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ANATOMY > WEEK 10 (Thoracic muscles) > Flashcards

WEEK 10 (Thoracic muscles) Flashcards

1
Q

What are the properties of Intercostal spaces?

A
  • Lie between adjacent ribs and are filled by intercostal muscles
  • Intercostal nerves and associated major arteries and veins lie in the costal groove along the inferior margin of the superior rib and pass in the plane between the inner two layers of muscles
  • In each space, the vein is the most superior structure and is therefore highest in the costal groove. The artery is inferior to the vein, and the nerve is inferior to the artery and often not protected by the groove
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2
Q

What do intercostal nerves carry in the thorax?

A
  • Somatic motor innervation to the muscles of the thoracic wall
  • Somatic sensory innervation from the skin and parietal pleura
  • Postganglionic sympathetic fibers to the periphery
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3
Q

Where do the posterior and anterior intercostal arteries originate from?

A

The aorta and internal thoracic arteries, which in turn arise from the SUBCLAVIAN ARTERIES

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4
Q

Lymphatic vessels of the thoracic wall drain mainly into lymph nodes of what?

A
  • Internal thoracic arteries
  • Head and necks of ribs
  • Diaphragm
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5
Q

What are the different thoracic muscles?

A
  • External intercostal
  • Internal intercostal
  • Innermost intercostal
  • Subcostales
  • Transversus thoracis
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6
Q

What is the function of the External intercostal muscle?

A
  • Most active during inspiration
  • Supports intercostal space
  • Moves ribs superiorly
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7
Q

What is the function of the Internal intercostal muscle?

A
  • Most active during expiration
  • Supports intercostal space
  • Moves ribs inferiorly
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8
Q

What is the function of the Innermost intercostal muscle?

A

Acts with internal intercostal muscles

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9
Q

What is the function of the Subcostales?

A

Depresses ribs

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10
Q

What is the function of the Transversus thoracis?

A

Depresses costal cartilages

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11
Q

What is the function of the Lavatores Costarum?

A

Elevates ribs

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12
Q

What is the function of the Serratus posterior superior?

A

Elevates ribs

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13
Q

What is the function of the Serratus posterior inferior?

A

Depresses ribs

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14
Q

What is the function of the Pectoralis Major?

A
  • Flexion
  • Adduction
  • Medial rotation of arm at glenohumeral joint
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15
Q

What is the function of the Pectoralis Minor?

A
  • Pulls tip of shoulder down
  • Protracts scapula
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16
Q

What is the function of the Subclavius muscle?

A
  • Pulls tip of shoulder down
  • Pulls clavicle medially to stabilise sternoclavicular joint
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17
Q

What is the function of the Serratus Anterior?

A
  • Protraction and rotation of the scapula
  • Keeps medial border and inferior angle of scapula opposed to thoracic wall
18
Q

What is the function of the Subscapularis?

A
  • Rotator cuff muscle
  • Medial rotation of the arm at the glenohumeral joint
19
Q

What is the function of the Teres Major?

A

Medial rotation and extension of the arm at the glenohumeral joint

20
Q

What is the function of the Latissmus dorsi?

A
  • Adduction
  • Medial rotation
  • Extension of the arm at the glenohumeral joint
21
Q

Describe the structure if the diaphragm

A
  • C-shaped thin MUSCULOTENDINOUS STRUCTURE that fills the INFERIOR THORACIC APERTURE and separates the THORACIC CAVITY from the ABDOMINAL CAVITY
  • Forms a dome between two cavities
  • Superior surface becomes floor of thoracic cavity & inferior surface makes the roof of the abdominal cavity
  • Anatomically, diaphragm is divided into RIGHT and LEFT HEMIDIAPHRAGM
  • RIGHT HEMIDIAPHRAGM is HIGHER than the left due to the presence of the liver
22
Q

What is the diaphragm attached peripherally to?

A
  • Xiphoid process of the sternum
  • Costal margin of the thoracic wall
  • Ends of ribs XI and XII
  • Vertebrae of the lumbar region
23
Q

What is the Crura of the diaphragm?

A

Musculotendinous bundles that attach to the anterior surface of the vertebral column, intervertebral disc and the anterior longitudinal ligament

STRUCTURE:
Right crura is LONGER and Left crura is SHORTER;
Right and Left crura join together via the MEDIAN ARCUATE LIGAMENT

24
Q

Where is the Central tendon of the diaphragm?

A

Point of convergence of the peripherally located muscles that make up the diaphragm

25
Q

Describe the parts of the Diaphragm’s Peripheral muscular region

A
  • Sternal part (originate from the posterior surface of the Sternum)
  • Costal part (originates from the inner surface of the 7th-12th ribs)
  • Lumbar part (originates from L1)
26
Q

What are the following openings seen in the thoracic/cranial view?

A
  • CAVAL HIATUS (serves inferior vena cava & right phrenic nerve)
  • ESOPHAGUL HIATUS (oesophagus & vagus nerve)
  • AORTIC HIATU (aorta, azygos vein & thoracic duct)
27
Q

What can be seen in the Inferior view?

A
  • Sternocostal triangles
  • Lumbocostal triangles
28
Q

How does depression and elevation of the Thorax happen?

A

When the muscle fibers of the diaphragm CONTRACT, DEPRESSION happens. ELEVATION occurs when the diaphragm RELAXES.

29
Q

What can happen as a result from elevation/depression of the ribs?

A

Elevation and depression of ribs result in changes in the ANTEROPOSTERIOR and LATERAL DIMENSIONS. Since anterior ends of ribs are INFERIOR to the posterior ends, when the ribs are ELEVATED, they move the sternum upward and forward.

30
Q

What is the function of Costal cartilages?

A
  • Prolong ribs anteriorly
  • Contribute to the elasticity of the thoracic wall

[In elderly, costal cartilages undergo CALCIFICATION making them LESS RESILIENT]

31
Q

What is the weakest part of the rib?

A

Just anterior to its angle

32
Q

Which ribs are most commonly fractured?

A

The middle ribs

33
Q

What is Flail chest?

A

Flail chest occurs when a sizeable segment of the anterior and/or lateral thoracic wall moves freely because of multiple rib fractures. This condition allows the loose segment of the wall to move PARADOXICALLY)

The loose segment is often fixed by hooks and/or wires

34
Q

What is the problem with Cervical ribs?

A

Cervical ribs are only present in up to 1% of people and articulate with CVII vertebra

PROBLEMS:
- Can compress spinal nerves CVIII and TI or the inferior trunk of the BRACHIAL PLEXUS supplying the upper limb
- Can compress the SUBCLAVIAN ARTERY resulting in ISCHEMIC MUSCLE PAIN in the UPPER LIMB

35
Q

What is a Thoracotomy?

A

The surgical creation of an opening through the thoracic wall to enter a pleural cavity

How it works:
Involves making H-shaped incisions through the PERICHONDRIUM of one or more costal cartilages and then shelling out segments of costal cartilage to gain entrance to the thoracic cavity

36
Q

Describe Sternal Biopsies

A

STERNAL BODY is often used for BONE MARROW NEEDLE BIOPSY because of its SUBCUTANEOUS POSITION. The needle pierces the thin CORTICAL BONE and enters the VASCULAR TRABECULAR (spongy) bone.

[sternal biopsy is commonly used to obtain specimens of bone marrow for transplantation and for detection of metastatic cancer]

37
Q

What happens in Median sternotomy?

A

To gain access to the thoracic cavity for surgical procedures, the sternum is split in the MEDIAN PLANE and RETRACTED.

38
Q

What are doctors referring to when they mention the thoracic “outlet”?

A

The important nerves and arteries that pass through the thoracic aperture into the lower neck and upper limb

39
Q

Describe Costoclavicular syndrome

A

A thoracic outlet syndrome characterised by COLDNESS of the skin of the upper limb and DIMINISHED RADIAL PULSE resulting from compression of the subclavian artery between the clavicle and 1st rib

40
Q

What is a rib dislocation?

A

Also known as ‘dislocation of a sternocostal joint’ is the displacement of a costal cartilage from the sternum

41
Q

How can paralysis of the diaphragm be detected?

A

Radiographically by noting it paradoxical movement

42
Q

Why doesn’t paralysis of half of the diaphragm because of injury to its motor supply from the phrenic nerve affect the other half?

A

Each dome has a separate nerve supply

ANATOMY (13 decks)

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