Basic Topography of the Lower Respiratory Tract: Thoracic cavity, Diaphragm and Surface Anatomy (AP)

Question 1

Which nerve supplies the diaphragm?

Answer 1

Phrenic nerve

Question 2

Spinal roots supplying the phrenic nerve

Answer 2

C3-5

Question 3

What passes through the superior thoracic aperture?

Answer 3

• Trachea
• Oesophagus
• Major blood vessels and nerves

Question 4

Boundaries of the inferior thoracic aperture

Answer 4

• Xiphoid process
• Costal margin
• Floating ribs
• T12 vertebra

Question 5

Where do ribs articulate with vertebrae?

Answer 5

• Facets on head of rib articulate with superior and inferior (demi)facets of vertebral body
• Facet on tubercle of rib articulates with facet on transverse process of vertebra

Question 6

How do ribs articulate with the intervertebral disc?

Answer 6

Intra-articular ligament runs from between the 2 facets on head of rib to the disc

Question 7

Bony attachments of the diaphragm

Answer 7

• Xiphoid process
• Costal margin
• Floating ribs
• Lumbar vertebrae

Question 8

How does the phrenic nerve pass with respect to the hilum of the lung?

Answer 8

Passes anteriorly to the hilum

Question 9

How does the vagus nerve pass with respect to the hilum of the lung?

Answer 9

Passes posteriorly to the hilum

Question 10

At what vertebral level does the IVC cross the diaphragm?

Answer 10

T8

Question 11

At what vertebral level does the oesophagus cross the diaphragm?

Answer 11

T10

Question 12

At what vertebral level does the aorta cross the diaphragm?

Answer 12

T12

Question 13

At what vertebral level does the thoracic duct cross the diaphragm?

Answer 13

T12

Question 14

At what vertebral level does the vagus nerve cross the diaphragm?

Answer 14

T10

Question 15

At what vertebral level does the azygous vein cross the diaphragm?

Answer 15

T12

Question 16

At what vertebral level does the left phrenic nerve cross the diaphragm?

Answer 16

T8

Question 17

At what vertebral level does the right phrenic nerve cross the diaphragm?

Answer 17

T8

Question 18

At what vertebral level do the left gastric vein and artery cross the diaphragm?

Answer 18

T10

Question 19

In which planes does the thorax increase in volume during inspiration?

Answer 19

• Sagittal (anteriorly)
• Coronal (laterally)

Question 20

Which anatomical landmarks occur at the sternal angle?

Answer 20

• Boundary between superior and other mediastinum
• Passage of thoracic duct from right to left
• Tracheal bifurcation
• Azygous vein enters SVC
• Loop of left recurrent laryngeal nerve around aortic arch
• Aortic arch starts and ends
• Ligamentum arteriosum

Question 21

Vertebral level of suprasternal notch

Answer 21

T2/3

Question 22

Places to listen to the right lung during auscultation for each lobe

Answer 22

• Front, near clavicle (superior lobe)
• Side, under armpit (middle lobe)
• Mid-lower back (inferior lobe)

Question 23

Places to listen to the left lung during auscultation for each lobe

Answer 23

• Front, near clavicle (superior lobe)
• Side, under armpit or mid-lower back (inferior lobe)