Exam IV Thorax

Question 1

What do we mean by true ribs, and which ribs are true?

Answer 1

• attach independently to sternum

- ribs 1-7

Question 2

What do we mean by false ribs, and which ribs are false?

Answer 2

• connect to stenum indirectly

- 8-10

Question 3

Which ribs are florating?

Answer 3

11-12

Question 4

Which ribs are typical?

Answer 4

3-9

Question 5

What are the 3 types of compression that can occur in thoracic outlet syndrome, and what is the result of each?

Answer 5

• compression of the brachial plexus, resulting in impaired neurotransmission
• compression of the subclavian artery (costoclavicular syndrome), resulting in weakened radial pulse
• compression of the clavipectoral fascia, leading to symptoms in arm and shoulder

Question 6

What muscles does the breast overlie?

Answer 6

• 2/3 overlies pectoralis major fascia

- the rest overlies serratus anterior

Question 7

What innervates breast tissue?

Answer 7

lateral cutaneous branches intercostal nerves 4-6

Question 8

What is the word meaning more than two nipples? Where do they usually appear?

Answer 8

• pollythelia

- along embryonic mamillary ridge from axilla to groin

Question 9

What are the thoracic muscles not part of the upper limb?

Answer 9

• intercostals (external, internal, innermost)
• transverse thoracic muscle
• subcostal muscle
• serratus posterior muscle
• levatores costarum

Question 10

What do the anterior rami of the thoracic spinal nerves branch into?

Answer 10

intercostal nerves, which branch into lateral cutaneous nerves near mid-axillary line, and also motor branches

Question 11

Where do the posterior intercostal and subcostal arteries arise from?

Answer 11

thoracic aorta

Question 12

From where does the internal thoracic arise?

Answer 12

subclavian artery

Question 13

From where do the superior and lateral thoracic arteries arise?

Answer 13

axillary artery

Question 14

What is the costodiaphragmatic recess?

Answer 14

• interpleural regions inferior to the margins of the lungs
• contain 10 mL of parietal fluid
• lungs occupy more of the recesses during inspiration than during exhalation

Question 15

What are the anterior inferior borders of the lungs and parietal pleura, respectively?

Answer 15

• rib 8

- rib 10

Question 16

What are the posterior inferior borders of the lungs and parietal pleura, respectively?

Answer 16

• rib 10

- rib 11-12

Question 17

Which of the 2 pleura has nociceptors?

Answer 17

parietal

Question 18

How are the 2 pleura innervated?

Answer 18

• visceral exclusively autonomic innervation

- parietal supplied by intercostal and phrenic nerves

Question 19

Pain referred from what regions of the parietal pleura gets referred to the the thoracic and abdominal wall?

Answer 19

costal and lateral diaphragmatic pleura

Question 20

Pain referred from what regions of the parietal pleura gets referred to the the neck and shoulder?

Answer 20

mediastinal and central diaphragmatic pleura

Question 21

Parietal membrane pleura consists of what 4 parts?

Answer 21

• costal pleura (thoracic wall)
• mediastinal pleura
• diaphragmatic pleura
• cervical (or cupula) pleura (through superior thoracic aperture)

Question 22

How many pulmonary segments do the right and left lung have?

Answer 22

• right: usually 10

- left: usually 8-9

Question 23

Which bronchi are the lobar bronchi? How many are there?

Answer 23

• secondary

- 3 on right, 2 on left

Question 24

Which bronchi are the segmental bronchi? How many are there?

Answer 24

• tertiary

- 20-25 generations (branches)

Question 25

Terminal bronchioles give rise to what?

Answer 25

- respiratory bronchioles - alveolar ducts - alveolar sacs

Question 26

What is the difference between pulmonary and bronchial blood?

Answer 26

- bronchial blood does not have bronchial vein, and is oxygenated in bronchial artery - except in the hilus of the lung where there are bronchial veins

Question 27

The right bronchial vein merges with the _____ vein. The left bronchial vein merges with the ______ vein.

Answer 27

azygous; hemiazygous

Question 28

What is the name of the flat surface between the IVC and SVC that is mostly open during gestation?

Answer 28

sinus venosus or sinus venarum

Question 29

What can result if septal defects are not corrected?

Answer 29

pulmonary hypertension or cardiac failure

Question 30

What is the cause of valves not being able to OPEN completely, and what is the result?

Answer 30

- stenosis | - results in limited flow of blood

Question 31

What is the cause of the valves not being able to CLOSE completely, and what is the result?

Answer 31

- insufficiency (often caused from scarring or abnormal valvular growths) - results in regurgitation

Question 32

What occurs in prolapsed mitral valve?

Answer 32

- the leaflets are enlarged or dysfunctional | - do not completely block flow of blood, generating murmur

Question 33

Which arteries are commonly involved in bypass procedures?

Answer 33

coronary and circumflex arteries

Question 34

Where does an MI most commonly occur?

Answer 34

left ventricle

Question 35

What is angina pectoris?

Answer 35

substernal pain that extends down medial left arm