from internal thoracic artery (1-6)
- musculophrenic artery (7-9)
intercostal artery of rib 12 makes the
subcostal artery - branch of the thoracic aorta
what accompanies the arteries in the costal space
intercostal veins
what drains to the internal thoracic veins
anterior intercostals vein
what drains to azygos and hemiazygos vein
posterior intercostals vein
what is between the visceral and parietal layers
serous fluid
which pleura attaches to the lung
visceral pleura
which pleura attaches to the thoracic wall
parietal pleura
what meets at the hilum
parietal and visceral pleura
which artery carries blood to the lungs and branches to lobar arteries
pulmonary artery
the importance of pulmonary veins
right and left superior and inferior pulmonary veins return blood to the heart
bronchial arteries supply to
-lungs, tissue of lungs and visceral pleura
-branches of the aorta
what is located posterior to carina and is the main innervation to the lung
posterior pulmonary plexus
open pneumothorax
punctured hole or the rib
heart is able to shift L/R
Tension pneumothorax
punctured hole of the rib but air is not getting out - the heart is on one side
Closed pneumothorax
visceral pleura tear - no hole but it heals by itself
