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Week 6 Anterior Thoracic Wall
UC MED 2015 Week 6 1003-1006 Ch 4 Anterior Thoracic Wall
70
Medical
Graduate
10/06/2011

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Term
shaft of the clavicle
Definition
elongated, rodlike body of the clavicle
Term
sternoclavicular joint
Definition
where the end of the clavicle articulates with the manubrium (sternum)
Term
acromioclavicular joint
Definition
where the end of the clavicle articulates with the acromion of the scapula
Term
acromion
Definition
The lateral extension of the spine of the scapula that projects as a broad flattened process overhanging the glenoid fossa; it articulates with the clavicle and gives attachment to part of the deltoid muscles. Its lateral border is a palpable landmark (“the point of the shoulder”).
Term
coracoid process
Definition
long, curved projection resembling a flexed finger arising from the neck of the scapula overhanging the glenoid cavity; it gives attachment to the short head of the biceps, the coracobrachialis, and the pectoralis minor muscles, and the conoid and coracoacromial ligaments
Term
True (vertebrocostal) ribs
Definition
1st-7th ribs. Attach directly to the sternum through their own costal cartilages
Term
False (vertebrochondral) ribs
Definition
8th, 9th, and usually 10th ribs. Cartilages are connected to the cartilage of the rib above them, thus their connection to the sternum is indirect
Term
Floating (vertebral, free) ribs
Definition
11th, 12th, and sometimes 10th ribs. Cartilages do not even connect directly with the sternum but end in the posterior abdominal musculature
Term
Costal cartilage
Definition
the cartilage forming the anterior continuation of a rib, providing the means by which it reaches and articulates with the sternum.
Term
Costal margin
Definition
that portion of the inferior aperture (opening) of the thorax formed by the articulated cartilages of the seventh to tenth (false) ribs.
Term
Intercostal spaces
Definition
an interval between the ribs, occupied by intercostal muscles, veins, arteries, and nerves
Term
Manubrium
Definition
Widest, thickest, and the superior part of the sternum
Term
sternum
Definition
flat, elongated bone that forms the middle of the anterior part of the thoracic cage
Term
body of the sternum
Definition
longer, narrower and thinner than the manubrium, and is located at the level of the T5-T9 vertebrae
Term
xiphoid process
Definition
smallest part of the sternum, thin, elongated, and its inferior end lies at the level of T10 vertebra.
Term
jugular (suprasternal) notch
Definition
easily palpated concave center of the superior border of the manubrium
Term
sternal angle
Definition
projection formed by the manubriosternal joint (where the body and manubrium meet)
Term
xiphisternal join
Definition
Where the xiphoid process connects to the sternal body
Term
Sternocostal joint
Definition
the joints between the cartilages of the first seven ribs and the sternum
Term
What part of the sternum do each rib articulate?
Definition
1st rib with manubrium, 2nd rib with sternal angle, 3rd to 7th ribs with body
Term
head of the rib
Definition
articulates with vertebral column
Term
sternal end of the rib
Definition
anterior end that articulates with its costal cartilage
Term
supraclavicular area
Definition
region above the upper border of the clavicle
Term
subclavicular area
Definition
region below the lower border of the clavicle
Term
subxiphoid area
Definition
region immediately below the lower end of the palpable sternum
Term
midsternal line
Definition
midline of the anterior chest wall
Term
left sternal border (LSB)
Definition
lateral to the left border of the sternum
Term
right sternal border (RSB)
Definition
lateral to the right broder of the sternum
Term
midclavicular line
Definition
vertical line that passes through the midpoint of the clavicle, at its bend between the convex and concave areas. It commonly passes through the medial side of the nipple
Term
anterior axillary line
Definition
extends inferiorly from the anterior axillary (underarm) fold (lateral edge of the pectoralis major muscle) along the lateral chest wall
Term
posterior axillary line
Definition
extends inferiorly from the posterior axillary (underarm) fold (lateral edge of the latissimus dorsi msucle) along the lateral chest wall
Term
midaxillary line
Definition
extends from the middle of the axilla (underarm, armpit) inferiorly along the middle of the lateral chest wall
Term
Anterior and Posterior landmarks of T2 vertebral level
Definition
Anterior is suprasternal notch, Posterior is T2 spinous process
Term
Anterior and posterior landmarks of T4 vertebral level
Definition
Anterior is sternal angle, posterior is T4 spinous process
Term
Anterior and posterior landmarks of T9 vertebral level
Definition
anterior is xiphisternal junction, posterior is T9 spinous process
Term
Nipple
Definition
the greatest prominence of the breast
Term
areola
Definition
circular pigmented area of skin that surrounds the nipple
Term
axillary tail
Definition
A small part of the mammary gland that extends along the inferolateral edge of the pectoralis major toward the axillary fossa (armpit)
Term
Rib fractures
Definition
Usually result from blows or crushing blows. Most common fractures are to the middle ribs. Weakest part of a rib is just anterior to its angle.
Term
Ossification of the xiphoid process
Definition
People in their 40s first become aware of their partly ossified xiphoid process and incorrectly fear they have a tumor
Term
median sternotomy
Definition
when the sternum is divided (split) in the median plane and retracted to allow access to the thoracic cavity for surgical operations in the mediastinum
Term
dislocation of the ribs
Definition
Displacement of a costal cartilage from the sternum (dislocation of a sternocostal joint or the displacement of the interchondral joints).
Term
separation of ribs
Definition
Dislocation of the costochondral junction between the rib and its costal cartilage
Term
paralysis of diaphragm
Definition
Half of the diaphragm can become paralyzed without affecting the other half. This can be detected radiographically by noting its paradoxical movement.
Term
What are the four breast quadrants?
Definition
superior medial, superior lateral, inferior medial, and inferior lateral
Term
Axillary lymph nodes
Definition
Where most of lymphatic drainage of the breast goes to
Term
Lymph nodes where breast cancers can metastasize
Definition
axillary, cervical, parasternal, supraclavicular, opposite breast, abdomen lymph nodes
Term
polythelia
Definition
Accessory nipples that can develop superior or inferior to the normal pair, occasionally developing in the axillary fossa or anterior abdominal wall
Term
hemidiaphragm
Definition
either the left or right functional half of the diaphragm. Although the diaphragm is a single anatomic unit, it is divided by the union of its central tendon and the pericardium into separate leaves, each with its own nerve supply, and each hemidiaphragm can function independently
Term
splenic flexur
Definition
a sharp bend between the transverse and the descending colon in the left upper quadrant of humans
Term
splenic flexur
Definition
a sharp bend between the transverse and the descending colon in the left upper quadrant of humans
Term
hilum of lung
Definition
radiologically, the composite shadow of the main pulmonary arteries, veins, and lymph nodes in the lung root adjacent to the anatomic hilum (which is a wedge-shaped depression on the mediastinal surface of each lung, where the bronchus, blood vessels, nerves, and lymphatics enter or leave the viscus)
Term
Gastric bubble
Definition
Air in the stomach
Term
aortic knuckle
Definition
the contour of the aortic arch protruding from the mediastinal silhouette in an anteroposterior (AP) radiograph of the chest.
Term
What to look for in lung fields in a PA chest film of lungs?
Definition
Lung fields should be of equal transradiancy and one should not be any whiter or darker than the other. One of the first signs of lung disease is loss of volume of that lung and so you need to determine whether either of the lung fields are smaller than they should be.
Term
What to look for in hilum of lungs in a PA chest film?
Definition
The left hilum should be higher than the right hilum, and they should look similar to each other.
Term
What to look for in heart of a PA chest film?
Definition
Check that heart is of normal shape and that the maximum diameter is less than half of the transthoracic diameter
Term
What to look for in mediastinum of PA chest film?
Definition
The edge of the mediastinum should be clear. A fuzzy edge suggests a problem with the neighboring lung (i.e., collapse).
Term
What to look for in diaphragm in a PA chest film?
Definition
The right diaphragm should be higher than the left and this can be remembered by thinking of the heart pushing the left diaphragm down. The outline of the diaphragm should be smooth
Term
What to look for in costophrenic angle in a PA chest film?
Definition
They should be well-defined acute angles.
Term
What to look for in trachea in a PA chest film?
Definition
This should be central but deviated slightly to the right around the aortic knuckle. The aortic knuckle is the contour of the aortic arch protruding from the mediastinal silhouette. If the trachea has been shifted it suggests a problem within the mediastinum or pathology within one of the lungs.
Term
What to look for in bones in a PA chest film?
Definition
Look at the ribs, scapulae and vertebrae. Follow the edges of each individual bone to look for fractures. Look for areas of blackness within each bone and compare the density of the bones which should be the same on both sides.
Term
What to look for in soft tissue in a PA chest film?
Definition
Look for any enlargement of soft tissue areas.
Term
What to look for in area under the diaphragm in a PA chest film?
Definition
Look for air under the diaphragm or obviously dilated loops of bowel. Abdominal pathology can occasionally present with chest symptoms.
Term
Dislocated rib fracture
Definition
A rib fracture is a crack or break in one of the bones of the thoracic cage. A break in the cartilage that connects the ribs to the sternum may also be called a fractured rib, even if the bone itself is not broken.
Term
Sternomanubrial dislocation
Definition
There is posterior dislocation of the body of the sternum in relation to the manubrium of the sternum
Term
cranio-caudal view (CC) mammogram
Definition
taken from above a horizontally-compressed breast (bird's eye view): this view will show as much as possible of the glandular tissue (ducts and lobes), the surrounding fatty tissue and the outermost edge of the chest muscle. The nipple will be shown in profile. The CC view can't capture much of the breast tissue that is in the armpit and upper chest.
Term
mediolateral-oblique view (MLO) of mammogram
Definition
taken from the side and at an angle of a diagonally-compressed breast: the angle of an MLO allows more of the breast tissue to be imaged (it covers the main area of the breast) as well as the tissue in the armpit. It will show glandular as well as fatty tissue, and it gives a larger area than a CC view.
Term
mammogram calcifications
Definition
Calcium deposits within breast tissue. They appear as white spots or flecks on a mammogram. They are usually noncancerous (benign), but certain patterns of calcifications — such as tight clusters with irregular shapes — may indicate breast cancer
Term
Key characteristic of fibroadenoma
Definition
large calcifications
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