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Question 1

What is the bony thorax made up of?

Answer 1

Thoracic vertebraeRibsIntercostal spacesSternumCostal Cartilages

Question 2

How many ribs and thoracic vertebrae in the bony thorax?

Answer 2

12

Question 3

What is the sternum made up of?

Answer 3

• Manubrium• Body• Xiphisternum

Question 4

How are ribs 1-7 connected to the sternum?

Answer 4

• Via the costal cartilages

Question 5

How are ribs 8-10 connected?

Answer 5

• Connected to the costal cartilages above

Question 6

Why are ribs 11 & 12 known as “floating ribs”

Answer 6

• End free in the abdominal muscles

Question 7

What is the sternal angle?

Answer 7

• The junction of the manubrium and body

Question 8

How can we identify the 2nd costal cartilage?

Answer 8

Articulates with the ribs at the level of the costal cartilage

Question 9

Outline the features of a typical rib and the number of articular facets on each

Answer 9

• The head - has 2 articular facets, for articular with corresponding vertebrae and vertebra above• Neck - Connects the head of the rib with the body• The tubercle - has 1 articular facet, articulation with transverse process of corresponding thoracic vertebra• The shaft - thin, flat and curved Costal groove of the shaft, protects intercostal nerves and vessels

Question 10

What is the joint of the head of the ribs called?

Answer 10

Costoverterbral joint

Question 11

What are the articulations involved in the costoverterbral joint?

Answer 11

• The head of the rib articulates with the body of the corresponding verterbra and the verterbra above

Question 12

Where do the movements of the costoverterbral joints occur?

Answer 12

Joint of the rib headCostotranverse joint

Question 13

What are the articulations of the costotransverse joint?

Answer 13

• The articular facet on the tubercle of the rib articulates with the transverse process of the corresponding vertebra

Question 14

How many thoracic vertebrae are there and describe their size

Answer 14

• 12 thoracic vertebrae• Increase in size as you move inferiorlyAre medium sized.

Question 15

Give some distinguishing features of thoracic vertebrae

Answer 15

• Have facets on the side of the body (demi facets) for articulating with the head of the ribs.• Have facets on the transverse process (except T11 & T12). Are costal facets for articulations with tubercles of the rib• Have small and circular vertebral foramen

Question 16

How many processes do the thoracic vertebra have for articular connections?

Answer 16

Seven

Question 17

Where are bilateral costal facets located?

Answer 17

• Ön the vertebral bodies, usually occurring in inferior and superior pairs Articulate with the heads of ribs

Question 18

What are the costal facets?

Answer 18

• Found on the transverse processes for articulation with the tubercles of ribsNot found on inferior two or three thoracic vertebra

Question 19

What is the joint of the rib head?

Answer 19

• The head of the rib articulates with the corresponding vertebra an the vertebra above

Question 20

What is the costotransverse joint?

Answer 20

• The articular facet on the tubercle of the rib articulates with the tranverse process of the corresponding vertebra

Question 21

Give some identifying features of the first rib

Answer 21

• First rib is shortest, broadest & most curved• The head has a single facet for articulation with T1• Two transversely directed grooves crossing its superior surface for subclavian vessels

Question 22

What are the transverse grooves of the first rib seperated by?

Answer 22

Scalene tubercle

Question 23

Give two distinct features of the second rib

Answer 23

• Two articular facets for articulation with the bodies of T1 and T2• Rough area on its upper surface, the tuberosity for serratus anterior

Question 24

How are the 10th - 12th rib weird?

Answer 24

• Single articular facet for articulation with single vertebra

Question 25

How are the 11th and 12th ribs different from the rest?

Answer 25

• Both floating• single facet on head• no tubercles

Question 26

What muscles lie in the intercostal spaces?

Answer 26

• 3 intercostal muscles ○ External ○ Internal ○ Innermost

Question 27

What is the neurovascular bundle?

Answer 27

• The neurovascular bundle runs in the costal groove at the lower border of the rib

Question 28

What are the nerve roots of the intercostal rami?

Answer 28

T1 - T12

Question 29

Where do the intercostal nerves run?

Answer 29

Internal & innermost intercostal muscles

Question 30

What do the intercostal nerves supply?

Answer 30

• Supply intercostal muscles, the parietal pleura , overlying skin

Question 31

Which way do the fibres of the external intercostal muscles run?

Answer 31

Downwards and anteriorly

Question 32

What is the function of the external intercostal muscles?

Answer 32

• Inspiratory muscles• Its action elevates the ribs in a "bucket hand" type of movement to increase antero posterior and transverse diameters of the chest• Responsible for 30% of chest expansion during quiet respiration

Question 33

What is the function of the internal intercostal muscles?

Answer 33

• Muscle fibres run downwards & posteriorly from the rib above to the rib below, pulling the ribs down from their position of chest expansionUsed during forced expiration

Question 34

What is the function of the innermost intercostal muscles?

Answer 34

Similar to internal intercostal muscles but less well developed

Question 35

What is the main muscle of inspiration?

Answer 35

The diaphragm

Question 36

Give the three openings of the diaphragm

Answer 36

• Vena cava - T8• Oesophagus - T10Aorta - T12

Question 37

Name the arteries which give rise to the anterior intercostal artery

Answer 37

• Brachiocephalic/Aortic Arch à Subclavian à Internal Thoracic/Musculophrenic (later) à Anterior Intercostal

Question 38

Name the arteries which give rise to the posterior intercostal arteries

Answer 38

Brachiocephalic/Aortic Arch à Subclavian -> Costocervical trunk -> Superior intercostal -> Posterior intercostal

Question 39

How do anterior intercostal arteries drain?

Answer 39

Into internal thoracic -> Subclavian

Question 40

Where do the posterior arteries of the intercostal spaces drain?

Answer 40

• Into the azygous vein on the right and the hemizyagous vein on the left, and then into the inferior vena cava (some into internal thoracic vein)

Question 41

What lies in the intercostal groove of the ribs?

Answer 41

Intercostal vein, artery and nerve (VAN)

Question 42

Why is it clinically significant that the intercostal vein, artery and nerve run in the intercostal groove

Answer 42

• Important during pleural aspiration or insertion of a chest drain, when the needle should be inserted at the upper border of the rib to avoid injury

Question 43

What do intercostal arteries supply?

Answer 43

• Intercostal muscles, parietal pleura and overlying skin

Question 44

Where do the anterior intercostal arteries arise?

Answer 44

• The internal thoracic artery and its continuation (the musculophrenic artery)

Question 45

Where do the intercostal nerves arise from?

Answer 45

• Anterior rami of thoracic spinal nerve T1-T12