Bones & Muscles of Thoracic Wall

Question 1

Describe the differences in ribs

1-2
3-10
11-12

Answer 1

1-2: somewhat squat, flat, and have an irregular, bumpy shape.

3-10: Ribs 3-10 are more gently curved with the costal heads and tubercles projecting notably.

11-12: Floating ribs. They do not connect to the sternum and have a subtle tuberosity.

Question 2

How do the ribs attach to each other?

1-7
8-10
11-12

Answer 2

1-7: Attach to sternum through individual costal cartilages

8-10: Attach to cartilage of rib 7

11-12: Do not attach to sternum, but are tipped by cartilage

Question 3

Radiate ligament of head of rib connects what?

Answer 3

Connects the head to vertebral facets/demifacets

Question 4

How do the ribs move during inspiration?

Answer 4

The 1st and 2nd ribs elevate
The 3rd-10th ribs open laterally (bucket-handle motion)
The 11th and 12th ribs swing laterally (pincers)
Rib movements push the sternum anteriorly

Question 5

Serratus anterior muscle is supplied by what artery?

What nerve?

Answer 5

Lateral thoracic artery

Long thoracic nerve

Question 6

What things travel through the diaphragm to get to the abdomen?

Answer 6

Inferior vena cava
Aorta
Esophagus

Question 7

What muscles are typically involved during inspiration?

Answer 7

Diaphragm
External intercostals
Internal intercostals- parasternal portion
Scalene muscles

Question 8

What muscles are typically involved during relaxed expiration?

Answer 8

Not many, just recoil of soft tissues

Question 9

What muscles are typically involved during forced expiration?

Answer 9

Internal intercostals-lateral portion
Innermost intercostals
Abdominal obliques
Rectus abdominis
Transversus thoracis

Question 10

The skin and muscles of the thoracic wall are innervated by what?

Answer 10

Intercostal nerves

Anterior rami from T1-T2

Question 11

What kind of branches come off both intercostal nerves and arteries?

Answer 11

Lateral cutaneous branches
Anterior cutaneous branches

Question 12

Intercostal veins drain to ___________ anteriorly and the azygos system posteriorly

Answer 12

Internal thoracic veins

Question 13

Azygos vein drains to what?

Answer 13

Superior vena cava

Question 14

Hemiazygos veins connects to what?

Answer 14

Azygos and accessory hemiazygos

Question 15

The intercostal
Vein
Artery
Nerve

Are protected by what?

Answer 15

Costal groove of superior rib

Question 16

Which gland is the place that T lymphocytes mature?

Answer 16

Thymus

Question 17

What is the route of milk through the breast?

Answer 17

Lobule
->
Lactiferous ducts
->
Lactiferous sinuses
->
Nipple

Question 18

Between lobules of the breast are ________ that extend from the thoracic wall and attach to skin of breast

Answer 18

Suspensory ligaments

Question 19

What is the space called between the breast and pectoralis major muscle?

Answer 19

Retromammary space

Question 20

What could be a physical sign of breast cancer?

Answer 20

Asymmetry

When female raises her arms and breast stays “fixed” to chest could indicate that cancer has adhered to the pectoralis muscle

Question 21

What are the main vessels supplying the breast?

Answer 21

Internal thoracic and lateral thoracic vessels

Question 22

Most lymphatic flow of breast travels to _________ lymph nodes

Answer 22

Axillary

Question 23

Describe the flow of lymph nodes from the breast?

Answer 23

Breast
->
Interpectoral nodes
->
Pectoral axillary nodes

Most of the remaining goes to:
Parasternal nodes