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20 Cards in this Set

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What are cervical ribs? And what can it cause?
-are only present in 1% of population
-they can stretch or compress the inferior trunk of brachial plexus or subclavian artery/vein and cause
==THORACIC OUTLET SYNDROME==
What do thoracic vertebrae have so it can articulate with ribs?
2 demifacets on each side of vertebral body to articulate with the heads of ribs
transverse costal facets on transverse processes for articulation with tubercles of ribs
What are the atypical thoracic vertebrae?
T1: has complete superior costal facet (head of rib 1 only articulates with T1)

T10-12: single complete costal facet (articulate with one rib)

T11, T12: lack transverse costal facets (ribs 11, 12 do not articulate with transverse processes)
Costochondral joints
bodies of ribs articulate with costal cartilages at fibrocartilaginous joints
Sternocostal joints
7 true ribs articulate with sternum
-joint at rib 1 is fibrocartilaginous joint (synchondrosis of first rib)
-rib 2-7 are synovial joints
Interchondral joints
ribs 7-10 articulate with cartilage above at synovial joints
(false ribs because they are fused with cartilage, not to sternum)
Costochondritis
-inflammation of the costochondral or sternocostal joints
-causes localized pain and tenderness
-pt. may mistake pain as a heart attack (can rule it out by pushing on it..if that makes it worse, you know it isn't heart attack)
Intercostal space is numbered according to what?
to the superior rib bordering the space
-has 3 layers of muscle, and the intercostal nerves and blood vessels are located near costal groove--nerve not in groove)
External intercostal
"forward and down" points to your "x-rated parts)
-from costochondral junciton to sternum, muscle replaced by external intercostal membrane
Internal intercostal
"backwards and down"
-posterior and medial to angles of ribs, muscles replaced by internal intercostal membrane
What are the contents of the intercostal space?
Posterior intercostal Vein
posterior intercostal Artery
intercostal Nerve

Forms VAN: V is superior
Herpes Zoster infection (shingles)
intercostal nerve may be involved with painful shingles with red vesicles in the dermatome supplied by the involved nerve
What are the 3 areas where blood supply to the thoracic wall comes from?
-thoracic aorta (via post. intercostal and subcostal arteries)
-subclavian artery, (via internal thoracic and supreme intercostal arteries)
-axillary artery (via superior and lateral thoracic arteries)
internal thoracic arteries arise from what artery? Where do they terminate at and what do they divide into?
-arise from subclavian arteries
-go down internal surface of thorax
-terminate in 6th intercostal space
-divides into the superior epigastric and musculophrenic arteries
Female breasts
-where?
-what nipples contain?
-pect major
-overlies ribs 2-6 from sternum to midaxillary line
-nipple contains openings of 15-20 lactiferous ducts
What is the lymphatic system?
-secondary "circulatory" system
-extensive network of vessels
-lymph nodes act like filters
-drains back into the venous system
What percent of lymph from breast drains into the axillary lymph nodes?
60-75%
Breast cancer: risk factors?
ranks 2nd in cancer deaths among women (lung is 1)
↑ Age
Familial Hx
Long menstrual Hx
Early menarche
Late menopause
Nulliparity or late parturition (30+)
Obesity
Oral contraceptives /estrogen therapy
Alcohol use/abuse
What are the clinical signs of breast cancer?
Dimpling of skin
Retraction of nipple
Peau D’orange sign
Lump
Fixed, amorphous, firm
Tenderness is rare, especially early on
Mammography can detect much earlier than physical exam
CHANGE is Key
Gynecomastia
breast enlargement may occur in males due to:
-medication
-certain types of tumors
-hormonal changes with age

Klinefelter syndrome: XXY trisomy