Anatomy

Question 0

Where can the trachea be palpated?

Answer 0

Jugular notch (of manubriun)

Question 1

Where does the lower respiratory tract start?

Answer 1

Level of C6 - trachea

Question 2

What lies just superior to the trachea in the jugular notch?

Answer 2

Isthmus of the thyroid (anterior to tracheal cartilages 2-4)

Question 3

How many lobes are in each lung?

Answer 3

Right - 3

Left - 2

Question 4

How do ribs articulate with the vertebrae?

Answer 4

Via the rib head - with body of vertebrae of same number and with superior vertebrae

Via the rib tubercle - with transverse process of same number vertebrae

Question 5

What is the purpose of the costal groove?

Answer 5

For the NVB

Question 6

What blood vessels supply the intercostal spaces?

Answer 6

Anterior aspect
- Branches of the internal thoracic artery
Posterior aspect
- Posterior intercostal arteries (paired branches of the thoracic aorta)

Question 7

What are the drainage vessels for the intercostal spaces?

Answer 7

Anterior aspect
- Paired internal thoracic veins
Posterior aspect
- Posterior intercostal veins drain to the azygous vein on the right and the hemiazygous vein on the left (drains to azygous)

Question 8

What arteries supply the lung tissue?

Answer 8

Brachial arteries (from thoracic aorta)

Question 9

What nerves supply the intercostal spaces?

Answer 9

Anterior rami of thoracic spinal nerves T1-T11 (intercostal nerves)

Question 10

What is the name of the T12 anterior rami?

Answer 10

Subcostal nerves

Question 11

What are the branches of the intercostal nerves?

Answer 11

Lateral and anterior cutaneous

Question 12

What do the posterior rami of the thoracic spinal nerves supply?

Answer 12

Bones, joints, deep back muscles and skin

Question 13

What is the function of the rami communicantes?

Answer 13

Connect intercostal and subcostal nerves to sympathetic trunk

Question 14

What are the names of the apertures in the diaphragm?

Answer 14

Caval opening (for IVC)
Oesophageal hiatus
Aortic hiatus

Question 15

Where does the diaphragm connect to?

Answer 15

Sternum
Lower six ribs
L1-L3 vertebral bodies

Question 16

What is the phrenic nerve made of?

Answer 16

C3, C4 and C5 anterior rami

Question 17

What is the route of the phrenic nerve?

Answer 17

Passes over anterior surface of scale is anterior

Descends over lateral aspect of fibrous pericardium

Question 18

The subclavian artery is anterior to the subclavian vein. True or false?

Answer 18

False. The vein is anterior to the artery.

Question 19

Where does the cephalic vein pass?

Answer 19

In the deltopectoral groove

Question 20

What is the role of the latissimus dorsi?

Answer 20

Shoulder movement

Question 21

Which muscle anchors the medial borders of the scapula to ribs 1-8?

Answer 21

Serrated anterior

Question 22

Paralysis of which nerve results in a “winged scapula”?

Answer 22

Long thoracic nerve (branch of the brachial plexus)

Question 23

Where do we auscultate the middle lung lobe?

Answer 23

Between ribs four and six in mid-clavicular and mid-axillary lines on the right side of the chest

Question 24

Where is the oblique fissure situated?

Answer 24

Anteriorly - rib 6 | Posteriorly - T3

Question 25

At what vertebral level is the lung base?

Answer 25

T11

Question 26

What is the sequence of events in coughing?

Answer 26

1. Deep inspiration 2. Adduction of vocal cords 3. Anterolateral abdo wall muscle contraction 4. Vocal folds abduct 5. Soft palate tense and elevates

Question 27

What cranial nerves are stimulated in coughing?

Answer 27

ix and x

Question 28

What are the accessory muscles of deep inspiration?

Answer 28

Pectoralis major Pectoralis minor Sternocleidomastoid Scalenus anterior, medium and posterior

Question 29

What structures are contained in the carotid sheath?

Answer 29

Vagus nerve Internal carotid artery Common carotid artery Internal jugular vein

Question 30

What are the anterolateral abdominal wall muscles?

Answer 30

``` Rectus abdominis External obliques Internal obliques Transverse abdominus Seratus anterior ```

Question 31

What is the linea alba?

Answer 31

The midline communication of the aponeurosis of each external oblique

Question 32

Where do the aponeuroses begin?

Answer 32

Linea semilunaris

Question 33

Which aponeuroses form the rectus sheath?

Answer 33

Both obliques | Transverse abdominus

Question 34

Which intercostal nerves become thoracoabdominal nerves?

Answer 34

7th-11th

Question 35

Which nerve does the subcostal nerve communicate with?

Answer 35

Iliohypogastric nerve of the lumbar plexus

Question 36

What is the name for the internal tracheal bifurcation?

Answer 36

Carina

Question 37

How can a pneumothorax be distinguished from a tension pneumothorax?

Answer 37

A tension pneumothorax will show mediastinal shift on CXR

Question 38

Management of large pneumothorax?

Answer 38

Thoracentesis

Question 39

Describe the location of the safe triangle for a chest tube

Answer 39

Anterior border of latissimus dorsi Posterior border of pectoralis major Axial lines sup. to nipple

Question 40

What is VATS?

Answer 40

Video Assisted Thorascopic Surgery

Question 41

What is chemical pleurodesis?

Answer 41

Talc slurry added to cavity of produce adhesion

Question 42

Where do the inguinal ligaments attach?

Answer 42

Between ASIS and pubic tubercle

Question 43

Where do lateral chest quadrants drain (lymph)?

Answer 43

Unilaterally to axillary nodes

Question 44

Where do the medial chest quadrants drain to (lymph)?

Answer 44

Bilaterally to the parasternal nodes