Thorax Comprehensive Exams
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| True Ribs | first 7 ribs, attached directly to sternum through own costal cartilages |
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| Typical Ribs | 3rd to 9th ribs; head -> wedge shaped w/ 2 facets separated by crest of head, facet articulate with corresp. vert. & superior to it. Neck->connects head w/ shaft at level of tubercle; tubercle & shaft |
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| manubrium | lies @ level of bodies of T3 & T4 vert; thickest & widest of 3-part sternum; 1st rib fuses w/lateral border of manubr. (sternocostal synchondrosis); angle of Louis @ 2nd cost. cart. @ level of IVD <-> T4 & T5 |
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| Xiphoid Process | lies @ T10 vert; cartilaginous in young people but ossified older than 40 yrs old, may fuse w/sternal body in elderly; important landmark: inferior limit of central thorax of inferior thor. aperture; midline marker for liver & inferior border of heart |
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| Serratus Posterior Superior | lies @ junction of neck & back; PA: nuchal lig, sp. proc. C7-T3 vert; DA: superior borders of 2-4 ribs; INN: 2nd-5th intercost. nrvs; ELEVATES superior 4 ribs, raises sternum & increases diameter of thorax |
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| Serratus Posterior Inferior | lies @ junction of thorac. & lumbar regions; PA: sp. proc. of T11-L2 vert; DA: inferior borders of 8-12 ribs near angles; INN: ventral rami of 9-12 t/spinal nrvs; DEPRESS RIBS preventing superior displacement by diaphram |
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| External Intercostals | muscles of inspiration - elevates ribs; 11 pairs; occupies between tubercles of ribs posteriorly to costochondral junctions anteriorly; run inferanteriorly from rib above to below; continuous w/ extern. oblique |
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| Internal Intercostals | muscles of expiration; 11 prs run deep to & at right angles to external intercostals, inferoposterior from floors of costal grooves to superior borders of ribs inferior to them; continuous w/ internal oblique muscles |
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| Pulmonary Veins | 2 on each side, carries oxygenated (arterial) blood from lungs to left atrium; |
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| Left Coronary Artery | arise from left aortic sinus of ascending aorta & passes <-> left aurical & pulm trunk; @ left end of coronary groove LCA splits into 2 branches -> anterior interventric. branch & circumflex branch | (blank)
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| Coronary Sinus | main vein of heart; receives anterior interventric. vein or GREAT CARDIAC VEIN at left & posterior intervent. (middle cardiac vein) & small cardiac veins at right. | (blank)
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| Superior Vena Cava (SVC) | returns blood from all structure superior to diaphragm except lungs & heart; passes infer. & ends @ level of 3rd costal cart. & enters right atrium; SVC lies in right side of superior mediastinum, anterolateral to trachea & posterolateral to ascend. aorta | (blank)
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| External Oblique | largest & most superficial of 3 flat anterolat. abdom. muscles; muscles anterolateral, aponeurosi anterior; direction of "fingers in pant pocket"; as muscle fibres pass infermedially, becomes aponeurotic approx. @ mid-clav. line & decussate @ linea alba | medial to pubic tubercle, external oblique apon. attaches to pubic crest; inferiorly, inferior margin of apon. thickens & folds back to form inguinal lig. (<-> ASIS & pubic tubercle)
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| Transverse Abdominal | innermost of 3 flat abdom. muscles (tranversomedial fibre direction) except for inferior ones that run parallel to internal oblique; fibres end in apon. contributing to formation of rectus sheath | look up attachments
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| Psoas Major | long thick fusiform; lies lateral to lumbar vert.; passes inferolat. deep to inguinal lig. to lesser trochanter of femur | PA: transverse proc. of lumbar vert, sides of bodies of T12-L5 & intervening IVD; DA: strong tendon to lesser trochanter; INN: Lumbar plexus via ventral branches of L2-L4 nrv
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| Quadratus Lumborum | thick musc. sheet in poster. abdom. wall; lies adjacent to lumbar transv. process; crossed by LATERAL ARCUATE LIG. | subcostal nerve passes posterior to lig & runs inferolaterally on QL; branches of lumbar plexus run inferiorly on anterior surface of muscle
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| Ilium | superior, flattened, fan-shaped part of hip bone; ALA is body & handle; BODY helps form acetabulum; iliac crest is rim of fan follows contour of ALA <-> ASIS & PSIS; anterior concave part forms iliac fossa | (blank)
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| Ischium | body & ramus; helps to form acetabulum & ramus forms obturator foramen; large posteroinferior protuberance is ischial tuberosity; small pointed posterior projection near junction of ramus & body is ishial spine | concavity <-> ischial spine & tuberosity is lesser sciatic notch; larger concavity is greater sciatic notch superior to ischial spine & is formed in part of ilium
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| Greater Pelvis | pelvis major or false pelvis; superior to pelvic inlet; location of abdom. viscera (ileum & sigmoid colon); bounded by abdom. wall anteriorly, iliac fossae posterolater & L5 & S1 vert posteriorly; cavity of greater pelvis is inferior part of abdom. cavity | (blank)
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| Sacroiliac joints | sacrum suspended <-> iliac bones & attached by interosseous & SI lig.; mvmt of slight gliding & rotary; sacrotuberous & sacrospinous lig. only limit upward mvmt of inferior end of sacrum thus provide resilience to SI region when weight increases in vert. | (blank)
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| Lateral Pelvic Wall | formed by hip bones & obturator foramen, closed by obturator membrane; obturator internus muscle cover & pad most of lat. pelv. wall; medial to muscle is obturator nrv & internal iliac vessels | obturator internus pass posteriorly from lesser pelvis thru lesser sciatic foramen & turns sharply laterally to attach to greater trochanter of femur
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| posterior pelvic wall | formed by sacrum & coccyx, adjacent parts of ilia & SI jts. Piriformis cover & pad wall posterlaterally. Each muscle leaves lesser pelvis thru greater sciatic foramen to attach to greater trochanter. Sacral plexus are medial to piriformis | (blank)
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| pelvic floor | formed by funnel-shaped pelvic diaphragm (levator ani & coccygeus); streches <-> pubis anter. & coccyx poster. & from lateral wall to other | levator ani attached to internal surface of lesser pelvis; 3 parts -> pubococcygeus, puborectalis & iliococcygeus; forms muscular sling supporting abdominpelvic viscera
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