Glossary of GA-8-21-06

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Borders of Thoracic Cavity
Posterior = thoracic vertebrae and IV discs (12)
Anterior = sternum
Lateral and Interior = ribs
True Ribs
- ribs 1-7
- articulate with sternum via condyl cartilage
False Ribs
-ribs 8-10
-condyl cartilages fuse together and join w/ 7th rib to articulate to inferior aspect of body of sternum
Floating Ribs
- ribs 11 and 12
-no cartilages connecting them to sternum but do have cartilaginous ends
-float freely in lateral aspects of anterior abdominal wall
Atypical Ribs
-ribs 1, 2, 11, and 12
-1st rib is shorter and broader than other ribs and fuses to sternum via cartilaginous joint, most sharply curved of the 7 true ribs
-ribs 11 and 12 don't articulate w/ sternum, short and have no necks or tubercles
-2nd rib is thinner, less curved, and much longer than 1st rib, has 2 facets on its head for articulation with bodies of T1 and T2 vertebrae
What thoracic vertebrae is the manubrium located opposite?
3rd and 4th
What thoracic vertebrae is the sternum located opposite to?
5th - 9th
What thoracic vertebra is the xiphoid process located opposite to?
Parts of the sternum
Xiphoid Process
Which of the following muscles is not an accessory muscle for respiration:
pectoralias major, pectoralis minor, serratus anterior, latissimus dorsi, scalene muscles
Latissimus dorsi
What is the angle between the manubrium and the body of the sternum called?
Sternal Angle/ Sternal Angle of Louis
Superior Aperture of Thorax
-provides a space for traches, esophagus, vagus nerve, and great vessels to pass into thorax
-6.2 cm in anterior-posterior direction and 11 cm across
Boundaries of Superior Aperture of Thorax
-1st thoracic vertebra
-first two ribs
-superior border of manubrium
Inferior Aperture of Thorax
-larger than anterior aperture
-IVC, abdominal aorta, nerves, and lymphatics pass through here
Boundaries of Inferior Aperture of Thorax
-inferior borders of 11th and 12th ribs
-costal cartilages anteriorly
-xiphoid process
Parts of a Typical Rib (3-9)
-Head - w/ 2 facets that articulate to thoracic vertebrae
-Neck - connects head to body
-Tubercle - between connection of ribs head to body, provides for articulation w/ transverse process of thoracic vertebrae, rough area is for costal transverse ligament which holds that joint in place
-Angle - weakest part of rib
-Costal Groove - contains and protects intercostal VAN
Costal Transverse Ligament
-attaches to rough part of tubercle on rib
-holds joint of rib to transverse process in place
Costal Groove
-on inferior part of rib
-contains and protect intercostal vein, artery, and nerve
Jugular Notch
-located at most superior aspect of manubrium
What all does the first rib fuse with?
1. Clavicle (synovial joint)
2. Body of Sternum (cartilaginous joint)
What kind of joints are the articulations of costal cartilages to the sternum?
synovial joints
What kind of joint is formed by the articulation of xiphoid process to sternum?
What kind of joint is the attachment of the tubercle of the rib to the transverse process?
synovial joint
What kind of joint is the attachment of the rib to the body of the vertebra?
synovial joint
What is the major muscle of respiration?
Phrenic Nerve
-originates for C3-C5 (mainly C4 and C5)
-descends through neck, in thoracic cavity descends along lateral aspect of paricardial sac
-terminates on either side by ending in diaphragm
-innervates diaphragm
External Intercostal Muscles
-run from the rib above it anteriorly and inferiorly to attach to the rib below it
-when contracted, elevate ribs
Internal Intercostal Muscles
-deep to external intercostals
-depress ribs
Innermost Intercostal Muscles
-deepest of the intercostal muscles
Intercostal Nerve
-primary ramus which extends laterally, all the way anteriorly
-innervates wall
-runs between Internal Intercostal muscles and innermost intercostals in a groove along w/ the artery and vein
Subcostal Muscles
-attach from a superior rib inferiorly and cross one or two intercostal spaces
Indothoracal Fascia
-lines all muscles of the thorax
-separates the muscles from the pleura of the lungs
Transversus Thoracis Muscle
-antiorly beneath the sternum
-runs from inferior aspect of sternum superior and laterally crosses several intercostal spaces and attaches to 2nd through 6th ribs or costal cartilages
Idiopathic Pulmonary Fibrosis
-lungs become fibrotic
-patients have to use a lot of accessory muscles to breathe
-scalene muscles often well developed
What innervates teh muscles of the thoracic wall?
-ventral ramus (intercostal nerve)
-passes posteriorly, laterally, then anteriorly
-gives off a lateral and anterior cutaneous branch
Thoracic Aorta
-gived off right and left intercostals
Internal Thoracic Artery
-comes off subclavian
-descends down along the anterior part of thoracic cage posterior to the sternum, continues down sternum, down to the diaphragm where it changes names to MUSCULOPHRENIC ARTERY
-frequently used in bypass surgery
-gives off two branches that are anterior intercostals, one medially and one laterally
Coarctation of Aorta
-congenital condition
-aorta is constricted
-blood coming out of heart is not able to pass inferiorly
-to compensate, intercostal arteries and internal thoracic take over and become enlarged so blood can reach descending aorta
Azygos Vein
-formed by joining of the right intercostal veins
-drains into SVC
Right Superior Intercostal Vein
-formed by joining of 2nd through 4th intercostal veins
-drains into SVC
Hemiazygos Vein
-on the left side
-formed by lower intercostal veins, segmental veins off of aorta and one from the renal vein
-crosses 8th thoracic vertebral level at midline to fuse with Azygos Vein
Accessory Azygos Vein
-above the level where Hemiazygos splits to join w/ Azygos
Left Superior Intercostal Vein
-drains into left brachiocephalic
Visceral Pleura
-pleura that surrounds the lung itself
Parietal Pleura
-lines the cavity
-4 parts: costal, diaphragmatic, mediastinal, cervical
Left and Right Costodiaphragmatic Recess
-during normal breathing the lung does not expand/extend down to fill the entire pleural space
-this is the space that is extra
-can do a thoracocentisis here
Where would you do a thoracocentesis?
-costodiaphragmatic recess
-put needle in posteriorly and laterally into 6th, 7th, or 8th intercostal space and aspirate fluid
Horner Syndrome
-compression of cervical chain ganglia
-results in classic triad of signs
1. constricted pupil
2. partial ptosis (droopy eyelid)
3. anhydrosis (loss of hemifacial sweating)
Pleural Effusion
-absence of breath sounds
-build up of serous fluid between pleura
-air in the thorax
-primarily iatrogenic in nature
-can collapse a lung if you put in a central line wrong and puncture space bt parietal and visceral pleur and introduce air into this potential space
-infection between the parietal pleura and visceral pleura
-very painful
blood in potential space between pleura

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