BRS Thorax HY

Question 1

The sternum

Answer 1

The sternum can be used for bone marrow biopsy because of its accessible location and it possesses hematopoietic marrow throughout life

Question 2

The sternal angle

Answer 2

The sternal angle (of Louis) is the junction between the manubrium and body of the sternum located at the level where (1) the second ribs articulate with the sternum, (2) the aortic arch begins and ends, (3) the trachea bifurcates into the right and left primary bronchi, and (4) it marks the plane of separation between the superior and inferior mediastinum.

Question 3

The true ribs

Answer 3

The true ribs are the first seven ribs (ribs 1–7)

Question 4

The false ribs

Answer 4

The false ribs are the lower five ribs (ribs 8–12)

Question 5

The floating ribs

Answer 5

The floating ribs are the last two ribs (ribs 11 and 12)

Question 6

Flail chest

Answer 6

Flail chest occurs when a segment of the anterior or lateral thoracic wall moves freely because of multiple rib fractures, allowing the loose segment to move inward on inspiration and outward on expiration.

Question 7

Muscles of inspiration

Answer 7

Include the diaphragm, external, internal (interchondral part), and innermost intercostal muscles, sternocleidomastoid, levator costarum, serratus anterior, serratus posterior superior, scalenus, and pectoral muscles.

Question 8

Muscles of expiration

Answer 8

Include anterior abdominal, internal intercostal (costal part), and serratus posterior inferior muscles. Quiet inspiration results from contraction of the diaphragm, whereas quiet expiration is a passive process caused by the elastic recoil of the lungs.

Question 9

The trachea

Answer 9

The trachea begins at the inferior border of the cricoid cartilage (C6) and has 16 to 20 incomplete hyaline cartilaginous rings that prevent the trachea from collapsing and that open posteriorly toward the esophagus. It bifurcates into right and left primary bronchi at the level of the sternal angle.

Question 10

The carina

Answer 10

The carina, the last tracheal cartilage, separates the openings of the right and left primary bronchi.

Question 11

The right primary bronchus

Answer 11

The right primary bronchus is shorter, wider, and more vertical than the left and divides into the superior (eparterial), middle, and inferior secondary (lobar) bronchi.

Question 12

The left primary bronchus

Answer 12

The left primary bronchus divides into the superior and inferior lobar bronchi.

Question 13

The bronchopulmonary segment

Answer 13

The bronchopulmonary segment is the anatomical, functional, and surgical unit of the lungs and consists of a segmental (tertiary or lobular) bronchus, a segmental branch of the pulmonary artery, and a segment of lung tissue, surrounded by a delicate connective tissue (intersegmental) septum.
The pulmonary veins are intersegmental.

Question 14

Bronchopulmonary (hilum) nodes

Answer 14

Bronchopulmonary (hilum) nodes drain into tracheobronchial nodes, then to paratracheal nodes,
and eventually to the thoracic duct.

Question 15

Lung buds

Answer 15

Lung buds arises from the laryngotracheal diverticulum in the embryonic foregut region.

Question 16

The right lung

Answer 16

The right lung is divided into the upper, middle, and

lower lobes by the oblique and horizontal fissures.

Question 17

The left lung

Answer 17

The left lung is divided into the upper and lower

lobes by an oblique fissure and contains the lingula and the cardiac notch.

Question 18

Most abscesses

Answer 18

Most abscesses occur in the right lung, because the right main bronchus is wider, shorter, and
more vertical than the left, and thus aspirated infective agents gain easier access to the right lung.

Question 19

The cupula

Answer 19

The cupula is the dome of cervical parietal pleura over the apex of the lung. It lies above the first rib
and is vulnerable to trauma at the root of the neck.

Question 20

Pancoast tumor

Answer 20

Pancoast tumor (superior pulmonary sulcus tumor) is a malignant neoplasm of the lung apex
which may cause a lower trunk brachial plexopathy and a lesion of cervical sympathetic chain
ganglia with Horner syndrome (ptosis, enophthalmos, miosis, anhidrosis, and vasodilation).

Question 21

Chronic obstructive pulmonary disease (COPD)

Answer 21

Chronic obstructive pulmonary disease (COPD) is an obstruction of airflow through the airways and lungs and includes chronic bronchitis and emphysema. Shortness of breath in COPD occur when the walls of airways and air sacs get inflamed, destroyed, lose elasticity, and hypersecrete
mucus

Question 22

Chronic bronchitis

Answer 22

Chronic bronchitis is an inflammation of the airways, which results in excessive mucus production
that plugs up the airways, causing a cough and dyspnea (difficulty in breathing).

Question 23

Emphysema

Answer 23

Emphysema is an accumulation of trapped air in the alveolar sacs, resulting in destruction of the
alveolar walls, reducing the surface area for gas exchange.

Question 24

Asthma

Answer 24

Asthma is an airway obstruction and is characterized by dyspnea, cough, and wheezing with
spasmodic contraction of smooth muscles in the bronchi and bronchioles, narrowing the airways.

Question 25

Barrel chest

Answer 25

Barrel chest is a chest resembling the shape of a barrel because the lungs are overinflated and the
thoracic cage becomes enlarged, as seen in cases of emphysema or asthma.

Question 26

Bronchiectasis

Answer 26

Bronchiectasis is a chronic dilation of bronchi and bronchioles, resulting from destruction of bronchial elastic and muscular elements, which may cause collapse of the bronchioles. It may be
caused by pulmonary infections or by a bronchial obstruction with heavy sputum production.

Question 27

Pleurisy (pleuritis)

Answer 27

Pleurisy (pleuritis) is inflammation of the pleura with exudation (escape of fluid from blood vessels)
into its cavity, causing the pleural surfaces to be roughened, producing friction.

Question 28

Pneumothorax

Answer 28

Pneumothorax is an accumulation of air in the pleural cavity because of an injury to the thoracic wall or the lung, causing no negative pressure in the chest and thus the lung collapses.

Question 29

Tension pneumothorax

Answer 29

Tension pneumothorax is a life-threatening pneumothorax in which air enters during inspiration and is trapped during expiration; therefore, the resultant increased pressure displaces the mediastinum
to the opposite side, with consequent cardiopulmonary impairment.

Question 30

Pleural effusion

Answer 30

Pleural effusion is an abnormal accumulation of excess fluid in the pleural space, having two types;
the transudate (clear watery fluid) and the exudate (cloudy viscous fluid).

Question 31

Thoracentesis (pleuracentesis or pleural tap)

Answer 31

Thoracentesis (pleuracentesis or pleural tap) is a surgical procedure to collect pleural effusion for analysis. A needle or tube is inserted through thoracic wall into the pleural cavity posterior to the midaxillary line one or two intercostal spaces below the fluid level but not below the ninth intercostal space.

Question 32

Fluid in the pleural cavity includes:

Answer 32

hydrothorax (water), hemothorax (blood),

chylothorax (lymph), and pyothorax (pus).

Question 33

Pneumonia (pneumonitis)

Answer 33

Pneumonia (pneumonitis) is an infection in the lungs, which is of bacterial, viral, or mycoplasmal
origin.

Question 34

Tuberculosis (TB)

Answer 34

Tuberculosis (TB) is an infectious lung disease caused by the bacterium Mycobacterium
tuberculosis and is characterized by the formation of tubercles that can undergo necrosis.

Question 35

Cystic fibrosis (CF)

Answer 35

Cystic fibrosis (CF) is an inherited multisystem disease that has widespread dysfunction of the exocrine glands and pulmonary and gastrointestinal tracts. CF affects the respiratory system by
causing an excess production of viscous mucus, obstructing the respiratory airway.

Question 36

Pulmonary edema

Answer 36

Pulmonary edema involves fluid accumulation in the lungs caused by lung toxins. As pressure in the pulmonary veins rises, fluid is pushed into the alveoli and becomes a barrier to normal oxygen
exchange, resulting in shortness of breath, increased heart rate, and cough.

Question 37

Atelectasis

Answer 37

Atelectasis is the collapse of a lung by blockage of the air passages, pressure on the outside of the lung, or shallow breathing. It is caused by mucus secretions that plug the airway, foreign bodies in
the airway, and tumors that compress or obstruct the airway.