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90 Cards in this Set

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  • Back
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Name the three parts of the sternum.
xiphoid process
Which ribs are true ribs?
false ribs?
floating ribs?
and describe their characteristics.
1-7 attach to sternum
8-12 have costal cartilages that don't attach to sternum
11-12 lack costal cartilage
Which ribs are typical?
Describe the parts that make them typical.
What does the head of the rib articulate w/?
the tubercle?
The head articulates w/ the body of corresponding vertebra and the vertbra immediately superior
The tubercle articulates w/ the transverse process of corresponding vertebra.
What does the inferior surface of the shaft or body house?
intercostal vein, artery & nerve
What makes the 1st rib atypical?
prominent scalene tubercle where anterior scalene muscle inserts on its superior surface
Which ribs are atypical?
Where does the 2nd rib attach?
attaches to the sternum @ sternal angle, the junction of manubrium
What makes the 2nd rib atypical? what attaches to it?
it has a scalene tubercle where the posterior scalene muscle attaches
What makes ribs 11 & 12 atypical? (4 things)
lack angle
end posteriorly
help protect kidneys
What makes ribs 8-10 atypical?
costal cartilage extensions
What do ribs 8-10 create?
costal margin of the thoracic cage
Where do ribs typically break?
near their angle
Describe the cervical rib.
What can it lead to?
elongation of the transverse process ossification center of the 7th vertebra
can compress brachial plexus nerves or subclavian artery
associated w/ thoracic outlet syndromes
where they originate from
compress what
associated w/ what
Discuss facets/demifacets
T1-facet for rib 1
demifacet for head of rib2
T2-9 2 demis for rib heads
T11-12 1 facet for resp rib heads
The superior edge of the manubrium forms what?
What attaches to it?
forms suprasternal (jugular notch)
clavicles, rib 1 and half of rib 2 attach
What articulates w/ the body of the sternum?
ribs 2-7
xiphoid process
3 different things
What are 3 sternal anomalies?
Describe them
pectus excavatum-sunken chest
pectus carinaum-pigeon chest
sternal fistula-holes in sternum
Discuss ossification of the sternum.
-it ossifies w/ age
-several centers of ossification
-xiphoid process doesn't fuse until middle age
What is the synovial joint between the head of the rib and body of vertebra at a facet or demifacet?
costovertebral joint
What is a synovial joint between tubercle of the rib and transverse process of the thoracic vertebra?
costotransverse joint
Describe the characteristic of costotransverse joints at T1-7?
fairly curved joint (1-7)
fairly flat joint (8-10)
What is a sternocostal joint?
A cartilaginous joint between 1st rib and manubrium
What is the union of rib bone w/ hyaline cartilage of the same rib?
costochondrial joint
What do external intercostal muscles do?
function to raise ribs during inspiration
What do internal intercostal muscles do?
interchondral portions anteriorly raise ribs and lateral fibers depress ribs
interchondral portions
lateral fibers
What do innermost intercostal muscles to?
keep intercostal space from bulging during respiration
Which muscles are on the inner surface of the thoracic wall?
transverse thoracic muscles
subcostal muscles
Where do the transverse thoracic muscles originate?
on the inner surface of the sternum
insert onto inner anterior surface of ribs 2-6
What do the transverse thoracic muscles do?
depress ribs during exhaling
Where do subcostal muscles attach?
to inner surface of the lower ribs on posterior portion of thoracic wall
What do the subcostal muscles do?
elevate ribs
Which muscles are on the back/posterior/external surface of thoracic wall?
serratus posterior superior
serratus posterior inferior
levator costarum
Origination and insertion of serratus posterior superior?
originate-nuchal ligament and spinous process of C7-T3

inserts-superior posterior border of ribs 2-5
What is the function of the serratus posterior superior?
raise ribs during inspiration
Origination and insertion of serratus posterior inferior?
originate-spinous process of T11-12
insert-inferior posterior border of ribs 9-12
What is the function of serratus posterior inferior?
depress ribs during experation
Origination and insertion of levator costarum?
originate-transverse process of C7-T11

insert-upper posterior edge of the rib just inferior
What is the function of levator costarum?
elevate ribs during inspiration
What are the muscles superior to the thoracic cage (neck muscles)?
anterior scalene muscle
middle scalene muscle
posterior scalene muscle
What is the fuction of the scalene muscles?
elevate ribs during inspiration
Where does the anterior scalene muscle originate and insert?
originate-transverse process of C3-C6

insert-scalene tubercle of 1st rib
Where does the middle scalene muscle originate and insert?
originate-transverse process of C2-C7

insert-1st rib posterior to subclavian artery groove
Where does the posterior scalene muscle originate and insert?
originate-transverse process of C5-C7

insert-upper surface of 2nd rib
Which muscles are responsible for raising ribs during inhalation?
external intercostal muscles
subcostal muscles
serratus posterior superior
levator costarum
anterior scalene muscle
middle scalene muscle
posterior scalene muscle
Which muscles are responsible for depressing ribs during exhalation?
transverse thoracic muscles
serratus posterior inferior
Name the muscles of the upper extremity that attach to the thoracic cage.
pectoralis major
pectoralis minor
serratus anterior
Origination and insertion of pectoralis major.
originate-costal margin, sternum and medial clavicle

insert-crest of greater tubercle of the humerus
What is the function of pectoralis major?
flex, adduct and medially rotate the arm
Origination and insertion of pectoralis minor.
originate-outer surface of ribs 3-5

insert-caracoid process of scapula
What is the function of the pectoralis minor?
pulls scapula down and anteriorly
Origination and insertion of serratus anterior.
originate-upper, outer surface of ribs 1-8

inserts onto medial angle, vertebral boarder, and inferior angle of scapula (undersurface of scapula)
What is the function of the serratus anterior?
pulls scapula forward
Where are intercostal nerves located?
between the internal and innermost intercostal muscles, partially under the groove of the superior rib
Name the two branches of the intercostal nerves and where they branch to.
lateral cutaneous branches to the skin
anterior cutaneous branch near the sternum
Which nerve is associated w/ T12?
subcostal nerve (12)
intercostal nerves
What is located in the intercostal space?
Where do intercostal arteries come from?
thoracic aorta
Where are intercostal nerve blocks generally injected?
-near the intercostal nerve and its collateral brances
-towards the top and bottom of each intercostal space
What can coarctation of the aorta lead to?
increased blood flow within the intercostal arteries
stenosis of the aorta
What characteristic of coarctaion (stenosis) of the aorta can be seen on AP chest films?
costal notching of the under surface of the ribs due to engorgement of the intercostal arteries
Which dermatomes are common sites of eruption of shingles?
thoracic and lumbar, some on face
What route does shingles take to get to the dorsal root ganglia?
peripheral sensory nerve
Blood within the intercostal arteries comes from what?
thoracic aorta
internal thoracic artery (internal mammary artery)
2 things
Name three blood vessels that serve the thoracic cage.
subclavian artery
supreme intercostal artery
axillary artery
Describe the veins of the thoracic wall.
11 posterior intercostal vein
1 subcostal vein
they drain into the azygos venous system, which returns blood to the superior vena cava
Where does the nipple lie?
4th intercostal space for males and prepuberal females
Which muscles does the breast develop on?
pectoralis major (2/3)
serratus anterior (1/3)
What attaches the breast to the skin?
suspensory ligaments
How many lobes of glandular tissue drain into corresponding lactiferous ducts?
What allows the breast to move independent of the underlying muscle?
retromammary space-loose areolar CT behind the breast on the deep perimysium
Which arteries supply blood to the breast?
-perforating braches of the internal thoracic (internal mammary)
-anterior and posterior intercostal
-lateral thoracic branch of axillary artery
(venous drainage is through the same named veins, w/ most into axillary)
Where does lymphatic drainage of the breast go?
-75% to axillary lymph node (mainly pectoral nodes)
-medial quadrant drains to parasternal node
Explain a breast exam.
What do you look for?
How is it done?
-look for thickening of skin, masses, dimpling & flattening
-raise & lower arms, press arms against hips, palpation
What is polythelia?
Where do they develop?
-additional nipple
-additional breast
along embryonic mammary ridge
What is Gynecomastia?
What are the causes?
-excessive development of the male mammary gland
-ductal proliferation and periductal edema, occurs at puberty and in obese males due to increased estrogen
What is the superior thoracic aperture bound by?
What is its shape?
-T1 vertebra, rib 1 and superior boarder of manubrium
-kidney bean shaped
Name 2 thoracic outlet syndromes and describe their characteristics.
costoclavicular syndrome-coldness of upper arm caused by lack of blood flow due to compression of subclavian artery as it passes over 1st rib & under clavicle
Cervical rib syndrome-Compression of C8-T1 nerve roots as they pass over 1st rib
What do the pleural cavities contain?
lung and pleural membranes
What does the mediastinum contain? (5 things)
heart, great vessels, trachea, esophagus, thymus
Name 2 things the thoracic diaphragm is responsible for.
-separates thorax from abdomen
-principal muscle of inspiration
What forms the thoracic diaphragm?
skeletal muscle and a central tendon
How high does the right dome of the diaphragm reach?
-4th intercostal space
-5th intercostal space
liver on R side pushes diaphragm up
What is the diaphragm derived from?
-septum transversum
-myoblast of 3rd, 4th, & 5th cervical myotomes (pleuroperitoneal fold)
What keeps the diaphragm alive?
C3, 4, 5
What are the 3 major openings in the diaphragm?
T8-inferior vena cava hiatus (caval hiatus)
T10-esophageal hiatus (allows vagal trunks to enter abdomen)
T12-aortic hiatus(allows thoracic duct and azygos vein to enter abdomen)
What are the peripheral attachments of the diaphragm?
medial & lateral arcuate ligament, sternal and postal part, lumbar part w/ 2 aponeurotic arches, L & R crura of the diaphragm on each side of vertebral bodies
What are the sensory parts of the diaphragm?
central phrenic nerve (C3,4,5); peripherally intercostal and subcostal nerves T5-12
What arteries supply the diaphragm?
-pericardiaophrenic artery, branches from internal thoracic artery near apex of thoracic cage=central supply
-musculophrenic artery-branches from internal thoracic artery near costal margin=anterior supply
The pericardiaophrenic artery runs w/ which nerve?