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Thoracic Wall and Apertures
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Thoracic Wall and Apertures

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Questions and Answers

What structures pass through the caval foramen of the diaphragm?

  • Oesophagus, vagus nerves
  • Aorta, thoracic duct
  • Azygos vein, hemiazygos vein
  • Inferior vena cava, right phrenic nerve (correct)

    • The esophageal hiatus is located at the T12 vertebral level.

    False

    What is the primary motor nerve that innervates the diaphragm?

    phrenic nerve

    The diaphragm has openings for the inferior vena cava, esophagus, and _____.

    <p>aorta</p> Signup and view all the answers

    Match the diaphragm openings with the structures passing through them:

    <p>Caval foramen = Inferior vena cava Esophageal hiatus = Oesophagus Aortic hiatus = Aorta Lumbar muscular part = Vagal trunks</p> Signup and view all the answers

    Which structure bounds the superior thoracic aperture anteriorly?

    <p>Manubrium of sternum</p> Signup and view all the answers

    The thoracic cage is fully ossified by age 30.

    <p>False</p> Signup and view all the answers

    What covers the thoracic wall externally?

    <p>Skin and muscles attaching the shoulder girdle to the trunk.</p> Signup and view all the answers

    The thoracic wall extends between the superior and inferior _______.

    <p>thoracic apertures</p> Signup and view all the answers

    Match the thoracic wall boundaries with their corresponding locations:

    <p>Posterior = Thoracic part of the vertebral column Anterior = Sternum and costal cartilages Laterally = Ribs and intercostal spaces Superiorly = Suprapleural membrane Inferiorly = Diaphragm</p> Signup and view all the answers

    What is lined internally by the endothoracic fascia?

    <p>Thoracic wall</p> Signup and view all the answers

    Name one muscle that forms part of the thoracic wall.

    <p>Transversus thoracis or any major muscle associated with the thoracic wall.</p> Signup and view all the answers

    The inferior thoracic aperture is bounded laterally by the 11th and 12th pairs of ribs.

    <p>True</p> Signup and view all the answers

    Which veins primarily drain the thoracic wall?

    <p>Azygos and hemiazygos veins</p> Signup and view all the answers

    The 1st intercostal nerve has an anterior cutaneous branch.

    <p>False</p> Signup and view all the answers

    What is the primary function of intercostal nerves?

    <p>Innervate the intercostal muscles and skin of the thoracic wall.</p> Signup and view all the answers

    The ___ intercostal nerves enter the anterior abdominal wall by passing deep to the costal cartilage.

    <p>7th-9th</p> Signup and view all the answers

    Match the following intercostal nerves with their functions:

    <p>T1 = Joins the brachial plexus 7th-9th = Pass deep to costal cartilage 10th = Pass directly into abdominal wall 12th = Runs forward in abdominal wall as subcostal nerve</p> Signup and view all the answers

    The venous drainage of the left side of the thoracic wall primarily goes into which vein?

    <p>Left brachiocephalic vein</p> Signup and view all the answers

    The intercostal nerves are all derived from the posterior rami of the thoracic nerves.

    <p>False</p> Signup and view all the answers

    Name the system of veins that drains the thoracic wall.

    <p>Azygos system</p> Signup and view all the answers

    Which intercostal nerve is joined to the medial cutaneous nerve of the arm?

    <p>2nd intercostal nerve</p> Signup and view all the answers

    The thoracic duct drains lymph from the right arm, thorax, head, and neck.

    <p>False</p> Signup and view all the answers

    What is the primary function of the diaphragm?

    <p>Respiratory muscle involved in inspiration and raising abdominal pressure.</p> Signup and view all the answers

    The __________ provides a space tightly packed with connective tissue coverings of the lungs and heart.

    <p>mediastinum</p> Signup and view all the answers

    Match the following components of the diaphragm with their locations:

    <p>Sternal part = Posterior surface of the xiphoid process Costal part = Deep surfaces of the lower six ribs and costal cartilages Vertebral part = Vertical columns or crura and arcuate ligaments</p> Signup and view all the answers

    Which lymphatic drainage path serves the thoracic wall?

    <p>To parasternal and axillary nodes</p> Signup and view all the answers

    The pleura has two layers: visceral and parietal.

    <p>True</p> Signup and view all the answers

    What structure is typically found in the thoracic cavity along with the heart?

    <p>Lungs</p> Signup and view all the answers

    Study Notes

    Thoracic Wall

    • The thoracic wall is the bony structure that encloses the chest cavity.
    • It is lined internally by endothoracic fascia and extends between the superior and inferior thoracic apertures.
    • The boundary of the thoracic wall includes the thoracic part of the vertebral column posteriorly, the sternum and costal cartilages anteriorly, ribs and intercostal spaces laterally.
    • The superior thoracic aperture is bounded by the first thoracic vertebra, first rib and manubrium of the sternum.
    • The inferior thoracic aperture is bounded by the 12th thoracic vertebra, 11th and 12th ribs, costal cartilages of ribs 7-10, and the xiphisternal joint.

    Superior Thoracic Aperture

    • It is the opening at the top of the thoracic cavity, where the neck meets the chest.
    • The diaphragm forms the inferior thoracic aperture, which is the opening at the bottom of the thoracic cavity.

    The Thoracic Cage

    • It is made up of the ribs, sternum and vertebral column.
    • It provides a framework for the lungs and other organs in the chest.
    • It is not completely ossified until around 40 years of age.

    Intercostal Space

    • The spaces between the ribs are called intercostal spaces.
    • Each intercostal space contains intercostal muscles, nerves, and blood vessels.
    • The intercostal muscles and nerves are responsible for breathing and sensation in the chest wall.

    Muscles of the Thoracic Wall

    • The muscles that comprise the thoracic wall include the intercostals, transversus thoracis, and diaphragm.
    • The transversus thoracis muscles are responsible for depressing the ribs during exhalation.

    Arterial Supply of the Thoracic Wall

    • The thoracic wall is supplied by arteries that include the internal thoracic artery and the posterior intercostal arteries.

    Venous Drainage of the Thoracic Wall

    • The veins that drain the thoracic wall include the internal thoracic vein, posterior intercostal vein, and the azygos system of veins.

    Azygos System of Veins

    • The azygos system of veins drains the thoracic wall, and then drains into the superior vena cava.

    Intercostal Nerves

    • The intercostal nerves are responsible for sensation and motor control in the chest wall.
    • They are the anterior branches of the first eleven thoracic nerves.
    • The first six intercostal nerves are distributed within their corresponding intercostal spaces.
    • The 7th-9th intercostal nerves leave the anterior end of their intercostal space and enter the anterior abdominal wall.
    • The 10th and 11th intercostal nerves pass directly into the abdominal wall.
    • The 12th intercostal nerve runs in the abdomen as the subcostal nerve.

    Atypical Intercostal Nerves

    • The first and second intercostal nerves have distinct paths and functions.
    • The first intercostal nerve courses on the internal surface of the first rib instead of its inferior margin.
    • The second intercostal nerve joins the medial cutaneous nerve of the arm through the intercostobrachial nerve.

    Lymphatic Drainage of the Thoracic Wall

    • The lymphatic drainage of the thoracic wall is via the axillary lymph nodes, parasternal lymph nodes, and intercostal lymph nodes.
    • The thoracic duct drains the lower limbs, pelvic cavity, abdominal cavity, left side of thorax, head, neck and arm.
    • The right lymphatic duct drains lymph from the right arm, thorax, head, and neck.

    Thoracic Cavity

    • The thoracic cavity contains the lungs, heart, and other organs.
    • The mediastinum is the space within the thoracic cavity that contains the heart, trachea, esophagus, major blood vessels, and lymph nodes.

    The Pleura and Lungs

    • The pleura is a double-layered membrane that surrounds the lungs.
    • The visceral pleura adheres directly to the lung surface.
    • The parietal pleura lines the chest wall and diaphragm, covering the mediastinal surface.
    • The pleura lubricates the lung's movement as it expands and contracts.

    The Heart

    • The heart is a four-chambered muscular organ that pumps blood throughout the body.
    • The heart is located in the mediastinum.

    The Diaphragm

    • The diaphragm is a dome-shaped muscle that separates the thoracic cavity from the abdominal cavity.
    • It is the primary muscle of respiration.
    • The diaphragm is composed of three parts: the sternal, costal, and vertebral (lumbar) parts.
    • The sternal part inserts at the posterior surface of the xiphoid process.
    • The costal part inserts at the lower six ribs and their costal cartilages.
    • The vertebral part originates from the lumbar vertebrae with two muscle columns called crura.
    • All three parts of the diaphragm converge at a central tendon.

    Diaphragm Nerve Supply

    • The diaphragm receives motor innervation from the phrenic nerves (C3-C5) and sensory innervation from the phrenic and lower six intercostal nerves.

    Openings of the Diaphragm

    • The diaphragm has three major openings: the caval foramen, the esophageal hiatus, and the aortic hiatus.
    • The caval foramen transmits the inferior vena cava.
    • The esophageal hiatus transmits the esophagus, vagal nerves, left gastric vessels, and lymphatics.
    • The aortic hiatus transmits the aorta, thoracic duct, azygos vein, and hemiazygous.

    Innervation of the Diaphragm

    • The diaphragm is innervated by the phrenic nerves (C3-C5) of the cervical plexus.

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    Description

    Explore the structure and boundaries of the thoracic wall, including the superior and inferior thoracic apertures. Understand the role and components that constitute the thoracic cage. This quiz covers the anatomy essential for comprehending chest cavity functions.

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