26 Mar - Thorax: Chest Wall & Mediastinum

How many vertebrae and pairs of ribs in the thorax

12 vertebrae and ribs

?

Jugular (=suprasternal) notch

?

Manubrium

?

sternal angle

?

Body of sternum

?

Xiphosternal joint/junction

?

Xiphoid process

?

Costal cartilage

Which ribs are not palpable?

ribs 1, 11, 12

What anatomical event happens at the sternal angle?

disc T4/5

The Xiphisternal joint aligns with ___

disc T9

The jugular notch aligns with ___

T3

Intercostal spaces are named for ___

rib above (place below rib 4 is 4th intercostal space)

What ribs signularly attach to the sternum

ribs 1-6

What ribs don’t reach the sternum by themselves

ribs 7-10

ribs 1-7 are called ___

true ribs

ribs 8-10 are called ___

false ribs

The ___ are made from costal cartilages 7-10

costal margin

ribs 11 + 12 are called ___

floating ribs

3 layers of intercostal muscles: external

fibers directed inferiorly & medially (hands in pockets)

3 layers of intercostal muscles: internal

fibers directed inferiorly and laterally

3 layers of intercostal muscles: innermost

discontinuous group of three muscles, directed inferiorly and laterally

Which two intercostal spaces have the same direction

internal and innermost

Which intercostal space helps us inhale (elevate ribs)

external

Which intercostal space helps us exhale (depress ribs)

internal

Intercostal neurovascular supply: located between ___muscle layers

innermost and internal

What’s in the intercostal neurovascular bundle (superior to inferior)

VAN: vein, artery, nerve

The ___ moves the sternum in a pump handle direction

anterior thoracic wall

The ___ moves the ribs in a bucket handle direction

lateral thoracic wall

The arteries that come off the aorta and supply most of the thorax are called __

posterior intercostal arteries

Where does the nipple sit?

midclavicular line

what arteries supply the front of the thoracic space?

anterior intercostal artery

Breasts are largely ___

fatty tissue resting on the pectoralis major muscle

the breat contains a supporting fibrous matrix, including ___ that hold up the breast tissue

suspensory ligaments

Mammary glands are __

modified sweat glands producing milk

Lactiferous ducts ___

collect milk from glands

The nipple is the ___

confluence of all lactiferous ducts

the Areola has ___ to protect nipples and areolae during lactation

sebaceous glands that produce oily substance

Where does breast lymph drain?

roughly 75% drains to axillary lymph nodes

When placing a chest tube into a patient to relieve a pleural effusion (fluid around the lungs), one aims for the superior border of the rib in the patients 8th intercostal space. What structure are they trying to avoid in this space?

intercostal nerve

?

superior mediatrinum

?

inferior mediastinum

?

posterior mediastinum

?

middle mediastinum

?

anterior mediastinum

?

sternal angle

?

trachea

?

aorta

?

esophagus

whats in the anterior mediastinum?

thymus gland

what does the phrenic nerve innervate?

diaphragm

where is the diaphragm higher?

higher on the right side because of the liver

the phrenic nevre travels ___

anterior the root of the lung (like suspendors)

Which pericardium surrounds the heart and is flexible

serous

Which pericardium surrounds the heart and is tough

fibrous

?

ascending aorta

?

pulmonary trunk

?

edge of pericardium

?

inferior vena cava opening

all venous blood gets to the heart through the ___

superior vena cava

what dumps blood into the superior vena cava?

right and left brachiocephalic veins

what artery supplies your neck / head with blood?

carotid artery

what runs right under the thyroid gland?

recurrent laryngeal nerves

the ___ used to be open in the fetal stage

ligamentum arteriosum

what vein dumps into the superior vena cava?

azygous vein

What system is valveless, thus based on pressure?

azygous venous system

What is chyle

interstitial fluid, fatty acids, and fats (basically fortified lymph)

Cisterna chyli

central point at which most lymph and chyle from below diaphragm meet to form thoracic duct