1.1.3 Thoracic Wall and Lung Cavities

Question 1

Identify the structures.

Answer 1

Question 3

Where is the thorax located?

Answer 3

B/t the neck and abdomen

Question 4

What are the components of the sternum?

Answer 4

Manubrium, body, xiphoid process

Question 5

What are the key skeletal elements of the thorax?

Answer 5

12 thoracic vertebrae

12 ribs and costal cartilages

1 sternum

Question 7

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

Answer 7

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 8

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

Answer 8

3-9

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

Question 9

What are these components of the ribs?

Answer 9

Question 10

What is the most frequent site of rib fractures?

Answer 10

Just lateral to the angle of the rib

Question 11

How many facets does the head of true ribs have?

Answer 11

2, a superior and inferior facet

Question 13

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

Answer 13

anterior scalene m.

Question 14

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

Answer 14

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

Question 15

What is another name for the sternal angle?

Answer 15

Angle of Lewis

Question 16

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

Answer 16

Question 17

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

Answer 17

Periosteum

Question 18

Where are the regions of the mediastinum located?

Answer 18

Question 19

Where is the 13th rib usually located?

Answer 19

On C7

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

Question 20

What is pectus carinatum?

Answer 20

Ridge projecting anteriorly (more rare than excavatum)

Question 22

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

Answer 22

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 24

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

Answer 24

Attachment of the 2nd rib

intervertebral level at disc b/t T4 and T5

bifurcation of trachea

azygos veins drains into the SVC

Question 26

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

Answer 26

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

Overuse injury in athletes

Question 27

What the three layers of the intercostal muscles?

Answer 27

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 28

What commorbidity is often associated with pectus excavatum?

Answer 28

Mitral valve prolapse

Question 30

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

Answer 30

Question 31

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

Answer 31

Question 32

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

Answer 32

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

Question 33

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

Answer 33

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

Question 34

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

Answer 34

tubercle of the rib and the transverse process of the vertebra

Question 35

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

Answer 35

Curved: 1-7

Flat: 8-12

Question 36

What type of joints are the sternocostal joints?

Answer 36

Cartilaginous

Question 39

What is gynecomastia?

Answer 39

Excessive development of the male mammary gland

Question 40

Where do the intercostal nerves run?

Answer 40

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

Question 41

What is different about the subcostal muscles?

Answer 41

They “skip” a rib

Found on the posterior portion of thoracic wall

Question 44

Which vein seperates the pectoralis major and the deltoid?

Answer 44

Cephalic vein

Question 45

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

Answer 45

VAN

V: vein

A: artery

N: nerve

Question 46

What is shingles?

Answer 46

A reactivation of a latent herpes varicella-zoster viral infection

Question 47

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

Answer 47

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 48

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

Answer 48

Axillary lymph nodes

Question 49

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

Answer 49

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

Males

Question 50

What is polymastia? When is most liked noticed?

Answer 50

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 52

What is contained in the mediastinum?

Answer 52

heart, great vessels, trachea, esophagus, and thymus

Question 53

Which muscle acts as the principal muscle of inspiration?

Answer 53

Diaphragm

Question 54

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

Answer 54

Lateral and Medial Pectoral Nerve

Medial pectoral nerve innervates both the major and minor pectoralis

Lateral pectoral nerve only innervates the pectoralis major

Question 55

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

Answer 55

These can become arthritic and be sources of back pain