Thorax

Question 1

Which bones make up the pectoral girdle?

Answer 1

Clavicle

Scapula

Question 2

Which are the “true” ribs and how do they connect to eh anterior rib cage?

Answer 2

Ribs 1-7, connect via their own cartilage

Question 3

Which are the “false” ribs and how do they connect to the anterior rib cage?

Answer 3

8-10, connect via the cartilage of rib above (7)

Question 4

Which are the floating ribs?

Answer 4

10-12

Question 5

Antero-lateral rib cage; refers to anterior/inferior border of the “connected” rib cage

Answer 5

Costal Margin

Question 6

What joints are found in the thoracic cavity?

Answer 6

Intervertebral Joints (2 kinds)

Costovertebral joints

Question 7

Compare the two kinds of intervertebral joints

Answer 7

1. Cartilaginous joints between vertebral bodies. Held in place by longitudinal ligaments and intervertebral discs
2. Synovial joints, at the junction of the lamina and pedicle

Question 8

Name the two longest longitudinal ligaments and were they are located

Answer 8

Anterior longitudinal ligament
*located anterior surface of vertebral bodies

Posterior longitudinal ligament
*located on posterior-most surface of the vertebral bodies

Question 9

How do the ribs articulate with the vertebrae

Answer 9

At two places:

1. Rib tubercle articulates with spinous process
   * this is also where the rib # and vertebra # match up
2. Rib head articulates at the vertebral bodies, between two.

Question 10

How do the ribs articulate anteriorly, with the manubrium and sternal body

Answer 10

Via costochondral joints (between rib and costal cartilage)

Question 11

Where might one find a “gliding synovial joint”?

Answer 11

Joints of the false ribs

Question 12

From what artery do most of the posterior intercostal arteries branch?

Answer 12

Aorta

Question 13

Where might one find the Costal Groove - and what’s in there?

Answer 13

Inferior / inTERIOR portion of a rib

Vein
Artery (posterior intercostal artery)
Nerve (intervostal neurovascular bundle)

Question 14

What is the primary blood source for the anterior intercostal arteries?

Answer 14

Internal Thoracic Artery (IMA)

Question 15

Where do thoracic wall veins drain?

Answer 15

Posteriorly - eventual to Azygous Venous System

Question 16

Describe drainage path from the R and L intercostal veins

Answer 16

R intercostal > Azygous Vein > Superior Vena Cava

L intercostal > Hemiazygous Veins > Azygous Vein > Superior Vena Cava

Question 17

What medical conditions can cause enlargement of the azygous system?

Answer 17

Anything that results in poor venous return

1. Obstructed Superior Vena Cava
2. Right heart failure
3. Liver problems (cirrhosis, portal hypertension)

Question 18

What facilitates the movement of the thoracic wall on inspiration?

Answer 18

Decreased Intra-abdominal volume on inspiration - facilitated by the diaphragm

Question 19

What facilitates expiration?

Answer 19

“Recoil” of the diaphragm and the compressed abdominal contents

Question 20

Which muscles, other than Scalenes and SCM can act as accessory muscles of respiration?

Answer 20

1. Serratus anterior

2. Pectoralis minor

Question 21

Where are the origins of the diaphragm?

Answer 21

At its circumferential lateral aspects:

Xyphoid
Costal Cartilages of ribs 5-10
Vertebral bodies L1-L3

Question 22

Where does the diaphragm insert?

Answer 22

on its Central Tendon - anterior-middle of the dome

Question 23

3 holes/hiatuses of the diaphragm

Answer 23

Vena Cava Foramen
Esophageal Hiatus
Aortic Hiatus

Question 24

_____ fibers extend downwards and forwards and _____ fibers extend downwards and backwards

Answer 24

External intercostal

Internal intercostal

Question 25

Where does the phrenic nerve originate?

Answer 25

Cervical Plexus, C3-C5 Travels downwards between lung and heart

Question 26

The phrenic nerve can be located in the neck, traveling just anterior to ____

Answer 26

the anterior scalene muscle

Question 27

What kind of nerve fibers does the phrenic nerve carry?

Answer 27

Sensory Somatic Motor Sympathetic

Question 28

Where might referred pain from the diaphragm manifest?

Answer 28

Anywhere C3-C5 enervates Lower neck, shoulders, lateral aspects of arms

Question 29

Where, in relation to the vertebra, do T1-T12 spinal nerves emerge?

Answer 29

Just INFERIOR to the vertebra with the same number

Question 30

What kind of fibers do spinal nerves carry?

Answer 30

Sensory Motor Sympathetic

Question 31

Which of the thoracic rami eventually runs within the costal groove?

Answer 31

Ventral Ramus! *(MOTOR)*

Question 32

Which roots, dorsal or ventral, are sensory? Which are motor?

Answer 32

Dorsal are Sensory Ventral are Motor

Question 33

What makes up the sympathetic trunk/

Answer 33

Ganglia (cell bodies) and axons

Question 34

Preganglionic sympathetic fibers - white or gray?

Answer 34

WHITE

Question 35

Postganglionic sympathetic fibers - white or gray?

Answer 35

GRAY