A2. Thoracic Wall

Question 1

3 parts of sternum

Answer 1

1. manubrium
2. body
3. xyphoid process

Question 2

jugular notch

Answer 2

indentation formed by both clavicular heads and the superior aspect of the manubrium

Question 3

angle of louis (sternal angle)

Answer 3

junction between the manubrium and the body of the sternum.

Also where the 2nd rib joins the sternum

Question 4

Thoracic inlet (superior thoracic aperture

Answer 4

Runs along top of 1st rib (not clavicle), manubrium, and T1. it is the opening through which structures enter and exit the thorax superiorly

Question 5

Structures that pass between thoracic inlet

Answer 5

1. trachea
2. esophagus
3. vasculature from heart to head
4. tops of the lungs will stick out a little as well

Question 6

Thoracic outlet (inferior thoracic aperture)

Answer 6

runs along the lower/inferior border of the ribs (costal margin). It can be though of as the perimeter of the diaphragm.

Question 7

Structures that pass through the thoracic outlet (diaphragm)

Answer 7

1. lymphatics
2. esophagus
3. descending aorta
4. inferior vena cava

Question 8

True ribs

Answer 8

first 7 ribs attach to the sternum via their own cartilage

Question 9

False ribs

Answer 9

8, 9, 10 don’t attach via their own cartilage, they attach onto the cartilage of rib 7

Question 10

Floating ribs

Answer 10

11, 12 ends do not attach to the cartilage of any ribs nor the sternum

*The kidney and spleen are close and can be prone to injury if these ribs become fractured

Question 11

Intercostal spaces

Answer 11

Between ribs and named after superior rib.

*There are only 11 interspaces

Question 12

Only joint connecting upper extremity to the trunk

Answer 12

sternoclavicular joint

Question 13

synchondrosis

Answer 13

structural joint with fusion of cartilage

Question 14

sternocostal joints

Answer 14

2-7 are synovial

Question 15

costochondral joints

Answer 15

joints between end of the bony part of ribs and the beginning of their cartilage - also synchondroses

Question 16

superior and inferior articular facets

Answer 16

the joint surfaces where the rib meets the vertebral body

Question 17

articular facet of transverse process

Answer 17

where the rib will meet the transverse process of the vertebrae

Question 18

tubercle

Answer 18

little bump on rib

Question 19

angle of rib

Answer 19

the point at which the rib curves anteriorly

Question 20

costal groove

Answer 20

inferior surface on deep aspect of the rib where the neurovascular bundle runs (1 nerve, 1 artery, 1 vein)

Question 21

intervertebral foramen

Answer 21

circle that is the space between the connecting inferior and superior vertebral notches

Question 22

external intercostal muscles

Answer 22

muscles of inspiration extend proximally from the rib above

Question 23

internal intercostal muscles

Answer 23

run distally from the rib above

Question 24

intrinsic muscles

Answer 24

muscles that perform function in the same area

Question 25

extrinsic muscles

Answer 25

muscles in which one end attaches somewhere else to perform function

Question 26

innermost intercostal muscles

Answer 26

innermost, deep to the internal intercostal muscles, do not extend all the way anteriorly nor posteriorly

Question 27

internal intercostal muscles

Answer 27

superficial to the innermost, do not extend all the way posteriorly but DO extend all the way anteriorly

Question 28

External intercostal muscles

Answer 28

outermost, extend posteriorly but not anteriorly. the membrane of the external intercostals extends this all the way anteriorly

Question 29

neurovascular bundle

Answer 29

runs between the innermost and internal intercostal layers

Question 30

subclavian artery

Answer 30

emerges from thoracic inlet, dives under the clavicle but over the first rib

Question 31

internal thoracic artery

Answer 31

branches off the subclavian artery and runs along the inside of the thorax

Question 32

axillary artery

Answer 32

subclavian artery becomes axillary artery once it crosses over the first rib

Question 33

lateral thoracic artery

Answer 33

branch off the axillary artery, supplies the muscles in and around the thoracic wall

Question 34

anterior intercostal arteries

Answer 34

branch from internal thoracic artery and run between ribs in the neurovascular bundle

Question 35

anterior perforating branches

Answer 35

come directly through the muscles of the chest wall to supply the breast, skin, etc.

Question 36

thoracic (descending) aorta

Answer 36

runs along the left side of the vertebral column, gives off branches bilaterally

Question 37

posterior intercostal arteries

Answer 37

branch from the descending aorta and run along the costal groove between ribs in the neurovascular bundle

Question 38

collateral (anastomotic) circulation

Answer 38

vessels and their supply intermingle

ex: anterior and posterior intercostal arteries

Question 39

intercostal nerve

Answer 39

coming from spinal cord through the intervertebral foramen, runs with the posterior intercostal artery along the neurovascular bundle

*there is no nerve equivalent to the anterior intercostal artery

Question 40

lateral cutaneous nerve

Answer 40

branches off the intercostal nerve to serve the skin

Question 41

deltoid

Answer 41

pennate muscle

originates from clavicle and comes anteriorly to the humerus

there is a spine on the scapula to which it also attaches

contraction = abduction of the arm away from the body

Question 42

pectoralis major

Answer 42

attaches to the clavicle, sternum, and costal margin

flexes the arm but also aids in partial extension

Question 43

pectoralis minor

Answer 43

smaller and lies deep to pect major

typically attaches to ribs 3-5, but can vary

covered by clavicpectoral fascia

Question 44

serratus anterior

Answer 44

attaches individually to the ribs

supplied by the long thoracic nerve

Question 45

deltopectoral triangle

Answer 45

clavicle, pectoralis major, deltoid

cephalic vein runs through this area

Question 46

brachial plexus

Answer 46

system of nerves arising from the neck that supply the arm

Question 47

lateral pectoral nerve

Answer 47

1 branch that goes directly to pectoralis major

Question 48

medial pectoral nerve

Answer 48

pierces the pectoralis minor, innervates it, and also goes to the pect major

Question 49

blood supply of breast

Answer 49

anterior perforating branches of the internal thoracic artery

Question 50

axillary tail of spence

Answer 50

comes off upper outer quadrant of breast, making it the biggest quadrant by volume

Question 51

retromammory space

Answer 51

posterior to breast

Question 52

suspensory ligaments

Answer 52

run through the breast tissue and anchor the structures of the breast to the fascia