lecture 6: thoracic wall

Question 1

what is the thoracic cage

Answer 1

osteocartilagenous structure that encloses the thorax and thoracic viscera

Question 2

give some examples of thoracic viscrea

Answer 2

heart, lungs, esophagus etc

Question 3

what is tthe rib cage bounded by

Answer 3

by the thoracic vertebrae, ribs and sternum

Question 4

what is the rib cage walled off by

Answer 4

muscles and conneective tissue with a few key passageways

Question 5

how many ribs are thre

Answer 5

12

Question 6

what are the 2 openings of the rib cage

Answer 6

=superior thoracic aperature (thoracic inlet)
=inferior thoracic aperature (thoracic outlet)

Question 7

which is larger the superior or inferior tthoracic aperature

Answer 7

the inferior

Question 8

what are the true ribs

Answer 8

1-7

Question 9

why are ribs 1-7 considered true ribs

Answer 9

direct insertion to the stternum via the costal cartilage

Question 10

what are the false ribs

Answer 10

8-10

Question 11

why are ribs 8-10 considered false ribs

Answer 11

they have an indirect insertion on sternum via costal margin (with the rib above them)

Question 12

what are the floating ribs

Answer 12

11-12

Question 13

why are ribs 11-12 called floating ribs

Answer 13

no insertion on the sternum att al l

Question 14

what is it the costal margin

Answer 14

The costal margin is the medial margin formed by the cartilages of the seventh to tenth ribs

-anterior side of tthe thoracic outlet

Question 15

what are the importtant features of a typical rib

Answer 15

head, tubercle, neck, costal angle, costal groove, body of the ribs, costal carttlage

Question 16

do the tubercle and costal groove lie inferior or superior

Answer 16

inferior

Question 17

where is the neck of the rib loacted

Answer 17

betweemn the head and the tubrecle

Question 18

what are the 3 articulations of the rib

Answer 18

1) hed of the rib (posterior, veertt)
2) tubercle of the rub (posterior, vert)
3) costal cartilage (anterior, sternum)

Question 19

is the articulation of the head of the rib located posterior or anterior

Answer 19

posterior

Question 20

is the articulation of the tuebrcle of the rib located posterior or anterior

Answer 20

posterior

Question 21

is the articulation of the costal cartilage of the rib located posterior or anterior

Answer 21

anterior

Question 22

where dos the head of the rib articulate

Answer 22

with the body of the vert (on the demi facets)

Question 23

where dos the ttubercle of the rib articulate

Answer 23

on the veertebra (specifcally on the costal facet on thte transverse process)

Question 24

whatt are the facets on the vertebral body of the thoracic vert called

Answer 24

demi facets

Question 25

whatt are the facets on the transverse process of the thoracic vert called

Answer 25

costal facet

Question 26

how many joint facets are unique to the thoracic vert

Answer 26

3 joint facets

Question 27

true or false: the ribs associate with the vert of the same nmber

Answer 27

ttrue

Question 28

where is the costotransverse joint located

Answer 28

betwen the rib and the transverse process

Question 29

explaiin the articulation of the costotransverse joint

Answer 29

rib at TP =tubercle of the rib articulates with the costal facet on the TP of the same numbered vertebra

Question 30

truue or false: tubercle of the rib articulates with the costal facet on the TP of the vertebra above

Answer 30

false, of the same numbereed vertebra

Question 31

explain thee articulation at the costovertbereal joint

Answer 31

rib at VB = head of the tubercle articulatese with 2 demi facets: 1) the VB of the same numbered vert and 2) the inferior demi facet of the VB above

Question 32

what are the posterior joints of the thoracic cage

Answer 32

costotranverse jointt costcovertebral joint

Question 33

true or false: rib 7 only acticulates with T7 (

Answer 33

false, also the inferior demi facet of t6

Question 34

which rib is condered short flat and horizontally oriented

Answer 34

rib 1

Question 35

what is special about the grooves on rib 1

Answer 35

anterior and psoterior grooves for subclavian vein and artery

Question 36

what is the articulation of the costovertberal joint of rib 1

Answer 36

articulates with VB of its own level only.

Question 37

what is the articulation of the costovertberal joint of ribs 10,11,12

Answer 37

the costovert joint articulatest with VB of own level only (no inferior facetts on t10,t11,t12)

Question 38

true or false: ribs 1,10,11,12 only articulate with VB of own level only

Answer 38

yes

Question 39

what is the missing physical feature of ribs 11,12

Answer 39

no tubercles or neck

Question 40

which ribs are shorter than normal

Answer 40

floating (11,12)

Question 41

whatt are tthe physical features of the sternum

Answer 41

jugular notch manubirum sternal angle/manubriosternal jointt body of the sternum xiphisternal joint xiphoid process

Question 42

what level is the sternal angle/manubriosternal jt

Answer 42

at tthe level of t4-t5

Question 43

what level is the xiphisetrnal jt

Answer 43

level of T9

Question 44

what are the anterior joints of the rib cage

Answer 44

1) costochondral 2) sternocostal 3) interchondral

Question 45

what typee of joint is the costochondral joint

Answer 45

solid, synchondrosis

Question 46

what typee of joint is the sternocostal joint

Answer 46

synovial, plane/gliding (exception: 1st rib-synchondrosis)

Question 47

what is the only rib that has an exception in terms of the sternocostal jt

Answer 47

1st rib is syncondhrosis

Question 48

where is the interchodnral joints loxated

Answer 48

between costal cartilageese of false ribs (8-10)

Question 49

what ttype of joints are interchondral

Answer 49

uniquely synovial

Question 50

what are the 2 movements of the thoracic cage for respiration

Answer 50

pump handle movement bucket handle movement

Question 51

explain the pump handle movement

Answer 51

volume of the thoracic cavity changes in an anteerior to posterior axis

Question 52

in the pump handle movement, where are there smaller movements and why

Answer 52

three are smallre movements superiorly (because of solid synchondrosis joints) and larger movement inferiorly

Question 53

where does the movement of tthe pump handle movement come from

Answer 53

costotransverse/vertebral of ribs 1-6

Question 54

explain the bucket handle movementt

Answer 54

laeteral (side to side) changes in thoracic cavity voke

Question 55

what joints are responsible for the bucket handle movement

Answer 55

costotransverse, costcovert and sterno costal joints for rib 6-12

Question 56

what muscle is responsible for forcee inspiration

Answer 56

extternal inteercostal muscles

Question 57

be able to know thee diffeerence in muscle oritenttaiton between exetrnal and internal interncsotals

Answer 57

l

Question 58

what is the fiber oritentation of the external intercostals

Answer 58

from orgin to isnertion (anterior and inferior)

Question 59

what is the function of external intercostal muscles

Answer 59

elevates ribs. forceful inspiration

Question 60

what muscles are responsible for forces expiration

Answer 60

internal intercosttal innermost intercostals transversus thorasis

Question 61

what is thee fiber orientation for intternal intercostals

Answer 61

from oirgin to insertion, posterior to infeerio

Question 62

what is the function of the internal intercosatl muscles

Answer 62

depresses ribs forceful expiration

Question 63

what is the fiber direction for innermost intercostal muscles

Answer 63

psoterior, inferior (like internal intercostals)

Question 64

what is the functino of the innermost intercostaks

Answer 64

depresses ribs forceful expiration

Question 65

where is tthe transversus thoracis located

Answer 65

sternum body and xiphoid process to ribs 2-6

Question 66

what is the function of transversus throracic

Answer 66

depresses ribs, froceful expiration

Question 67

how many intercondral joints are there

Answer 67

betwteen 3 and 4

Question 68

does the neurovasculature for thee thoracic wall come from anterior or postterior rami

Answer 68

anterior

Question 69

what are the main nerves that innervate the tnoracic wall

Answer 69

Intercostal n (t1-t11) and subcostal n (t12) =anterior rami of thoracic spinal n

Question 70

what is the function of intercostal and subcostal nerves

Answer 70

motor/sensory

Question 71

what are some of the nerves tah branch off the intercostals

Answer 71

lateral cutaneous neve and anterior cutaneous

Question 72

what is lateral and anterior cutaneuous nerve responsible for

Answer 72

somattic sensory

Question 73

wwhat is a dermatone

Answer 73

area/region of the skin innerevated by a single spinal nerve

Question 74

what is the dermatome area for t4

Answer 74

nipple

Question 75

what is the dermatome area for t6

Answer 75

skin over xiphoid process

Question 76

what is the dermatome area for t10

Answer 76

umbilicus

Question 77

what is the nerve responsible for nipple dermatome

Answer 77

t4

Question 78

what is the nerve responsible for skin over xiphoid dermatome

Answer 78

t6

Question 79

what is the nerve responsible for umbilicus dermatome

Answer 79

t10

Question 80

what si the clinical signigicance of thoracic dermatomes

Answer 80

youu can have pathology associated to 1 nerve root ex: shnigles

Question 81

explain shingles

Answer 81

lies dorman in spinal nerve =affected is spinal cord level tt5 since its right below the nipple which is t4

Question 82

what is the blood supply for the thoracic wakk

Answer 82

thoracic aorta posttrior intercostals anterior intersoclsa internal thoracic

Question 83

what two veins form an anastomosis in the thoracic wall

Answer 83

the posterior and anterior intercostatls

Question 84

where do the posterior intercostatls branch off

Answer 84

thoracic aorta

Question 85

wheree do the anterior intervostals branch off from

Answer 85

the internal thoracic (which is off the subclavian)

Question 86

true or false: the anterior and psoterior drainage of the thoracic wall is the same

Answer 86

false, the anterior side is paired with the blood but the posterior side is diff

Question 87

what is an anastomosis

Answer 87

joining of arterial supply in opp. direction

Question 88

what is the neurovascular bundle under the costal groove

Answer 88

intercosttal nerve, artery and vein

Question 89

what is the order of the vessels under the costal grove (sup to inferior)

Answer 89

intercostal vein, arterey nerve VAN

Question 90

between what muscles is the intercostal nerve

Answer 90

betweeen innermost and intercostals

Question 91

what is the clinical significanc eof the neurovasculature bundle

Answer 91

where to insert a chest tube

Question 92

why is the left domee of the diaphram lower

Answer 92

because of the heart

Question 93

what is the diapgram involved in

Answer 93

normal resting breathing

Question 94

what level is the diaphragm located during resp

Answer 94

att rib 5

Question 95

true or false: thoracic cavity volume chanes in an inferior to superior axis

Answer 95

no , opposite

Question 96

what is the innervation of the diaphragm

Answer 96

phrenic nerve (anterior rami of spinal nerves c3-c5

Question 97

truee or false: the sphenic splits to leeft and right

Answer 97

true