Anatomy Topic 2 Case 1 Flashcards

- Surface Anatomy of the Thorax - Muscles of the Chest Wall - Thorax, its associated bones, joints and ligaments - Neurovascular Supply of the Thorax - Diaphragm

1
Q

At which vertebral level is the jugular notch located?

A
  • TII
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2
Q

The costal cartilage of which rib articulates with the sternum at the level of the sternal angle?

A
  • Rib 2
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3
Q

What occurs at the vertebral level TIV/V?

A
  • Costal cartilage of rib 2 articulates with sternum
  • Superior mediastinum is separated from the inferior mediastinum
  • Arch of the aorta begins
  • Thoracic aorta begins
  • Trachea bifurcates
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4
Q

What is the origin of the sternocleidomastoid?

A
  • Sternal head, upper part of anterior surface of manubrium of sternum
  • Clavicular head, superior surface of medial one third of clavicle
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5
Q

What is the insertion of the sternocleidomastoid?

A
  • Sternal head, lateral one-half of superior nuchal line

- Clavicular head, lateral surface of mastoid process

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6
Q

What is the innervation of the sternocleidomastoid?

A
  • Accessory Nerve [CNXI)

- Anterior Rami of C2, C3 and C4

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7
Q

What is the function of the sternocleidomastoid?

A
  • Tilt head towards shoulder on same side
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8
Q

What is the origin of the anterior scalene?

A
  • Anterior tubercles of transverse processes of C3 to C6
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9
Q

What is the insertion of the anterior scalene?

A
  • Scalene tubercle and upper surface of rib 1
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10
Q

What is the innervation of the anterior scalene?

A
  • Anterior rami of C4 to C7
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11
Q

What is the function of the anterior scalene?

A
  • Elevation of rib 1
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12
Q

What is the origin of the middle scalene?

A
  • Transverse processes of vertebrae C3 to C7
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13
Q

What is the origin of middle scalene?

A
  • Upper surface of rib 1
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14
Q

What is the innervation of the middle scalene?

A
  • Anterior rami of C3 to C7
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15
Q

What is the function of the middle scalene muscle?

A
  • Elevation of rib 1
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16
Q

What is the origin of the posterior scalene?

A
  • Posterior tubercles of transverse processes of C4 to C6
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17
Q

What is the insertion of the posterior scalene?

A
  • Upper surface of rib 2
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18
Q

What is the innervation of the posterior scalene?

A
  • Anterior rami of C5 to C7
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19
Q

What is the function of the posterior scalene?

A
  • Elevation of rib 2
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20
Q

Identify three functions of the thorax

A
  • Breathing
  • Protection
  • Conduit
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21
Q

What are the anterior, lateral and posterior margins of the superior thoracic aperture?

A
  • Anterior: Manubrium
  • Lateral: Rib 1
  • Posterior: Vertebra T1
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22
Q

What are the anterior, anterolateral, posterolateral and lateral margins of the inferior thoracic aperture?

A
  • Anterior: Xiphoid Process
  • Anterolateral: Ribs 7-10
  • Posterolateral: Ribs 10-12
  • Posterior: Vertebra T12
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23
Q

What are the anterior, posterior and lateral margins of the thoracic wall?

A
  • Anterior: Sternum
  • Lateral: Ribs
  • Posterior: Thoracic Vertebra
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24
Q

Identify the three articulations of each rib to the vertebral column

A
  • Head: Facet to its own vertebral body and body above

- Angle: Transverse process of its own vertebra

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25
Q

What is a true rib?

Identify the true ribs

A
  • Articulate with sternum

- Ribs 1 - 7

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26
Q

What is a false rib?

Identify the false ribs

A
  • Articulate with costal cartilage above

- Ribs 8 - 10

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27
Q

What is a floating rib?

Identify the floating ribs

A
  • No anterior connection

- Ribs 10 - 12

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28
Q

Describe the head of a rib

A
  • Two articular facets
  • Smaller superior facet for articulation with above rib
  • Larger inferior facet for articulation with its own rib
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29
Q

Describe the neck of a rib

A
  • Short flat region

- Separating the head from the tubercle

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30
Q

Describe the tubercle of a rib

A
  • Between the neck and shaft

- Articulates with a facet on the transverse process of its own vertebrae

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31
Q

Why is Rib 1 considered an atypical rib?

A
  • Flat in transverse plane
  • Single facet
  • Scalene tubercle (anterior by scalene vein, posterior scalene artery)
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32
Q

Why is Rib X considered an atypical rib?

A
  • Single
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33
Q

Why are ribs XI and XII considered atypical ribs?

A
  • Single facet
  • No tubercles or necks
  • Short and little curve
  • Pointed anteriorly
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34
Q

Identify four bony landmarks of the manubrium of the sternum?

A
  • Jugular notch
  • Fossa for articulation with clavicle
  • Facet for articulation with first costal cartilage
  • Demi-facet for articulation with superior aspect of second costal cartilage
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35
Q

Identify four bony landmarks of the body of the sternum

A
  • Transverse ridges
  • Demi-facet for articulation with inferior aspect of second costal cartilage
  • Four facets for articulation with ribs 3 - 6
  • Demi-facet for articulation with the superior aspect of seventh costal cartilage
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36
Q

At which vertebral level is the xiphoid process located?

A
  • T10
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37
Q

How does the xiphoid process differ in children and adults?

A
  • Cartilaginous structure at birth

- Which becomes ossified in the adult

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38
Q

Identify one bony landmark on the xiphoid process

A
  • Demi-facet for articulation with inferior aspect of seventh costal cartilage
39
Q

Pump handle changes the dimensions of the thorax in which dimension?

A
  • Anteroposterior dimension
40
Q

Bucket handle changes the dimensions of the thorax in which dimension?

A
  • Lateral dimension
41
Q

Which types of movement do the costovertebral joints facilitate?

A
  • Rotation in the upper ribs

- Ascension / descension, relative to vertebral column, in the lower ribs

42
Q

Where are costotransverse joints located?

A
  • Between tubercle of rib and the transverse process of its own vertebrae
43
Q

Identify the three ligaments that support the costotransverse joints?

A
  • Costotransverse ligament, medial to the joint
  • Lateral costotransverse ligament, lateral to the joint
  • Superior costotransverse ligament, attaches from transverse process of vertebra above
44
Q

Where are the sternocostal joints located?

A
  • Between the upper seven costal cartilages and the sternum
45
Q

What type of joints are the sternocostal joints?

A
  • Rib 1: Cartilaginous

- Ribs 2-7: Synovial

46
Q

The sternocostal joint of which rib is divided into two compartments by an intra-articular ligament?

A
  • Rib 2
47
Q

Where are the interchondral joints located?

A
  • Between ribs 8 to 10
48
Q

What type of joints are the interchondral joints?

A
  • Synovial joints
49
Q

Identify two additional joints associated with the sternum

A
  • Manubriosternal joint

- Xiphisternal joint

50
Q

Describe the layers between the lung and skin from deep to superficial

A
  • Visceral pleura
  • Pleural cavity
  • Parietal pleura
  • Endothoracic fascia
  • Innermost intercostal muscle
  • Internal intercostal muscle
  • External intercostal muscle
  • Serratus anterior muscle
  • Superficial fascia
51
Q

Where are the intercostal vessels located?

A
  • Costal groove
  • Which is located between the innermost and internal intercostal muscles
  • Vein is superior to artery which is superior to nerve
52
Q

How many pairs of external and internal intercostal muscles are there?

A
  • 11
53
Q

The external intercostal muscles are most active during which process?

A
  • Inspiration
54
Q

Identify the superior and inferior attachments of the external intercostal muscles

A
  • Inferior surface of rib above to superior margins of rib below
55
Q

In which direction do the external intercostal muscles pass

A
  • Obliquely in an anteroinferior direction
56
Q

Identify the superior and inferior attachments of the internal intercostal muscles

A
  • Inferior surface of rib above to superior margins of rib below
57
Q

In which direction do the internal intercostal muscles pass

A
  • Obliquely in a posteroinferior direction
58
Q

The internal intercostal muscles are most active during which process?

A
  • Expiration
59
Q

Where do the anterior intercostal arteries arise from?

A
  • Lateral branches of internal thoracic arteries

which descend vertically along the anterior thoracic wall

60
Q

Identify the two terminal branches of the internal thoracic arteries?

A
  • Superior epigastric artery

- Musculophrenic artery

61
Q

Anterior intercostal arteries that supply the upper six intercostal spaces arise as lateral branches of which artery?

A
  • Internal thoracic artery
62
Q

Anterior intercostal arteries that supply the lower six intercostal spaces arise as lateral branches of which artery?

A
  • Musculophrenic artery
63
Q

The upper two posterior intercostal arteries are derived from which artery?

A
  • Supreme intercostal artery
64
Q

The lower nine pairs of posterior intercostal arteries are derived from which artery?

A
  • Thoracic aorta
65
Q

The posterior intercostal veins on the left side come together to form which vein?

Where does this vein drain?

A
  • Left superior intercostal vein

- Left brachiocephalic vein

66
Q

The posterior intercostal veins on the right side come together to form which vein?

A
  • Right superior intercostal vein

- Azygos vein

67
Q

Where do intercostal nodes in the upper thorax drain?

A
  • Bronchomediastinal trunk
68
Q

Where do intercostal nodes in the lower thorax drain?

A
  • Thoracic duct
69
Q

Where do superficial nodes of the thoracic wall drain?

A
  • Axillary nodes
70
Q

What are the intercostal nerves?

Where are they located?

A
  • Anterior rami of T1 to T11

- Intercostal spaces

71
Q

What is the subcostal nerve?

A
  • Anterior rami of T12

- Inferior to rib 12

72
Q

The lateral cutaneous branch divides into which branches?

A
  • Anterior and posterior cutaneous branches

- Which supply the skin of the thoracic wall

73
Q

Which nerve contributes to the brachial plexus?

A
  • Anterior rami of T1
74
Q

Which nerve contributes to cutaneous innervation of the of the medial surface of the upper arm?

A
  • Intercostobrachial nerve

Lateral cutaneous branch of second intercostal nerve

75
Q

Identify 3 attachments of the diaphragm

A
  • XIphoid process
  • Costal margins
  • Ends of ribs XI and XII
76
Q

Where do muscle fibres of the diaphragm converge?

A
  • Central tendon
77
Q

Where does the inferior vena cava pass through the diaphragm?

A
  • Central tendon (T8)
78
Q

Where do the phrenic nerves pass through the diaphragm?

A
  • Central tendon (T8)
79
Q

How does the oesophagus enter the abdominal cavity?

A
  • Posterior to the diaphragm

- Oesophageal hiatus (T10)

80
Q

Where does the vagus nerve pass through the diaphragm?

A
  • Oesophageal hiatus (T10)
81
Q

Where does the aorta pass through the diaphragm?

A
  • Aortic hiatus (T12)
82
Q

Where does the thoracic duct pass through the diaphragm?

A
  • Aortic hiatus (T12)
83
Q

Where does the azygos vein pass through the diaphragm?

A
  • Aortic hiatus (T12)
84
Q

Why is the left dome higher than the right dome?

The left dome reaches as high as which rib?

A
  • Liver

- Rib 5

85
Q

Identify four arteries that supply the diaphragm

A
  • Pericardiacophrenic
  • Musculophrenic
  • Superior phrenic
  • Inferior phrenic
86
Q

The veins that drain the diaphragm drain into which vessels?

A
  • Brachiocephalic veins
  • Azygos system
  • Inferior Vena Cava
  • Left Suprarenal Vein
87
Q

Which nerve innervates the diaphragm?

A
  • Phrenic Nerve

- C3, C4 and C5

88
Q

Identify the superior, inferior and medial boundaries of each pleural cavity

A
  • Superiorly, above rib 1
  • Medially, mediastinum
  • Inferiorly, just above costal margin
89
Q

Which type of cells line the pleural cavities?

A
  • Mesothelium
90
Q

What is contained within the pleural space?

A
  • Serous fluid
91
Q

What is the important of pleural recesses?

A
  • Accommodate changes in lung pressure during breathing
92
Q

Which functional division of the nervous system innervates the parietal pleura?

A
  • Somatic
93
Q

Which functional division of the nervous system innervates the visceral pleura?

A
  • Autonomic