2401- Anatomy Thoracic Cavity, Thoracic Wall And Diaphragm

Question 1

What are true ribs?

Answer 1

Ribs 1-7 that articulate directly with the sternum (vertebrosternal ribs)

Question 2

Define false ribs.

Answer 2

Ribs 8-10 that do not articulate directly with the sternum (vertebrochondral ribs)

Question 3

What are floating ribs?

Answer 3

Ribs 11-12 that do not have any anterior attachment (vertebral ribs)

Question 4

What is the primary function of the thoracic cage?

Answer 4

• Protects upper abdominal viscera
• Protects heart and lungs
• Serves for muscle attachment involved in respiration

Question 5

What is thoracic inlet syndrome?

Answer 5

A condition caused by compression of the subclavian artery and brachial plexus due to structural anomalies

Question 6

What are the clinical features of thoracic inlet syndrome?

Answer 6

• Numbness and tingling in the forearm and hand
• Wasting of small hand muscles
• Ischemic symptoms in the upper limb

Question 7

Where is the sternal angle located?

Answer 7

Around 5cm below the suprasternal notch at the level of the intervertebral disc between T4 and T5

Question 8

What anatomical structures bifurcate at the level of the sternal angle?

Answer 8

• Trachea into right and left principal bronchi
• Pulmonary trunk into right and left pulmonary arteries
• ascending aorta ends, arch of aorta begins and ends and descending aorta begins.

Question 9

What is funnel chest (pectus excavatum)?

Answer 9

A condition where the chest is compressed anteroposteriorly, pushing the sternum backward

Question 10

Describe pigeon chest (pectus carinatum).

Answer 10

A condition where the chest is compressed laterally, projecting the sternum forward and downward

Question 11

What is the preferred site for bone marrow aspiration?

Answer 11

Manubrium Sterni

Question 12

What distinguishes typical thoracic vertebrae from atypical vertebrae?

Answer 12

Typical vertebrae (T2-T8) have standard features, while atypical ones (T1, T9-T12) have unique characteristics

Question 13

What are the classifications of ribs based on features?

Answer 13

• Typical ribs: 3rd - 9th ribs (CAT)
• Atypical ribs: 1st, 2nd, 10th, 11th, 12th ribs

Question 14

Give some characteristics of typical thoracic vertebrae.

Answer 14

Articular faucets on each side
Upper larger costal facet corresponds with rib.
Body heart shaped
Vertebral foreman circular
Spinous process long, slender

Question 15

List the ligaments of the vertebral column.

Answer 15

LA LISI

Ligamenta flava
Anterior and posterior longitudinal ligaments
Ligamentum nuchae
Interspinous ligament
Supraspinous ligament
Intertransvere ligament

Question 16

Give the characteristics of the typical ribs.

Answer 16

Head, neck, angle
Upper and lower faucet with intra- articular crest in between
Upper and lower boarder
Inner (costal groove) and outer surface
Posterior (weakest point of rib) and anterior angle

Question 17

Give the characteristics of the atypical ribs.

Answer 17

Single head
Neck and tubercle (1st, 2nd and 10th rib)
11th and 12th - no neck and tubercle
12th - no angle and costal groove.
11th rib- small angle and shallow groove.

Question 18

List the intercostal muscles and give its function.

Answer 18

External intercostal - elevates the ribs during inspiration
Internal intercostal - elevates/ pull down ribs during expiration
Intercostalis intimi - Elevates the ribs during expiration
Subcostalis- depressor of the ribs
Sternocostalis - pulls/ draws down the costal cartilage
Levatores Costarum - rotates and elevates the neck of the ribs and rotates and flexor of the vertebral column.

Question 19

List the nerve supply of intercostal muscles, parietal pleura and periosteum of the ribs.

Answer 19

Collateral branch of intercostal nerve.

Question 20

At which rib would a thoracotomy be performed?

Answer 20

The 6th rib

Question 21

Give the origin of the anterior and posterior intercostal arteries.

Answer 21

Anterior -
1-6 derived from the internal thoracic artery.
7-9 derived from the musculophrenic artery

Posterior -
1-2 derived from the superior intercostal artery - costocervical trunk
3-11 derived from the descending thoracic aorta.

Question 22

List your posterior arteries of the diaphragm

Answer 22

DM LCM
Dorsal
Muscular
Lateral cutaneous
Collateral
Mammary

Question 23

The coarctation of aorta involves which arteries.

Answer 23

Posterior intercostal

Arteries are markedly enlarged and causes notching of the ribs.

Question 24

Give the relations/ boundaries of the Thoracic outlet.

Answer 24

Anteriorly - xiphoid process
Posteriorly - thoracic vertebrae
Laterally - costal margin and 11&12 ribs

Question 25

List the strutures that pass through the following:
Median arcuate ligament
Medial lumbocostal arch
Lateral lumbocostal arch

Answer 25

A) aorta
B) sympathetic trunk
C) subcostal nerves and vessels

Medial and lateral arcuate ligaments contains B and C respectively.

Question 26

List the structures that are found in the following major openings in the diaphragm:
A) vena caval
B) oesophageal
C) aortic

Answer 26

A) superior vena cava & right phrenic nerve
B) esophagus, right and left vagus trunks & esophagus opening of left gastric artery
C) aorta, thoracic duct and azygos vein

The nerves for openings are T8, T10 and T12 respectively.

Question 27

State the blood supply of the diaphragm.

Answer 27

Superior and inferior phrenic arteries
Pericardiophrenic arteries
Musculophrenic arteries
Superior epigastric arteries
Posterior intercostal and subcostal arteries

Question 28

Give the nerve supply of the diaphragm.

Answer 28

Right and left phrenic nerve
Lower 5 intercostal and subcostal nerves

Question 29

Diaphragmatic paralysis results in the damage of ___?

Answer 29

Phrenic nerve

Question 30

Give the development of the diaphragm.

Answer 30

Septum transversum, ventrally
Pleuro-Peritoneal membrane, sides
Dorsal mesentery of esophagus, dorsally
Body wall, peripherally.

Question 31

Give the development of the following:
A) central tendon
B) domes of diaphragm
C) section of diaphragm around esophagus
D) peripheral part of diaphragm

Answer 31

A) septum transversum
B) pleuroperitoneal membrane
C) dorsal mesentery of esophagus
D) body wall

Question 32

State how the following of the thoracic cavity is increased:
A) anterior posterior diameter
B) transverse diameter
C) vertical diameter

Answer 32

A) pump handle movement by the vertebrosternal ribs (2-6)
B) bucket- handle movement by the vertebrochondral ribs (7-10)
C) contraction (descent) of diaphragm