Structure of the Thoracic wall and Diaphragm

Question 1

What forms the thoracic skeleton

Answer 1

12 pairs of ribs
12 thoracic vertebra
sternum

Question 2

The Superior thoracic aperture communicates which structures with each other

Answer 2

thoracic cavity to upper limb and neck.

Question 3

What are the boundaries of the superior thoracic aperture

Answer 3

behind: T1 vertebra
infront: 1st rib
sides: manubrium of sternum

Question 4

The inferior thoracic aperture communicates which structures with each other

Answer 4

thoracic cavity with the abdomen

Question 5

Which structure closes the inferior thoracic aperture

Answer 5

diaphragm

Question 6

What are the boundaries of the inferior thoracic aperture

Answer 6

behind: T12
sides: 11th & 12th ribs
front: xiphisternum

Question 7

What are the 2 joints in the sternum

Answer 7

Manubriosternal joint (sternal angle)

Xiphisternal joint

Question 8

The Xiphisternal joint corresponds with which rib and which vertebra

Answer 8

7th rib

T9 vertebra

Question 9

What are the 3 types of ribs

Answer 9

True
False
Floating

Question 10

Which ribs are true ribs

Answer 10

1st -7th ribs

Question 11

Which ribs are false ribs

Answer 11

8th – 10th ribs

Question 12

Which ribs are floating ribs

Answer 12

11th & 12th ribs

Question 13

What makes a false rib what it is

Answer 13

cartilages of these ribs are joined to the cartilages of the ribs above

Question 14

What makes a floating rib what it is

Answer 14

no cartilages in front, articulates with vertebrae behind

Question 15

The sternal angle corresponds with which rib and which vertebra

Answer 15

2nd rib

T4/T5

Question 16

Which surgical procedure can be used to gain access to thoracic cavity for surgical procedures on heart and great vessels

Answer 16

Median sternotomy

Question 17

Which surgical procedure can be used to enter pleural cavity

Answer 17

Thoracotomy

Question 18

What are the three types of intercostal muscles

Answer 18

External intercostal, Internal intercostal and Innermost intercostal muscle

Question 19

What is the arrangement of structures of the neurovascular bundle from superior to inferior

Answer 19

Vein, Artery and Nerve

Question 20

Nerves of the thoracic wall are located between which 2 layers of muscle

Answer 20

internal intercostal muscle and innermost intercostal muscle (between 2nd and 3rd layer of muscle)

Question 21

Which nerves supply the intercostal space

Answer 21

Intercostal nerves, anterior rami of T1- T11 spinal nerves including T12 (subcostal nerve) supply the intercostal spaces

Question 22

Each intercostal space is supplied by which arteries

Answer 22

a posterior intercostal artery and a pair of anterior intercostal arteries

Question 23

posterior intercostal and subcostal arteries arise from which vessel

Answer 23

thoracic aorta

Question 24

internal thoracic and supreme intercostal arteries arise from which vessel

Answer 24

subclavian artery

Question 25

superior and lateral thoracic arteries arise from which vessel

Answer 25

axillary artery

Question 26

Which veins drain the thoracic wall

Answer 26

Anterior and Posterior intercostal veins

Question 27

The posterior intercostal veins drain into which veins

Answer 27

azygos/ hemiazygos veins

Question 28

The anterior intercostal veins drain into which veins

Answer 28

internal thoracic veins

Question 29

Which part of the ribs move like a “pump handle” during breathing

Answer 29

upper ribs

Question 30

Which part of the ribs move like a “bucket-handle” during breathing

Answer 30

middle parts of the lower ribs

Question 31

The primary movement of inspiration is contraction of which structure

Answer 31

The diaphragm

Question 32

Contraction of the diaphragm increased which dimension (vertical, horizontal) of the thoracic cavity

Answer 32

Vertical

Question 33

Intercostal nerve blocks require how many adjacent intercostal spaces to be completely anesthetized

Answer 33

2 or more

Question 34

Which dome of the diaphragm is higher

Answer 34

right

Question 35

What is another name for the trifoliate tendinous part of the diaphragm

Answer 35

central tendon

Question 36

The diaphragm is attached to which sternal part

Answer 36

posterior part of xiphoid process

Question 37

The diaphragm is attached to which costal part

Answer 37

inner surface of lower six ribs and their costal cartilages

Question 38

The diaphragm is attached to which lumbar part

Answer 38

Upper 3 lumbar vertebrae, medial and lateral arcuate ligaments

Question 39

What passes through the caval opening of the diaphragm

Answer 39

IVC, right phrenic nerve and some lymphatics from liver

Question 40

What passes through the esophageal opening of the diaphragm

Answer 40

esophagus, anterior & posterior vagal trunks, esophageal branches of left gastric vessels and lymphatics

Question 41

What passes through the aorta opening of the diaphragm

Answer 41

descending aorta, azygos vein and thoracic duct

Question 42

The caval opening in the diaphragm is at which vertebral level

Answer 42

T8

Question 43

The esophageal opening in the diaphragm is at which vertebral level

Answer 43

T10

Question 44

The aortic opening in the diaphragm is at which vertebral level

Answer 44

T12

Question 45

The lymphatic vessels from liver and superior epigastric vessels are transmitted through which opening in the diaphragm

Answer 45

sternocostal foramen

Question 46

The greater and lesser splanchnic nerves travel through which opening of the diaphragm

Answer 46

Crura of the diaphragam

Question 47

What is the motor supply of the diaphragm

Answer 47

Right and left phrenic nerves

Question 48

What is the sensory supply of the disphragm

Answer 48

Phrenic nerve (most part)

Lower six intercostal nerves (periphery)