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Question 1

What are the two types of intercostal arteries?

Answer 1

Posterior intercoastal artery

Anterior intercostal artery

Question 2

What are the two posterior intercoastal arteries?

Answer 2

Superior intercostal artery

Descending (thoracic) aorta

Question 3

Where does the superior intercostal artery originate from?
What does it supply?

Answer 3

Originate: Costocervical trunk (of subclavian artery) (bc costco is superior to any other supermarket chain) (cervical bc it is up)

Supply: The first 2 intercoastal spaces

Question 4

What does the Descending thoracic aorta supply?
What is special about the 12th rib?

Answer 4

Supply: 3rd - 11th intercostal space and below 12th rib (subcostal artery)

(bc it doesn’t have a inercostal space)

Question 5

What are the two anterior intercoastal arteries?

Answer 5

Internal thoracic artery (from the subclavian artery) (bc the thorax is anterior, and the the intercostal spaces are internal)

Musculophrenic artery (a branch of the internal thoracic artery)

Question 6

Where does the internal thoracic artery originate from?
What does it supply?

Answer 6

Originate: from subclavian artery

Supply: 1st-6th (bc it is the main so it is going to supply the top (6))

Question 7

Where does the Musclophernic artery originate from?
What does it supply?

Answer 7

Originate: from internal intercostal artery

Supply: 7th-9th

Question 8

What part of the subclavian artery does the Internal thoracic artery branch from?
What its branches?

Answer 8

Branches from: First part of the subclavian artery

Internal thoracic artery branches:
Musculophrenic artery

Superior epigastric artery

Pericardiacophrenic artery

Perforating arteries

Anterior intercostal arteries

Question 9

What does the Anterior intercostal arteries supply?

Answer 9

1st-6th intercostal

Question 10

What does the perforating arteries follow?
What gland does it supply?

Answer 10

Follows: The terminal branches of the corresponding intercostal nerves

Supplies: Mammary gland

(bc it is like performance rating, so if you’re goin to rate something, you have to follow it to know how good it is, it has to see how good the nerves are performing, and terminal, bc when something is being performance rated, it has to be at its terminal speed)

Question 11

What does the Pericardiacophrenic artery follow?
What does it supply?

Answer 11

Follows: phernic nerve
Supplies: Pericardium

Question 12

Where does the Superior epigastric artery enter?
What does it supply?

Answer 12

Enter: Rectus sheath

Supplies: Upper half of rectus abdominis muscle

(makes sense, bc epigastric so near the stomach, so abdomen, superior so the upper part of the rectus abdominis muscle)

Question 13

Where does the Musculophrenic artery run around?
What does it supply?

Answer 13

Run around: the costal margin of the diaphragm.

Supply:7th-9th intercostal spaces and diaphragm

Question 14

What is the Coarctation of the aorta? What is the cardinal clincal (diagnosis) sign?
What is a identification point of it in an xray picture?

Answer 14

It is congenital narrowing in the aorta just after the left subclavian artery branches

Diagnosis: Higher blood pressure in the upper limbs than lower limbs (bc of the fact that the heart has to push harder)

Xray: serrated appearance of inferior borders of ribs (rib notching)

Question 15

What is collateral circulation?

Answer 15

The intercostal arteries provide an alternate route for blood flow between the internal thoracic artery and the thoracic aorta to provide blood supply to the lower body.

Question 16

What are the two types of intercostal Veins

Answer 16

Anterior intercostal
veins
Posterior intercostal
veins

Question 17

WHat do the Posterior intercostal
veins supply?

Answer 17

to azygos or
hemiazygos veins

(bc hemi engines make a load roar from posterior (exhaust) and vein bc it releases CO2)

Question 18

WHat do the anterior intercostal
veins supply?

Answer 18

internal
thoracic or musculophrenic veins (same as arteries)

Question 19

What are the two major lymphatic vessels that recive lymph from all over the body?

Answer 19

Thoracic duct

Right lymphatic duct

Question 20

Where do the right lymphatic and thoracic ducts drain into?

Answer 20

Right; The junction where the right subclavian and right internal juglar veins meet.

Thoracic; The junction where the Left subclavian and Left internal juglar veins meet.

(veins bc it takes them from tissues, so the oxyen is already emptyed)

Question 21

How does the thoracic duct begin? what is that begining called?
What major structure does it pass through?

Answer 21

Begins: As a dilated sac called the cisterna chyle

Pass through: aortic opening

Question 22

Where does the thoracic duct enter the thorax? Where and how does it ascend? Where does it join the blood vascular system?

Answer 22

Enter: In the posterior mediastenium (right of the aorta) (bc it passes behind the heart, so posterior)

Ascend: posterior and left to the esophagus (makes sense bc it is smaller so it will be behind it)

Join: left venous angle

Question 23

What are the tributaries of the thoracic duct at the root of the neck?

Answer 23

Left jugular vein

Left subclavian vein

Left bronchomediastinal trunk

Question 24

Do the anterior primary rami of the thoracic spinal nerves form plexuses?

Answer 24

No, they do not form plexuses but instead come out individually as intercostal nerves.

Question 25

What is the anterior primary ramus of T12 called?

Answer 25

**Subcostal nerve** (bc it is under the 12th rib where no intercostal space exists)

Question 26

What does each intercostal nerve supply? (skin and muscle)

Answer 26

**Skin:** Dermatomes **Muscles:** Myotome

Question 27

What is the **dermatomal** distribution of the nipple area? (what spine segment)

Answer 27

From T4

Question 28

What do the **Gray and white rami communicantes** do in relation to intercostal nerves?

Answer 28

Connect the intercostal nerves to the sympathetic trunk

Question 29

Where does the **anterior and lateral cutaneous** branch into?

Answer 29

to adjacent skin of thorax and abdomen **parietal pleura**, parietal peritoneum, peripheral portions of the diaphragm (bc these areas are often cut (stabbed) so it makes sense )

Question 30

What do typical motor intercostal nerves branch into?

Answer 30

intercostal and anterior abdominal wall muscles (bc you typically see anterior abdominal wall intercostal as well muscles bc mototr)

Question 31

Where do the **collateral branches** arise? Where do they descend? What does it help in supplying?

Answer 31

**Arise:** near the angles of the ribs **Descend:** descend to course along the superior margin of the lower rib **Help in supplying:** intercostal muscles and pariteal pleura (bc there is sometimes collateral damage that is caused near the angle of the rib)

Question 32

What does T1 give off a branch to?

Answer 32

Brachial plexus

Question 33

What does T2 give off a branch to?

Answer 33

intercostobrachial nerve medial cutaneous n. of the arm

Question 34

In coronary artery disease pain is reffered along which nerve? To which limb is it referred to?

Answer 34

**Along:** intercostobrachial nerve **Limb:** Medial side of the upper limb

Question 35

What is herpes zoster? What causes it? What are the symptoms? How does it cause those symptoms? What are some of the visual symptoms?

Answer 35

**It is:** viral disease of spinal ganglia **Cause:** reactivation of the varicella-zoster virus (VZV), or chickenpox virus **Symptoms and how they are caused** Caused by the virus invading the spinal ganglia which causes a sharp burning pain in the dermatome supplied by the involved nerve. **Visual symptoms:** The affected skin area becomes red, and vesicular eruptions appear.