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Thoracic Wall LAB MANUAL
|Topic and Text Reference | Learning Objectives | Special Instructions | Clinical Exercises | Key Structures
TOPIC AND TEXT REFERENCE: THORACIC WALL PP. 42-48
LEARNING OBJECTIVES:Learn the bony landmarks of the anterior thoracic wall.
Learn the characteristics of the ribs and how they articulate with the vertebrae.
Understand the different fascial layers that comprise the thoracic wall.
Review the pectoralis major and pectoralis minor, their nerve supply and blood supply.
Identify the three layers of intercostal muscles and their key differences (fiber direction, membrane component).
Isolate one of the intercostal neurovascular bundle and note the relationship of the components to each other (VAN).
Observe and understand how the intercostal neurovascular bundles travel within the costal groove and supply the thoracic wall.
SPECIAL INSTRUCTIONS FOR LAB TODAY:Pg. 43: We have already dissected the pectoral regions so disregard the skin incision directions.
Pg. 45-46: Review the pectoral muscles and their neurovascular supply.
Pg. 46- 47: You do not need to detach the serratus anterior muscle. Then proceed as directed in the dissector until the removal of the thoracic wall.
Pg. 47: The faculty and staff have already partially cut the portion of the anterior thoracic wall. You may finish the job now being careful of the sharp ends of the ribs with the help of the faculty members who are circulating with the stryker saws.
CLINICAL CORRELATIONS AND EXERCISES:
1. Palpate the sternal angle of Louis on your cadaver and on yourself. What is its clinical significance?It allows you to count the ribs with confidence. The second rib articulates with the sternum at this point. Since the first rib is hidden beneath the clavicle, it is often difficult to palpate. The sternal angle is located at the level of the T4/T5 intervertebral disc.
2. Note that the rib cage is much larger than the thorax. Therefore, it not only protects the organs of the thorax but also some of the organs of the abdomen.3. Make sure you look at a diagram of the lymphatic drainage of the breast.
KEY STRUCTURES:
You should be able to identify in a cadaver all the structures listed under key words unless they have an asterisk.
Arteries pectoralis minor N1 axillary artery N1 G1 serratus anterior N1 G1 internal thoracic artery N1 G1 platysma N1 G1 anterior intercostal artery N1 Nerves lateral thoracic artery N1 anterior cutaneous branches N1 thoracoacromial artery N1 intercostobrachial nerve N1 Bones - lateral cutaneous branches N1 costal groove N1 G1 lateral pectoral nerve N1 jugular notch N1 G1 medial pectoral nerve N1 sternal angle of Louis G1 Veins Cartilages axillary vein N1 G1 costal cartilages N1 G1 cephalic vein N1 Muscles internal thoracic vein N1 external intercostal muscle N1 G1 Other structures innermost intercostal muscle N1 G1 deltopectoral triangle N1 internal intercostal muscle N1 G1 parietal pleura N1 pectoralis major N1 skin and superficial fascia N1
Topic and Text Reference | Learning Objectives | Special Instructions | Clinical Exercises | Key Structures
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