SEM2: Thorax I

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what are the borders of the superior thoracic aperture
ant. superior border of manubrium, post. 1st thorasic vertebra, lat. medial border of 1st rib
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what structures run through the superior thoracic aperture
oesophagus, trachea, subclavian artery and vein, common carotid artery, internal jugular vein
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what are the borders of the inferior thoracic aperture
ant. xiphisternal joint, post. 12th thorasic vertebra, lat. curvature of costal margin
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what structures run through the inferior thoracic aperture
diaphragm, oesophagus, aorta
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what is thoracic outlet syndrome
compression of the brachial plexus and/or subclavian artery and vein as they pass out of the superior thoracic aperture
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what bones are responsible for thoracic outlet syndrome
cervical rib C7 or first thoracic rib T1
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how are floating ribs different to false and true ribs?
they don't have anterior attachments
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what is costochondritis
inflammation of your costochondrial joint (joint between the rib and cartilage)
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why might damage to the cartilage take time to heal
the cartilage has poor perfusion
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what are the costotranverse and costovertebral joints
costotranverse: where the tubercle on the neck of the rib articulates with the transverse process of the vertebrae. costovertebral: where the articular facet on the head of the rib articulates with the superior costal facet on the corresponding vertebrae
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what are the three layers of the intercostal muscles
external, internal and innermost
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what is the action of the deltoid
abducts arm, flexion and extension
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what is the action of the pectorals major
adducts and medially rotates humerus; extends and flexes arm
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what is the action of the platysma muscle
pulling down the mandible (opening the mouth) and pulling the corners or the mouth (frowning)
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what is the action of the pectorals minor
depresses scapular, accessory respiration
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what is the action of the serratus anterior
protraction and rotation of scapular
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what does the medial and lethal pectoral nerves supply
pectorals major and minor
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what does the long thoracic nerve supply
serratus anterior
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what are the attachments of the pec major
clavicle and sternocostal
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what are the attachments of the pec minor
ribs 3-5 and the coracoid process of the scapula
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what do the subclavian muscle and clavipectoral fascia protect
brachial plexus and subclavian vessels from a broken clavicle
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at what point does the external intercostal muscle become the external intercostal membrane
aperneurosis at the costochondrial joint
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at what point does the internal intercostal muscle become the internal intercostal membrane
the angle of the rib
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where does the neuromuscular bundle of each rib run?
costal groove (inferior medial surface of rib)
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what are the typical and atypical ribs?
atypical = 1,2, 10,11,12 typical: 3-9
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which muscles are used in passive inspiration
external intercostal muscles and diaphragm contract
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which muscles are used in passive expiration
external intercostal muscles and diaphragm relax
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which muscles are used in active inspiration
accessory muscles, external intercostal muscles and diaphragm contract
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which muscles are used in active expiration
external intercostal muscles and diaphragm relax, anterolateral abdominal wall, innermost and internal intercostal muscles contract
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what are the accessory muscles
Scalene, sternocleidomastoid, pec maj. and min., serratus anterior and lattimus dorsi
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between which muscles does the neurovascular bundle run
between the internal and innermost
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what is the order of structures in the neurovascular bundle (superior to inferior)
vein, artery and nerve
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what structures pass the diaphragm
inferior vena cava at T8 (through tendon), oesophagus at T10 (through muscle), aorta at T12 (behind)
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how are the inter costal spaces named
their number corresponds to the rib superior
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how many posterior intercostal arteries are there and where do they arise from
11. 1-2 from superior intercostal artery, 3-11 from descending thoracic aorta
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how many anterior intercostal arteries are there and where do they arise from
9. 1-6 from internal thoracic artery, 7-10 from musculophrenic branch
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in what direction do the external intercostal muscle fibres run
down and forwards (hands in pockets)
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in what direction do the internal intercostal muscle fibres run
down and backwards
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in what direction do the intermost intercostal muscle fibres run
down and backwards
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where is a chest drain inserted and why
5th ics, midclavicular line. to avoid the neurovascular bundle
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what is the triangle of safety
the area where it is safe to insert a chest drain: lateral border of pec major, lateral border of latissimus dorsi, 5th ic space (horizontal line)
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what does the medial and lateral pectoral nerves supply
pectorals major and minor
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how does the diaphragm develop
starts as a central tendon at C2 , then descends though C3,4,5 collecting myotomes
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what is the nerve supply of the diaphragm
phrenic
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what is a hiatus hernia
weakness of the diaphragm leading to an oesophageal hiatus that abdominal contents push through - usually the stomach
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what is congenital diaphragmatic hernia
failure of closure of the diaphragm causing abdominal contents to push into the thorax, making the lungs and pulmonary vessels smaller causing pulmonary hypotension
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what is hemi-diaphragm
paralysis of half the diaphragm. one side appears higher than the other on X-rays and moves paradoxically (up breathing out and down breathing in)
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what are venae comitantes
a pair of veins running alongside an artery. the pulsations of the artery aid venous return
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where do anterior intercostal veins drain to
internal thoracic or musuculophrenic branch -> subclavian ->svc
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where do posterior intercostal veins drain to
2nd - 4th left posterior intercostal -> left superior intercostal ->accessory hemiazygous -> azygous -> svc.5th - 8th left posterior intercostal -> accessory hemiazygous -> azygous -> svc. 9th -11th left posterior intercostal ->hemiazygous -> azygous -> s
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what vessels form the azygous vein
right ascending lumbar and right subcostal
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what vessels form the hemiazygous vein
left ascending lumbar and left subcostal
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how does the neurovascular bundle of the 12th rib differ
it doesn't run in the costal groove and instead runs along the lower border of the 12th rib. the order is nerve, artery, vein (superior to inferior) rather than vein, artery, nerve.
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how do the intercostal nerves divide
intercostal nerve -> lateral cutaneous ->posterior and anterior branch. intercostal nerve -> anterior cutaneous -> medial and lateral branch
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what is the function of the intercostal nerves
1st divides to form part of the brachial plexus, 2nd -6th innervates thorax muscles and parietal pleura. 7th - 11th innervate the rectus abdominus and provide sensation.
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what are lobules
exocrine modified sweat glands that produce milk
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what are lactiferous ducts
buds that appear like spikes on a bike wheel
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what are aureoles
sebaceous glands that enlarge
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what are *******
conical/cyclindrical prominences
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what are fibrous septae
suspensory ligaments attaching mammary glands to dermis of skin
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what is the blood supply to the breast
axillary and acromiothoracic-> lateral thoracic, internal thoracic and intercostal arteries
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what is the venous drainage of the breast
circular venous plexus at base of ****** ->axillary and internal thoracic v.
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what are the 5 groups of axillary lymph nodes
pectoral (on pec maj.), subscapular (posterior wall of axilla), brachial (lateral wall of axilla), central (base of axilla), apical (apex of axilla)
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what are the relations of the phrenic n.
left runs by pericardium, right runs anterior to vertebral bodies and sympathetic trunk
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what are the reaction of the vagus nerve
runs around aorta and around oesophagus to the diaphragm
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Other cards in this set

Card 2

Front

what structures run through the superior thoracic aperture

Back

oesophagus, trachea, subclavian artery and vein, common carotid artery, internal jugular vein

Card 3

Front

what are the borders of the inferior thoracic aperture

Back

Preview of the front of card 3

Card 4

Front

what structures run through the inferior thoracic aperture

Back

Preview of the front of card 4

Card 5

Front

what is thoracic outlet syndrome

Back

Preview of the front of card 5
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