Resp-Thoracic Wall and Diaphragm

Question 1

What are the 5 atypical ribs?

Answer 1

1, 2, 10, 11, 12

First 2 and last 3

Question 2

What is the arrangement of structures in the costal groove? (from top down)

Answer 2

Vein Artery Nerve

VAN

Question 3

The tubercle of the rib connects to the thoracic vertebrae at the ________.

Answer 3

Costal facet

Question 4

How many facets are present on the head of a typical rib?

Answer 4

2

Question 5

What are the 2 synovial joints of the thoracic wall?

Answer 5

Between the ribs & vertebrae (costovertebral joints)
Between the sternum & clavicles (sternoclavicular joints)

Question 6

What is the significance of the synovial joints?

Answer 6

They allow for more movement at the joint

Question 7

The EICMs run ________ & ________. They are muscles for ________

Answer 7

The EICMs run downwards & forwards. They are muscles for inspiration

There are 12 ribs hence 11 intercoastal?

Question 8

The IICMs run ________ & ________. They are muscles for ________

Answer 8

The IICMs run downwards & backwards. They are muscles for expiration

Question 9

How many pairs of ICMs are there?

Answer 9

11 pairs

Question 10

Between which 2 layers are the intercostal VAN located?

Answer 10

Between the innermost intercostal muscle & the internal intercostal muscle

Question 11

Where does the collateral branch of the IC nerve run?

Answer 11

Runs along the upper border of the inferior rib

The main intercostal nerve of rib 9 runs in the subcostal groove of rib 9, while the collateral branch runs along the upper border of rib 10

Question 12

The ________ horn of the spinal cord supplies somatic motor innervation to the skeletal muscles of the thoracic wall

Answer 12

The ventral horn of the spinal cord supplies somatic motor innervation to the skeletal muscles of the thoracic wall

Question 13

Primary somatic ________ (sensory) neurons synapse onto secondary somatic ________ neurons in the ____________ before entering the ________ horn of the spinal cord

Answer 13

Primary somatic afferent (sensory) neurons synapse onto secondary somatic afferent neurons in the dorsal root ganglion before entering the dorsal horn of the spinal cord

Question 14

Which artery supplies the PIA of the upper 2 IC spaces?

PIA = Posterior Intercostal Artery

Answer 14

Costocervical artery; branch of subclavian artery

Question 15

Which artery supplies the PIA of IC space 3-11?

PIA = Posterior Intercostal Artery

Answer 15

Descending aorta

Question 16

Which arteries supply the AIAs?

Anterior Intercostal Artery

Answer 16

Internal mammary artery (IMA) and musculophrenic artery

Internal mammary artery (IMA) and musculophrenic artery## FootnoteMusculophrenic artery is the terminal branch of the IMA

Question 17

What 3 arteries are located at the anterior of the thoracic wall?

Answer 17

Subclavian artery
Internal mammary artery
Musculophrenic artery

Question 18

Where do the AIVs drain into?

Anterior Intercostal Vein

Answer 18

Internal mammary vein

Question 19

Where do the PIVs drain into?

PIV = Posterior Intercostal Vein

Answer 19

Azygos vein & brachiocephalic vein

Question 20

Which nerve innervates the diaphragm?

Answer 20

Phrenic nerve (C3-5)

Question 21

Which 3 structures pierce the diaphragm at T12?

Answer 21

Aorta
Thoracic duct
Azygos vein

Question 22

Which 2 structures pierce the diaphragm at T10?

Answer 22

Oesphagus
Vagus nerve

Question 23

At what level does the IVC pierce the diaphragm?

Answer 23

T8

Question 24

What are the 4 accessory muscles of respiration?

Answer 24

Pectoralis major
Pectoralis minor
Subclavius
Serratus anterior