TAP exam 1

What is the landmark for suprasternal notch?

T2/T3

What is the landmark for the sternal angle?

T4/T5

What is the landmark for the Xiphisternal joint?

T9/T10

What is the landmark for the subcostal plane?

L3

What is the landmark for the apex beat?

Intercostal space 5

What cutaneous nerves supply the Anterior thoracic wall?

Supraclavicular nerves

Intercostal nerves (anterior rami)

What cutaneous nerves supply the Posterior thoracic wall?

posterior rami of thoracic spina nerves

supraclavicular nerves originate from __________

C3 and C4

What are the branches of the Supraclavicular nerves?

Medial (anterior)

Intermediate (middle)

Lateral

What branch of the Supraclavicular nerve is described?

-medial infraclavicular region

-below clavicle in front

Medial (anterior)

What branch of the Supraclavicular nerve is described?

-pectoral and deltoid regions

-pectoral, outer pectoral, deltoid

Intermediate (middle)

What branch of the Supraclavicular nerve is described?

-upper and posterior shoulder

-posterior

Lateral

- consists of mammary glands, associated skin, and CT

- lies in superficial fascia anterior to pec major

Breast

What are mammary glands?

Modified sweat glands

the breasts extend vertically from ribs __________

2-6

the breasts are innervated by __________

Intercostal nerves 2-6

the breasts extend transversely from the ___________ to the ____________

sternum

mid-axillary line (axillary processs/tail)

- 15-20 lobes

- suspensory ligaments run from dermis to deep fascia

mammary gland

What are the contents of the mammary glands?

Glandular tissue

Lactiferous ducts (open onto nipple)

CT

What hormone is responsible for milky production?

Prolactin

What hormone is responsible for milk ejection?

Oxytocin

What is the arterial supply of the breasts?

Intercostal arteries

Axillary artery

Internal thoracic artery

the __________ artery supplies the superior medial breast

Superior thoracic

the __________ artery supplies the superior lateral breast

Thoracoacromial

the __________ artery supplies the lateral breast

Lateral thoracic

the __________ supply the medial breast

mammary branches

the anterior axillary nodes receive _______% of lymph

75

What lymph nodes are the internal thoracic nodes?

Parasternal nodes

What is the origin of the Pectoralis major?

Clavicle, sternum, costal cartilages, external oblique aponeurosis

What is the insertion of the pectoralis major?

Lateral lip of the intertubercular groove of humerus

What is the nerve supply of the pectoralis major?

Medial and lateral pectoral nerves

What is the action of the pectoralis major?

Flexion, Adduction, and medial rotation of arm

What is the origin of the pectoralis minor?

ribs 3-5

What is the insertion of the pectoralis minor?

Scapula (coracoid process)

What is the nerve supply of the pectoralis minor?

Medial pectoral nerve

What is the action of the pectoralis minor?

Pulls the shoulder downward and forward

Elevates the ribs

What is the origin of the Subclavius?

First costal cartilage

What is the insertion of the Subclavius?

Clavicle (inferior surface)

What is the nerve supply of the Subclavius?

Nerve to Subclavius

What is the action of the Subclavius?

Depresses the clavicle

Stabilizes the sternoclavicular joint

the __________ thoracic wall contains:

- 12 thoracic vertebrae

- intervertebral discs

posterior

the __________ thoracic wall contains:

- Twelve ribs

- Three flat muscles (intercostal space)

- Intercostal vein, artery, nerve (intercostal space)

lateral

the __________ thoracic wall contains the sternum

anterior

What muscle of the thoracic wall is active during inspiration?

External intercostal

What muscle of the thoracic wall is active during expiration?

Internal intercostal

-same plane as innermost intercostals

-spans multiple ribs

Subcostales

-same plane as innermost intercostals

-secure internal thoracic vessels to wall

Transversus thoracis

What are the actions of the intercostal muscles?

Support intercostal spaces during breathing

Pull ribs nearer to one another

What is the nerve supply of the intercostals?

Intercostal nerves

What are present between internal intercostal and innermost layer of muscle in the intercostal space and are arranged along the lower border of the rib?

Intercostal vein, artery and nerve

descends posteriorly to the costal cartilages and ends in the 6th intercostal space by dividing into its two terminal branches (superior epigastric and musculophrenic arteries)

Internal thoracic artery

the internal thoracic vein drains into the ___________

brachiocephalic vein

What internal thoracic artery enters rectus sheath and supplies rectus muscle to umbilicus?

Superior epigastric artery

What internal thoracic artery supplies the diaphragm and is the origin for lower anterior intercostal arteries?

Musculophrenic artery

What internal thoracic artery connects with posterior intercostal arteries?

Anterior intercostal arteries

What internal thoracic artery accompanies the phrenic nerve and supplies the pericardium?

Pericardiophrenic artery

What internal thoracic artery supplies anterior mediastinum (thymus)?

Mediastinal artery

what drains into the brachiocephalic vein?

internal thoracic vein

What are the anterior rami of the first eleven thoracic spinal nerves?

Intercostal nerves

internal thoracic artery

musculophrenic artery

anterior IC arteries

subclavian artery

thoracic aorta

posterior IC arteries

anterior IC artery; origin for ribs 1-6

internal thoracic artery

anterior IC artery; origin for ribs 7-10

musculophrenic artery

posterior IC artery; origin for costocervical trunk, superior 2 posterior IC arteries

subclavian artery

posterior IC artery; origin for lower 9 posterior IC arteries

thoracic aorta

Where do the musculophrenic vein and internal thoracic vein drain into?

Brachiocephalic veins on both sides

On the right side where do the posterior IC veins drain to?

Azygos vein

Where does the azygos vein drain into?

Superior vena cava

On the left side, where do the inferior posterior IC veins drain to?

Hemiazygos vein

Where does the hemiazygos vein drain into?

Azygos vein

Where do the first two left posterior IC veins drain into?

Left brachiocephalic vein

What is the anterior rami of T12 spinal nerves?

Subcostal nerve

What does the lateral cutaneous branch of T12 innervate?

Medial surface of upper arm

upper left intercostal veins drain into the __________ vein

left superior intercostal

middle left intercostal veins drain into the __________ vein

accessory hemiazygous

lower left intercostal veins drain into the __________ vein

hemiazygous

left superior intercostal vein drains into ___________

left brachiocephalic vein

Hemiazygous and accessory hemiazygous veins drain into _________ vein at T9

azygos

Upper thoracic aperture AKA ____

Thoracic inlet

What is the anterior thoracic inlet landmark?

Manubrium

What is the lateral thoracic inlet landmark?

Medial margin of rib 1

What is the posterior thoracic inlet landmark?

T1

the __________membrane present is in the thoracic inlet

suprapleural

Lower thoracic aperture aka ______

Thoracic outlet

What is the anterior thoracic oulet landmark?

Xiphoid process

What is the anterolateral thoracic outlet landmark?

Costal margin (Ribs 7-10)

What is the posterolateral thoracic outlet landmark?

End of rib 11

Rib 12

What is the posterior thoracic outlet landmark?

Body of T12

the thoracic outlet is closed by the __________

Diaphragm

What type of joint is the Manubriosternal joint?

Secondary cartilaginous (symphysis)

What type of joint is the Xiphisternal joint?

Secondary cartilaginous

What type of joint is the 1st Sternocostal joint?

Primary cartilaginous (synchondrosis)

What type of joint is the 2nd-7th Sternocostal joint?

Synovial plane

What type of joint is the 7th-10thInterchondral joint?

Small synovial plane

costovertebral joints

Costocorporeal joint

Costotransverse joint

What type of septum is the diaphragm?

Musculotendinous

What dome of the diaphragm is slightly higher?

Right due to liver

What do the domes of the diaphragm support?

Lungs

What in the diaphragm is related to pericardium and heart?

Central tendon

What are the parts of the diaphragm?

Sternal

Costal

Vertebral