1.1.3 Thoracic Wall and Lung Cavities

Question 1

Where are the regions of the mediastinum located?

Answer 1

Question 2

Identify the structures.

Answer 2

Question 3

What is the clinical importance of the costotranverse joint and the costovertebral joint?

Answer 3

These can become arthritic and be sources of back pain

Question 4

What the three layers of the intercostal muscles?

Answer 4

External, internal, and innermost

The external runs down and medial on both sides (like putting hands into front pockets), and the internal and innermost run direction 90 degrees to that

Question 5

What is the name of the joint between the ribs and its corresponding vertabrae?

Answer 5

Costovertebral joint, it’s a synovial joint b/t head of rib and body of vertebra at a facet or demifacet

Question 6

What are the components of the sternum?

Answer 6

Manubrium, body, xiphoid process

Question 7

If which structure is left intact, will it allow for possible regeneration of the rib?

Answer 7

Periosteum

Question 8

What is gynecomastia?

Answer 8

Excessive development of the male mammary gland

Question 9

What condition is associated with the presence of the cervical rib?

Answer 9

Venous Thoracic Outlet Syndrome

(Fun fact: Your fellow classmate THE Miles Sanderson had this syndrome, which led to a blood clot in his shoulder.)

Question 10

Where are the lateral cutaneous and anterior cutaneous branches given of the intercostal nerves?

Answer 10

Question 11

What is a dermatome? Where are dermatomes C5, T4, T7, T10, L1

Answer 11

An area of the skin which receives innervation from a single spinal nerve.

C5: clavicle

T4: “teat”, nipple

T7: xiphoid process (pointy)

T10: umbilicus (O reminds you of the umbilicus)

L1: inguinal ligament

Question 12

Where do the intercostal nerves run?

Answer 12

Between the internal and innermost intercostal muscle (b/t I and I)

Question 13

What 4 bodily landmarks occur at the level of the sternal angle (the junction of the manubrium with body of sternum)?

Answer 13

Attachment of the 2nd rib

intervertebral level at disc b/t T4 and T5

bifurcation of trachea

azygos veins drains into the SVC

Question 14

Which vein seperates the pectoralis major and the deltoid?

Answer 14

Cephalic vein

Question 15

What is polymastia? When is most liked noticed?

Answer 15

Additonal breast along the milk line b/t the axilla and groin.

Rare, most likely noticed at the time of pregnancy due to enlargement and possible production of milk

Question 16

What is costochondritis? In what population is it most common?

Answer 16

Chest pain due to inflammation of the cartilage and bones in the chest wall.

Overuse injury in athletes

Question 17

What is pectus carinatum?

Answer 17

Ridge projecting anteriorly (more rare than excavatum)

Question 18

What is the most frequent site of rib fractures?

Answer 18

Just lateral to the angle of the rib

Question 19

Where is the thorax located?

Answer 19

B/t the neck and abdomen

Question 20

What is polythelia? In what population is it most common?

Answer 20

Supernumerary nipple(s) which may appear similar to a mole, anywhere along the mammalian lines (milk lines)

Males

Question 21

Which ribs are included in the typical ribs? What are there four common structures?

Answer 21

3-9

Head, tubercle, shaft/body, and angle of rib

Question 22

In what patient population is pectus carinatum most likely to develop?

Answer 22

11 to 14 y/o pubertal males undergoing a growth spurt

Question 23

What are these components of the ribs?

Answer 23

Question 24

Where do the ribs 1-7 articulate with the stenurm?

Answer 24

Question 25

Where does the pectoralis major originate and insert? pectoralis minor? serratus anterior muscle?

Answer 25

Question 26

How many facets does the head of true ribs have?

Answer 26

2, a superior and inferior facet

Question 27

What is contained in the mediastinum?

Answer 27

heart, great vessels, trachea, esophagus, and thymus

Question 28

What is circumscribed in green? What is the dense fibrous band connecting it to?

Answer 28

The cervical rib; the dense fibrous band is connecting it to the 1st rib

Question 29

What type of joints are the sternocostal joints?

Answer 29

Cartilaginous at the first rib. Ribs 2-7 have synovial joints with the sternum.

Question 30

The costotranverse joint is a synovial joint b/t what two structures?

Answer 30

tubercle of the rib and the transverse process of the vertebra

Question 31

Where is the 13th rib usually located?

Answer 31

On C7

about 0.5 to 1% of the population has a cervical rib

Question 32

What are the three types of ribs? Which ribs belong to each of these classifications?

Answer 32

True ribs (1-7): attach directly to sternum

False ribs (8-10 or some say 8-12): costal cartilages do not directly attach to sternum)

Floating ribs (11-12): lack costal cartilage

Question 33

What commorbidity is often associated with pectus excavatum?

Answer 33

Mitral valve prolapse

Question 34

In which ribs is the costotranverse joint fairly curved? fairly flat?

Answer 34

Curved: 1-7

Flat: 8-12

Question 35

What is shingles?

Answer 35

A reactivation of a latent herpes varicella-zoster viral infection

Question 36

~75% of the breast is drained into which lymph nodes?

Answer 36

Axillary lymph nodes

Question 37

Describe the typical positioning of artery, vein, and nerve from cranial to caudal under the groove of each rib?

Answer 37

VAN

V: vein

A: artery

N: nerve

Question 38

Which muscle acts as the principal muscle of inspiration?

Answer 38

Diaphragm

Question 39

What are the key skeletal elements of the thorax?

Answer 39

12 thoracic vertebrae

12 ribs and costal cartilages

1 sternum

Question 40

What is different about the subcostal muscles?

Answer 40

They “skip” a rib

Found on the posterior portion of thoracic wall

Question 41

What is another name for the sternal angle?

Answer 41

Angle of Lewis

Question 42

The are two pectoral nerves? Which pectoralis muscles do they innervate?

Answer 42

Lateral and Medial Pectoral Nerve

Medial pectoral nerve innervates both the major and minor pectoralis

Lateral pectoral nerve only innervates the pectoralis major

Question 43

The scalene tubercle in the 1st rib is the site of attachment for which muscle?

Answer 43

anterior scalene m.