Thoracic Cage and Breast Flashcards
(130 cards)
1
Q
Level of Thoracic Inlet
A
T1. Duh.
2
Q
Level of Thoracic Outlet
A
T11 or T12. Duh.
3
Q
Neurovascular connections of the thorax
A
Neck, Upper Ex, Abdomen
4
Q
Most important landmark of the thorax where all ribs are counted from
A
sternal angle
5
Q
Primary functions of the thorax
A
1) Protect lungs and heart
2) RBC formation
3) Blood aeration via expansion of thoracic cage
6
Q
Type of joint of sternal angle of Louie
A
synchondrosis
7
Q
At around which intercostal space is the sternal angle of Louie located?
A
2nd
8
Q
Surface landmarks of the thorax
A
jugular notch of the manubrium
sternal angle of Louie/manubriosternal junction
sternoclavicular joint
xiphoid process
9
Q
T or F: In infants, thoracic cage AP>Transverse diameter
A
False. It is more or less equal. The infant’s thoracic cage is barrel-shaped.
10
Q
T or F: The transverse diameter of an adult’s thoracic cage is greater than its AP diameter
A
True
11
Q
The cavity of the thorax is divided into:
A
Mediastinum and the Pleurae
12
Q
T or F: Full size of the lung is achieved during expiration
A
False. It is during inspiration
13
Q
Main components of the thoracic cage
A
Muscle and bone. However, it is also osteocartilaginous which prevents it from getting damaged during proper CPR
14
Q
Boundaries of the Triangle of Auscultation
A
1) Inf. Traps
2) Superior Lats
3) Vertebral border of Scapula
4) Rhomboid major (floor)
15
Q
Where can the space between the 6th and the 7th ribs (aka 6th ICS) be located?
A
Triangle of Auscultation
16
Q
Level of Jugular/Suprasternal Notch
A
T2
17
Q
What can be found at T9?
A
Inferior border of the heart, xiphisternal joint on the OPPOSITE side
18
Q
T or F: Inserting a needle on the xiphoid cartilage will damage the diaphragm and heart
A
False. This is just right below the inferior border of the heart. No danger here.
19
Q
The subcostal angle is used in reference for what?
A
The edge of the liver, which is 2cm below this.
20
Q
Which ribs’ costal cartilages form the costal margin?
A
7th-12th
21
Q
T or F: On the manubrium, the notch is for the 1st costal cartilage (CC), while the depression is for the 2nd CC
A
False. Depression: 1st CC :: Notch: 2nd CC
22
Q
The adult length of the manubrium
A
17cm
23
Q
T or F: The manubrium slopes downward and forward
A
True
24
Q
T or F: The manubrium is concave anteriorly and convex posteriorly
A
False. It is convex anteriorly, and concave posteriorly.
25
What major vein runs from the upper left to the lower right side beneath the manubrium? What vein does this connect to?
Left brachiocephalic to Right brachiocephalic
26
What do the L and R brachiocephalic veins form?
The superior vena cava
27
The transverse facets of the body of the sternum articulates with what?
3rd-5th CCs
28
Vertebral level length of the body of the sternum
T5-T9
29
T or F: The xiphoid is cartilaginous in the youth and ossified in the adult
True
30
Which ribs are true?
1-7
31
Which ribs are false?
8-10
32
Which ribs are floating?
11-12
33
Which ribs may be palpated?
2-10
34
T or F: female nipples are located at the 4th ICS
False. This is not always the case as female breasts vary in size and shape. However, male nipples are consistently located at the level of the 4th ICS
35
Where is the apex beat of the heart located?
5th ICS, approx. 7-9cm from the midsternal line
36
What is the axillary fold?
It is the area between the ant. fold by the pecs major, and the post. fold by the lats dorsi
37
Where is the cephalic vein located?
At the delto-pectoral groove
38
1st most prominent spine/spinous process
C7 aka vertebra prominens
39
Level of the superior angle of the scapula
T2
40
Which part of the scapula is subcutaneous?
Spine
41
Level of the inferior angle of the scapula
opposite T7
42
T or F: The thoracic inlet is oblique
True
43
T or F: The thoracic outlet is oblique
True
44
What closes the thoracic outlet?
The diaphragm
45
Atypical vs Typical Ribs: How many facets does a typical rib have?
2
46
Atypical vs Typical Ribs: Which rib is atypical and most sharply curved?
1st
47
Atypical vs Typical Ribs: Which atypical rib has a prominent tubercle?
1st
48
Atypical vs Typical Ribs: Which atypical rib has a small tubercle?
11th
49
The shallow grooves on the 1st rib are for?
The subclavian artery and vein
50
The eminence of the 2nd rib serves as an attachment for what?
1st and 2nd digitation of the serratus ant.
51
WHich atypical rib has an ill-defined angle?
11th
52
T or F: The 12th rib is longer than the 1st
False. It is shorter
53
Which part of the rib articulates with the vertebral transverse processes?
The tubercle
54
Part of the rib that is the broadest
Neck
55
Rib Ossification (order and events)
"7-14-25"
7 weeks: 1 center of ossification
14 weeks: 2ndary center of ossification
25 weeks: Fusion of 2ndary centers of ossification
56
What does the sternochondral joint consist of?
Synchondroses joints basically attached to the sternum; Rib 1. Ribs 2-7 are also attached to the sternum but they are SYNOVIAL
57
A joint that is basically just the connection of the costal cartilage and the actual rib bone
Costochondral
58
The costotransverse joint consists of: rib tubercle + _________
surface of transverse process of inferior
verterbrae to which head is joined
anterior
59
What kind of movement does the capitular joint produce?
Gliding
60
The 2 movements of the ribs and sternum
1) Water bucket handle
| 2) Water pump handle
61
Pecs Major controls w/c ribs?
1-6
62
Pecs minor controls w/c ribs?
2-5
63
Scalenes control w/c ribs?
1-2
64
What other muscle controls ribs 1-2?
SCMs
65
How many ext. intercostals are there?
11
66
What is the direction of the ext. intercostals?
inferomedially (btw, ext. intercostals are those fascia-like muscles that cover the intercostal spaces)
67
Innervation of intercostals
branches of the intercostal nerve
68
How many internal intercostals?
11 din
69
The spleen corresponds to which ribs?
9th-11th
70
Under which cases and where would the pain be located when the spleen is ruptured?
Trauma to 7th-11th ribs and abdominal pain
71
Where is the apex beat located?
5th intercostal space
72
T or F: The superficial fascia contains blood and lymphatic vessels
True
73
T or F: The deep fascia serves as a barrier to infection
True
74
T or F: The deep fascia is devoid of fat
True
75
Percussion of lungs produces what kind of sound?
Resonant
76
Percussion of the heart produces what kind of sound?
Dull
77
Where is the neurovascular bundle of the rib located?
Lower border of the rib. Therefore DO NOT insert a needle in this area.
78
What is the use of thoracentesis?
Drain fluid from lungs, but SMALL AMOUNT ONLY
79
What are the structures you will pass by IN ORDER when you insert a needle in the 6th ICS for thoracentesis?
skin, subcutaneous layer, serratus ant., ext. intercostals, int. intercostals, pleural cavity
80
What is the use of the Tube Thoracostomy?
Drain fluid from lungs but LARGE AMOUNT
81
What is the proper way to do a tube thoracostomy?
30 degrees from horizontal angle, xiphisternal space, directed to the left shoulder, then aspirate
82
How much amount in the pericardial spacewould cause the heart to stop?
50cc
83
A precess wherein a needle is inserted in the pericardial cavity
Pericardiocentesis
84
T or F: The sternal puncture aka bone marrow biopsy via sternum has been abandoned
True. Due to its proxmity to the heart
85
In a chylothorax, what is ruptured? What enters the pleural cavity?
Thoracic duct. Lymph and emulsified fat
86
T or F: In tension pneumothorax, air enters the lungs
False. It escapes the lungs and enters the pleural cavity and causes the lungs to collapse
87
Paradoxical breathing is present in what thoracic condition?
Multiple rib fracture. Aka "flail chest" Btw, paradoxical breathing means that instead of the normal expansion of the chest during inhalation, it contracts. A depression is seen in the affected area.
88
The long axis of the spleen is located along which rib and its specific area
10th, long shaft
89
Shape of the breast in nullipara
smooth and conical
90
Shape of breast in multipara
pendulous and elongated
91
Shape of breast in old age/emaciated individuals
flattened discs with irregular surfaces
92
Where are males' mamary glands found?
intercostal spaces
93
Rib landmarks for female breasts
2nd-6th ribs
94
T or F: The breast lies in the deep fascia of the ant. surface of the thorax
False. It lies in the superficial fascia
95
How much of the mammary gland overlies the deep pectoral fascia of the pecs major?
2/3
96
How much of the mammary gland overlies the fascia of the serratus major?
1/3
97
What separates the breast from the pecs maj?
Retromammary space
98
What kind of tissue is found in the retromammary space?
connective tissue
99
T or F: The gland tissue is thicker in the periphery of the breast than in the center
False. It is thicker in the center
100
How many lobes of pyramidal tissue is present in an average breast?
15-20
101
Place in correct order from inner to outer: lobes, lobules, lactiferous ducts, mammary papilla, alveoli
alveoli, lactiferous ducts, lobule, lobe, mammary papilla
102
T or F: The Suspensory Ligaments of Cooper are attached to the superficial layer of the deep fascia
False. It is attached to the DEEP layer of the SUPERFICIAL fascia, and gives the breast its posture
103
What does the varying amounts of fat around the glandular lobe give the breast?
Its shape
104
When does the branching of the alveoli and ducts occur?
In puberty
105
When are breasts considered mature?
After pregnancy, at onset of milk secretion. During pregnancy, the glands enlarge and undergo rapid multiplication (hyperplasia and hypertrophy)
106
Cells in the center of the alveolus undergo fatty degeneration and are eliminated in the first milk as _______?
Colostrum corpuscles
107
What are the reservoirs of milk (converging beneath the areola)
Tubulactiferi/ Galactophores
108
T or F: Muscular fibers are present in galactophores
False
109
T or F: Galactophores have a mucus lining
True
110
How many lactiferous ducts are there?
15-20
111
Are there sebaceous glands in the nipple?
Yes there are
112
What do you call the normal extension of the breast tissue towards or into the axilla?
Axilla of Spence
113
What do you call the median area between the breasts aka "curbs"?
Sinus Mammarium
114
What causes the rough surface of the areola?
Tubercles of Montgomery
115
Lymph from the nipple, areola, and lobules drains to ____?
Subareolar plexus
116
Lymph drainage of the lateral and inferior portions of the breast (75%)
Along thoraco-acromial and lat. thoracic vessels towards pecs nodes and eventually to axillary nodes
117
Lymph drainage of medial portion
Parasternal nodes/int. thoracic nodes along int. thora. artery
118
T or F: Lymph from the medial portion can cross to the opposite breast
True
119
Lymph drainage of the small superior portion
Supraclavicular nodes
120
T or F: Inferior phrenic nodes may also receive some lymphatic drainage
True
121
Veins anastomosing around the base of the nipple is also known as the_______?
Circulus venosus
122
Innervation of breasts
4th-6th lat and inf. cutaneous nerve branches of the intercostal nerve
123
T or F: Breast innervation is parasympathetic.
False. It is sympathetic.
124
The cutting of this nerve causes cutaneous anesthesia in the inner side of the arm and axilla
Intercostobrachial n. (think: intercostals + brachial)
125
This nerve is usually preserved during axillary dissection but may be sacrificed if it gets in the way
Thoracodorsal n. (nerve to lats dorsi)
126
Where do supernumerary nipples or accessory breast develop?
Along the milkline from axilla to groin
127
What is athelia?
Absence of nipple
128
T or F: Fibroadenoma is malignant
False. It is benign. A solid, solitary movable mass. Painless to tender on palpation
129
A palpable mass that is hard, immobile, and painful upon palpation, presenting with bloody or watery nipple discharge
Malignant. May be intraductal carcinoma or breast cancer
130
Predisposing factors to carcinoma
Radiation, family history, hormonal-endogenous or exogenous env., previous benign heart disease
