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THORACIC WALL/DIAPHRAGM > ALL THE THINGS > Flashcards

ALL THE THINGS Flashcards

1
Q

What are the true ribs?

A

Ribs 1-7

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2
Q

Why are true ribs called “true”?

A

connect directly to sternum via costal cartilage

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3
Q

Which of the true ribs is sort of odd?

A

rib 1 because it is very short and C-Shaped

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4
Q

What are the false ribs?

A

ribs 8-10

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5
Q

Why are false ribs called “false”?

A

connect directly to the sternum via the costal cartilages above them

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6
Q

What are the floating ribs?

A

ribs 11-12

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7
Q

What is weird about the floating ribs?

A

have no attachment to the sternum at all

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8
Q

Where do you find the neuromuscular bundle? (which ribs)

A

On the inferior border of the superior rib

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9
Q

Where do you find the neuromuscular bundle? (Between what layers of muscle)

A

between the internal intercostal and innermost intercostal muscles

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10
Q

What is the order of the neuromuscular bundle (NMB)?

A

VAN: Vein - Artery - Nerve

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11
Q

Which rib is “privileged”?

A

rib 2 because it is longer and thinner than rib one and is attached at two points

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12
Q

Where do common rib fractures occur?

A

the middle of the ribs along the posterior angle (ribs 3-10)

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13
Q

What is Flail Chest?

A

If a rib is broken and loses attachment to the structures that contain it in the thoracic cage

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14
Q

What movement is associated with Flail Chest?

A

paradoxical movement

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15
Q

What is paradoxical movement?

A

the segment around the broken rib looks as if it is moving in the opposite direction of the breath motions.

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16
Q

What else can paradoxical movement lead to?

A

hypoventilation due to insufficient ventilation

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17
Q

What are the 3 major dermatomes?

A

T4 - Nipples (MOST IMPORTANT FOR NWOSU)

T7 - Xiphoid Process

T10 - Umbilicus

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18
Q

What is Herpes Zoster’s precursor?

A

Chicken pox (Varicella)

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19
Q

Where are Herpes Zoster infections commonly latent?

A

Dorsal root ganglia of one spinal level

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20
Q

What happens when the Herpes Zoster virus leaves latency?

A

the area that is serviced by that sensory root (dermatome) receieve a pattern of blistered lesions

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21
Q

What term is used to describe the blistered lesions of Herpes Zoster?

A

herpetic

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22
Q

What are the important levels of the Sternum that we should consider?

A

Manubrium, sternal body, and xiphoid process

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23
Q

Where is the manubrium found?

A

T3/4

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24
Q

Where is the sternal body found?

A

T5-9

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25
Q

Where is the xiphoid process found?

A

T10/11

26
Q

A Sternal puncture is commonly performed to obtain what?

A

bone marrow

27
Q

Where are sternal fractures common?

A

Mid body and transverse ridge fractures followed by the manubrium

28
Q

Where are fractures commonly incorrectly predicted?

A

xiphoid process

29
Q

What two notches are visible on the manubrium?

A

clavicular notches on the sides and the jugular notch in the middle

30
Q

What is another name for the sternal angle?

A

manubriosternal joint

31
Q

What is Thoracic outlet syndrome?

A

compression of the neuromuscular structures contained in the thoracic outlet

32
Q

What are the causes of Thoracic outlet syndrome?

A

cervical rib, hypertrophy of Scalene Muscles, or a Pancoast Tumor

33
Q

What are the symptoms associated with Thoracic outlet syndrome?

A

pain, numbness, tingling in the arms. brachial plexus compression. Ischemic muscle pain. Subclavian artery compression

34
Q

Describe Horner’s Syndrome

A

Psuedo-ptosis - droopy eyelids

Anhydrosis - can’t sweat

Miosis - pupil constiction

PAM IS HORNY!

35
Q

What is the cause of Horner’s syndrome?

A

compression of the Stellate

36
Q

What is the Stellate?

A

Superior cervical ganglion - is compressed causing Horner’s

37
Q

What is the Thoracic Diaphragm?

A

a musculo-tendinous partition that is the principle muscle of inspiration

38
Q

How is the Thoracic diaphragm innervated?

A

Phrenic nerve C3-4

39
Q

What also provides sensory innervation to the Thoracic diaphragm?

A

lower 6-7 intercostal nerves

40
Q

What are the three thoracic apertures?

A

T8 - IVC

T10 - Esophagus

T12 - Aorta

41
Q

What passes through thoracic aperture T8?

A

Phrenic nerve C3-5

42
Q

What passes through thoracic aperture T10?

A

Vagus Nerve

43
Q

What passes through thoracic aperture T12?

A

Azygous nerve and thoracic duct

44
Q

What do the external intercostals assist with?

A

forced inspiration

45
Q

What do the internal and innermost intercostals assist with?

A

forced expiration

46
Q

What happens to the diaphragm during inhalation?

A

Contracts and flattens as the lungs fill with air. (Descends)

47
Q

What happens to the diaphragm during exhalation?

A

relaxes and moves upward as the air is released

48
Q

What are the 2 congenital diaphragmatic hernias?

A

Morgagni and Bochdalek Hernia

49
Q

What are the 2 acquired diaphragmatic hernias?

A

Rolling and Sliding Esophageal Hernias

50
Q

Describe Morgagni Hernia

A

anterior herniation of the diaphragm

51
Q

Describe Bochdalek hernia

A

Posterolateral herniation of the diaphragm that causes compression to the left lung

52
Q

What do Bochdalek hernias lead to?

A

hypoplasticity due to compression of the left lung

53
Q

Describe Rolling esophageal hernias

A

The cardia of the stomach rolls up through the esophageal hiatus. Hernia is to the side of the LES

54
Q

Describe Sliding esophageal hernias

A

The cardia of the stomach along with the lower esophageal sphincter slide up through the esophageal hiatus.

55
Q

What can be caused by sliding esophageal hernias?

A

severe acid reflux due to the disruption of the LES

56
Q

Name the significant ligament of the breast?

A

Suspensory Ligament of Cooper

57
Q

What is significant about the suspensory ligament of Cooper?

A

some breast cancers can cause these ligaments to pull down and cause the appearance of an orange peel (dimples)

58
Q

What is are the common signs of breast cancer?

A

dimples and inversion of the nipple

59
Q

What region of the breast is known as the million dollar space?

A

Retro-mammary space

60
Q

What are common complications seen during mastectomies?

A

winged scapula due to damage to the long thoracic nerve. Leads to unopposed retraction of the rhomboids

61
Q

Where is the first place you’d look for breast cancer?

A

Pectoral lymph nodes

THORACIC WALL/DIAPHRAGM (1 decks)

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