Unit 4 Pectoral Region, Thoracic Wall and Cavity Flashcards
1
Q
Jugular (suprasernal notch)
A
Important thoracic landmark
2
Q
What is the most frequently borken bone?
A
Clavicle
3
Q
With what two structues does the clavicle articulate with?
A
Manubrium of the sternum, and acromion process of the scapula
4
Q
What are the three parts of the sternum?
A
Manubrium, body, and xiphoid process
5
Q
sternal angle
A
at junction of manubrium and sternum;
level of second rib, T4 and T5
6
Q
xiphosternal junction
A
at level of T9
7
Q
Costal Arch
A
8
Q
anterior axillary fold
A
9
Q
Where is the nipple generally located?
A
fourth intercostal space
10
Q
What is the mid-clavicular line?
A
line midway through clavicle
11
Q
What does the thoracic wall consist of?
A
sternum, 12 ribs, 12 thoracic vertebrae
12
Q
What does the manubrium articulate with?
A
clavicles, first two ribs, and body of sternum
13
Q
Where does the plane pass at the top of the sternum? What is this called?
A
jugular notch, passes through t2 and t3 posteriorly
14
Q
Can the first rib normally be palpitated?
A
No
15
Q
Where does the second rib articulate?
A
articulates at the sternal angle
16
Q
Describe the sternalclavicular joint.
A
contains a fibrocartilaginous disk, encapsulated from the medial end of the clavicle to the articular surface of the manubrium, contains a interclavicular ligament, contains anterior and posterior sternoclavicular ligaments, also contains a costoclavicular ligament
17
Q
what is the interclavicular ligament?
A
stretches from one clavicle to the other, strengthens the superior surface of the capsule
18
Q
What is the function of the anterior and posterior sternoclavicular ligaments?
A
anterior and posterior surface of the capsule, therefore capsule is
strengthened
19
Q
What is the function of the costoclavicular ligament?
A
a strong accessory ligament which joins the
clavicle to the first rib
20
Q
what are the parts of a rib?
A
head, neck, tubercle, shaft, angle, costal cartilage
21
Q
What is the head of a rib?
A
articulates with the body of the thoracic vertebrae
22
Q
what is the tubercle of the rib?
A
part that articulates with the transverse process of the vertebrae
23
Q
Where does the angle of the rib lie in the thoracic cavity?
A
most posterior portion of the cavity
24
Q
what is another name for the first 7 ribs?
A
true ribs
25
what are the remaining 5 ribs called?
false ribs
26
What are the criteria for a typical rib? Which ribs are typical?
they have an angle, the have a groove at their lower border containing the intercostal vein, artery, and nerve, they do not run horizontally they slope inferiorly from posterior to anterior...ribs 3-7 are considered typical
27
What does rib one articulate with posteriorly?
TV1
28
What does rib 2 articulate with posteriorly?
TV1 and TV2
29
What is the costal margin composed of?
costal cartilages of ribs 7-10
30
What do ribs 8,9, and 10 articulate with through their costal cartilages?
the rib above
31
What do ribs 11 and 12 articulate with anteriorly?
nothing
32
Which are the floating ribs?
11 and 12
33
What part of TV1 does the first rib articulate with posteriorly?
the upper portion of the body close to the pedicle
34
What does the head of the second rib articulate with?
lower part of TV1, disk between, upper part of TV2
35
What does the tubercle of the second rib articulate with?
transverse process of TV2
36
Where does the breast extend from?
second to 6h or 7th rib
37
what are the three nipple shapes?
inverted, flat, project outward
38
how many ducts are generally present on the nipple?
15-25
39
what is polythelia?
extra nipples
40
what is polymastia?
extra breast tissue
41
What is the areola?
pigmented area around the breast tissue which contains sebacceous glands
42
What is the connective tiisue that suspend the lobules of the breast?
Cooper's ligaments
43
What is the dilation of the lactiferous duct?
lactiferous sinus
44
What provides the blood supply for the breasts?
1. anterior perforating branches of the internal thoracic artery
2. perforating branches from intercostal arteries
3. pectoral branches from thoracoacromial trunk
4 lateral thoracic branch of the axillary artery
45
Where does lymph from the breasts drain?
1. about 3/4 of lymphatic drainage to the axillary nodes
2. medially to internal thoracic nodes or to opposite breast
3. down to abdomen and subperitoneal lymphatics
46
What are the three muscles of the pectoral region?
pectoralis major, pectoralis minor, subclavius
47
what is the origin of the pectoralis major?
medial part of the clavicle, sternum, costal cartilages of 2-5, and upper rectus sheath
48
What is the insertion of the pectoralis major muscle?
greater tubercular crest of humerus
49
What is the action of the pectoralis major muscle?
adduction, medial rotation, flexion of the arm at the shoulder joint
50
what provides the innervation for the pectoralis major?
medial and lateral pectoral nerves
51
what provides the blood supply for the pectoralis major muscle?
thoracoacromial trunk, lateral thoracic artery, perforating intercostal branches, anterior perforating branches of internal thoracic artery
52
where is the origin of the pectoralis minor?
ribs 2-4 or 3-5
53
where is the insertion of the pectoralis minor?
coracoid process of scapula
54
what is the action of the pectoralis minor?
protracts and depresses shoulder
55
what innervates the pectoralis minor?
medial pectoral nerve
56
Where is the origin of the subclavian muscle?
from junction of the first rib with cartilage
57
Where does the subclavian muscle insert?
inferior surface of the calvicle
58
What is the action of the subclavian muscle?
depresses clavicle
59
what innervates the subclavian muscle?
upper third of the brachial plexus
60
what clothes the pectoralis major?
pectoral fascia
61
what surrounds both the subclavius and pectoralis minor?
clavipectoral fascia
62
what is the portion of the clavipectoral fascia from the clavicle to the upperborder of the pectoralis minor muscle?
costocoracoid membrane
63
What is the thickened part of the costacoracoid membrane from the first rib to the coracoid process called?
costacoracoid ligament
64
What is the portion of the clavipectoral fascia from the lower border of the pectoralis minor to the axillary fascia called?
suspensory ligament of the axilla
65
Where doe sthe external intercostal muscle arrise from?
lower border of rib above
66
where does the external intercostal muscle insert?
upper border of the rib below
67
what is the action of the external intercosal muscle?
stabilizes rib and aids in inspiration
68
what is the anterior intercostal muscle membrane considered to be a part of?
continuation of the epimysium
69
where does the internal intercostal muscle arrise from? Where does it insert?
arrises from the upper border of the rib below and inserts on the lower border of the rib above
70
what is the action of the internal intercostal muscle, and what does it end in?
expiration, ends in the postierior intercostal membrane
71
What is the innermost intercostal muscle?
the internal intercostal muscle
72
Where do the intercostal nerves exit from?
intervertebral foramina
73
What are the intercostals derived from?
anterior primary ramus
74
What does the anterior primary ramus of T1 contribute to?
brachial plexus
75
What does the lateral cutaneous branch of the anterior primary ramus of T2 become?
intercostobrachial nerve
76
Which intercostal nerves are typical?
T3-11
77
Where do the first and second intercostal spaces recieve there blood supply from?
highest intercostal branch of the costalcervical trunk of the subclavian artery.
78
Where do the remaining intercostal spaces receive blood from?
aorta
79
Where do the first 5 intercostal spaces receive blood from anteriorly?
internal thoracic branch of the subclavian artery
80
what accomanies the posterior and anterior intercostal arteries?
psoterior and anterior intercostal veins
81
What is the superior thoracic aperature bounded by?
first pair of thoracic vertebrae, first pair of ribs, top of sternum
82
What is the inferior thoracic aperature bounded by?
12 TV, 12th ribs, anterior extremities of 11th and 12th, costal cartilages of 7, 8, 9, 10, xiphoid process
83
What are the lungs enclosed in?
pleura
84
What is the thick partition of tissue between the lungs called?
the mediastinum
85
What makes up the mediastinum?
thymus, heart and pericardium, great vessels, trachea and primary bronchi, esophagus, nerves and lymphatics
86
What is the inner layer of lung pleura called?
visceral pleura
87
What is the outer layer of lung pleura called?
parietal pleura
88
What are the 4 parts of the parietal pleura?
costal, diaphramic, cervical, mediastinal
89
what is the costomedial reflection of the parietal pleura?
junction of costal and mediastinal portions
90
what does the costamedial reflection contain?
costomedial recess
91
What is contained within the costodiaphramatic reflection?
The costodiaphragmatic recess
92
what do the reflections do at rib 6?
they diverge laterally to become the costodiaphragmatic reflections
93
Are the parietal and visceral pleura continuous at the root of the lung and pulmonary ligament?
yes
94
What innervates the parietal pleura?
intercostal nerves and phrenic nerves
95
What are the borders of the mediastinum?
superior thoracic aperature, diaphram, sternum, vertebral column, between mediastinal pleura
96
What divides the mediastinum into the superior and inferior portions?
horizontal plane extending through the sternal angle
97
What are the divisions of the inferior mediastinum?
anterior middle posterior
98
What is contained in the middle inferior mediastinum?
heart and pericardial sac
99
What is found in the superior mediastinum?
thymus, brachiocephalic veins, superior vena cava, aprtic arch, trachea, esophagus, thoracic duct, phrenic nerves, vagus nerves, phrenic nerves
100
What forms the brachiocephalic veins?
confluence of subclavian and internal jugular
101
What is the orientation of the right brachiocephalic?
vertical
102
What is the orientation of the left brachiocephalic?
oblique
103
what continues the vertical course of the right brachiocephalic vein?
superior vena cava
104
What connects the inferior surface of the aortic arch to the beginning of the left pulmonary artery?
ligamentum arteriosus
105
what is the first branch of the aortic arch?
the brachiocephalic trunk
106
Where does the brachiocephalic trunk ascend?
in front of the trachea to the right
107
What does the brachiocephalic trunk divide into?
right subclavian and right common carotid arteries
108
What else arrises independently from the arch?
left common carotid and left subclavian
109
What is behind the great vessels?
trachea
110
What is the most posterior structure?
esophagus
111
What lies on the left side of the esophagus?
the thoracic duct
112
What passes anteriorly to both subclavian arteries and the root of the lung?
the phrenic nerves
113
What runs on the lateral sideof the great veins?
right phrenic nerve
114
What runs antero-lateral to the left common carotid?
the left phrenic nerve
115
What pass anterior to the subclavian arteries?
vagus nerves
116
Which nerve is lateral to the trachea?
right vagus
117
What passes under the right subclavian artery and ascends the larynx?
right recurrent laryngeal nerve
118
What runs between the left common carotid and subclavian?
left vagus nerve
119
What passes underneath the aortic arch immediately to the left of the ligamentum arteriosus?
left recurrent laryngeal nerve
120
Which nerves decend the cervical sympathetic trunk to reach the cardiac plexuses around the aortic arch?
cardiac nerves
121
What is found in the anterior mediastinum?
fat, connective tissue, lowest extension of the thymus and some lymph nodes
122
what does the parietal pericardium consist of?
fibrous outer layer, inner serous layer
123
What does the pericardium fuse to?
diaphram
124
What is between the visceral and parietal layers of pericardium?
the pericardial cavity
125
What is the visceral layer of serous membrane that covers the heart?
epicardium or visceral pericardieum
126
What space is posterior to the acending aorta and pumonary trunk and anterior to the superior vena cava?
transverse pericardial sinus
127
What space is a blind recess on the posterior aspect of the heart?
oblique pericardial sinus
