Ribs, Costal Cartilages, and Intercostal Spaces - 0 views

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  #1 Trevor Bernard on 18 May 12

   

  There are 11 intercostal spaces and 11 intercostal nerves. Intercostal spaces are occupied by intercostal muscles and membranes, and two sets (main and collateral) of intercostal blood vessels and nerves, identified by the same number assigned to the space. The space below the 12th rib does not lie between ribs and thus is referred to as the subcostal space, and the anterior ramus of spinal nerve T12 is the subcostal nerve. The intercostal spaces are widest anterolaterally, and they widen with inspiration. They can be further widened by extension and/or lateral flexion of the thoracic vertebral column to the contralateral side.medical surgical
  
  

  Rib Fractures

  
  
  

  The short, broad 1st rib, posteroinferior to the clavicle, is rarely fractured because of its protected position (it cannot be palpated). When it is broken, however, injury to the brachial plexus of nerves and subclavian vessels may occur. The middle ribs are most commonly fractured. Rib fractures usually result from blows or from crushing injuries. The weakest part of a rib is just anterior to its angle; however, direct violence may fracture a rib anywhere, and its broken end may injure internal organs such as a lung and/or the spleen. Lower rib fractures may tear the diaphragm and result in a diaphragmatic hernia usmle stepRib fractures are painful because the broken parts move during respiration, coughing, laughing, and sneezing.

  
  
  

  Flail Chest

  
  
  

  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). Flail chest (stove-in chest) is an extremely painful injury and impairs ventilation, thereby affecting oxygenation of the blood. During treatment, the loose segment is often fixed by hooks and/or wires so that it cannot move.

  
  
  

  Thoracotomy, Intercostal Space Incisions, Rib Excision, and Bone Grafting

  
  
  

  The surgical creation of an opening through the thoracic wall to enter a pleural cavity is a thoracotomy

  
  
  

  An anterior thoracotomy may involve making H-shaped cuts through the perichondrium of one or more costal cartilages and then shelling out segments of costal cartilage to gain entrance to the thoracic cavity The posterolateral aspects of the 5thâ€"7th intercostal spaces are important sites for posterior thoracotomy incisions. In general, a lateral approach is most satisfactory for entry into the thoracic cage. online classes Surgeons use an H-shaped incision to incise the superficial aspect of the periosteum that ensheaths the rib, strip the periosteum from the rib, and then remove a wide segment of the rib to gain better access, as might be required to enter the thoracic cavity and remove a lung (pneumonectomy), for example.

  People usually have 12 ribs on each side, but the number is increased by the presence of cervical and/or lumbar ribs, or decreased by failure of the 12th pair to form Cervical ribs are relatively common (0.5â€"2%), but Medical physical examinations lumbar ribs are less common. Because of the remarkable elasticity of the ribs and costal cartilages in children, chest compression may Free medical books produce injury within the thorax even in the absence of a rib fracture.

   

  <div class="cArrow"> </div><div class="cContentInner">There are 11 intercostal spaces and 11 intercostal nerves. Intercostal spaces are occupied by intercostal muscles and membranes, and two sets (main and collateral) of intercostal blood vessels and nerves, identified by the same number assigned to the space. The space below the 12th rib does not lie between ribs and thus is referred to as the subcostal space, and the anterior ramus of spinal nerve T12 is the subcostal nerve. The intercostal spaces are widest anterolaterally, and they widen with inspiration. They can be further widened by extension and/or lateral flexion of the thoracic vertebral column to the contralateral side.<a rel="nofollow" href="http://www.medicalosces.com/">medical surgical</a> <br /><br /><p><strong>Rib Fractures</strong></p><br /><br /><p>The short, broad 1st rib, posteroinferior to the clavicle, is rarely fractured because of its protected position (it cannot be palpated). When it is broken, however, injury to the brachial plexus of nerves and subclavian vessels may occur. The middle ribs are most commonly fractured. Rib fractures usually result from blows or from crushing injuries. The weakest part of a rib is just anterior to its angle; however, direct violence may fracture a rib anywhere, and its broken end may injure internal organs such as a lung and/or the spleen. Lower rib fractures may tear the diaphragm and result in a diaphragmatic hernia <a rel="nofollow" href="http://www.medisl.com/">usmle step</a>Rib fractures are painful because the broken parts move during respiration, coughing, laughing, and sneezing.</p><br /><br /><p><strong>Flail Chest</strong></p><br /><br /><p>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). Flail chest (stove-in chest) is an extremely painful injury and impairs ventilation, thereby affecting oxygenation of the blood. During treatment, the loose segment is often fixed by hooks and/or wires so that it cannot move.</p><br /><br /><p>Thoracotomy, Intercostal Space Incisions, Rib Excision, and Bone Grafting</p><br /><br /><p>The surgical creation of an opening through the thoracic wall to enter a pleural cavity is a thoracotomy</p><br /><br /><p>An anterior thoracotomy may involve making H-shaped cuts through the perichondrium of one or more costal cartilages and then shelling out segments of costal cartilage to gain entrance to the thoracic cavity The posterolateral aspects of the 5thâ€"7th intercostal spaces are important sites for posterior thoracotomy incisions. In general, a lateral approach is most satisfactory for entry into the thoracic cage. <a rel="nofollow" href="http://www.medicallecturenotes.com/">online classes</a> Surgeons use an H-shaped incision to incise the superficial aspect of the periosteum that ensheaths the rib, strip the periosteum from the rib, and then remove a wide segment of the rib to gain better access, as might be required to enter the thoracic cavity and remove a lung (pneumonectomy), for example. <p>People usually have 12 ribs on each side, but the number is increased by the presence of cervical and/or lumbar ribs, or decreased by failure of the 12th pair to form Cervical ribs are relatively common (0.5â€"2%), but <a rel="nofollow" href="http://medicalphysicalexam.com/">Medical physical examinations</a> lumbar ribs are less common. Because of the remarkable elasticity of the ribs and costal cartilages in children, chest compression may <a rel="nofollow" href="http://www.facebook.com/freemediebooks">Free medical books</a> produce injury within the thorax even in the absence of a rib fracture.</p></p></div>

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