Lecture 4: Thoracic wall

Question 1

Identify the structure with the star.

Answer 1

tubercle

Question 2

Identify the structure with the red arrow

Answer 2

costal groove

Question 3

articulate with inferior and superior costal facets of adjacent thoracic vertebrae

Answer 3

head

Question 4

term used to describe a group of disorder that occur when there is compression, injury, or irritation of the brachial plexus and/or subclavian vessels in the lower neck and upper chest

Answer 4

thoracic outlet syndrome

Question 5

This structure separates the ribs and costal cartilages

Answer 5

intercostal space

Question 6

__ to ___ are TRUE ribs

Answer 6

1-7

Question 7

___ to ___ have cartilages attached to cartilages of ribs superior.

Answer 7

8-10

Question 8

Floating ribs are which number?

Answer 8

11-12

Question 9

space between the pericardium and the sternum

Answer 9

anterior mediastinum

Question 10

pericardium and heart lie in this part of the thoracic cavity

Answer 10

middle mediastinum

Question 11

part of the body between the neck and abdomen including the cavirty enclosed by the ribs, breastbone and dorsal vertebrae and containing the chief organs of circulation and respiration, the chest

Answer 11

the thorax

Question 12

Identify all the features of the generalized vertebra

Answer 12

see slide 17 thoracic wall MC

Question 13

which muscle lies between the ribs?

Answer 13

intercostal muscles

Question 14

function during respiration both by moving the ribs and by helping to keep the intercostal spaces rigid

Answer 14

intercostal muscles

Question 15

5 muscles included in the intercostal muscles

Answer 15

1. ) external intercostal
2. ) internal intercostal
3. ) innermost intercostal
4. ) subcostal
5. ) transversus thoracis

Question 16

elevate ribs during forced inspiration

Answer 16

external intercostals

Question 17

internal and innermost intercostals are separated from the innermost layer by the ____.

Answer 17

neurovascular bundle

Question 18

Identify muscles in green

Answer 18

subcostalis

Question 19

functions to depress ribs

Answer 19

transversus thoracis

Question 20

where is/are the primary blood supply to the thoracic wall derived from?

Answer 20

aorta and subclavian arteries

Question 21

most of these veins return blood to the azygous and hemiazygous veins

Answer 21

posterior intercostal veins

Question 22

an area of the skin supplied by the nerves from a single spinal root

Answer 22

dermatomes

Question 23

a procedure to remove fluid from the space between the lining of the outside of the lungs and the wall of the chest

Answer 23

thoracentesis

Question 24

origin is the transverse processes; insertion: rib below b/w tubercle and angle; action: elevates ribs

Answer 24

levator costae

Question 25

origin: spines of C7-T3; insertion: ribs 2-4; action: elevate ribs

Answer 25

serratus posterior superior

Question 26

origin: spines of T11-L2; insertion: ribs 8-12; action: depress ribs

Answer 26

serratus posterior inferior

Question 27

most important muscle of respiration

Answer 27

diaphragm

Question 28

Identify the structure with the star on the diagram.

Answer 28

serratus posterior inferior

Question 29

Identify the structure with the star on the diagram.

Answer 29

right crus

Question 30

Identify the structure with the star on the diagram.

Answer 30

medial arcuate ligament

Question 31

unites the crura and forms the aortic hiatus

Answer 31

MEDIAN arcuate ligament

Question 32

what innervates the respiratory diaphragm

Answer 32

phrenic nerve C3, C4, C5 "keep the diaphragm alive"

Question 33

posterior intercostal veins return blood to ____ and ___ veins

Answer 33

azygos and hemiazygos

Question 34

flatten the dome of the diaphragm, providing the lung with greater volume for expansion

Answer 34

diaphragmatic plication

Question 35

increasingly being employed in patients with central respiratory paralysis and upper cervical spinal cord injury to wean patients off mechanical ventilation

Answer 35

phrenic pacing

Question 36

describe 2 things that happen during INSPIRATION

Answer 36

1. ) rib cage expand as rib muscle contract 2. ) diaphragm contracts/ moves down

Question 37

describe 2 things that happen during expiration

Answer 37

1. ) ribe cage gets smaller as rib muscles relax 2. ) diaphragm relaxes/ moves up

Question 38

principal muscle involved in INSPIRATION

Answer 38

external intercostals (elevate ribs)

Question 39

principal muscle(s) involved in expiration

Answer 39

internal intercostal, rectus abdominis, external oblique, internal oblique, transversus abdominis CONTRACT during expiration

Question 40

superior surface of the diaphgram is supplied by ____ arteries (3)

Answer 40

musculophrenic, pericardiacophrenic, and superior phrenic arteries

Question 41

the inferior surface of the diaphragm is supplied by \_\_\_.

Answer 41

inferior phrenic

Question 42

Identify the artery by the star on the diagram

Answer 42

musculophrenic artery

Question 43

Identify the structure labeled by the stars on the diagram

Answer 43

inferior phrenic arteries

Question 44

superior venous drainage of the diaphragm (3 veins)

Answer 44

musculophrenic, pericardiacophrenic and right superior phrenic

Question 45

inferior surface venous drainage of diaphragm (2 veins)

Answer 45

right and left inferior phrenic veins

Question 46

Most veins return blood to the azygous and hemiazygous veins EXCEPT

Answer 46

Left Superior intercostal

Question 47

ID the structure with the star

Answer 47

left pericardiacophrenic artery

Question 48

ID the structure with the star

Answer 48

Right pericardiacophrenic artery

Question 49

What surgical treatment is used to treat pts with severe dyspnea upon excursion (unilateral diaphragmatic paralysis) ?

Answer 49

diaphragmatic plication

Question 50

What is currently being used to treat bilateral diaphragmatic paralysis and allows pts to speak again and use their olfaction systems?

Answer 50

diaphragm pacing

Question 51

At what level does the caval hiatus open?

Answer 51

T8

Question 52

At what level does the esophageal hiatus come out?

Answer 52

T10

Question 53

At what level does the aortic hiatus come out?

Answer 53

T12

Question 54

Part of diaphragm that arises from L1-L2 and their intervertebral discs

Answer 54

left crus

Question 55

arises from L1-L3 and their intervertebral discs

Answer 55

right crus

Question 56

which diaphragmatic aperture/opening does the azygous vein go into?

Answer 56

aortic hiatus

Question 57

Which intercostal muscle(s) has actions to both depress and elevate the ribs?

Answer 57

internal intercostal and innermost intercostal muscle

Question 58

Transversus thoracic attaches to which costal cartilages?

Answer 58

2-6

Question 59

Most common type of scoliosis

Answer 59

idiopathic scoliosis

Question 60

may result from traumatic bone callapse, previous mahor back surgery, or osteoporosis

Answer 60

degenerative scoliosis