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THORACIC WALL &CAVITY - Coggle Diagram

- - - - External Intercostal muscles
        
        Function: Elevate ribs during inspiration.
        
        Innervation: intercostal nerves.
        
        Course: External ( Anteroinferior)
      - Transverse thoracic muscle
        
        Function: Lower ribs during expiration (except intercartilaginous internal intercostal which work like external ICM)
        
        Innervation: intercostal nerves.
        
        Course: Craniolateral (from posterior of the lower sternum to cartilages of 2nd - 6th ribs)
      - Internal muscles, innermost & subcostal.
        
        Function: Lower ribs during expiration (except intercartilaginous internal intercostal which work like external ICM)
        
        Innervation: intercostal nerves.
        
        Course: Posteroinferior.
      - Other muscles:
        
        Pectoralis major muscle
        
        Sternocostal part
        
        Clavicular part
        
        Abdominal part
        
        Function: Anteversion of the arm, Adduction of arm, Inward rotation of the arm, Retroversion of the arm in anteversion more than 90.
        
        Coracobrachialis muscle
        
        Function: Anteversion of the arm, Adduction of arm, Inward rotation of the arm.
        
        Subclavius muscle
        
        Serratus muscles
        
        Anterior
        
        Middle part
        
        Inferior part
        
        Superior part
        
        Posterior
        
        Superior
        
        inferior
        
        Latissimus dorsi muscle
        
        vertebral part
        
        Costal part
        
        Scapular part
        
        par iliac part
        
        Function: Retroversion of the arm, Adduction of arm, internal rotation of the arm.
        
        Teres major muscle
        
        Function: Retroversion of the arm, Adduction of arm, internal rotation of the arm
    - - Ribs & Costal cartilages
        
        Definition: Long, curved bones that surround the vital organs within the thoracic cavity.
        
        12 pairs: True (1-7); False (8-10); Floating (11-12)
        
        Intercostal space: Space between ribs; below each rib parks a VAN (Vein, Artery, Nerve)
        
        Clinical Relevance: Passage of instruments through ICS take place in the lower part of the space; An intercostal Nerve block is done in the upper portion of ICS.
      - Sternum
        
        Suprasternal\jugular notch: Palpable depression above manubrium.
        
        Sternal angle: palpable connection between manubrium and sternal body; Important land marks: Second rib, T4\5 intervertebral disc, Aortic arch, Bifurcation.
        
        Three flat bones: Manubrium (attachment of 1st rib cartilages); Sternal body (attachment of 3rd - 7th rib cartilages); Xiphoid process (small cartilaginous extension at the 7th dermatome that ossifies in adults).
      - Thoracic vertebrae: 12 vertebrae attached to the rib cage..
    - - Superior Thoracic aperture
        
        Organs: Esophagus, Trachea
        
        Vessels: Common carotid artery, Subclavian artery and vein, Jugular vein.
      - Inferior thoracic aperture
        
        Closed by the diaphragm.
    - - 1- Posterior axillary line 2- middle axillary line 3- Anterior axillary line.
      - 1- Posterior median line 2- paravertebral line 3- Scapular line.
      - 1- Anterior median line 2- Sternal line 3- Parasternal 4- Midclavicular line.
- - - - Arranged into 10-20 lobes and contain lactiferous (milk) ducts.
      - Immature in men.
      - Functional component of the breast responsible for milk production.
    - - Nipple: Area in which the milk ducts join and open onto the skin
      - Areola: Pigmented area surrounding the nipple; Contain areolar glands (Montgomery tubercles)
  - - - Internal thoracic artery (internal mammary)
        
        Pathway: Aorta-> Subclavian-> Internal thoracic artery.
        
        Supplies: medial breast.
      - Lateral thoracic artery
        
        Pathway: Aorta-> Subclavian-> Axillary artery-> Lateral artery.
        
        Supplies: lateral breasts.
    - - Axillary Nodes
        
        Drainage: The nipples, and 75% of the lateral parts breast.
      - Parasternal (internal thoracic) lymph nodes
        
        Lie along the internal thoracic arteries
        
        it is also through this medial route that cancer can spread to opposite breast
        
        Drain most of the medial parts of the breast