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Flashcards

RCA Thoracic wall:

Binura Wijesinghe English 47 cards

RCA Thoracic wall:

Cards in this deck (47)

  1. 1Name the 3 functions of the thorax:The functions of the thorax include:
    1. Breathing.
    2. Protection of vital organs, including abdominal organs.
    3. Provide a passage for structures which pass through (trachea, bronchi, aorta and esophagus).    Name the 3 functions of the thorax:
  2. 2Name the structure: Describe whether it is protected by the thorax or not:This is the apex of the lung.
    It is above the 1st rib and is therefore not protected by the thoracic cavity.    Name the structure: Describe whether it is protected by the thorax or not:Name the structure: Describe whether it is protected by the thorax or not:
  3. 3Name the surgical approach shown: Describe the surgical approach and the uses:Posterolateral thoracotomy: either via the 5th intercostal space or periosteal bed. This is the standard approach for operations on the lung and posterior mediastinum.Name the surgical approach shown: Describe the surgical approach and the uses:Name the surgical approach shown: Describe the surgical approach and the uses:
  4. 4Name the surgical approach the incision line suggests:Anterior thoracotomyName the surgical approach the incision line suggests:
  5. 5Name the surgical approach suggested by the incision line: What are its uses:Median sternotomy: Used to approach the heart and the aorta. In addition, this incision can be extended upwards into the cervical region.Name the surgical approach suggested by the incision line: What are its uses:Name the surgical approach suggested by the incision line: What are its uses:
  6. 6Name the surgical approach suggested by the incision line:Partial sternotomy: An incision through only a part of the sternum.Name the surgical approach suggested by the incision line:
  7. 7Name the surface landmark indicated by 1: What structure lies deep to 1:Surface landmark: Suprasternal/jugular notch
    Deep to the notch is the trachea    Name the surface landmark indicated by 1: What structure lies deep to 1:Name the surface landmark indicated by 1: What structure lies deep to 1:
  8. 8Name the surface landmark indicated by the arrow: Name the level this landmark is with reference to the ribs and vertebra:Surface landmark: Sternal angle
    Level: At the Level of rib 2 and the inferior border of the 4th thoracic vertebra    Name the surface landmark indicated by the arrow: Name the level this landmark is with reference to the ribs and vertebra:
  9. 9Name the surface landmark labelled 2:Surface landmark: Xiphoid processName the surface landmark labelled 2:Name the surface landmark labelled 2:
  10. 10Name the surface landmark highlighted by the arrow:Surface landmark: Infrasternal (subcostal) angleName the surface landmark highlighted by the arrow:Name the surface landmark highlighted by the arrow:
  11. 11Name the surface landmark:Surface landmark: Costal margin/archName the surface landmark:Name the surface landmark:
  12. 12Name the surface landmarks labelled:A: Suprasternal/jugular notch
    B: Sternal angle
    C: Anterior median line
    D: Mid-clavicular line    Name the surface landmarks labelled:Name the surface landmarks labelled:
  13. 13Name the surface landmarks labelled E, F, G:E: Posterior axillary line
    F: Midaxillary line
    G: Anterior axillary line    Name the surface landmarks labelled E, F, G:Name the surface landmarks labelled E, F, G:
  14. 14Name the surface landmarks unlabelled:Name the surface landmarks unlabelled:Name the surface landmarks unlabelled:
  15. 15Name the surface landmark: Name the rib level of the surface landmark:Surface landmark: Inferior angle of scapula
    Rib level: 7    Name the surface landmark: Name the rib level of the surface landmark:
  16. 16Name the surface landmark labelled with the red dot arrow:Surface landmark: Anterior axillary foldName the surface landmark labelled with the red dot arrow:Name the surface landmark labelled with the red dot arrow:
  17. 17Describe the layers of the superficial thoracic wall:1. Skin
    2. Subcutaneous tissue:
    -Fat.
    -Superficial skin ligaments- these are fibrous bundles which attach the dermis to the deep fascia (or epimysium of shoulder girdle muscles) and they are well developed over the breasts. If they support an organ they are called suspensory ligaments, and in the breasts they are called Cooper’s ligaments.
    -Superficial blood vessels.
    -Cutaneous nerves.
    3. Deep fascia    Describe the layers of the superficial thoracic wall:
  18. 18Why does breast tissue sag with breast cancer?Breast cancer causes shrinkage of the superficial skin ligaments, which are suspensory in function, and in the breasts called Cooper's ligaments.Why does breast tissue sag with breast cancer?
  19. 19—
  20. 20Name the structures deep to the deep fascia: Describe their distribution:Deep to the deep fascia are the shoulder girdle muscles.
    Anteriorly there is the pectoralis major and minor.
    Anterior and posterior is the serratus anterior.
    Posterior is the latissimus dorsi as well as the trapezius.
    Deep to the shoulder girdle muscles are the intercostal muscles.    Name the structures deep to the deep fascia: Describe their distribution:
  21. 21Describe the nature of interaction between the pectoral region and the thoracic wall:The pectoral region is not a part of the thoracic wall but contributes to its functions; deep respiration and protection.
  22. 22Name the muscles which cover the lower part of the thoracic wall:Serratus anterior and the abdominal muscles; rectus abdominus and external oblique.Name the muscles which cover the lower part of the thoracic wall:
  23. 23Name the muscles which cover the upper thoracic wall:Pectoralis major and minorName the muscles which cover the upper thoracic wall:
  24. 24Name the muscles which are divided by this surgical approach: Name the blood vessel the branches of which are controlled in this surgical approach:Muscles: Pectoralis major and minor, and serratus anterior.
    Blood vessel: Thoracoacromial artery (clamp off branches which provide blood supply to the muscles which are divided).    Name the muscles which are divided by this surgical approach: Name the blood vessel the branches of which are controlled in this surgical...Name the muscles which are divided by this surgical approach: Name the blood vessel the branches of which are controlled in this surgical...
  25. 25Name the surgical approach which uses the fatty/auscultatory triangle: Describe the borders of the fatty triangle: Describe the benefits of surgery through this approach: What could be a barrier to this approach:Surgical approach: Posterior thoracotomy
    Borders: space between the scapula, posterior border of the latissimus dorsi and the anterior border of the trapezius.
    Benefits: The muscle sparing approach involves approach via the fatty triangle, preserving the serratus and latissimus dorsi muscles. This is ideal in patients with borderline respiratory function since these are secondary respiratory muscles. However, if the musculature is well developed, adequate access is difficult through this approach.    Name the surgical approach which uses the fatty/auscultatory triangle: Describe the borders of the fatty triangle: Describe the benefits ...
  26. 26Name the anterior, lateral and posterior thoracic skeletal elements:Anterior: Sternum
    Lateral: 12 ribs
    Posterior: 12 thoracic vertebrae    Name the anterior, lateral and posterior thoracic skeletal elements:Name the anterior, lateral and posterior thoracic skeletal elements:
  27. 27Describe the borders of the superior thoracic aperture:Superior thoracic aperture: Formed by the 1st thoracic vertebra posteriorly, the medial margin or rib 1 either side and the manubrium of the sternum anteriorly.Describe the borders of the superior thoracic aperture:Describe the borders of the superior thoracic aperture:
  28. 28Describe the borders of the inferior thoracic aperture:Inferior thoracic aperture: Formed by the 12th thoracic vertebra posteriorly, medial margin of rib 12 either side, end of rib 11, the costal margin (end of ribs 7-10) and the xiphoid process anteriorly.Describe the borders of the inferior thoracic aperture:Describe the borders of the inferior thoracic aperture:
  29. 29Name the structure:Intervertebral discName the structure:
  30. 30Name the joint indicated:Joint: SternocostalName the joint indicated:
  31. 31Name the joint indicated:Joint: CostovertebralName the joint indicated:
  32. 32Describe in general the contents of the intercostal spaces:It is filled by the 3 layers of the intercostal muscles (external, internal and innermost).
    There are also blood vessels and nerves (anterior and posterior intercostal arteries and veins, and the intercostal nerves).    Describe in general the contents of the intercostal spaces:Describe in general the contents of the intercostal spaces:
  33. 33Name the muscle: Direction of fibres: Function: Completeness of muscle around thorax:External intercostals
    Direction: hands in pockets-way of remembering the direction of fibres, downwards and medially.
    Function: When it contracts it elevates the rib cage during inspiration.
    Completeness: Does not extend all the way to attach to the sternum. Instead, the attachment is completed by the anterior intercostal membrane.    Name the muscle: Direction of fibres: Function: Completeness of muscle around thorax:Name the muscle: Direction of fibres: Function: Completeness of muscle around thorax:
  34. 34Name the muscle: Direction of fibres: Function: Completeness of muscle around thorax:Internal intercostals
    Direction: up and out.
    Function: Depress the rib cage during forced expiration.
    Completeness: Does not extend all the way to attach to the vertebrae. Instead, the attachment is completed by the posterior intercostal membrane.    Name the muscle: Direction of fibres: Function: Completeness of muscle around thorax:Name the muscle: Direction of fibres: Function: Completeness of muscle around thorax:
  35. 35Name the 3 muscles which comprise the innermost layer of intercostal muscles:Anteriorly: Transversus thoracis.
    Laterally: Innermost intercostals.
    Posteriorly: Subcostalis.    Name the 3 muscles which comprise the innermost layer of intercostal muscles:
  36. 36Name the structure pointed to:Transversus thoracisName the structure pointed to:Name the structure pointed to:
  37. 37Name the structure:Subcostalis muscleName the structure:Name the structure:
  38. 38Name the structure highlighted:Innermost intercostal muscleName the structure highlighted:Name the structure highlighted:
  39. 39Name the structure highlighted: From superior to inferior, name the structures which run in this:Structure: Costal groove, found on the inner surface of the inferior border of each thoracic rib.
    From superior to inferior, intercostal vein, artery and nerve run in the costal groove.    Name the structure highlighted: From superior to inferior, name the structures which run in this:Name the structure highlighted: From superior to inferior, name the structures which run in this:
  40. 40Name the muscle layers between which the intercostal vessels and nerves run in, in the costal groove.Between the internal and innermost intercostal muscle layers.Name the muscle layers between which the intercostal vessels and nerves run in, in the costal groove.
  41. 41Name the structure highlighted: Origin: Course: Supplies:Posterior intercostal artery
    Origin: Thoracic aorta
    Course: Enters the intercostal space at the posterior border of the innermost intercostal muscle layer and then anastomoses with the anterior intercostal artery.
    Supplies: Bone, muscle, subcutaneous tissue and skin.    Name the structure highlighted: Origin: Course: Supplies:Name the structure highlighted: Origin: Course: Supplies:
  42. 42Name the structure highlighted: Origin: Course: Supplies:Anterior intercostal artery
    Origin: Internal thoracic artery (a branch of the subclavian artery).
    Course: Enters the intercostal space at the anterior border of the innermost layer of intercostal muscles and anastomoses with the posterior intercostal artery.
    Supplies: Bone, muscle, subcutaneous tissue and skin.    Name the structure highlighted: Origin: Course: Supplies:Name the structure highlighted: Origin: Course: Supplies:
  43. 43Name the structure highlighted: Course: Drainage:Posterior intercostal vein
    Course: Runs in the intercostal space and anastomoses with the anterior intercostal vein.
    Drainage:
    Left side: 1st intercostal vein drains into brachiocephalic.
    2-8 into superior hemiazygos, 9-11 into inferior hemiazygos. The hemiazygos veins drain into the azygos.
    Right side: 1st into brachiocephalic, 2-3 into right superior intercostal vein which drains into azygos, 4-11 into azygos direct. Azygos drains into SVC.    Name the structure highlighted: Course: Drainage:Name the structure highlighted: Course: Drainage:
  44. 44Name the structure highlighted: Course: Drainage:Anterior intercostal vein
    Course: Runs in the costal groove and anastomoses with the posterior intercostal vein.
    Drainage: Internal thoracic vein which drains into the subclavian vein and then SVC.    Name the structure highlighted: Course: Drainage:Name the structure highlighted: Course: Drainage:
  45. 45Name the structures superficial and deep to the intercostal space:Superficial: Shoulder girdle muscles.
    Deep: Endothoracic fascia and parietal pleura.    Name the structures superficial and deep to the intercostal space:
  46. 46Describe the constituents of the endothoracic fascia: Describe the function of the endothoracic fascia:Constituents: Bundles of collagen, fibroblasts and adipocytes.
    Function: This layer is essential for respiration as it anchors the parietal pleura onto the periosteum or epimysium of the chest wall muscles. This is essential for expansion of the lungs with expansion of the thoracic cavity. Also provides an extrapleural surgical plane.    Describe the constituents of the endothoracic fascia: Describe the function of the endothoracic fascia:Describe the constituents of the endothoracic fascia: Describe the function of the endothoracic fascia:
  47. 47Name the layers encountered by approach of the lung through: 1. Intercostal space 2. Periosteal bed 3. Median sternumName the layers encountered by approach of the lung through: 1. Intercostal space 2. Periosteal bed 3. Median sternum

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Description
RCA Thoracic wall
Created by
Binura Wijesinghe · Sep 2016
Updated
Jan 18, 2017
Views
13
History
  • Created by Ashutosh Kumar · Sep 14, 2016
  • Copied by Binura Wijesinghe · Sep 18, 2016
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