what are teh layers of the thoracic wall from superficial to deep
skin
superficial fascia
msucles of upper limb, covered by deep fascia: atatched to bones
intercostal muscles: attached to ribs
endothoracic fascia (areolar CT that lines thoracic wall)
parietal pleura (a thin membrane that lines teh cavities that house the lungs)
thoracic cavity
what is the bony architecthre of teh thorax
thoracic vertebrae
ribs
sternum: manubrium, body (sternal angle), xiphoid process
what is the sternal angle
junction of manubrium and body forms prominent horizontal ridge that may be easily palpated: costal cartilage of 2nd rib attaches here
what are the muscles of the upper limb
pectoralis major
pectoralis minor
serratus anterior
how many intercostal spaces are there
11
what is the fiber direction of the external intercostals
inferomedially (down and in)
what is the outermost intercostal muscle layer
external intercostals
where are the external intercostals present
everywhere but the front 1/2
where is the external intercostal membrane
front 1/2 near sternum
what direction do the external intercostals go
inferomedially
" hands in pockets"
what takes over where there is no external intercostal muscles
anterior/external intercostal membrane
where are the internal intercostals present
sternum to angles
what direction do fibers run of the internal intercostals
inferolaterally
what is present where there is not internal intercostals
posterior/internal intercostal membrane
where are teh innermost intercostals
from sides of body to back
where is the transversus thoracis
just in front near the sternum, maybe half of where the external intercostal membrane is
what is present where the transversus thoracis and innermost intercostal isn't
common membrane of innermost intercostal and transversus thoracis
what direction do the fibers of the innermost intercostals run
inferolaterally
what innervates the thoracic wall
anterior rami of T1 to T11, called intercostal nerves
where do the main branches of intercostal nerves run
costal groove of rib just below the said rib
where do the collateral branches of the intercostal nerves run
just above the rib, no groove
what is the order of the intercostal vein, artery, and nerve in teh costal groove
superior to inferior VAN
whta are the blood vessels in intercostal spaces called
intercostal vessels
- there are anterior and posterior intercostal vessels
where do the main branches of intercostal vessels run
with nerve in costal groove
what is the internal thoracic artery a branch of
subclavian artery
what are teh branches of the internal thoracic artery
first6 anterior intercostal arteries
musculophrenic artery
superior epigastric artery
what is a continuation of the internal thoracic artery
superior epigastric artery
what will the musculophrenic artery give off
branches 7-9 of anterior intercostal arteries
what large arteries supply the posterior intercostal area
supreme intercostal artery
descending aorta
which posterior intercostal arteries are supplied by the supreme intercostal artery
1 and 2
which posterior intercostal arteries are supplied by the descending aorta
3-11
when removing fluid/pus from thoracic cavity, where would you stick needle: just superior to rib or just inferior?
just superior to avoid intercostal nerve that lies below every rib
what is the breast drainage system like
axillary and parasternal lymph nodes
what are the axillary lymph nodes
pectoral
subscapular
humeral (lateral)
central
apical
what are the main points of interest on the thoracic diaphragm
central tendon
aortic opening
esophageal opening
caval opening
where is the aortic opening
T12
where is the esophageal opening
T10
where is the caval opening
T8
what innervates the diaphragm
C3, C4, C5
what four structures form the diaphram embryologically
septum transversum
2 pleuroperitoneal membranes (folds)
dorsal mesentery of the esophagus
lateral body walls
what is the septum transversum
transverse sheet of mesoderm that separates the pericardial (heart) cavity from the peritoneal cavity
what are the pleuroperitoneal membranes/folds
membranes taht are forming as the lungs develop
what is the dorsal mesentery of the esophagus
mesentery of peritoneum holding the esophagus in place
what are the lateral body walls
muscular components
how is the septum transversum originally oriented
lies at C3-C5 somite levels (hence its innervation)
why does the dorsal part of the diaphragm migrate from C5 to L1?
due to rapid growth of the dorsal part of the body during weeks 5-7
what is a congenital diaphragmatic hernia
result of one of the pleuroperitoneal membranes failing to completely form/fuse with the other diaphragm components, usually on the left side