Thoracic Wall

Question 1

What is the location of the thorax?

Answer 1

between neck and abdomen

Question 2

What are the contents of the thorax?

Answer 2

heart, lungs, and structures passing between neck and abdomen

Question 3

What is the shape of the thorax?

Answer 3

truncated cone with inlet and outlet

Question 4

What is the inlet of the thorax?

Answer 4

superior thoracic aperture

Question 5

What is the outlet of the thorax? What is it closed off by?

Answer 5

inferior thoracic aperture

respiratory diaphragm

Question 6

What does the bony thorax consist of?

Answer 6

12 thoracic vertebrae, 12 pairs of costae (ribs and costal cartilages), and sternum

Question 7

What are the boundaries of the superior thoracic aperture?

Answer 7

body of T1 vertebra posteriorly, 1st pair of costae laterally, and manubrium anteriorly

Question 8

What are the boundaries of the inferior thoracic aperture?

Answer 8

body of T12 vertebra posteriorly, 11th and 12th costae laterally, and xiphoid process and costal cartilages of 7-`10 anteriorly

Question 9

What separates the thorax from the abdomen?

Answer 9

respiratory diaphragm

Question 10

What level does the dome of the diaphragm rise to on the right and left?

Answer 10

right - 5th intercostal space

left - 6th intercostal space

Question 11

What does the manubrium articulate with?

Answer 11

clavicles - sternoclavicular joints
1st pair of ribs
2nd pair of ribs
body of the sternum at sternal angle

Question 12

How many sternabrae in the body of the sternum?

Answer 12

4

Question 13

What does the body of the sternum articulate with?

Answer 13

manubrium, costal cartilages 2-7, and xiphoid process

Question 14

What is the movement of the manubriosternal joint? What does this allow?

Answer 14

hinge-like movement of the body of the sternum anteriorly and posteriorly
facilitates increased respiration by allowing expansion of the thoracic cavity

Question 15

What level is the xiphisternal joint at?

Answer 15

T8 vertebra

Question 16

Can you palpate the xiphoid process?

Answer 16

yes, with discomfort

Question 17

Can you palpate the xiphisternal joint?

Answer 17

yes

Question 18

What is the length of the xiphoid process?

Answer 18

variable

Question 19

What are the 3 types of ribs?

Answer 19

true ribs (1-7)
false ribs (8-10)
floating ribs (11-12)

Question 20

What are true ribs?

Answer 20

costal cartilages attach directly to the sternum

Question 21

What are false ribs?

Answer 21

costal cartilage attach indirectly to the sternum

Question 22

What are floating ribs?

Answer 22

do not have any attachment to sternum

Question 23

What are the intercostal muscles?

Answer 23

external intercostals, internal intercostals, innermost intercostals

Question 24

What is the most superficial layer of intercostal muscles?

Answer 24

external intercostals

Question 25

Where do the external intercostal muscles extend?

Answer 25

from the tubercles of the ribs to the junction of the costal cartilages with the bony ribs

Question 26

What passes from the anterior margin of external intercostals to the lateral border of the sternum?

Answer 26

external intercostal membrane

Question 27

What is the orientation of muscle fibers for external intercostal muscles?

Answer 27

inferomedial orientation

Question 28

What is the action of the external intercostal muscles?

Answer 28

elevate ribs for inspiration

Question 29

What is the middle layer of intercostal muscles?

Answer 29

internal intercostal muscles

Question 30

Where does the internal intercostal muscles extend?

Answer 30

sternum to mid-axillary line

Question 31

What passes from the lateral margin of the internal intercostal muscles to the region of the vertebral column to fuse with the superior costotransverse ligaments?

Answer 31

internal intercostal membrane

Question 32

What orientation do the internal intercostal muscles run?

Answer 32

inferolateral

Question 33

What is the action of the internal intercostal muscles?

Answer 33

rib depression for exhalation

Question 34

What is the deepest layer of the intercostal muscles?

Answer 34

innermost intercostal muscles

Question 35

Where do the innermost intercostal muscles extend?

Answer 35

from the angles of the ribs to just anterior of the mid-axillary line

Question 36

What passes from the anterior border of the innermost intercostal muscles to the lateral border of the transversus thoracis muscle?

Answer 36

innermost intercostal membrane

Question 37

What orientation do the innermost intercostal muscle fibers run?

Answer 37

inferolateral

Question 38

What is the action of the innermost intercostal muscles?

Answer 38

rib depression for exhalation

Question 39

Where do the transversus thoracis muscles extend?

Answer 39

from the posterior surface of the lower half of the body of the sternum and xiphoid process to the costochondral junction of ribs 3-6

Question 40

What is the action of the transversus thoracis muscles?

Answer 40

depress the ribs for exhalation

Question 41

What are the intercostal nerves?

Answer 41

ventral primary rami of T1-T11

Question 42

What do the motor branches of the intercostal nerves innervate?

Answer 42

external intercostal muscles, internal intercostal muscles, innermost intercostal muscles, and transversus thoracis muscles

Question 43

What do the cutaneous branches fo the intercostal nerves innervate?

Answer 43

skin on the lateral and anterior surfaces of the thorax

Question 44

What intercostal nerves continue into the abdominal wall? What do they do?

Answer 44

T1-T7 | provide motor and cutaneous branches to the muscles and skin of the abdomen region

Question 45

Where are the posterior intercostal arteries located?

Answer 45

between the internal intercostal muscles and innermost intercostal muscles from the descending aorta in intercostal spacees 3-11

Question 46

What do the posterior intercostal arteries supply?

Answer 46

intercostal, pectoral, and serratus anterior muscles

Question 47

What is the blood supply for the breast in females?

Answer 47

lateral branches from posterior intercostal arteries in ICS 3-5

Question 48

Where does the supreme thoracic artery branch from?

Answer 48

axillary A

Question 49

What does the supreme thoracic artery supply?

Answer 49

intercostal spaces 1-2

Question 50

What does the supreme intercostal arteries branch from?

Answer 50

costocervical trunk

Question 51

What do the supreme intercostal arteries supply?

Answer 51

intercostal spaces 1-2

Question 52

What do the anterior intercostal arteries branch from?

Answer 52

internal thoracic A

Question 53

Where are the anterior intercostal arteries found?

Answer 53

intercostal spaces 1-6

Question 54

What do the anterior intercostal arteries supply?

Answer 54

skin, intercostal muscles, breasts, and thymus gland

Question 55

Where is the thymus gland located?

Answer 55

anterior mediastinum

Question 56

Where does the musculophrenic artery branch from?

Answer 56

terminal branch of internal thoracic artery

Question 57

What does the musculophrenic artery supply?

Answer 57

anterior intercostal arteries to intercostal spaces 7-9

Question 58

What does the parietal pleura line?

Answer 58

pleural cavity

Question 59

What are the surfaces of the parietal pleura? What are they attached to?

Answer 59

costal pleura - ribs and intercostal spaces mediastinal pleura - mediastinum diaphragmatic pleura - superior surface of the respiratory diaphragm cervical pleura - pleural cavity above 1st ribs, in the root of the neck

Question 60

What does the visceral pleura cover?

Answer 60

surface of the lungs and structures that pass into the lungs (bronchi, pulmonary vessels, nerves, lymphatics)

Question 61

Where is the vertebral reflection?

Answer 61

where the costal and mediastinal pleurae become continuous posteriorly

Question 62

Where is the sternal reflection?

Answer 62

where the costal and mediastinal pleurae become continuous anteriorly

Question 63

Where is the costal reflection?

Answer 63

wehre the costal and diaphragmatic pleurae become continuous inferiorly

Question 64

What are the 3 pleural recesses?

Answer 64

right costodiaphragmatic recess left costodiaphragmatic recess left costomediastinal recess

Question 65

Where is the right costodiaphragmatic recess located?

Answer 65

laterally along the costal reflection

Question 66

Where is the left costodiaphragmatic recess located?

Answer 66

laterally along the costal reflection

Question 67

Where is the left costomediastinal recess located?

Answer 67

anteriorly along the sternal reflection

Question 68

Do the lungs normally occupy recesses?

Answer 68

no

Question 69

What may collect in the recess during respiratory infections?

Answer 69

pus, fluid, or dead cells

Question 70

What is the pleural cavity?

Answer 70

potential space located between the pleural layers of the parietal and visceral pleura

Question 71

What do pleuaral cavities contain?

Answer 71

fluid produced by pleural membranes to lubricate surface and prevent adhesion

Question 72

What are intercostal nerve sensory fibers for?

Answer 72

pain and irritation to costal pleura in addition to supplying the periphery of the respiratory diaphragm

Question 73

What do the phrenic nerves supply?

Answer 73

fibers for pain and irritation to the mediastinal pleura and diaphragmatic pleura

Question 74

What is the pleural sac?

Answer 74

Location where the lungs are found contained within the visceral pleura