Chest wall and diaphragm

Question 1

functions of the chest wall

Answer 1

respiration
protection
muscle attachments

Question 2

area in-between lungs?

Answer 2

mediastinum

Question 3

what covers the lungs

Answer 3

pleura

Question 4

what covers the heart

Answer 4

pericardium

Question 5

what is T1, rib 1 and the superior aspect of the sternum boundaries for?

Answer 5

superior thoracic aperture (opening at top of thoracic cavity)

Question 6

what are the boundaries of the inferior thoracic aperture and what is this almost completely covered by

Answer 6

11th and 12th ribs, costal margin
covered by diaphragm

Question 7

characteristics of thoracic vertebrae

Answer 7

heart shaped body
costal facets
transverse costal facets
small vertebral foramen
long spinous process

Question 8

3 categories of ribs

Answer 8

true: 1-7 articulate directly with sternum via costal cartilage
false: 8-10 articulate via costal margin
floating: 11-12 don’t articulate with sternum

Question 9

atypical and typical ribs?

Answer 9

typical: 3-9
atypical: 1, 2, 10, 11, 12

Question 10

features on typical ribs?

Answer 10

head
neck
tubercle
angle
subcostal groove

Question 11

features on first rib not present on others?

Answer 11

scalene tubercle (between grooves)
groove for subclavian artery (more posterior) and vein (more anterior)

Question 12

what muscle attaches to the scalene tubercle

Answer 12

anterior scalene muscle

Question 13

features on the sternum?

Answer 13

body
manubrium
xyphoid process (inferior)
sternal angle (between body and manubrium

Question 14

which ribs articulate with the sternum at the sternal angle? What vertebral level does it indicate?

Answer 14

2nd ribs
vertebral level T4/5

Question 15

what other structures are located at the sternal angle

Answer 15

junction between ascending/arch/descending aorta
bifurcation of trachea

Question 16

costovertebral joints?

Answer 16

costotransverse joint
joints of heads of ribs

Question 17

joints between ribs and sternum? which ribs?

Answer 17

sternocostal/sternochondral (?)
ribs 1-7

Question 18

joints fusing lower costal cartilages and costal margin?

Answer 18

interchondral

Question 19

what movement causes increase in vertical dimension of the thoracic cage

Answer 19

inferior movement of diaphragm

Question 20

what movement causes increase in transverse dimension of thoracic cage

Answer 20

bucket handle motion of ribs

Question 21

what movement causes increase in anterior/posterior dimension of thoracic cage

Answer 21

pump handle action of sternum

Question 22

features of the thoracic diaphragm?

Answer 22

right and left domes
central tendon
oesophageal hiatus
aortic hiatus

Question 23

what attaches the diaphragm to the lumbar vertebrae

Answer 23

crura (left and right)

Question 24

where do different structures pass through the diaphragm

Answer 24

inferior vena cava - T8 through central tendon (caval opening)
oesophagus - T10 through oesophageal hiatus
aorta - T12 through aortic hiatus

Question 25

what innervates the diaphragm? roots?

Answer 25

motor and sensory - phrenic nerves (c3,4,5)
sensory - intercostal and subcostal nerves (peripheral parts)

Question 26

what also passes through openings in the diaphragm

Answer 26

caval opening - phrenic nerves
oesophageal hiatus - vagus nerve
aortic hiatus - azygous vein, thoracic duct

Question 27

which artery runs deep to each side of the sternum

Answer 27

internal thoracic artery

Question 28

which artery runs through the thoracic cavity with the phrenic nerve

Answer 28

pericardiacophrenic artery

Question 29

which nerve runs through the thoracic cavity with the pericardiacophrenic artery

Answer 29

phrenic nerve

Question 30

what does the internal thoracic artery split into in the abdomen

Answer 30

musculophrenic and superior epigastric artery

Question 31

which arteries branch off from the abdominal aorta and run along the abdominal side of the diaphragm

Answer 31

inferior phrenic arteries

Question 32

which arteries supply the diaphragm?

Answer 32

superior phrenic
musculophrenic
inferior phrenic
pericardiacophrenic
lower internal intercostal arteries

Question 33

muscles in intercostal space and their action?

Answer 33

external intercostal (elevate ribs for inspiration)
internal intercostal (depress ribs for active expiration)
innermost intercostal (depress ribs for active expiration)

Question 34

innermost intercostal muscles features

Answer 34

same orientation to internal intercostal
deep to neurovascular bundle
only found laterally

Question 35

where are the external and internal intercostal muscles not present and replaced by membrane

Answer 35

external - not present anteriorly
internal - not present posteriorly

Question 36

accessory muscles of respiration?

Answer 36

pectoralis major
scalenus anterior (anterior scalene muscle)
serratus anterior
sternocleidomastoid

Question 37

exterior intercostal muscle orientation?

Answer 37

points forward and down - ‘hand in pocket’

Question 38

what is found between internal and intercostal muscles

Answer 38

intercostal neurovascular bundle

Question 39

where in the intercostal space is the neurovascular bundle found?

Answer 39

superior portion, along subcostal groove

Question 40

what is found in the neurovascular bundle?

Answer 40

anterior and posterior intercostal arteries/veins
intercostal nerves

Question 41

where do the intercostal arteries arise from

Answer 41

anterior - internal thoracic artery or musculophrenic artery
posterior - thoracic aorta

Question 42

where do the intercostal veins drain

Answer 42

anterior - internal thoracic vein or musculophrenic vein
posterior - azygous system

Question 43

where do the intercostal nerves come from

Answer 43

anterior rami of thoracic spinal nerves