Anatomy Unit 4: Pectoral Reigon, Thoracic Wall And Cavity

Front 1

Jugular Notch Location

Back 1

Horizontal plane at level of intervertebral disk between TV2 and 3.

Front 2

What are the bends of the clavicle and its two articulations?

Back 2

Is bent anteriorly convex medially and concave laterally. Articulates with manubrium of sternum medially and the acromion process laterally.

Front 3

What makes up the sternum?

Back 3

Manubrium, body, and xiphoid process.

Front 4

Sternal Angle Location

Back 4

At junction of manubrium and body of sternum; is at level of second rib and and of TV4 and 5.

Front 5

Xiphosternal Junction Location

Back 5

At plane of TV9.

Front 6

Costal Arch

Back 6

Lower anterior margin of the chest wall consisting of the costal cartilages of ribs 7-10.

Front 7

Anterior Axillary Fold

Back 7

Formed by lateral part of pectoral muscle.

Front 8

Nipple Location

Back 8

4th intercostal space of males and girls.

Front 9

Manubrium and Articulations

Back 9

Most cranial aspect of sternum. Articulates with clavicles, first two ribs, and body of sternum.

Front 10

Sternoclavicular Articulation

Back 10

Articulation of manubrium and clavical. Sits above first rib preventing rib from being palpated.

Front 11

Articulation of 2nd Rib on Sternum

Back 11

Articulates at junction of manubrium and body.

Front 12

Sternum Body Articulations

Back 12

Manubrium, ribs 2-7, and xiphoid process.

Front 13

Sternoclavicular Joint and Associated Ligaments

Back 13

Synovial Joint with a fibrocartilaginous disk which separates the cavity into 2. Surrounded by a capsule.
Have anterior and posterior sternoclavicular ligaments and an interclavicular ligament. Also has a costoclavicular ligament to the first rib.

Front 14

True and false ribs

Back 14

First 7 ribs are true ribs. 8-12 are false. 8-10 articulate with rib prior and 11 and 12 have no articulations after vertebral column.

Front 15

Location of intercostal nerve and vessels

Back 15

Lower border of Rib

Front 16

Costal Margin

Back 16

Formed by the costal cartilage of 7-10th ribs.

Front 17

Costo-sternal articulations

Back 17

Rib 1 articulates on manubrium. Rib 2 articulates on sternomanubrium articulation.

Front 18

Costovertebral articulation

Back 18

Rib 1 only articulates with TV1. Rib 2 articulates with Tv1 and 2 which is pattern up till 10th rib.

Front 19

Breast Location

Back 19

From 2nd to 6th or 7th rib from the sternum to the axilla.
2/3 on pectoralis muscle, 1/3 on serratus anterior.
Confined to the superficial fascia.

Front 20

Ligaments and Ducts of breast

Back 20

Connective tissue between lobules which sends bundles out to skin are suspensory ligaments. There are 15-25 lactiferous ducts which extend towards nipple. Dialations are called lactiferous sinuses.

Front 21

Blood Supply of Breast

Back 21

Anterior perforating branch of internal thoracic artery.
Perforating branchs from intercostal arteries.
Pectoral branches from thoracocromial trunk.
Lateral thoracic branch of axillary artery.

Front 22

Lymph drainage of Breast

Back 22

3/4 drains to axillary nodes. Also drain medially to internal thoracic nodes or down to abdomen to subperitoneal lymphatics.

Front 23

Pectoralis Major

Back 23

Origin: Medial part of clavicle, sternum, costal cartilage of ribs 2-5, and upper rectus sheath.
Inserts: Greater tubercular crest of humerus.
Action: Adduction, medial rotation, and flexion of arm at shoulder joint.
Nerve: Median and Lateral pectorla nerves.
Blood: Thoracoacromial Trunk Branch, Lateral thoracic artery, perforating intercostal branches, anterior perforating branches of internal thoracic artery.

Front 24

Pectoralis Minor

Back 24

Origin: ribs 2-4 or 3-5
Insertion: Coracoid process
Action: Protracts and depresses shoulder
Innervation: Medial Pectoral Nerve

Front 25

Subclavius Muscle

Back 25

Origin: Junction of first rib and its cartilage.
Inserts: Inferior surface of clavicle
Action: Depresses clavical
Innervation: Subclavius Nerve

Front 26

Pectoral Fascia

Back 26

Covers Pectoralis Major

Front 27

Clavipectoral Fascia

Back 27

Extends from clavicle to axillary fascia, surrounds the subclavius and pectoralis minor.

Front 28

Costocoracoid Membrane

Back 28

Portion of clavipectoral from clavical to upper border of pec minor. Has thickening of membrane from first rib to coracoid process called costocoracoid ligament. Membrane is pierced by bracnhes of thoracoacromial trunk, cephalic vein, lateral pectoral nerve, and lymphatic vessels.

Front 29

Suspensory ligament of Axilla

Back 29

Portion of clavipectoral fascia from lower border of pec minor to axillary fascia.

Front 30

External Intercostal Muscles

Back 30

Origin: Lower border of higher rib.
Inserts: Higher border of lower rib.
Action: Stabalizes rib, helps with inspiration.
Hands in the pockets.

Front 31

Anterior Intercostal membrane

Back 31

Separates the external and internal intercostal muscles.

Front 32

Internal intercostal muscles

Back 32

Origin: Upper border of lower rib
Inserts: lower border of upper rib
Action: Aids in expiration

Front 33

Innermost Intercostal muscles

Back 33

Fibers of internal intercostal muscle separated from it by the intercostal nerve and vessels

Front 34

Intercostal Nerves

Back 34

Exit Intervertebral foramena and pass inferior to the correspoding rib which it follows. Nerves below T6 continue, leave intercostal space, and innervate the abdominal wall.
Main part of anterior primary rammus for T1goes over the first rib and goes to brachial plexus sending a small first intercostal nerve for first space.
The lateral cutaneous branch of T2 becomes intercostobrachial nerve.

Front 35

Posterior Intercostal Arteries

Back 35

First and Second spaces receive blood from highest intercostal branch of costcocervical trunk of subclavian artery. Rest receive blood from aorta.

Front 36

Anterior Intercostal Arteries

Back 36

First 5-6 spaces receive blood from the internal thoracic branch of the subclavian artery. Remaining spaces receive blood from musculophrenic branch of internal thoracic artery.

Front 37

Intercostal Veins

Back 37

Accompany arteries. Anterior drained by vessels corresponding to arteries. Posterior drain into azygous system.

Front 38

Superior Thoracic Aperture

Back 38

First thoracic vertebrae
first pair of ribs
top of sternum

Front 39

Inferior thoracic aperture

Back 39

12th TV
12th ribs
anterior extremeties of 11 and 12 rib
costal cartilage of 7 8 9 10 ribs.
xiphoid process

Front 40

Structures making up mediastinum

Back 40

thymus
heart and pericardium
great vessels
trachea and primary bronchi
esophagus
nerves and lymphatics

Front 41

Lung Pleura

Back 41

Inner part is visceral pleura. Outer part is parietal pleura. Parietal pleura has costal, diaphragmatic, cervical, and mediastinal portions. Pleural cavity is a serous cavity.

Front 42

Lung Recesses

Back 42

Costomediastinal Recess and Costodiaphragmatic Recess. This recess does not get filled during inspiration.

Front 43

Parietal Pleura Innvervation

Back 43

Intercostal and phrenic nerves.

Front 44

Superior and inferior Mediastinum

Back 44

Separated by horizontal plane from the sternal angle.

Front 45

Thoracic Duct

Back 45

On left side of esophagus and vertebral column. Arches over subclavian artery from behind to reach left subclavian vein where it drains at junction of subclavian and internal jugular.

Front 46

Phrenic Nerves

Back 46

Pass anterior to subclavian arteries and root of lung then between the pericardium and mediastinal pleura

Front 47

Right and Left recurrecnt Laryngeal Nerves

Back 47

RIght - Passes under right subclavian artery and ascends to larynx.
Left - Passes under aortic arch just left of ligament arteriosus and ascends in groov between trachea and esophagus.

Front 48

Cardiac Nerves

Back 48

Descend form Vagus Nerve and sympathetic trunk to cardiac plexus.