Thorax

Question 1

What forms the thoracic cage?

Answer 1

12 pairs of ribs
sternum
costal cartilages
12 thoracic vertebrae

Question 2

What forms the thoracic wall?

Answer 2

cage + muscles and fascia

Question 3

What is the function of the thoracic wall?

Answer 3

1) Protect thoracic cavity and upper abdominal
2) respiration
3) attachment for skin, fascia, muslces of neck, thorax, upper limbs, abdomen, back

Question 4

What are the boundaries of the thoracic wall?

Answer 4

anterior: sternum, costal cartilages
laterally- ribs
posteriorly- thoracic vertebrae and IV discs

Question 5

What are the special features of the thoracic vertebrae?

Answer 5

1) long, inferiorly angled spinous processes
2) costal facets on the transverse processes where ribs articulate (except last 2 or 3)
3) 2 demifacets on bodies T2-T9 for articulation with other ribs
- superior articulates with head of same rib number
- inferior articulates with head of inferior (higher number)

Question 6

What does the inferior articular facet on the rib head articulate with?

Answer 6

vertebra of same number as rib

Question 7

What does the superior articular facet of the rib head articulate with?

Answer 7

vertebra above (lower number)

Question 8

What does the rib tubercle articulate with?

Answer 8

same number vertebra
attachment site for costotranserse ligaments
in neck

Question 9

What are the true ribs?

Answer 9

1st-7th

Question 10

What are the false ribs?

Answer 10

8th- 10th

Question 11

What are the floating ribs?

Answer 11

11th and 12th

Question 12

What are the atypical features of the first rib?

Answer 12

1) scalene tubercle

2) single facet for articulation with only the T1 vertebra

Question 13

What are the atypical features of the 2nd rib?

Answer 13

tubercle for origin of serratus anterior muscle

Question 14

What are the atyipcal features of the 10th rib?

Answer 14

only one faet for articulation with only one vertebra

Question 15

What are the atypical features of the 11th and 12th ribs?

Answer 15

no necks or tubercles
free floating
articulate with only one vertebra

Question 16

Where is the manubrium of the sternum?

Answer 16

level of T3 and T4 with jugular notch

Question 17

Where is the body of the sternum?

Answer 17

T5-T9

Question 18

Where is the xiphoid process of the sternum?

Answer 18

T10

Question 19

Where can the jugular (suprasternal) notch be felt?

Answer 19

palpated at T2 level

Question 20

Where can the sternal angle be felt?

Answer 20

palpated at the T4 level

Question 21

What are the boundaries of the superior thoracic aperture?

Answer 21

T1
1st ribs and cartilage
superior border of manubrium

Question 22

What passes through the superior thoracic aperture?

Answer 22

1 trachea
2 esophagus
3 nerves and blood vessels for head neck and upper extremities

Question 23

What binds the inferior thoracic aperture?

Answer 23

T12
11th and 12th rib pairs
costal cartilages of ribs 7-10 
xiphisternal joint
closed by diaphragm

Question 24

What are the 3 openings to the inferior thoracic aperture?

Answer 24

1. inferior vena cava hiatus (T8)
2. esophageal hiatus (T10)
3. aortic hiatus (T12)

Question 25

What are the four intercostal muscles of the thoracic cage?

Answer 25

external intercostal- raise ribs inspiration internal intercostal - lowers ribs exspiration innermost intercostal- raise ribs inspiration transversus thoracis- w/ sternum

Question 26

Where do the thoracic fibers run?

Answer 26

anterior superior | posterior inferior

Question 27

What innervates the diaphragm?

Answer 27

phrenic nerve C3-5 cerivical plexus Attached to: xiphoid process, lower 6 intercostal cartilages and L1-L3 vertebrae and converge into central tendon functino: draw central tendn down and forward during inspiration

Question 28

What are the 3 major openings of the diaphragm>

Answer 28

1) inferior vena cava (T8) 2) esophagus (T10) 3. Aorta (T12) I ate ten eggs at noon

Question 29

How does the thoracic cage move during breathing?

Answer 29

vertical diameter increases during inspiration as diaphragm decends diaphragm ascent during expiration to return to size transverse diameter = increases slightly when intercostals contract= BUCKET HANDLE motion Anteroposterior diameter= movemnt of ribs 2-6 and sternal ends of ribs raise = PUMP HANDLE motion sternum moves forward as lift chest= scalene and SCM can help with respiration to bring in 02 if struggling

Question 30

What is the neurovasculature of the throcic wall?

Answer 30

Intercostal vein intercostal artery interscostal nerve nerve most exposed because most superficial dont stick needed between ribs on up angle

Question 31

What is the blood supply to the posterior wall of the thoracic cage?

Answer 31

posterior intercostals branches of aorta and costocervical trunk

Question 32

What is the blood supply to the anterior wall if the thoracic cage?

Answer 32

anterior intercostals branches of internal thoracic and musculophrenic arteries

Question 33

Where do the intercostal veins drain?

Answer 33

azygos (right) vein then hemizygos veins (left) deep and run opposite arterys

Question 34

What is the nerve supply to the thoracic wall?

Answer 34

intercostal muscles innervated by ventral rami of thoracic nerves

Question 35

What are the important dermatomes?

Answer 35

``` C4 = clavical and jugular notch (supraclavicular) T2= sternal angle T4 = nipples ``` dermatomes usually drop 2 levels from posterior to anterior (T2 front = T4 back)

Question 36

What are the 2 divisons of the mediastinum?

Answer 36

superior mediastinum and inferior mediastinum

Question 37

What is in the superior mediastinum?

Answer 37

above sternal angle 1) thymus 2) brachiocephalic veins and superior vena cava 3) phrenic and vagus nerve (recurrent laryengeal) 4) aortic arch and branches 5) trachea 6) esophageous 7) thoracic duct

Question 38

What is the in the inferior mediastinum?

Answer 38

inferior to sternal angle superior to diaphragm anterior mediastinum = thymus and sternopericardial ligs middle mediastinum= pericardial cavity/heart, great vessels, phrenic m, roots of lung posterior mediastium= esophagous, descending aorta branches, azygos veins, thoracic duct, sympathetic chair and splanchnic nerve

Question 39

What is the most superficial structure against the ribs?

Answer 39

branches of interal thoracic vessels in ant mediastinum

Question 40

Where is the aortic arch and branches?

Answer 40

superior mediastinum brachiocephalic trunk left common cartotid a left subclavian a

Question 41

Where is the phrenic nerve?

Answer 41

on top of lungs

Question 42

Where is the vagus nerve?

Answer 42

with aortic arch behind heart- plexus

Question 43

Where is the recurrent largyngeal nerve?

Answer 43

in tracheoesophageal groove

Question 44

How do the lungs appear in a CT?

Answer 44

black hole = air