Term
| Name and discuss the 2 functions of the thoracic cage |
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Definition
| 1. protection of the contents of the thoracic viscera (lungs, heart, vessels) and some abdominal organs, 2. provides mechanical functions of breathing: muscles of the thoracic wall, abdominal wall, and diaphragm vary the volume of the thoracic cavity allowing the lungs to expand (inhale) and relax (exhale) |
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Term
| Name and describe the primary muscle for inhalation |
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Definition
| diaphram: a skeletal muscle inside the body cavity; when diaphragm contracts it descends, increasing the thoracic cavity |
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Term
| Name 5 accessory muscles that assist with respiration |
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Definition
| external intercostals, scalenes, sternocleidomastoid, pectoralis minor, serratus posteriors |
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Term
| What is the primary mechanism for expiration |
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Definition
| passive recoil of the chest and lung tissue |
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Term
| What are some of the accessory muscles that can assist with expiration? |
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Definition
| internal intercostals, abdominal wall muscles (compress abdominal contents into thorax pushing the diaphragm up) |
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Term
| what is the osteocartilagenous thoracic cage composed of? |
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Definition
| 12 pairs of ribs and their costal cartilages, 12 vertebrae and their intervertebral discs, sternum |
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Term
| what does the manubrium articulate with? |
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Definition
| 1st and 2nd ribs, clavicle |
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Term
| where is the sternal angle? |
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Definition
| between manubrium and sternum body, directly in front of T4-T5 intervertebral disc |
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Term
| describe the body of the sternum: what are sternebrae, which costal cartilages articulate with body |
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Definition
| middle and largest portion of the sternum, composed of 4 sternebrae that fuse at transverse ridges. Has facets for costal cartilages of ridges 2-7 on lateral sides |
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Term
| what is the xiphisternal joint? |
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Definition
| articulation of body and xiphoid process of sternum |
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Term
| name and describe true ribs |
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Definition
| vertebrocostal = ribs 1-7, articulate directly with sternum via costal cartilages |
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Term
| name and describe false ribs |
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Definition
| vertebrochondral = ribs 8-10, indirect articulation with sternum via cartilage of superior rib |
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Term
| name and describe floating ribs |
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Definition
| vertebral = ribs 11-12, do not articulate with sternum but end in poterior abdominal wall |
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Term
| where is the head of a rib? |
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Definition
| on the vertebral (NOT sternal) end |
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Term
| what are the facets on the head of a rib called and what are they for? |
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Definition
| superior facet, inferior facet = for articulation with 2 vertebrae |
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Term
| what is the name of the area between the superior and inferior facets of the rib? |
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Definition
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Term
| which ribs are "typical," meaning they have 3 facets |
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Definition
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Term
| what is the tubercle ofa rib? |
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Definition
| rough region at the junction of the neck and the shaft that has a smooth facet for articulation with the transverse process of a corresponding vertebrae |
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Term
| what is the shaft of a rib? |
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Definition
| the thin, flat curved part of the rib |
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Term
| what is the neck of a rib? |
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Definition
| the slightly constricted area just distal to the head |
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Term
| what is the costal angle and why is it significant? |
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Definition
| the angle of the rib where it turns anterolateral; weakest and most commonly fractured area of the rib |
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Term
| where are ribs most commonly fractured? |
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Definition
| just anterior to the angle |
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Term
| how are middle ribs most commonly fractured? |
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Definition
| by crushing or by a direct blow to the chest |
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Term
| why are rib fractures so painful? |
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Definition
| bone fragments move when breathing |
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Term
| which rib is rarely fractured and why? |
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Definition
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Term
| what do costal cartilages do? |
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Definition
| prolong ribs anteriorly and contribute to the elasticity of the thoracic cage |
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Term
| what is the function of intercostal spaces? |
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Definition
| separate the ribs and costal cartilages from each other |
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Term
| what things are in the intercostal spaces? |
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Definition
| intercostal muscles, vessels and nerves |
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Term
| describe spinous processes of thoracic vertebrae |
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Definition
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Term
| describe the body of a thoracic vertebrae |
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Definition
| smaller than lumbar, larger than cervical |
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Term
| describe the facets found on typical thoracic vertebrae |
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Definition
| two costal facets (inferior and superior), on each side of the vertebral body articulate with head of ribs (except last 3-4 thoracic vertebrae); transverse costal facets for articulation with tubercles of ribs (except last 2 vertebrae) |
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Term
| what is a costovertebral joint? |
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Definition
| synovial plane joint between ribs and vertebrae |
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Term
| what is a costotransverse joint? |
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Definition
| synovial plane joint between ribs and transverse processes |
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Term
| What 2 things does a typical rib head articulate with? |
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Definition
| superior costal facet of the vertebrae of its same number and the inferior costal facet of the vertebrae above |
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Term
| what does the costal tubercle of a rib articulate with? |
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Definition
| transverse process of the vertebrae of the same number |
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Term
| What will Rib 6 articulate with besides its costal cartilage? |
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Definition
| head articulates with superior costal facet of T6 and inferior costal facet of T5; costal tubercle articulates with transverse costal facet of T6 |
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Term
| what type of joints are costovertebral and costotransverse joints? |
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Definition
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Term
| what is a costochondral joint? |
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Definition
| the cartilaginous (no synovial fluid) joint between ribs and costal cartilage |
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Term
| what is a sternocostal joint? |
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Definition
| a synovial plane type joint between the sternum and costal cartilage of ribs 2-7 |
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Term
| what is the sternoclavicular joint? |
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Definition
| saddle type synovial joint between sternum and clavicle |
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Term
| what is the superior thoracic aperture (inlet) |
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Definition
| opening at the top of the thoracic cavity |
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Term
| inferior thoracic aperture (inlet) |
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Definition
| opening at the bottom of the thoracic cavity, provides attachment for the diaphragm and communicates with abdominal cavity |
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Term
| what are the three layers of the intercostal muscles, from superficial to deep? |
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Definition
| external intercostals, internal intercostals, innermost intercostals |
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Term
| what innervates the intercostal muscles? |
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Definition
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Term
| what is the order of the neurovascular structures within the costal groove from superior to inferior? |
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Definition
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Term
| where are the neurovascular structures within the intercostal muscles? |
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Definition
| between the innermost intercostals and the internal intercostals |
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Term
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Definition
| a needle is inserted directly in the middle of an intercostal space (to avoid vasculature) into the pleural cavity to remove blood or pus (goes past innermost intercostals) |
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Term
| describe intercostal nerve blocks |
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Definition
| a local anesthetic is infiltrated around several intercostal nerves to provide anesthesia to thoracic wall; needle does not go past vasculature (goes between internal intercostals and innermost intercostals) |
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Term
| what do external intercostal muscles do? |
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Definition
| they are respiratory muscles: elevate and depress ribs |
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Term
| what innervates the external intercostal muscles? |
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Definition
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Term
| describe the fibers of external intercostal muscles (their direction, their location |
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Definition
| fibers course down and medial from inferior border of rib above to superior border of rib below (like putting your hands in your front pockets); go from tubercles of ribs posteriorly to their costal cartilages anteriorly |
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Term
| how do external intercostal muscles change as they reach the costal cartilage parts of ribs anteriorly? |
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Definition
| fade out and are replaced by an aponeurotic membrane called the external intercostal membrane |
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Term
| describe the fibers of internal costal muscles |
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Definition
| fibers course down and lateral from inferior border of above rib to superior border of rib below (like putting your hands in your back pockets); fibers course from sternal border anteriorly to costal angles posteriorly |
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Term
| what happens to intercostal muscles as they reach the costal angles? |
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Definition
| near costal angles, the fibers fade and are replaced by an aponeurotic membrane called the internal intercostal membrane |
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Term
| what do the internal intercostal muscles do? |
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Definition
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Term
| describe the innermost intercostal muscles |
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Definition
| they are not a continuous layer like the external or internal intercostals; they are respiratory muscles; they are separated from the internal intercostal muscles by the vasculature |
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Term
| what is the name for the region of vasculature between the internal intercostals and the innermost intercostals? |
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Definition
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Term
| what kind of muscle is the transversus thoracis? |
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Definition
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Term
| OIAN of transversus thoracis |
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Definition
| O: posterior surface of lower sternum, I: internal surface of costal cartilages 1-6, A: depresses ribs, N: intercostal nerves |
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Term
| which 2 major arteries supply vasculature to the thoracic wall? |
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Definition
| thoracic artery, subclavian arteries |
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Term
| internal thoracic arteries |
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Definition
| arise from the subclavian arteries and descend along the sternum giving off the superior 5 anterior intercostal arteries between the ribs |
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Term
| posterior intercostal arteries |
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Definition
| arise from the aorta and course between the ribs where they anastomose with the anterior intercostals |
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Term
| what do the internal thoracic arteries divide into? |
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Definition
| superior epigastric and musculophrenic arteries |
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Term
| where do the inferior 5/6 anterior interocostal arteries come from? |
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Definition
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Term
| where is the mediastinum? |
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Definition
| it is the central compartment of the thoracic cavity, located between the 2 pulmonary cavities; extends from the superior thoracic inlet to the diaphragm and from the sternum to the bodies of the thoracic vertebrae |
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Term
| what is inside the mediastinum? |
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Definition
| hollow visceral structures such as the heart, esophagus, aorta, etc |
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Term
| how is the mediastinum further divided? |
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Definition
| into superior and inferior divisions |
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Term
| what is the extent of the superior division of the mediastinum? |
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Definition
| from thoracic inlet to transverse thoracic plane |
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Term
| what is the transverse thoracic plane? |
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Definition
| imaginary plane from sternal angle to T4/T5 level |
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Term
| what is the extent of the inferior division of the mediastinum? |
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Definition
| from transverse thoracic plane to the diaphragm |
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Term
| how is the inferior division of the mediastinum further divided? |
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Definition
| anterior, middle, and posterior subdivisions |
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Term
| what structures are in the superior mediastinum? |
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Definition
| thymus gland, brachiocephalic veins, superior vena cava, aortic arch and roots of main branches (brachiocephalic trunk, left common carotid, left subclavian), vagus and phrenic nerves, trachea and esophagus |
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Term
| what structres are in the anterior mediastinum? |
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Definition
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Term
| what structure is in the middle mediastinum? |
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Definition
| heart and pericardium, roots of: ascending aorta, pulmonary trunk, superior vena cava |
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Term
| what structure is in the posterior mediastinum? |
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Definition
| thoracic part of esophagus |
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Term
| what does the external jugular vein do? |
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Definition
| drain blood from scalp and face to return to heart |
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Term
| what is the venous angle? |
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Definition
| the junction of the internal jugular veins with the subclavian veins |
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Term
| what happens at the venous angle |
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Definition
| major lymphatic vessels such as the thoracic duct join the systemic venous circulation |
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Term
| what do the internal jugular veins and subclavian veins unite to form? |
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Definition
| right and left brachiocephalic arteries |
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Term
| what is formed from the junction of the right and left brachiocephalic arteries? |
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Definition
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Term
| what are the major arterial branches that arise from the aortic arch? |
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Definition
| brachiocephalic trunk, left common carotid, left subclavian |
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Term
| what arteries arise from the brachiocephalic trunk? |
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Definition
| right common carotid, right subclavian |
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Term
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Definition
| a double walled fibrous sac that encloses the heart and the roots of the great vessels (ascending aorta, pulmonary trunk, superior vena cava) |
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Term
| what is the fibrous pericardium? |
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Definition
| tough external fibrous layer of the pericardium that protects the heart |
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Term
| what is the serous pericardium? |
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Definition
| the internal layer of the pericardium that has 2 parts: parietal pericardium and visceral pericardium |
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Term
| describe the parts of the serous pericardium |
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Definition
| parietal pericardium lines the fibrous pericardium and reflects onto the heart as the visceral pericardium which forms the epicardium of the heart |
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Term
| what is the pericardial cavity? |
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Definition
| potential space between the parietal and visceral layers of the serous pericardium; contains only fluid |
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Term
| what are the roots of the phrenic nerve and what does it innervate? |
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Definition
| C345, diaphragm and pericardium |
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Term
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Definition
| inflammation of the pericardium that often results in edema in the pericardial cavity, resulting in pericardial effusion which can compress the heart and render it ineffective |
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Term
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Definition
| life threatening effusion of the pericardium caused by pericarditis that limits blood flow into the ventricles |
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Term
| what nerve components are found within the phrenic nerve? |
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Definition
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Term
| Describe two synovial articulations between a rib and a thoracic vertebra |
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Definition
| 1. costovertebral = synovial plane type joint between ribs and vertebrae: the head of a typical rib articulates with a. superior costal facet of thoracic vertebrae of same number with its own inferior articular facet, b. inferior costal facet of the vertebra above with its own superior articular facet; 2. costotransverse = synovial plane joint between ribs and transverse processes: the costal tubercle articulates with transverse process of the vertebra of the same number |
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Term
| anterior intercostal arteries arise from which 2 arteries? |
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Definition
| internal thoracic, musculophrenic |
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Term
| path of needle into pericardial cavity |
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Definition
| epidermis, dermis, external intercostal membrane, internal intercostal muscle, transversus thoracis, fibrous pericardium, serous pericardium parietal layer into pericardial cavity |
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