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Questions and Answers
What structures pass through the caval foramen of the diaphragm?
What structures pass through the caval foramen of the diaphragm?
The esophageal hiatus is located at the T12 vertebral level.
The esophageal hiatus is located at the T12 vertebral level.
False
What is the primary motor nerve that innervates the diaphragm?
What is the primary motor nerve that innervates the diaphragm?
phrenic nerve
The diaphragm has openings for the inferior vena cava, esophagus, and _____.
The diaphragm has openings for the inferior vena cava, esophagus, and _____.
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Match the diaphragm openings with the structures passing through them:
Match the diaphragm openings with the structures passing through them:
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Which structure bounds the superior thoracic aperture anteriorly?
Which structure bounds the superior thoracic aperture anteriorly?
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The thoracic cage is fully ossified by age 30.
The thoracic cage is fully ossified by age 30.
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What covers the thoracic wall externally?
What covers the thoracic wall externally?
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The thoracic wall extends between the superior and inferior _______.
The thoracic wall extends between the superior and inferior _______.
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Match the thoracic wall boundaries with their corresponding locations:
Match the thoracic wall boundaries with their corresponding locations:
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What is lined internally by the endothoracic fascia?
What is lined internally by the endothoracic fascia?
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Name one muscle that forms part of the thoracic wall.
Name one muscle that forms part of the thoracic wall.
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The inferior thoracic aperture is bounded laterally by the 11th and 12th pairs of ribs.
The inferior thoracic aperture is bounded laterally by the 11th and 12th pairs of ribs.
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Which veins primarily drain the thoracic wall?
Which veins primarily drain the thoracic wall?
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The 1st intercostal nerve has an anterior cutaneous branch.
The 1st intercostal nerve has an anterior cutaneous branch.
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What is the primary function of intercostal nerves?
What is the primary function of intercostal nerves?
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The ___ intercostal nerves enter the anterior abdominal wall by passing deep to the costal cartilage.
The ___ intercostal nerves enter the anterior abdominal wall by passing deep to the costal cartilage.
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Match the following intercostal nerves with their functions:
Match the following intercostal nerves with their functions:
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The venous drainage of the left side of the thoracic wall primarily goes into which vein?
The venous drainage of the left side of the thoracic wall primarily goes into which vein?
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The intercostal nerves are all derived from the posterior rami of the thoracic nerves.
The intercostal nerves are all derived from the posterior rami of the thoracic nerves.
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Name the system of veins that drains the thoracic wall.
Name the system of veins that drains the thoracic wall.
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Which intercostal nerve is joined to the medial cutaneous nerve of the arm?
Which intercostal nerve is joined to the medial cutaneous nerve of the arm?
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The thoracic duct drains lymph from the right arm, thorax, head, and neck.
The thoracic duct drains lymph from the right arm, thorax, head, and neck.
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What is the primary function of the diaphragm?
What is the primary function of the diaphragm?
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The __________ provides a space tightly packed with connective tissue coverings of the lungs and heart.
The __________ provides a space tightly packed with connective tissue coverings of the lungs and heart.
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Match the following components of the diaphragm with their locations:
Match the following components of the diaphragm with their locations:
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Which lymphatic drainage path serves the thoracic wall?
Which lymphatic drainage path serves the thoracic wall?
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The pleura has two layers: visceral and parietal.
The pleura has two layers: visceral and parietal.
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What structure is typically found in the thoracic cavity along with the heart?
What structure is typically found in the thoracic cavity along with the heart?
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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.
