Thorax

Question 1

Superior thoracic aperture

Answer 1

Boundaries - Posterior: T1, Lateral: 1st pair of ribs, Anterior: superior border of mandible
Structures running through: trachea, esophagus, phrenic and vagus nerves enter, great vessels exit

Question 2

Inferior thoracic aperture

Answer 2

Boundaries - posterior: T12, lateral: post. - ribs 11 + 12, ant. - ribs 7-10, anterior: xiphisternal joint between xiphoid process and sternum.
Diaphragm takes origin here.

Question 3

Mediastinum

Answer 3

Space between spine, sternum, manubrium, and xiphoid process. Where heart rests along with esophagus and great vessels. Has sections.

Question 4

Which are the true ribs, and what type of articulation do they have?

Answer 4

1-7, vertebrocostal

Question 5

Which are the atypical ribs?

Answer 5

1,2,11, and 12

Question 6

Which are the false ribs, and what type of articulation do they have?

Answer 6

8-10, vertebrochondral

Question 7

Which are the floating ribs

Answer 7

11 + 12

Question 8

What are the unique aspects of the first rib?

Answer 8

Grooves for subclavian vein + artery, Scalene tubercle and ridge, and only one facet on head

Question 9

What are the unique aspects of the second rib?

Answer 9

Tuberosity for serratus anterior

Question 10

What runs through the costal groove?

Answer 10

Intercostal arteries, veins, and nerves

Question 11

Intervertebral Joint

Answer 11

Type: symphysis (secondary cartilaginous joint)
Articulation: adjacent vertebral bodies bound together by intervertebral discs
Ligaments: anterior and posterior longitudinal

Question 12

Costovertebral joints of head of ribs (1)

Answer 12

Type: synovial plane of joint
Articulation: head of each rib with superior demarcate of corresponding vertebral body and inferior demarcate or costal facet of vertebral body superior to it
Ligaments: radiate and intra-articular ligaments of head of rib

Question 13

Costotransverse joint (2)

Answer 13

Type: synovial plane of joint
Articulation: Articulation of tubercle of rib with transverse process of corresponding vertebra
Ligaments: Lateral and superior costotransverse

Question 14

1st sternocostal joint (3)

Answer 14

Type: primary cartilaginous joint
Articulation: articulation of 1st costal cartilages with manubrium of sternum
Ligaments: anterior and posterior radiate sternocostal

Question 15

2nd - 7th strenocostal joints (4)

Answer 15

Type: synovial plane joints
Articulation: articulation of 2nd-7th pair of costal cartilages with sternum
Ligaments: anterior and posterior radiate sternocostal

Question 16

Sternoclavicular joint (5)

Answer 16

Type: saddle type of synovial joint
Articulation: sternal end of clavicle with manubrium and 1st costal cartilage
Ligaments: anterior and posterior sternoclavicular ligaments; costoclavicular ligament

Question 17

Costochondral joint (6)

Answer 17

Type: primary cartilaginous joint
Articulation: articulation of lateral end of costal cartilage with sternal end of rib
Ligament: cartilage and bone; bound together by periosteum

Question 18

Interchondral joint (7)

Answer 18

Type: synovial plane joint
Articulation: articulation between costal cartilages of 6th-7th, 7th-8th, and 8th-9th ribs
Ligaments: interchondral ligaments

Question 19

Manubriosternal joint

Answer 19

Type: secondary cartilaginous joint (symphysis)
Articulation: articulation between manubrium and body of sternum

Question 20

Xiphisternal joint

Answer 20

Type: primary cartilaginous joint (synchondrosis)
Articulation: articulation between xiphoid process and body of sternum

Question 21

What are the innervations to the diaphragm?

Answer 21

Phrenic nerve and musculophrenic arteries

Question 22

External intercostal muscle

Answer 22

Superior attachment: inferior border of ribs
Inferior attachment: superior border of ribs below
Innervation: Intercostal nerve
Action: elevates ribs during inspiration during forced inspiration

Question 23

Internal intercostal muscle and innermost intercostal muscle

Answer 23

Superior attachment: inferior border of ribs
Inferior attachment: superior border of ribs below
Innervation: Intercostal nerve
Action: during forced inspiration interosseous part depresses ribs, interchondral part elevates ribs

Question 24

Transversus thoracis

Answer 24

Superior attachment: posterior surface of lower sternum
Inferior attachment: internal surface of costal cartilage 2-6
Action: weakly depresses ribs

Question 25

Subcostal muscle

Answer 25

Superior attachment: internal surface of lower ribs near their angle Inferior attachment: superior borders of 2nd or 3rd ribs below Action: during forced inspiration interosseous part depresses ribs, interchondral part elevates ribs

Question 26

Levatores costarum muscle

Answer 26

Superior attachment: transverse process of T7-11 Inferior attachment: subjacent ribs between tubercle and angle Innervation: posterior rami of C8-T11 Action: elevates ribs

Question 27

Serratus posterior superior muscle

Answer 27

Superior attachment: nuchal ligament, spinous process of C7-T3 vertebrae Inferior attachment: superior border of ribs 2-4 Innervation: 2nd-5th intercostal nerves Action: elevates ribs

Question 28

Serratus posterior inferior muscles

Answer 28

Superior attachment: spinous process of T11-L2 vertebrae Inferior attachment: inferior border of ribs 8-12 near their angle Innervation: 9th-11th intercostal nerves, subcostal (T12) nerve Action: depress ribs

Question 29

Posterior intercostal artery origin

Answer 29

thoracic aorta

Question 30

Anterior intercostal arteries origins

Answer 30

internal thoracic arteries and musculophrenic arteries

Question 31

Unique aspects of right pleura

Answer 31

Horizontal fissure between superior and middle lobe

Question 32

Uniques aspects of left pleura

Answer 32

Cardiac notch in superior lobe and lingula at apex of superior lobe. Where the heart sits.

Question 33

Order of bronchial tree from top of right pleura to bottom

Answer 33

Right main bronchus, right superior lobar ("eparterial") bronchus, right middle lobar bronchus, segmental bronchus, right lower lobe bronchus

Question 34

Order of bronchial tree from top of left pleura to bottom

Answer 34

Left main bronchus, left superior lobar bronchus, left inferior lobar bronchus

Question 35

Origins of left vs. right bronchial arteries

Answer 35

Left: aorta Right: intercostal arteries, aorta, and left bronchial artery

Question 36

Bronchial vein drainage left vs. right

Answer 36

Left: accessory hemiazygous vein or intercostal vein Right: azygous vein

Question 37

Pulmonary Collapse

Answer 37

Air infiltrating pleural cavity (pneumothorax) can break surface tension between visceral and parietal pleura. When this happens, the elastic lung tissue will recoil (collapse) leaving air filled space within the pleural cavity that prevents expansion of the lung during inspiration.

Question 38

Hemothorax, Hydrothorax, and Chylothorax

Answer 38

Infiltration of pleural cavity via different substances causes lung collapse. Hemo - blood Hydro - fluid Lymph - chylo

Question 39

Pleuritis/pleurisy

Answer 39

Inflammation of pleura, may cause "scraping sounds" during auscultation, and can cause sharp stabbing pain.

Question 40

Pulmonary embolism (PE)

Answer 40

Obstruction of pulmonary artery by blood clot, fat globule, or air bubble; often fatal. Passes form vein into right side of heart via vena cava and then travels through heart an into pulmonary artery, obstructing blood flow. Deep vein thrombosis (DVT) is a common cause.

Question 41

Bronchogenic carcinoma

Answer 41

Common type of lung cancer arising from bronchial epithelium. Smoking is a major cause. Highly metastatic due to association of lymphatics in bronchial tissue. Typically metastasizes to brain and cranium.

Question 42

Malignant Mesothelioma

Answer 42

Rarer type of lung cancer affecting pleura (mesothelium) Caused by exposure to asbestos. Can affect other internal organs.

Question 43

Pulmonary tuberculosis

Answer 43

Bacterial infection of the lungs (mycobacterium tuberculosis). Can spread to other organs. Contagion spread through air through droplets from an infected individual coughing, sneezing, or talking. 1/3 of the world's population is currently infected with TB, but only 5-10% become sick or infection (active TB).