L24

Question 1

what superficial structure isn’t part of the thoracic wall but is integral to its function?

Answer 1

skin and superficial fascia including breast tissue

Question 2

what bones aren’t part of the thoracic wall but are integral to the thorax’s function?

Answer 2

clavicle and scapula

Question 3

what muscles aren’t part of the thoracic wall but are integral to the thorax’s function?

Answer 3

pectoralis major, serratus anterior, rectus abdominis

Question 4

what bones is pectoralis major attached to? 4

Answer 4

clavicle, sternum, costal cartilages, humerus

Question 5

what innervates the pectoralis major? 2

Answer 5

medial and lateral pectoral nerves

Question 6

what bones and tissues does the serratus anterior attach to? 3

Answer 6

ribs 1-9, intercostal fascia, medial border of scapula

Question 7

what innervates the serratus anterior?

Answer 7

long thoracic nerve

Question 8

what bones and tissues does rectus abdominis attach to? 3

Answer 8

costal cartilages of ribs 5-7, xiphoid process, pubic bones

Question 9

what innervates rectus abdominis? 1

Answer 9

anterior rami of T7-T12 spinal nerves

Question 10

what are the 3 kinds of anterior thoracic cage joints?

Answer 10

sternocostal/sternochondral, costochondral, interchondral

Question 11

what are the sternocostal/sternochondral joints in the anterior thoracic cage? and what kind of joint is it?

Answer 11

sternum to cartilages, synovial

Question 12

what is the exception to the sternocostal joints?

Answer 12

joint between sternum and R1 = cartilaginous

Question 13

what are the costochondral joints and what kind of joint is this?

Answer 13

ribs 1 - 10 to cartilages, cartilaginous

Question 14

what are the interchondral joints and what kind of joint is this?

Answer 14

ribs 6 - 9 to costal cartilages, synovial

Question 15

what are the 2 kinds of posterior thoracic cage joints?

Answer 15

costovertebral and costotransverse

Question 16

what does the costovertebral joint articulate?

Answer 16

head of rib and vertebral body

Question 17

what does the costotransverse joint articulate?

Answer 17

tubercle of rib and transverse process of vertebra

Question 18

what do the synovial joints allow the rib cage to do during respiration?

Answer 18

movement

Question 19

when the thoracic joints are damaged this?

Answer 19

reduces the movement of the thorax

Question 20

if there is reduced movement of the thorax due to injury what affects does this have on respiration?

Answer 20

respiration becomes diaphragmatic breathing

Question 21

what are the three layers of intercostal muscle called?

Answer 21

external, internal and innermost

Question 22

what are the nerves and blood vessels of the intercostal space?

Answer 22

intercostal nerves, anterior/posterior intercostal arteries and veins

Question 23

where do the intercostal nerves and blood vessels lie within the intercostal space?

Answer 23

between the inner and innermost layers

Question 24

what layer of connective tissue lies deep to the innermost intercostal muscle?

Answer 24

endothoracic fascia

Question 25

what direction do the fibres of the external intercostal muscle travel and work in?

Answer 25

anterior inferiorly

Question 26

what action does the external intercostal muscle cause?

Answer 26

contracts to lift the thoracic cage in inspiration

Question 27

what direction do the fibres of the internal and innermost intercostal muscles travel and work in?

Answer 27

posterior inferiorly

Question 28

what action do the inner and innermost intercostal muscles cause?

Answer 28

contracts to lower the thoracic cage in forced expiration

Question 29

how do the intercostal veins and arteries interact?

Answer 29

anastomose laterally

Question 30

what arteries is the anterior intercostal artery derived from?

Answer 30

subclavian --> internal thoracic --> anterior intercostal

Question 31

what artery is the posterior intercostal artery derived from?

Answer 31

thoracic aorta --> posterior intercostal artery

Question 32

what does the anterior intercostal vein drain into?

Answer 32

internal thoracic vein

Question 33

what does the posterior intercostal vein drain into?

Answer 33

azygos system (depending on location)

Question 34

what leads the blood drain from the body wall to superior vena cava?

Answer 34

anastomotic pathway of azygos system

Question 35

what vein is the main drainage on the right?

Answer 35

azygos vein

Question 36

what vein is the main drainage on the left?

Answer 36

accessory hemiazygos vein

Question 37

what other vein allows drainage on the left?

Answer 37

hemiazygos vein

Question 38

what does the accessory hemiazygos vein drain into?

Answer 38

azygos vein

Question 39

what do the intercostal nerves accompany?

Answer 39

blood vessels

Question 40

intercostal nerves are what in relation to the spinal nerves?

Answer 40

ventral ramus of spinal nerves

Question 41

what do the intercostal nerves innervate?

Answer 41

intercostal muscles, skin and parietal pleura

Question 42

what are the three main surgical approaches to the thoracic cavity?

Answer 42

intercostal space, rib bed, sternum

Question 43

what fills in the inferior thoracic aperture?

Answer 43

diaphragm

Question 44

what separates the thoracic from the abdominopelvic cavity?

Answer 44

diaphragm

Question 45

what muscle of the thoracic cavity has fibres in all directions?

Answer 45

diaphragm

Question 46

what attachments does the central tendon of the diaphragm have? 3

Answer 46

sternal, costal and lumbar

Question 47

what shape is the diaphragm when relaxed?

Answer 47

dome-shaped

Question 48

what shape is the diaphragm when contracted?

Answer 48

flat

Question 49

what is the diaphragm innervated by?

Answer 49

phrenic nerve

Question 50

what supplies the diaphragm?

Answer 50

internal thoracic artery

Question 51

what are the 3 apertures in the diaphragm?

Answer 51

aortic hiatus, vena cava foramen, oesophageal hiatus

Question 52

what travels through the aortic hiatus?

Answer 52

descending aorta, thoracic duct, azygos vein

Question 53

what travels through the vena cava foramen?

Answer 53

inferior vena cava

Question 54

what travels through the oesophageal hiatus?

Answer 54

oesophagus and vagus nerves

Question 55

at what level is the aortic hiatus?

Answer 55

T12

Question 56

at what level is the vena cava foramen?

Answer 56

T8

Question 57

at what level is the oesophageal hiatus?

Answer 57

T10

Question 58

what happens first in inspiration?

Answer 58

external intercostal muscles contract

Question 59

what happens second in inspiration?

Answer 59

rib cage rises and expands

Question 60

what happens to the diaphragm during inspiration?

Answer 60

contracts to become flattened

Question 61

what happens to the thoracic cavity volume during inspiration?

Answer 61

increases

Question 62

what happens to intrapulmonary volume during inspiration?

Answer 62

increases

Question 63

what happens to intrapulmonary pressure during inspiration?

Answer 63

decreases

Question 64

how does air move into the lungs?

Answer 64

by flowing down the pressure gradient

Question 65

what happens first in expiration?

Answer 65

external intercostal muscles relax

Question 66

what happens second in expiration?

Answer 66

rib cage descends and reduces

Question 67

what happens to the diaphragm in expiration?

Answer 67

diaphragm relaxes and rises becoming dome-shaped

Question 68

what do the lungs do during expiration?

Answer 68

recoil

Question 69

what happens to the thoracic cavity volume during expiration?

Answer 69

decreases

Question 70

what happens to intrapulmonary volume during expiration?

Answer 70

decreases

Question 71

what happens to intrapulmonary pressure during expiration?

Answer 71

increases

Question 72

how does the air get expired?

Answer 72

flows down the pressure gradient which is now lower outside