Thoracic Cavity and Mediastinum
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What are the articulations of the manubrium?
Clavicle and first costal cartilage
Describe the ribs and their names:
- True Ribs: 1-7.
- - Ribs 2-7 articulate in synovial joint
- False ribs: 8-12
- - Ribs 11, 12 are floating ribs
- - Ribs 8-10 articulate in cartilages
What are the limits of the thoracic inlet?
What are the limits of the thoracic oulet?
- Xiphoid process
- Costal arch of 7-10 and 12th rib
Describe the superficial layer of musculature in the thoracic wall:
- External intercostal muscles
- From the tubercles of ribs to the costochondral junctions
Describe the middle layer of musculature in the thoracic wall:
- Internal intercostal muscles
- From the sternum and costal cartilages to the angles of the rib
Describe the deep layer of musculature in the thoracic wall?
- Transversus thoracic: From posterior surface of lower sternum to superior costal cartilages
- Innermost intercostal: When they span two or more segments called subcostal muscles
Where do the nerves/vessels of the thoracic wall run?
Between the middle and deep layers of muscles
What innervates the skin/muscles of the thoracic wall?
- Ventral rami iof thoracic spinal nerves
- T1-T11 = intercostal nerves
- T12 = subcostal nerve
- All muscles EXCEPT the diaphragm (phrenic)
Where do the posterior intercostal arteries arise from?
- First 2 are from the costocervical trunk of subclavian artery
- Remainder are branches of thoracic aorta
Where do the anterior intercostal arteries arise from?
Internal thoracic artery or musculophrenic artery
How is the superoinferior, anteroposterior and lateral diameter increased?
- Superoinferior: Flattening diaphragm
- Anteriopasterior: Elevating upper 6 ribs
- Lateral: Elevating lower ribs
Where does the division for the mediastinum occur?
Horizontal plane from sternal angle to intervertebral discs between T4 and T5
What is located within the superior mediastinum?
- 1. Thymus
- 2. Trachea
- 3. Esophagus
- 4. Thoracic Duct
- 5. Phrenic Nerve
- 6. Vagus Nerve
- 7. Superior Vena Cava
- 8. Arch of aorta
- 9. Brachiocephalic vein
What is located in the anterior mediastinum?
- Internal thoracic vessels
What does the middle mediastinum contain?
Pericardium, heart, roots of great vessels
What does the posterior mediastinum contain?
- 1. Esophagus
- 2. Thoracic Duct
- 3. Vagus nerve
- 4. Splanchnic nerve
- 5. Azygous venous system
- 6. Descending aorta
Where do the esophagus, inferior vena cava and the descending aorta peirce through the diaphragm?
- Inferior VC: T8
- Esophagus: T10
- Descending Aorta: T12
What do the hemiazygous and accessory hemiazygous veins drain?
- Hemiazygous: Lower 1/3 of thoracic wall
- Accessory: Middle 1/3 of thoracic wall
How does the thoracic duct enter the thoracic cavity?
Aortic hiatus at T12
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