Chest Wall Lecture

Question 1

Which ribs are typical?

Answer 1

3-9

Question 2

Which ribs are atypical?

Answer 2

1,2,11,12 (sometimes 10)

Question 3

What type of joint is the manubrial-sternal joint?

Answer 3

secondary cartilaginous

Question 4

Which ribs are true ribs?

Answer 4

1-7

Question 5

Which joint is primary cartilaginous?

Answer 5

1st sternocostal joint

Question 6

What are the two neck muscles that support the rib cage?

Answer 6

1. Sterno-cleidomastoid

2. Scalenes muscles - anterior, medius, posterior

Question 7

what is atypical about the 1st rib?

Answer 7

very curved, has a tubercle for scalenus anterior, single facet on head

Question 8

what is atypical about 11th and 12th?

Answer 8

no tubercles

do not attach to anything (free floating)

Question 9

Which vertebrae are atypical?

Answer 9

1st, 10th, 11th and 12th

Question 10

What is pump handle movement of the chest wall?

Answer 10

Sternum moves upwards and forwards due to movement of true ribs

Question 11

What is bucket handle movement of the chest wall?

Answer 11

Ribs move out to the side - due to the movement of the false ribs

Question 12

What is the blood supply to the chest wall?

Answer 12

1. Anterior - internal thoracic arteries

2. Posterior - descending thoracic aorta

Question 13

What is the venous drainage of the chest wall?

Answer 13

1. Anterior - internal thoracic veins

2. Posterior - azygos veins (azygos on RHS, hemiazygos on LHS)

Question 14

What is the lymphatic drainage of the chest wall?

Answer 14

Lots of lymph nodes

1. Anteriorly - drainage into brachiomediastinal trunk
2. Posteriorly - drainage into thoracic duct.

Question 15

What is the nerve supply to the chest wall?

Answer 15

Intercostal muscles innervated by intercostal nerves (T2-T12)
1,2 and 7-11 intercostal nerves are atypical