Term
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Definition
| Look at (configuration of the chest, range of respiratory movement, symmetry) |
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Term
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Definition
| Feel (note abnormalities in chest wall, pulsations, sensitivities) |
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Term
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Definition
| Tap (tapping chest with fingers, distinguish "air-containing" organs (lungs) from solid organs (heart, liver)) |
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Term
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Definition
| Listen (breath sounds, fluid sounds, heart sounds |
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Term
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Definition
| Superior angle of the scapula |
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Term
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Definition
| Suprasternal (Jugular) notch |
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Term
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Definition
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Term
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Definition
| Sternal angle (of Louis)- sternal-manubrial joint |
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Term
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Definition
| Inferior angle of the scapula |
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Definition
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Definition
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Definition
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Definition
| T4 (sternal angle of Louis) |
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Term
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Definition
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Term
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Definition
| behind the 5th and 6th left costal cartilage |
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Term
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Definition
| a line from the 6th rib (mid-clavicular) to 8th rib (mid-axillary) to 10th rib (posterior, adjacent to vertebral column) |
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Term
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Definition
| divides each lung into superior and inferior lobes. A line from the level of T3 posteriorly to the 5th intercostal space lateral/anteriorly (Corresponds to the medial border of the scapula when the shoulder is abductor completely). |
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Term
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Definition
| creates a middle lobe in the RIGHT lung. A horizontal line across the 4th costal cartilage. |
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Term
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Definition
2nd LEFT costal cartilage 0.5 in from sternum
3rd RIGHT costal cartilage 0.5 in from sternum
5th LEFT costal cartilage 3.5 in from midline
6th RIGHT costal cartilage 0.5 in from sternum |
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Term
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Definition
| supplied by lateral and medial pectoral nerves |
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Term
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Definition
| Supplied by medial pectoral nerve |
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Term
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Definition
superficial fascia covering the anterior chest wall, superficial to the Pectoralis Major
extends from lateral margin of Sternum to the Midaxillary line; upper lateral edge extends arounf lower border of Pec. major and enters the axilla; overlies the 2nd to 6th rib. |
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Term
| Mammary gland: consists of |
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Definition
15-20 lobes of glandular tissue embedded in fat.
lobes separated by fibrous septa (Cooper's ligaments, suspensory ligaments)
each lobule drains via lactiferous duct to lactiferous sinus which surrounds the nipple |
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Term
| Mammary gland: blood supply |
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Definition
perforating branches of the internal thoracic artery, intercostal arteries, and lateral thoracic and thoracoacromial branches of the axillary artery.
(Veins correspond to arteries) |
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Term
| Mammary gland: lymph drainage |
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Definition
Lateral quadrants drain into the axillary (pectoral) group of nodes, posterior to the lower border of the Pec. major
Medial quadrants drain via vessels that pierce the intercostal spaces to enter the internal thoracic group of nodes, w/in the thoracic cavity near the internal thoracic artery |
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Term
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Definition
vertebral column, posteriorly
ribs and intercostal spaces, laterally
sternum and costal cartilage, anteriorly |
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Term
| Thoracic Cage: Cavity is divided into |
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Definition
Medial region - mediastinum
Lateral region - lungs and pleurae |
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Term
| Thoracic Cage: Thoracic inlet (called ‘outlet’ by clinicians) Boundaries: |
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Definition
posterior - 1st thoracic vertebra
lateral - medial border of 1st ribs
anterior - superior border of the manubrium |
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Term
| Thoracic Cage Thoracic outlet - boundaries: |
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Definition
posterior - 12th thoracic vertebra
lateral - costal margin as it curves
anterior - xiphosternal joint |
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Term
| Thoracic portion of vertebral column: |
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Definition
Concave forward
12 vertebrae |
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Term
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Definition
| Vertebral Foramen (in which spinal cord travels), formed by: Body, Vertebral arch (formed by Pedicle on either side, supporting a Lamina) |
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Term
| Vertebral arch consists of: |
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Definition
1 spinous - ‘spine’, posterior from junction of the laminae
2 transverse - directed laterally from junction of laminae/pedicles
Spinous and transverse processes receive attachments of muscles and ligaments
4 articular - vertically arranged, arising from junction of laminae and pedicles. 2 superior and 2 inferior |
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Term
| Intervertebral foramen: made of- |
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Definition
superior notch of one vertebra and inferior notch of the adjacent vertebra (in which spinal nerves and blood vessels
travel) |
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Term
| Typical Thoracic Vertebra: |
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Definition
body is medium-sized and heart-shaped
vertebral foramen is small and circular
spines are long, and point inferiorly
costal facets on lateral aspects of body (for articulation with heads of ribs)
costal facets on transverse processes (for articulation with tubercles of ribs) |
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Term
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Definition
Manubrium-Triangular. Articulates with clavicles and 1st and upper part of the 2nd costal cartilage on either side.
Body-Lateral border is notched for articulation with the lower part of the 2nd - 7th costal cartilage Xiphoid process |
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Term
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Definition
Bars of hyaline cartilage
Connect upper 7 ribs directly to the lateral edge of the sternum, and the 8th, 9th and 10th ribs to the 7th costal cartilage
Cartilage of 11th and 12th ribs end in the abdominal musculature
Sternal angle – anterior end of 2nd costal cartilage= reliable landmark to locate interspaces 1 and 2, etc. |
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Term
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Definition
12 pair, each connected posteriorly to the thoracic vertebrae
1-7 are connected anteriorly to the sternum via costal cartilage
8-10 are connected anteriorly to each other and to the 7th rib via costal cartilage
11-12 have no anterior connection - “floating ribs” |
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Term
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Definition
| 2 articular facets for articulation with the numerically corresponding vertebral body and the vertebral immediately above |
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Term
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Definition
1st rib - flattened from above downward. shortest rib. has a prominent tubercle (scalene tubercle) for insertion of the anterior scalene muscle; anterior
to the tubercle the subclavian vein crosses the rib; posterior to the tubercle the subclavian artery and lower trunk of the brachial plexus cross the rib in the subclavian groove
2nd rib - much less curved than the 1st and twice as long
10th rib - has only one articular facet in the head
11th and 12th ribs - short, no tubercles, and a single facet on the head |
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Term
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Definition
External intercostal fibers pass inferior and anterior from the inferior border of a rib to the superior border of the rib below. Extend from the vertebra (posterior) to the costo-chondral junction (anterior), where muscle is replaced by the anterior (external) intercostal membrane
Internal intercostal fibers pass inferior and posterior from the sternum to the angles of the ribs, where they become the posterior (internal)
intercostal membrane
Innermost intercostal separated from the internal intercostal muscles by the intercostal nerves and vessels |
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Term
| Intercostal Spaces-additional muscles |
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Definition
Subcostal Similar to innermost, but traverses 2-3 ribs
Transversus thoracis Crosses more than one intercostal space; thin muscle arising from the xiphoid process and inferior part of the body of the sternum to insert on the 2nd to 6th costal cartilage
Levatores costarum 12 fan-shaped muscles arising from the transverse processes of C7 to T11 vertebrae, and insert inferiorly on ribs |
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Term
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Definition
constricted portion between the head and the
tubercle |
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Term
| Parts of the rib: tubercle |
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Definition
| a prominence on the outer surface of the rib; has a rough non-articular portion and a smooth facet for articulation with the transverse process of the numerically corresponding vertebra shaft (also called body) - thin, flattened region angle- where the shaft of the rib bends sharply forward; divides the shaft into 2 parts |
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Term
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Definition
| Found between the middle and innermost layers of muscles, and lie in a groove on the inferior aspect of the rib; from superior to inferior they are found in the order Vein, Artery, and Nerve (VAN) |
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Term
| Posterior intercostal arteries |
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Definition
| 1st 2 spaces are branches of the superior intercostal artery, which is a branch of the costo-cervical trunk of the subclavian artery. The lower 9 spaces are branches of the descending thoracic aorta. Each artery runs anteriorly in the subcostal groove (inferior to its corresponding vein) to anastamose with the anterior intercostal artery. |
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Term
| Anterior intercostal arteries |
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Definition
| branches of the internal thoracic artery (spaces 1-6) or its branch, the musculophrenic artery (spaces 7-9). |
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Term
| posterior intercostal veins empty into |
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Definition
| azygos or hemiazygos veins |
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Term
| anterior intercostal veins empty into |
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Definition
| internal thoracic and musculophrenic veins |
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Term
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Definition
| are the anterior primary rami of the thoracic nerves. Each gives off a collateral muscular branch and lateral and anterior cutaneous branches to innervate the thoracic and abdominal walls |
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Term
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Definition
| Dome-shaped septum dividing the thoracic and abdominal cavities (in the thoracic outlet). Comprises a peripheral muscular part and a central aponeurosis |
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Term
| Diaphragm muscle fibers: (3 parts) |
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Definition
Vertebral part
Costal part
Sternal part |
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Term
| Diaphragm: Vertebral part |
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Definition
right crus, arising from bodies of upper 3 lumbar
vertebrae, and left crus, arising only from the upper 2 vertebrae. Arcuate ligaments, a series of fibrous arches (medial - covering psoas major, and lateral - covering quadratus lumborum). The fibrous medial borders of the 2 crura form a median arcuate ligament in front of the aorta |
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Term
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Definition
| attached to the lower 6 ribs and costal cartilage |
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Term
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Definition
| 2 small (right and left) slips from the posterior surface of the xiphoid process |
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Term
| Diaphragm: central tendon |
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Definition
| Shaped like 3 leaves, partially fused with the inferior aspect of the pericardium |
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Term
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Definition
| Motor innervation via the phrenic nerve (C3,4,5). Sensory fibers also run in the phrenic nerve from the central portion of the diaphragm. |
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Term
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Definition
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Term
| Diaphragm: aortic opening |
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Definition
| T12 level, transmits the abdominal aorta, thoracic duct, azygos vein |
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Term
| Diaphragm: esophageal opening |
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Definition
| T10 level, transmits the esophagus, right/left vagus nerves, esophageal branches of the left gastric vessels, and lymphatics from lower 1/3 of the esophagus |
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Term
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Definition
| T8 level, transmits the inferior vena cava and terminal branches of the right phrenic nerve |
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Term
| Diaphragm: additional info |
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Definition
the greater, lesser, and lowest splanchnic nerves pierce the crura; the sympathetic trunks pass posterior to the medial arcuate ligaments on
each side; superior epigastric vessels pass between the sternal and costal origins of the diaphragm on each side; left phrenic nerve pierces the left part of the diaphragm; neurovascular bundles of intercostal spaces 7-11 pass between the muscular slips of the costal origin |
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