Chest Wall, Diaphragm, & Breast

Question 1

In addition to the ribs and sternum, which other bones make up the chest wall?

Answer 1

• the thoracic spine (T1 to T12)

Question 2

What do the superior and inferior vertebral notches on adjacent vertebrae form?

Answer 2

• the intervertebral foramina

Question 3

Which rib attaches to the sternum at the sternal angle of Louis? What vertebral level does this occur at?

Answer 3

• rib #2

- occurs at the T4 level

Question 4

How many pairs of facets does each thoracic vertebra have? What are they?

Answer 4

• 5 pairs
• superior costal facets, inferior costal facets, transverse costal facets, superior articular facets, and inferior articular facets

Question 5

Name the joint that attaches each rib to the vertebral column.

Answer 5

• costovertebral joint

Question 6

Name the joint that “fastens” each rib to a vertebra’s transverse process.

Answer 6

• costotransverse joint

Question 7

Name the joint that attaches a rib to the sternum.

Answer 7

• sternochondral joint

Question 8

Which joint forms the sternal angle of Louis?

Answer 8

• the manubriosternal joint

- (joint between the manubrium and sternum)

Question 9

What is the only joint between the entire upper limb and the axial (trunk) skeleton?

Answer 9

• the sternoclavicular joint

Question 10

The striations of the internal intercostals point MEDIALLY/LATERALLY.

Answer 10

• they point laterally/outwards

- “downwards and backwards”

Question 11

The striations of the external intercostals point MEDIALLY/LATERALLY.

Answer 11

• they point medially/inwards

- “downwards and forwards”

Question 12

There are three layers of intercostal muscles (external/outer, internal/middle, and innermost/inner), what comprises the innermost layer?

Answer 12

• the innermost intercostals, the subcostals, and the transversus thoracis muscles

Question 13

Between which two layers of the intercostal muscles do the vessels and nerves run?

Answer 13

• between the innermost/inner and the internal/middle layers

Question 14

The diaphragm separates which two cavities?

Answer 14

• the thoracic and abdominal cavities

Question 15

How many arcuate ligaments does the diaphragm have? What are they?

Answer 15

• three arcuate ligaments

- median, medial, and lateral

Question 16

At what vertebral level does the IVC pierce through the diaphragm? The esophagus? The abdominal aorta?

Answer 16

• IVC: T8
• esophagus: T10
• aorta: T12
• “i ate ten eggs at twelve”

Question 17

Which nerves supply the diaphragm? Which vertebral level do they arise from?

Answer 17

• the phrenic nerves
• C3, C4, and C5
• “C3, 4, 5 keeps you alive”

Question 18

Where do the posterior intercostal arteries arise from?

Answer 18

• most arise from the descending thoracic aorta

- the upper one or two arise from the subclavian artery (via the costocervical trunk)

Question 19

Where do the anterior intercostal arteries arise from?

Answer 19

• the internal thoracic arteries (one on each side) running alongside the sternum
• (each internal thoracic artery comes from each subclavian artery)

Question 20

Where do most intercostal veins on the right side drain into? What about on the left side?

Answer 20

• right: azygous vein (and then into the SVC)

- left: hemiazygous vein (eventually joins the azygous)

Question 21

The upper 2 or 3 intercostal veins drain uniquely - where do these usually drain into?

Answer 21

• 1st one: the brachiocephalic vein on each side
• 2nd & 3rd: these veins join up to form a larger vein, which dumps into the azygous vein on the right and into the left brachiocephalic on the left

Question 22

T or F: like all other ribs, the 1st rib articulates with two vertebrae.

Answer 22

• false!

- the 1st rib actually only articulates with only T1

Question 23

What are the two terminal branches of the internal thoracic artery? At what costal level does this occur at?

Answer 23

• branches into the superior epigastric artery and the musculophrenic artery
• occurs at the level of the 6th costal cartilage

Question 24

What runs alongside the vertebral bodies on each side in the thoracic cavity?

Answer 24

• the sympathetic trunk