DSA sternum/sibson's/clavicle

Question 1

where does the abdominal diaphragm attach

Answer 1

to the first three lumbar vertebrae
lower 6 ribs
xiphoid process of the sternum

Question 2

during respiration which part of the chest cage changes more dramatically

Answer 2

the inferior portion

Question 3

with deep inhalation what happens to the sternum

Answer 3

the entire sternum glides superiorly and the caudal end moves anteriorly

Question 4

with exhalation what happens to the sternum

Answer 4

the entire sternum glides inferiorly and the inferior end moves posteriorly

Question 5

what are the different diagnoses of the sternum

Answer 5

rotated right (manubrium and body)
sidebending (manubrium and body)
backward and forward bending (manubrium and body)

Question 6

what happens with forward bending of the manubrium

Answer 6

decreases the angle (measured from the outside)

Question 7

what happens with backward bending of the manubrium

Answer 7

increases the angle

Question 8

what happens with sidebending of the sternum

Answer 8

it is based on the top part of the sternum body and which direction that goes

Question 9

what happens with backward bending of the body of the sternum

Answer 9

decreases angle

Question 10

what happens with forward bending of the body of the sternum

Answer 10

increases angle

Question 11

in abduction the distal end of the clavicle moves… and the proximal end moves

Answer 11

superiorly (distal end)

inferiorly (proximal end)

Question 12

in flexion the distal end of the clavicle moves ….

and the proximal end moves…

Answer 12

distal end–> anterioly

proximal end–> moves posteriorly

Question 13

what does the intervclavicular ligament resist

Answer 13

superior displacement of the sternal end of the clavicle

Question 14

the costoclavicular ligament resists what

Answer 14

limits upward movement of the lateral end of the clavicle

helps with a downward glide of the sternal end of the clavicle with abduction of the clavicle

Question 15

what is the strongest ligament between the clavicle and the scapula

Answer 15

coracoclavicular ligament

conoid
trapezoid part

Question 16

what is the thoracic inlet boundaries

Answer 16

manubrium of sternum anterioly
first thoracic posteriorly
first rib laterally

Question 17

where is the thoracic outlet

Answer 17

space between the anterior scalenes where the subclavian artery and brachial plexus pass

Question 18

where does sibson’s fascia originate

Answer 18

originates from the deep cervical fascia surrounding the longus coli musculature of the anterior cervical spine. Some texts suggest that it also attaches to the transverse processes of C7

Question 19

where does sibson’s fascia connect

Answer 19

to the superomedial border of the 1st rib

it is contiguous with the axillary sheath and endothoracic fascia covering the cupula of the lungs

and therefore it is also called suprpleural membrane

Question 20

what structures pass through the functional diaphragm created by sibson’s fascia

Answer 20

1. Recurrent Laryngeal Nerve
2. Vagus Nerve
3. Stellate Ganglion
4. Phrenic Nerve
5. Brachial Plexus
6. Common Carotid Artery
7. Vertebral Artery
8. Thyrocervical Trunk
9. Internal Thoracic Artery (especially cardiothoracic surgeons)
10. Internal Jugular Vein
11. Subclavian Artery and Vein
12. Thoracic Duct and Right Lymphatic Duct
13. Anterior Cervical Lymph Nodes

Question 21

what does the right lymphatic duct drain

Answer 21

lymph from the upper right quadrant of the body into the right subclavian vein

Question 22

what does the thoracic duct drain

Answer 22

lymph from the rest of the body into the left jugulovenous angle

Question 23

WHAT happens if lymphatic return is inhibited

Answer 23

stagnation of pressure gradients occurs leading to lymphatic stasis and diminishment of cellular, tissue and organs