DBAS 712- Thoracic Wall

Function of thorax

breathing, protection, conduit

Superior thoracic aperature

manubrium, 1st ribs, T1 vertebra

Inferior thoracic aperature

vertebrae T XII, rib XII, rin XI, costal margin, xiphoid process

Boundaries of thoracic cavity

Posterior- 12 thoracic vertebrae, Lateral- 12 ribs, Anterior- sternum

Intercostal space allows for

movement and support

costal cartilage function

mobility and elasticity

Floating ribs

no anterior connection with other ribs or sternum, ribs XI and XII

True ribs

articulate directly with sternum

Supernumerary cervical rib

extra cervical rib arising from seventh cervical vertebrae

Costochondral joints

between the ribs and the costal cartilages, immobile

Costochondritis

inflammation of costochondral joints causing sharp, localized pain

Thoracic vertrbae

12 that articulate with ribs

what shape do thoracic vertebrae have posterlaterally

cube shaped

anterior shape of T vertebrae

heart

what do muscles of thoracic wall do?

provide structural support for intercostal spaces during breathing and move the ribs

Expiration muscles

internal intercostals and abdominal muscles

Inspiration muscles

diaphragm and external intercostals

Subcostal muscles

parallel intercostal muscles and extend from angle of ribs to more medial positions

what muscles pass superiorly and laterally to insert into lower borders of costal cartilages of ribs III and VI

transversus thoracis muscles

Internal thoracic artery branches off of

subclavian artery

Posterior intercostal artery, anterior intercostal artery branch off of

aorta

Thoracic wall veins branch off of

brachiocephalic veins

Intercostal nerves come from

anterior rami of spinal nerves T1-T11

Subcostal nerves come from

anterior rami T12

Diaphragm attached peripherally to

xiphoid process, costal margin, ribs XI and XII, ligaments of posterior abdominal wall, lumbar vertebrae

thoracic duct is the ____ lymphatic vessel

largest

What separates thoracic and abdominal cavity

diaphragm

Aorta passes ____ diaphragm at ___ level

behind; T XII

Esophagus passes ____ diaphragm left of midline at ____ level

through; T X

Inferior vena cava passes ________ at _____ level

central tendon; T VII

innervation of diaphragm

phrenic nerve

Sensory innervation of diaphragm also includes

intercostal n

Neurovascular of thoracic wall from most superior to inferior

vein, artery, nerve

why is the nerve at most risk for damage

not protected by costal groove because of inferior location

Dyspnea

shortness of breath

Flail chest

multiple rib fractures, free moving thoracic segments part, very painful, affect breathing

Thoracic outlet syndrome

neurovascular compression of brachial plexus causing pain and weakness