imaging and clinical anatomy of the thorax

Question 1

In which sensory ganglia does herpes zoster lay dormant

Answer 1

-Dorsal root ganglia of spinal nerves
-Trigeminal ganglion
-Geniculate ganglion of facial
nerve

Question 2

The milk line (ridges)

Answer 2

Two vertical thickenings of the ectoderm

from the axilla to the inguinal region

Question 3

Polythelia

Answer 3

extra nipples
more common in
males

Question 4

Polymastia:

Answer 4

ectopic mammary gland, fully

functional

Question 5

mammary gland : Axillary tail (of Spence)

Answer 5

Breast tissue that extend
into the axilla
Subject to tumor
development even if the rest
of the breast is clea

Question 6

Retromammary space

Answer 6

Space between the breast
and the pec muscles
Allows for free movement
of the breast

Question 7

Peau d’ orange o the breast is due to :

Answer 7

This is due to blockage of the lymphatic channels leading to

lymphedema in the skin, akin to water retention

Question 8

during Peau d’ orange of the breast when does the nipple retract

Answer 8

During a more advanced stage, the

cancerous cells have invaded the suspensory ligaments

Question 9

Mammography

Answer 9

Specific for viewing the breast

Also uses x-rays

Question 10

Lymph node biopsy essential for :

Answer 10

determining the stage of cancer

Question 11

what are some examples of non malignant lumps :

Answer 11

• Fibroadenomas
• Fibroadenosis
• Breast cysts

Question 12

Blood supply of the breast :

Answer 12

• Lateral thoracic artery
• Pectoral artery
• Internal thoracic

Question 13

Innervation of the breast :

Answer 13

The nipple is supplied by the

T4 nerve

Question 14

Lymphatic drainage of the breast nodes involved

Answer 14

Axillary nodes : receives

Parasternal nodes:Receives only 25%

Question 15

Sentinel node

Answer 15

The first node into which lymph drains from any of the quadrants

Question 16

Lymphatic drainage of the breast

Answer 16

-Lymph will drain into the nearest group of nodes (1st is anterior)
-will move from node-node and then into the apical nodes
-then drains into bronchomediastinal and
subclavian trunk
-Then joins the venous system by left or right main duct

Question 17

Radical mastectomy

Answer 17

Surgical resection of the entire

breast(inclusive of axillary tail and ass. lymph nodes )

Question 18

3 common nerves that are damaged by radical mastectomy

Answer 18

• Long thoracic
• Thoracodorsal
• Intercostobrachial

Question 19

Lymphedema:

Answer 19

• Accumulation of interstitial
fluid
- Can be a consequence of
mastectomy

Question 20

During full respiration how my ribs should be visible ?

Answer 20

9-10

Question 21

what are the symptoms of a rib fracture

Answer 21

chest pain or even none

Question 22

Multiple point fractures

Answer 22

ass. with trauma
• When pressure is applied from anterior, ribs may fracture in more
than one place

Question 23

Pneumothorax

Answer 23

air in the pleural cavity

Question 24

Hemothorax

Answer 24

blood in the pleural cavity

Question 25

Flail chest – from a motor vehicle

accident

Answer 25

• Multipoint fracture of consecutive ribs
• Segment becomes loose from the rest of the chest wall
Patient has shallow labored breathing

Question 26

Pleurisy/Pleuritis

Answer 26

The inflamed pleural layers rub against
each other every time the lungs expand
Pain is localized
Or pain may radiate to shoulder due to phrenic nerve innervation to the central diaphragmatic pleura

Question 27

on auscultation what sound does pleuritis produce ?

Answer 27

scratching sound as the patient breathes

Question 28

Thoracocentesis

Answer 28

“pleural tap” to sample fluid from pleural space
Needle inserted into the pleural cavity to obtain a sample of fluid.
9 th ICS →midaxillary line during expiration, directed slightly upwards

Question 29

Thoracostomy

Answer 29

Chest tube inserted to drain fluid or air from pleural

cavity

Question 30

Neurovascular bundle

Answer 30

Travels in costal groove on inferior aspect of rib

all incisions/tubes placed above rib to avoid VAN: