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Thoracic Wall, Pleura & Mediastinum
N/A
21
Medical
Professional
09/16/2010

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Cards

Term
Functions of Thorax (5)
Definition
1)Protects important structures in the thoracic and abdominal cavities
2)Provides attachments for several muscles that act on the upper extremity
3)Provides attachments to the diaphragm
4)Resists the negative pressure produced by inspiration and lungs
5)Gives attachments to some abdominal muscles
Term
Bony thorax (3)
Definition
1)Sternum
2)Ribs
3)Thoracic vertebrae
Term
Sternum
Definition
1)Manubrium: Jugular notch (site of suprasternoid fossa), clavicular notch
- facet for the first rib
2)Body
-Joins the manubrium at sternal angle of Louis (important landmark of where trachea bifocuates) that marks the articulation with the 2nd rib
-Articulates with 3rd-7th rib
3)Xiphoid process
-Forms synchondrosis (cartilaginous joint) with the body of sternum
-Gives attachments to the rectus abdominis muscles
Term
Sternal Angle
Definition
1)Corresponds to lower border of T4 (slightly inferior to where your nipple is)
2)Corresponds to the tracheal bifurcation
3)Separates the superior and inferior mediastina
4)Also where 2nd rib articulates and forms the articulation between manubrium and body.
Term
Ribs
Definition
Typical ribs (3rd-9th)
-Head- has two articular facets separated by crest
-Upper facet articulates with the vertebra above, lower facet articulates with the vertebra below
-Crest articulates with the intervertebral disc
-Neck- transition between the head and body
-Tubercle- at the junction of neck and body and contains a facet that articulates with costal facet of the transverse process
-Body- contains the costal groove on the concave medial surface; gives attachments to the erector spinae
Term
Atypical ribs
Definition
1)Include
1st, 2nd, 10th -12th
2)First rib
-shortest, lack costal groove, tubercle and angle at the same location; contains single facet on the head, contains the scalene tubercle for the attachment of the anterior scalene
Term
Thorax
Definition
1)10th-12th ribs have single articular surface on the head and articulate with single vertebra
2)11th-12th ribs lack neck and tubercle and do not articulate with the costal cartilages
3)Ribs are also classified into:
4)Vertebro-sternal (1st-7th)
5)Vertebro-chondral (8th-10th)
6)Vertebral (floating) ribs are the 11th and 12th
Term
Vertebro-sternal, Vertebro-chondral, Floating Ribs
Definition
1)Vertebro-sternal ribs articulate anteriorly with the sternum via the costal cartilages (1-7) and posteriorly with the vertebral bodies and transverse processes
2)Vertebro-chondral ribs articulate anteriorly with the costal cartilages of the 7th rib to form the costal arch (8-10) and posteriorly with the thoracic vertebrae
3)Vertebral ribs articulate with thoracic vertebrae only
Term
Characteristics of Ribs
Definition
1) Anterior ends are lower than the posterior ends
a) Elevation of the ribs thus increases the anteroposterior dimension of the thoracic cavity
2) Midpoints of the ribs are lower than both anterior and posterior ends
b) Elevation of the ribs increases the transverse diameter of the thoracic cavity
3)Fractures of the lower ribs may tear the diaphragm
4)Fractures of ribs commonly occur anterior to the angle
5)Fracture of the lower ribs on the left side is most likely to damage the spleen
6)12th rib demarcates the lower reflection of the pleura
Term
Thoracic Vertebrae
Definition
1) Heart-shaped bodies
2)exhibit one or two articular facets
3)Transverse processes support the neck and tubercle of the ribs and contain facets that articulate with the tubercles of the ribs
Term
Thorax (part 2)
Definition
1) Superior thoracic aperture (thoracic outlet)
- formed by the manubrium sterni, first rib and first thoracic vertebra
- anterior end is lower than the posterior end which exposes the apex of the lung anteriorly
2) Inferior thoracic aperture
- formed by the 12th thoracic vertebra, 11th & 12th ribs and costal arch (7-10)
- Covered by the diaphragm
Term
Intercostal Muscles
Definition
1) Intercostal muscles attach above to the lower borders and below to the upper borders of the ribs
2) External intercostal muscle- runs from the costal tubercle downward and medially to the costochondral junction where it forms the external intercostal membrane- Elevates the ribs
3)Internal intercostal muscle
-Runs deep and at a right angle to the external intercostal muscle
-Runs from the costal groove to the upper borders of the ribs
-Extends from the sternum to the angles of the ribs where it becomes the internal intercostal membrane
4)Innermost intercostals have the same attachments and features of that of the internal intercostal muscles and they are separated by the intercostal vessels and nerves - Interosseous part depresses the ribs, interchondral elevates the ribs.
Term
Thoracic Muscles
Definition
1)Subcostal Muscle
a)Well developed in the lower thoracic region
b)Stretches from the medial surface of the angle of one rib to the to the internal surface of the second or third rib below, thus crossing one or two intercostal spaces
c)Acts with internal intercostal
2)Transverse thoracis
a)extends from the xiphoid process and lower part of body of sternum to the 2nd and 3rd costal cartilages- weal expiratory function
Term
Thoracic Muscles (6)
Definition
1)Levator costarum
2)Serratus posterior superior
3)Serratus posterior inferior
4)Anterior scalene
5)Middle scalene
6)Posterior scalene
Term
Pleurae
Definition
1)Serous membrane that lines the thoracic wall, covers the diaphragm and then invests the lung
2)Consists of parietal and visceral layers
3)Space between the parietal and visceral pleura is known as pleural cavity
4)Parietal and visceral pleurae meet around the root of the lung and form the pulmonary ligament
5)Parietal layer divides into:
- Cervica, Costa, Mediastinal, Diaphragm *must know, parietal covers lungs*
6) *KEY POINT* Costal pleura attaches to the thoracic wall via the endothoracic fascia
7)Costal pleurae on both sides meet at the sternal angle
8)At the 4th rib the left pleural reflection separates from right pleural reflection due to the positioning of the heart and presence of the cardiac notch (Site of costmediastinal recess)
9)Pleura reflections reaches the 8th rib at midclavicular, 10th rib at midaxillary and the neck of 12th rib *ON THE BOARDS, ALSO YOU MUST KNOW THIS!* at the vertebral column
Term
Pleural Recesses
Definition
1)Pockets that allow expansion of the lung
2)Costal and mediastinal pleura meet to form the costomediastinal recess
3)Left costmediastinal recess is larger because of presence of the cardiac notch
4)Costal and diaphragmatic pleura meet to form the costdiaphragmatic space- sampling of pleural effusion-5th-6th intercostal
Term
Mediastinum
Definition
1)A midline space between two pleural cavities
2)Boundaries
-Sternum
-Thoracic vertebrae
-Mediastinal pleura
3)Compartments
a) Superior mediastinum
b) Inferior mediastinum
Term
Superior Mediastinum
Definition
1)Boundaries
Anteriorly: Manubrium sterni
Posteriorly: Upper four thoracic vertebrae
2)Superiorly: Superior thoracic aperture
3)Inferiorly: Plane that passes through the sternal angle and lower border of T4
Term
Anterior Mediastinum
Definition
1)Lies anterior to the heart and pericardium, posterior to the sternum, inferior to the planes that traverses the sternal angle and T4
2)Bounded inferiorly by the diaphragm
3)Contains the sternopericardial ligaments, thymus
Term
Middle Mediastinum
Definition
1)Boundaries
superiorly by a plane that connects the sternal angle to the lower border of T4
2)Inferiorly by the diaphragm
3)Laterally by the mediastinal pleura
4)Anterior mediastinum
5)Posteriorly-Posterior mediatsinum
Term
Posterior Mediastinum
Definition
1)Boundaries
- Superior: a plane that traverses the sternal angle and lower border of T4
- Inferior: Diaphragm
- Lateral: Mediastinal pleura
- Anterior: Pericardium
- Posterior: Lower 8 thoracic vertebrae
Contents: Esophagus, thoracic duct.
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