Thorax

Question 1

Where do you put a chest tube?

Answer 1

Midclavicular line + nipple line (5th intercostal space) + mid-axillary line

Question 2

Where is the point of max intensity?

Answer 2

5th intercostal space on the left side to listen to heart

Question 3

What is the composition of the female breast?

Answer 3

glandular tissue made up of lobes (15-20) made up of smaller structures of lobules where milk is produced…drains into lactiferous ducts independently onto the nipple

Question 4

The most important part of the breast exam is the _______ portion

Answer 4

axilla

Question 5

What is the arterial supply of the breast?

Answer 5

axillary artery –> lateral thoracic artery –> lateral mammary arteries
right common carotid –>internal thoracic artery –> medial mammary arteries

Question 5

What is the major drainage area of the breast?

Answer 5

axillary area, as well as along arteries in the medial region

Question 6

Where is the most common location of breast cancer?

Answer 6

upper left quadrant is 60% and goes clockwise from there

Question 7

What are signs of breast cancer??

Answer 7

abnormal bumps, dimpling, nipple retraction, masses

Question 8

What does the thoracic cage consist of?

Answer 8

Sternum-> manubrium, body, xiphoid process
12 ribs, thoracic vertebrae

Question 9

Where is the sternal notch?

Answer 9

T2 & T3

Question 10

Where is the sternal angle?

Answer 10

T4 & T5

Question 11

Where is the xiphoid process?

Answer 11

T8 & T9

Question 12

What is important about the costal groove?

Answer 12

where nerve, vein, and artery are located and essential to avoid in bedside procedures

Question 13

What is special about the costal angle?

Answer 13

Most common location for fracture

Question 14

How do nerves run?

Answer 14

with arteries

Question 15

What coincides with any articulations?

Answer 15

Joints and ligaments

Question 16

What is unique about how the rib articulates with the spine?

Answer 16

articulates between two vertebrae

Question 17

What is thoracic outlet syndrome?

Answer 17

repetitive motions of arm that cause pinching and compression of nerves and arteries. Common in women, trauma, can have a cervical rib… can remove this rib, PT, NSAIDS, change activity

Question 18

What are accessory muscles of respiration?

Answer 18

sternocleidomastoid and scalenes

Question 19

What are principal muscles of respiration?

Answer 19

external intercostals, diaphragm, internal intercostals*

Question 20

What are muscles of expiration?

Answer 20

internal intercostals, external oblique, internal oblique, transversus abdominis, rectus abdominus

Question 21

What muscle elevates the sternum?

Answer 21

sternocleidomastoid

Question 22

What muscle elevates and fixes upper ribs?

Answer 22

scalenes

Question 23

What muscle elevates ribs the width of thoracic cavity?

Answer 23

external intercostals

Question 24

What muscle descends for inspiration and rises for expiration?

Answer 24

diaphram

Question 25

What nerve innervates the diaphram?

Answer 25

phrenic nerves C3, C4, C5 voluntary and involuntary

Question 26

Where is the esophageal hiatus?

Answer 26

T10, diaphram

Question 27

What does the esophageal hiatus consist of?

Answer 27

esophagus, vagus nerves, esophageal arteries

Question 28

Where is the vena caval foramen?

Answer 28

T8

Question 29

What does the vena caval foramen consist of?

Answer 29

inferior vena cava, right phrenic nerve

Question 30

Where is the aortic hiatus?

Answer 30

T12

Question 31

What does the aortic hiatus consist of?

Answer 31

aorta, azygos vein, thoracic duct

Question 32

What does the internal thoracic arteries converge and become?

Answer 32

epigastric arteries

Question 33

What is the arterial supply for the ribs?

Answer 33

internal thoracics on both sides --> intercostal arteries

Question 34

What is the venous drainage of the ribcage?

Answer 34

Azygos on the right side, hemiazygous + accessory on left that drain into the azygous . follows arterial supply

Question 35

What does the superior thoracic aperture consist of?

Answer 35

esophagus, trachea, common carotid and subclavian arteries, internal jugular and subclavian veins

Question 36

What does the inferior thoracic aperture consist of?

Answer 36

large and expandable diaphragm

Question 37

What does the pectoralis major muscle do?

Answer 37

flexion, adduction, medial rotation

Question 38

How is the pectoralis major innervated?

Answer 38

lateral and medial pectoral nerves

Question 39

Where does the pectoralis major attach?

Answer 39

sternum/clavicle and proximal humeral shaft

Question 40

What does the pectoralis minor do?

Answer 40

scapular stabilization, some protraction

Question 41

Where is the pectoralis minor?

Answer 41

under pec major, ribs, scapula

Question 42

What innervates the pectoralis minor?

Answer 42

medial pectoral nerve

Question 43

What are the attachments of the subclavius muscle?

Answer 43

1st rib, middle 1/3 of clavicle, behind pec major

Question 44

What is the innervation of the subclavius muscle?

Answer 44

subclavian nerve

Question 45

What does the subclavius muscle do?

Answer 45

anchors clavicle during movement of shoulder and arm

Question 46

What is the origin and insertion of the serratus anterior?

Answer 46

O: upper 8 or 9 ribs I: vertebral border of scapula

Question 47

What does the serratus anterior do?

Answer 47

draws scapula forward and up, abducts scapula and rotates it, stabilizes vertebral border of scapula

Question 48

What innervates the serratus anterior?

Answer 48

long thoracic nerve (C5, 6, 7)

Question 49

What supplies the serratus anterior?

Answer 49

circumflex scapular artery