2. Cardiopulmonary: Osteology, Arthrology, Myology

Question 1

What is contained in the pulmonary cavities and the mediastinum?

Answer 1

The lungs and the heart

Question 2

What are the three bones that make up the sternum?

Answer 2

Manubrium (handle), body of the sternum, and the xiphoid process

Question 3

There are 7 costal notches on the sternum, what goes in these?

Answer 3

NOT THE RIBS, costal cartilages meet the costal notches

Question 4

What ribs are considered to be true (vertebrocostal) ribs? What ribs are considered to be flase (vertebrochondral) ribs? What ribs are considered to be floating (vertebral) ribs? Why?

Answer 4

1. Ribs 1-7 d/t costal cartilage meeting sternum 2. Ribs 8-10 d/t all cartilage merging with the 7th ribs cartilage 3. Ribs 11-12 b/c they are not connected by cartilage to the sternum at all

Question 5

What ribs are atypical and typical ribs?

Answer 5

Atypical are ribs 1-2, 10-12 Typical ribs are 3-9

Question 6

How does vertebra 6 meet rib 6?

Answer 6

Rib 6’s inferior articular facet meets V6’s superior costal facet. The tubercle of the rib meets the transver process of V6. The rib’s superior aritcular facet meets with V5’s inferior costal facet

Question 7

What is unique about the 1st rib?

Answer 7

Shortest, broadest rib, grooves for subclavian vein and artery, vein being anterior to the scalene tubercle, artery being posterior. Only has one articular facet

Question 8

What is unique about the 2nd rib?

Answer 8

Short and broad, has a tuberosity for serratus anterior

Question 9

What is unique about ribs 10-12 and 11/12?

Answer 9

Ribs 10-12 only have one articular facet on the head and no tubercle Ribs 11/12 are short and have no articulation with sternum

Question 10

What are some common differences between simple and complicated rib fractures?

Answer 10

Simple: Transverse/Oblique/Overriding/Chondral fractures Costovertebral dislocation or Costochondral separation Complicated: Injure pluera and lung/many rib fractures/tear blood vessels/ puncture/injury to heart

Question 11

What are supernumerary ribs? What can it cause?

Answer 11

When a cervical vertibra has transverse/horizontal element on the transverse process Causes thoracic outlet syndrome

Question 12

What are the differences between synovial, fibrous, and cartilagenous joints and what are the types?

Answer 12

Synovial joints have a articular capsule and many different types: Plane, hinge, saddle, condyloid, ball and socket, and pivot Fibrous joints are like sutures in skull, between two bones, syndesmosis, schindylesis, gomphosis (tooth/socket) Cartilaginous Joints: Synchondrosis (primary) and Symphisis (secondary)

Question 13

Manubriosternal Joint (Joint type, Bones involved, ligaments)

Answer 13

Joint Type:Symphysis

Bones: Sternal Angle/Second costal notch

Ligaments: None

Question 14

Xiphisternal Joint (***First primary cartilage joint***)

Answer 14

Joint Type: Synchondrosis

Bones: Inferior limit of the thorax

Ligaments: None

Question 15

Sternocostal Joints (Rib 1 different from 2-7)

Answer 15

Joint Type: Rib 1: Synchondrosis Rib2-7: Planar Synovial

Bones: Ribs and Sternum

Ligaments: Anterior/Posterior Radiate Sternocostal L

Question 16

Costovertebral Joints

Answer 16

Joint Type: Planar Synovial

Bones: Ribs and Vertebrae

Ligaments: Radiate L

Intraarticular L.

Articular Capsule

Question 17

Costotransverse Joint

Answer 17

Joint Type: Planar Synovial

Bones: Ribs and Transver processes of vertebrae

Ligaments:

Lateral Costotransverse L (rib/T process same segment)

Superior Costotransverse L (neck rib to T process one segment up)

Question 18

Costochondral Joints

Answer 18

Joint Type: Synchondrosis

Bones: Ribs and costal cartilages

Ligaments: None

Question 19

Interchondral Joints (different for between 6-9 and 9-10)

Answer 19

Joint Type: 6-7-8-9 : Planar Synovial 9-10: Fibrous Joint

Bones: Costal cartilages

Ligaments: Interchondral L.

Question 20

Thoracic Vertebral Joints

Answer 20

Joint Type: Intervertebral Joint: Symphysis Zygopophyseal Joint: Planar Synovial (COMPOUND JOINT)

Bones: Between vertebrae

Ligaments:

Anterior Longitudinal L

Posterior Longitudinal L

Ligamentum Flavum

Interspinous L

Intertransverse L

Supraspinous L

Intervertebral Discs: Annulus fibrosis and Nucleus Pulposus

Question 21

There are two forms of movement for the costovertebral joint, what are they called and what do they do?

Answer 21

Bucket Handle Movement: Elevation of the lateral most part of the rib- increases transverse diameter

Pump Handle: Elevation of the sternal end of the rib, increases anterior to posterior diameter of thorax

Question 22

What is difference between elevation of the thorax and depression of the thorax?

Answer 22

Elevation of the ribs leads to an increase in thorax diameter, leading to an increase in air inside. Opposite for depression.

Question 23

What is the difference between dislocation and separation of the ribs and the sternum?

Answer 23

Dislocation occurs at the sternocostal joint, costocartilage is dislocated from the sternum.

Separation occurs at the costochondral joint, rib is separated from the costocartilage

Question 24

External Intercostal M. (Origin/Insertion, Action and Innervation)

Answer 24

Origin/Insertion: From posterior inferior rib to superior anterior rib

Action: Elevate Ribs

Innervation: Intercostal N

Question 25

Internal Intercostal M

Answer 25

Origin/Insertion: Inferior anterior border ribs to superior posterior border (muscle fibers run perpendicular to external intercostal Mm)

Action: Depress ribs

Innervation: Intercostal N.

Question 26

Innermost Intercostal M.

Answer 26

Origin/Insertion: Inferior border to superior border ribs

Action: IDK, probably depress ribs

Innervation: Intercostal N.

*** Remember*** Innermost intercostal M will obstruct view of intercostal N… So when you can see intercostal N, you can say the muscle behind it is internal intercostal M

Question 27

Transverse Thoracic M

Answer 27

Origin/Insertion: Posterior surface of xiphoid process and inferior sternum to internal costal cartilages 3, 4, 5 and 6

Action: Depress Ribs

Innervation: Intercostal N

Question 28

Subcostal M.

Answer 28

Origin/Insertion: inferior border of rib to superior border of rib (1-2 segments)

Action: Probabaly depress ribs

Innervation: Intercostal N.

**Usually more than one rib spaces**

Question 29

What do the external intercostal M. and internal intercostal Mm form into near the sternum and vertebra, respectively?

Answer 29

External becomes Anterior (External) Intercostal Membrane

Internal becomes Posterior (Internal) Intercostal Membrane

Question 30

How do you differentiate between external and internal intercostal muscles?

Answer 30

External muscles go in the direction as if you are putting your hands in your pockets, and internal muscles are perpendicular to those fibers, opposite direction

Question 31

What is thoracentisis and what is important to do?

Answer 31

It is the insertion of a needle through the intercostal musculature to obtain fluid/drain blood from PLEURAL CAVITY

Make sure to insert need INFERIOR to intercostal neurovascular bundle and SUPERIOR to collateral branches

Question 32

Describe how a chest tube is placed.

Answer 32

Insertion of a tube to remove LARGE amounts of air, fluid or blood from the pleural cavity. The tube is typically placed between the 5th and 6th intercostal space

Question 33

What is a thorascopy and what is it used for?

Answer 33

It is insertion of a thorascope into the pleural cavity through small incisions for visualizing and biopsying space inside the cavity (5th/6th rib)