Bone Of The Thorax PDF 2013

BONES OF THE THORAX Lecture (1) Hosam Eldeen Elsadig MBBS , M.Sc Last updated : 2013  Objectives: 2  Basic anatomy, to identify:  Names of parts of ribs, sternum and thoracic vertebra.  Types of...

BONES OF THE THORAX Lecture (1) Hosam Eldeen Elsadig MBBS , M.Sc Last updated : 2013  Objectives: 2  Basic anatomy, to identify:  Names of parts of ribs, sternum and thoracic vertebra.  Types of articulations (joints) of the thoracic wall.  Clinical notes, to define:  Sternal biopsy.  Flail Chest.  Surface anatomy:  How to count ribs?  Radiology, to identify:  Normal appearance of the bones of the thorax in X-ray image. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Think about this 3  Hamid is 22 years old student; he was brought to the emergency department in Omdurman Military Hospital following road traffic accident, he had been driving his motorbike when suddenly a car hit him, on examination he was drowsy, his pulse rate was 100 bpm, BP was 110/70 , the doctor noticed that there were some contusions to the left side of his chest and a reverse movement of a chest wall segment at that part during spontaneouse breathing, after requesting chest X-ray the doctor made the diagnosis of flail chest, and he requested CT scan. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  By the end of this lecture, try to answer these questions about the previous story: 4  Mention the anatomical structure of the chest wall.  Define the term: flail chest.  Mention the possible anatomical structures that could be injured following such trauma.  Why did the doctor request CT scan although he had made the diagnosis? Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Introduction: Lecture's map 5 1. Sternum: a. Manubrium. b. Body of Sternum. c. Xiphiod process. 2. Ribs. 3. Vertebra (vertebrae). Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  THORACIC BONY SKELETON 6 1. Sternum: a. Manubrium. b. Body of Sternum. c. Xiphiod process. 2. Ribs. 3. Vertebra (vertebrae). Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Bones of the thorax 7 Image from: Susan Standring, GRAYS the anatomical basis for clinical practice, 39th Ed. Elsevier Inc. 2007 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Sternum 8  It is a flat bone.  It consists of: Manubrium. Body of Sternum. Xiphiod process. Image from: Richard L.Drake, Wayne Vogl,Adam W.M.Mitchell, GRAYS anatomy for students, Elsevier Inc. 2007 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Clinical note: Sternal Biopsy 9  The sternum is a common site for bone marrow biopsy because:  It contains red hematopoietic marrow throughout life.  It is subcutaneous in position.  Benefits of bone marrow biopsy:  To Diagnose of certain blood diseases such as leukemia.  To obtain specimens of marrow for transplantation. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Joints of The Sternum 10  Manubriosternal joint.  Xiphisternal joint.  Type of both joints:  Secondry cartilagenous joints.  Sternocostal joints.  Type of this joint:  Synovial joints Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Words meaning: Sternum 11 From Greek sternon, breast, breastbon Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Lecture's map 12 1. Sternum: a. Manubrium. b. Body of Sternum. c. Xiphiod process. 2. Ribs. 3. Vertebra (vertebrae). Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Ribs (Typical rib) 13 Image from: Susan Standring, GRAYS the anatomical basis for clinical practice, 39th Ed. Elsevier Inc. 2007 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Ribs (Typical Ribs) 14 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Image from: Moore, Keith L.; Dalley, Arthur F, Clinically Oriented Anatomy, 5th Ed. Lippincott Williams & Wilkins; 2006. 15 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Atypical ribs 16 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013 17 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Clinical note: Flail Chest 18  Multiple rib fractures may allow a sizable segment of the anterior and/or lateral thoracic wall to move freely.  The loose segment of the wall moves paradoxically (inward on inspiration and outward on expiration). Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Flial chest Or Flial segment 19 Image from: Abraham's et al , McMinn clinical atlas. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Flial chest Or Flial segment Image from: Abraham's et al , McMinn clinical atlas. 20 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Surface anatomy: How to count ribs? 21 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Lecture's map 22 1. Sternum: a. Manubrium. b. Body of Sternum. c. Xiphiod process. 2. Ribs. 3. Vertebra (vertebrae). Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Vertebral column Image from: Richard L.Drake, Wayne Vogl,Adam W.M.Mitchell, GRAYS anatomy for students, Elsevier Inc. 2007 23 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Vertebra 24  Consists of:  Body.  Pedicle.  Transverse process.  Lamina.  Spine.  Articular facets. Image from: Richard L.Drake, Wayne Vogl,Adam W.M.Mitchell, GRAYS anatomy for students, Elsevier Inc. 2007 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Image from: Agur, Anne M.R.; Dalley, Arthur F. Grant’s Atlas of Human Anatomy. 12th Ed. Lippincott Williams & Wilkins; 2009. 25 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Comparison Between T1 and T10 26 T1 T 10 Image from: Richard L.Drake, Wayne Vogl,Adam W.M.Mitchell, GRAYS anatomy for students, Elsevier Inc. 2007 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Comparison Between T10 and T12 27 T 10 T 12 Image from: Richard L.Drake, Wayne Vogl,Adam W.M.Mitchell, GRAYS anatomy for students, Elsevier Inc. 2007 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Articulation between vertebrae (Video) Video from: Acland's video Atlas of Human Anatomy, Robert D.Acland M.D , FRCS. 28 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013 Articulation between rib and vertebrae (1) 29  (Head) of rib articulates with the (body) of the vertebra: Name of joint: costo- vertebral joint. Type of joint: synovial joint. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013 Articulation between rib and vertebrae (2) 30  (Tubercle) of rib articulates with the (transvere process) of the vertebra: Name of joint: costo- transverse joint. Type of joint: synovial joint. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013 31 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Image from: Moore, Keith L.; Dalley, Arthur F, Clinically Oriented Anatomy, 5th Ed. Lippincott Williams & Wilkins; 2006. 32 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013 Articulation between rib and vertebrae (Video) Video from: Acland's video Atlas of Human Anatomy, Robert D.Acland M.D , FRCS. 33 Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Summary 34 1. Sternum: a. Manubrium. b. Body of Sternum. c. Xiphiod process. 2. Ribs. 3. Vertebra (vertebrae). Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Please try to answer this question 35  The sternum forms a synovial joint with: a) The manubrium. b) Xiphoid process. c) 1st rib. d) 2nd costal cartilage. e) Floating rib. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Please try to answer this question 36  Which one of the following could be identified using the sternal angle (angle of Louis) as land mark: a) The inferior vena cava. b) The second costal cartilage. c) The base of the right lung. d) The right ventricle of the heart. e) The roots of the lung. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  References 37  R.M.H.McMinn, LAST‘S anatomy regional and applied, 9th Ed. Churchill livingstone; 1997  Richard L.Drake, Wayne Vogl,Adam W.M.Mitchell, GRAYS anatomy for students, Elsevier Inc. 2007  Susan Standring, GRAYS the anatomical basis for clinical practice, 39th Ed. Elsevier Inc. 2007  Harold Ellis, Clinical Anatomy,Applied anatomy for students and junior doctors, 11th Ed, Blackwell Publishing Ltd, 2006  Richard S.Snell, Clinical Anatomy by Regions, 8th Ed. Lippincott Williams & Wilkins.  Moore, Keith L.; Dalley, Arthur F, Clinically Oriented Anatomy, 5th Ed. Lippincott Williams & Wilkins; 2006.  Agur, Anne M.R.; Dalley, Arthur F. Grant’s Atlas of Human Anatomy. 12th Ed. Lippincott Williams & Wilkins; 2009.  Abraham's et al , McMinn clinical atlas.  Acland's video Atlas of Human Anatomy, Robert D.Acland M.D , FRCS. Hosam Eldeen Elsadig MBBS , M.Sc. Last updated : 2013  Have fun 38