Podcast
Questions and Answers
What is the endpoint of the right superior intercostal vein?
What is the endpoint of the right superior intercostal vein?
- Left brachiocephalic vein
- SVC (correct)
- Inferior vena cava
- Brachiocephalic vein
The inferior vena cava (IVC) drains which posterior intercostal veins?
The inferior vena cava (IVC) drains which posterior intercostal veins?
- 1st to 5th
- 5th to 10th
- 4th to 11th (correct)
- 1st to 3rd
Which vein receives the anterior intercostal veins?
Which vein receives the anterior intercostal veins?
- Superior vena cava
- Hemiazygos vein
- Azygos vein
- Internal thoracic vein (correct)
What does the left superior intercostal vein drain?
What does the left superior intercostal vein drain?
Which of the following veins receives blood from the left side?
Which of the following veins receives blood from the left side?
What is the origin of the azygos vein?
What is the origin of the azygos vein?
The superficial lymphatics of the thoracic wall primarily drain into which nodes?
The superficial lymphatics of the thoracic wall primarily drain into which nodes?
The deep lymphatics from the posterior wall drain primarily into which lymph nodes?
The deep lymphatics from the posterior wall drain primarily into which lymph nodes?
Which joint allows the rib to articulate with the corresponding vertebra and the vertebra above?
Which joint allows the rib to articulate with the corresponding vertebra and the vertebra above?
What is the site of the weakest point of the rib?
What is the site of the weakest point of the rib?
Which layer does the external intercostal muscle originate from?
Which layer does the external intercostal muscle originate from?
Where are the intercostal vessels and nerve located within the intercostal space?
Where are the intercostal vessels and nerve located within the intercostal space?
What is the direction of the fibers of the internal intercostal muscle?
What is the direction of the fibers of the internal intercostal muscle?
Which muscle is located only in the lateral part of the thoracic wall?
Which muscle is located only in the lateral part of the thoracic wall?
What is the insertion of the transversus thoracis muscle?
What is the insertion of the transversus thoracis muscle?
At which point does the external intercostal muscle get replaced by a membrane?
At which point does the external intercostal muscle get replaced by a membrane?
Which structure runs along the inferior border of the rib?
Which structure runs along the inferior border of the rib?
What type of joint are the costo-vertebral joints?
What type of joint are the costo-vertebral joints?
Which artery is a branch of the subclavian artery?
Which artery is a branch of the subclavian artery?
What are the anterior intercostal arteries sourced from?
What are the anterior intercostal arteries sourced from?
What is the main function of the internal thoracic vein?
What is the main function of the internal thoracic vein?
Which artery supplies the upper six intercostal spaces?
Which artery supplies the upper six intercostal spaces?
Where do the 1st right and left posterior intercostal veins terminate?
Where do the 1st right and left posterior intercostal veins terminate?
What branches supply the lower five intercostal spaces?
What branches supply the lower five intercostal spaces?
Which artery provides branches to the thymus gland?
Which artery provides branches to the thymus gland?
What is the origin of the posterior intercostal arteries?
What is the origin of the posterior intercostal arteries?
What is the primary function of the intercostal muscles during inspiration?
What is the primary function of the intercostal muscles during inspiration?
Which muscles assist in fixing the first rib during inspiration?
Which muscles assist in fixing the first rib during inspiration?
What action do internal intercostal muscles perform during forced expiration?
What action do internal intercostal muscles perform during forced expiration?
How does the contraction of the diaphragm affect the thoracic cavity?
How does the contraction of the diaphragm affect the thoracic cavity?
Which type of movement does the elevation of the ribs resemble?
Which type of movement does the elevation of the ribs resemble?
What is a key characteristic of the subcostal muscles?
What is a key characteristic of the subcostal muscles?
Which diameter of the thoracic cavity is increased by the movement of the sternum during inspiration?
Which diameter of the thoracic cavity is increased by the movement of the sternum during inspiration?
What is the role of the quadratus lumborum muscle during forced expiration?
What is the role of the quadratus lumborum muscle during forced expiration?
What is the primary action of the transversus thoracis muscle?
What is the primary action of the transversus thoracis muscle?
Which intercostal nerve is referred to as the subcostal nerve?
Which intercostal nerve is referred to as the subcostal nerve?
Which branch is NOT typically found in a typical intercostal nerve?
Which branch is NOT typically found in a typical intercostal nerve?
What characterizes the atypical 1st intercostal nerve?
What characterizes the atypical 1st intercostal nerve?
Where do the typical intercostal nerves mostly originate from?
Where do the typical intercostal nerves mostly originate from?
What is the function of the 7th to 11th intercostal nerves?
What is the function of the 7th to 11th intercostal nerves?
Which artery does NOT supply the thoracic wall?
Which artery does NOT supply the thoracic wall?
What is a branch of the typical intercostal nerves responsible for supplying intercostal muscles?
What is a branch of the typical intercostal nerves responsible for supplying intercostal muscles?
What distinguishes the 2nd intercostal nerve from the typical intercostal nerves?
What distinguishes the 2nd intercostal nerve from the typical intercostal nerves?
What is the course of typical intercostal nerves?
What is the course of typical intercostal nerves?
Which of the following ribs are considered true ribs?
Which of the following ribs are considered true ribs?
What structure closes the thoracic outlet?
What structure closes the thoracic outlet?
Which of the following statements about typical ribs is correct?
Which of the following statements about typical ribs is correct?
What type of joint is formed at the costochondral junction?
What type of joint is formed at the costochondral junction?
Which rib is classified as atypical due to its specific structural characteristics?
Which rib is classified as atypical due to its specific structural characteristics?
Which vertebral level corresponds to the upper border of the manubrium sterni?
Which vertebral level corresponds to the upper border of the manubrium sterni?
What constitutes the anterior boundary of the thoracic inlet?
What constitutes the anterior boundary of the thoracic inlet?
Which of the following best describes the location of the xiphisternal joint?
Which of the following best describes the location of the xiphisternal joint?
Which vessels and nerves are contained within the thoracic inlet?
Which vessels and nerves are contained within the thoracic inlet?
Which of the following distinguishes the 11th and 12th ribs from typical ribs?
Which of the following distinguishes the 11th and 12th ribs from typical ribs?
What is the main function of intercostal muscles?
What is the main function of intercostal muscles?
Which structure serves as the posterior boundary of the thoracic outlet?
Which structure serves as the posterior boundary of the thoracic outlet?
What role do intercostal arteries play?
What role do intercostal arteries play?
Which type of joint connects the vertebral bodies in the thoracic spine?
Which type of joint connects the vertebral bodies in the thoracic spine?
Flashcards
Costo-Vertebral Joint
Costo-Vertebral Joint
The joint where a typical rib articulates with the corresponding vertebra (same number) and the vertebra above it.
Costovertebral Joint
Costovertebral Joint
The articulation between the rib and its corresponding vertebra. This is a synovial joint.
Costochondral Junction
Costochondral Junction
The weakest point of the rib, located just in front of the angle, where the rib twists. This is the most common site for rib fractures.
Costal Groove
Costal Groove
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Intercostal Space
Intercostal Space
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External Intercostal Muscle
External Intercostal Muscle
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Internal Intercostal Muscle
Internal Intercostal Muscle
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Innermost Intercostal Muscle
Innermost Intercostal Muscle
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Transversus Thoracis Muscle
Transversus Thoracis Muscle
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Intercostal VAN
Intercostal VAN
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Chondrosternal junction
Chondrosternal junction
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Thoracic cage
Thoracic cage
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Thoracic inlet
Thoracic inlet
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Thoracic outlet
Thoracic outlet
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True ribs
True ribs
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False ribs
False ribs
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Floating ribs
Floating ribs
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Sternal angle
Sternal angle
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Xiphisternal junction
Xiphisternal junction
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1st rib
1st rib
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Twist in rib shaft
Twist in rib shaft
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Superior demifacet
Superior demifacet
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Subcostal Muscles
Subcostal Muscles
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Bucket Handle Movement
Bucket Handle Movement
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Pump Handle Movement
Pump Handle Movement
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Diaphragm
Diaphragm
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Inspiration
Inspiration
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Expiration
Expiration
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Origin of Upper Anterior Intercostal Arteries
Origin of Upper Anterior Intercostal Arteries
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Origin of Lower Anterior Intercostal Arteries
Origin of Lower Anterior Intercostal Arteries
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Origin of Upper Posterior Intercostal Arteries
Origin of Upper Posterior Intercostal Arteries
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Origin of Lower Posterior Intercostal Arteries
Origin of Lower Posterior Intercostal Arteries
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Drainage of Anterior Intercostal Veins
Drainage of Anterior Intercostal Veins
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Formation and Drainage of Internal Thoracic Vein
Formation and Drainage of Internal Thoracic Vein
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Drainage of First Right Posterior Intercostal Vein
Drainage of First Right Posterior Intercostal Vein
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Drainage of First Left Posterior Intercostal Vein
Drainage of First Left Posterior Intercostal Vein
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What is unique about the 1st intercostal nerve?
What is unique about the 1st intercostal nerve?
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What are intercostal nerves?
What are intercostal nerves?
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What is the subcostal nerve?
What is the subcostal nerve?
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What makes the 2nd intercostal nerve atypical?
What makes the 2nd intercostal nerve atypical?
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Where are intercostal nerves located?
Where are intercostal nerves located?
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What is the anterior cutaneous branch of the intercostal nerve?
What is the anterior cutaneous branch of the intercostal nerve?
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What are typical intercostal nerves?
What are typical intercostal nerves?
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What is the function of the muscular branch of the intercostal nerve?
What is the function of the muscular branch of the intercostal nerve?
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What is the collateral branch of the intercostal nerve?
What is the collateral branch of the intercostal nerve?
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What is the function of the lateral cutaneous branch of the intercostal nerve?
What is the function of the lateral cutaneous branch of the intercostal nerve?
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Right Superior Intercostal Vein
Right Superior Intercostal Vein
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Left Superior Intercostal Vein
Left Superior Intercostal Vein
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Azygos Vein
Azygos Vein
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Hemiazygos Veins
Hemiazygos Veins
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Internal Thoracic Vein
Internal Thoracic Vein
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Superficial Lymphatic Drainage of Thoracic Wall
Superficial Lymphatic Drainage of Thoracic Wall
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Deep Lymphatic Drainage of Thoracic Wall
Deep Lymphatic Drainage of Thoracic Wall
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Superior Vena Cava (SVC)
Superior Vena Cava (SVC)
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Study Notes
Thoracic Cage
- Composed of the vertebral column posteriorly, ribs laterally, and the sternum anteriorly
- Encloses the 11 intercostal spaces
- Contains the trachea, esophagus, blood vessels, nerves, and the apices of the lungs.
- The thoracic inlet is a narrow opening bounded by the first thoracic vertebra, the first rib, and the superior border of the manubrium sterni.
- The thoracic outlet is a lower, wider opening closed by the diaphragm.
- The costal margin is formed by the fusion of the 7th, 8th, 9th, and 10th costal cartilages.
- Ribs are classified into true ribs (1-7), false ribs (8-10), and floating ribs (11-12) based on their attachment to the sternum.
- The thoracic cage has synovial and cartilaginous joints.
Types of Joints in the Thoracic Cage
- Costochondral joints are primary cartilaginous joints connecting the ribs to their costal cartilages.
- Chondrosternal joints are synovial joints linking costal cartilages to the sternum.
- Intervertebral joints connect vertebral bodies, classified as secondary cartilaginous joints.
Intercostal Muscles
- External intercostal muscles have fibers running downward and forward, originating from the lower border of a rib and inserting into the upper border of the rib below.
- Internal intercostal muscles run downward and backward, originating from the lower border of a rib and inserting into the upper border of the rib below.
- Innermost intercostal muscles run downward and backward, found only in the lateral parts of the thoracic wall.
- Subcostal muscles are fiber bundles located on the inner surface of the thoracic wall posterior rib angles.
- Transversus thoracis muscles (sternocostalis) originate on the lower sternum, and insert into the costal cartilages from the 2nd to the 6th rib.
Nerves
- Intercostal nerves are ventral rami of thoracic spinal nerves (T1 through T11 or T12).
- They run in the groove between ribs and layers of intercostal muscles.
- They have both anterior and lateral cutaneous branches that innervate cutaneous areas.
- The nerve to the innermost intercostal muscle and the vessels are superficial to it.
- The first intercostal nerve is small; its fibers share in the brachial plexus.
- The second intercostal nerve has a lateral branch that forms the intercostobrachial nerve, supplying skin along the medial side of the arm.
Arteries
- Intercostal arteries are branches of the aorta and internal thoracic artery.
- Anterior intercostal arteries supply the upper six spaces, while posterior intercostal arteries supply the lower nine spaces.
- Anastomosis occurs between anterior and posterior intercostal arteries.
- The internal thoracic artery divides into anterior intercostal arteries.
- The branches of the internal thoracic artery are anterior intercostal arteries, perforating branches to breast tissue, branches to the thymus gland, mediastinal branches to the mediastinum, and the superior epigastric artery.
- Musculophrenic artery in the lower six spaces supplies the diaphragm.
Veins
- Anterior intercostal veins drain into the internal thoracic veins that empty into the brachiocephalic or superior vena cava.
- Posterior intercostal veins drain into the azygos, hemiazygos and accessory hemiazygos veins.
- The first posterior intercostal vein drains into the brachiocephaic vein.
Lymphatic Drainage
- Superficial lymphatics drain into the axillary lymph nodes.
- Anterior thoracic wall drains into the pectoral nodes.
- Posterior thoracic wall drains into the subscapular nodes.
- Deep lymphatics drain into the internal thoracic (parasternal) nodes and intercostal nodes
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