The Chest Wall, Breast and Thoracic Cavity Flashcards

1
Q

List the 7 major components of the bony thorax.

A

1 - Manubrium.

2 - Sternum.

3 - Xiphoid process.

4 - Costal cartilages.

5 - Clavicles.

6 - Ribs.

7 - Thoracic vertebrae.

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2
Q

List the boundaries of the thorax.

A
  • Superiorly: Thoracic inlet.
  • Inferiorly: Thoracic diaphragm.
  • Antero-latero-posteriorly: Ribs.
  • Posteriorly: Thoracic vertebrae and scapulae.
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3
Q

How many ribs are there?

A

12.

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4
Q

Which ribs are have no cartilaginous connection to the manubrium or sternum?

What is the name given to these ribs?

A
  • Ribs 11 and 12.

- Floating ribs.

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5
Q

At which vertebral level is the manubriosternal joint?

A

T4/5.

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6
Q

At which vertebral level is the xiphisternal joint?

A
  • T9.
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7
Q

What are the other names for the manubriosternal joint?

List 3 important anatomical structures that occur at this level.

A
  • The sternal angle / angle of Louis.

1 - It overlies the aortic arch on the left and the superior vena cava on the right.

2 - It marks the bifurcation of the trachea.

3 - The second pair of costal cartilages.

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8
Q

Which of the ribs are true ribs?

A

Ribs 1-7.

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9
Q

Define false ribs, and explain why the false ribs of the body are false.

A
  • Ribs that do not connect directly to the sternum (ribs 8-12).
  • The upper three false ribs connect to the costal cartilages of the ribs just above them. The last two false ribs are floating ribs.
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10
Q

List the margins of the thoracic inlet.

A
  • The body of the first thoracic vertebra.
  • The first ribs and their cartilages.
  • The manubrium of the sternum.
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11
Q

What types of joints are found in ribs 1-7?

A
  • Rib 1 has a fibrous joint.

- Ribs 2-7 have gliding synovial joints.

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12
Q

Where does the first rib articulate anteriorly?

A

On the superolateral surfaces of the manubrium.

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13
Q

Where do ribs 2-7 articulate anteriorly?

A
  • Rib 2 articulates at the manubriosternal joint.
  • Ribs 3-6 articulate with the lateral surfaces of the body of the sternum.
  • Rib 7 articulates at the xiphisternal joint.
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14
Q

Describe the posterior joints formed by ribs.

A
  • Each rib has two articulations with two vertebrae on each side of the vertebral column.
  • One articulation is made the inferior surface of the superior vertebra, and another articulation is made at the superior surface of the inferior vertebra.
  • The rib therefore traverses the discs between the bodies of the vertebrae.
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15
Q

What is the median septum?

A

A membrane that separates the lungs.

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16
Q

List the 6 major structures contained within the thorax.

A

1 - Lungs.

2 - Great vessels.

3 - The heart.

4 - Mediastinum.

5 - The trachea.

6 - The oesophagus.

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17
Q

Which dermatome covers the nipples?

A

T4.

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18
Q

Which dermatomes cover the area between the nipples and the umbilicus?

A

T5-T9.

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19
Q

Which dermatome covers the umbilicus?

A

T10.

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20
Q

Which dermatomes cover the area between the umbilicus and the genitalia?

A

T11 and T12.

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21
Q

Which dermatomes cover the genitalia?

A

S2 and S3.

22
Q

List the thoracic structures at vertebral level T2.

A

The superior border of the scapula.

23
Q

List the thoracic structures at vertebral level T2/3.

A

The suprasternal notch.

24
Q

List the thoracic structures at vertebral level T3.

A
  • The medial end of the spine of the scapula.

- The posterior end of the oblique fissure of the lung.

25
Q

List the thoracic structures at vertebral level T4.

A
  • The end of the arch of the aorta.

- The azygous vein enters the superior vena cava.

26
Q

List the thoracic structures at vertebral level T4/5.

A
  • The manubriosternal junction (the angle of louis).

- The start and end of the arch of the aorta.

27
Q

List the thoracic structures at vertebral level T5.

A

The thoracic duct crosses the midline.

28
Q

List the thoracic structures at vertebral level T7.

A

The inferior angle of the scapula.

29
Q

List the thoracic structures at vertebral level T8.

A
  • The caval opening in the diaphragm.
  • The left phrenic nerve pierces the diaphragm.
  • The hemi-azygous vein crosses to the left.
30
Q

List the thoracic structures at vertebral level T10.

A

The oesophageal opening in the diaphragm.

31
Q

List the thoracic structures at vertebral level T12.

A
  • The aortic opening in the diaphragm.
  • The coeliac trunk.
  • The splanchnic nerve pierces the crura.
  • The sympathetic trunk passes behind the median arcuate ligament.
  • The subcostal bundle passes behind the lateral arcuate ligament.
32
Q

Which structures pass through the caval opening in the diaphragm?

A

The inferior vena cava and the right phrenic nerve.

33
Q

Which structures pass though the oesophageal opening in the diaphragm?

A
  • The oesophagus.
  • Branches of left gastric vessels.
  • The vagus nerve.
34
Q

Which structures pass through the aortic opening in the diaphragm?

A
  • The aorta.
  • The azygos vein.
  • The hemi-azygos vein.
  • The thoracic duct.
35
Q

List the cavities of the thorax.

A
  • The left pleural cavity.
  • The right pleural cavity.
  • The mediastinum.
36
Q

What is contained in the mediastinum?

A

The heart and great vessels of the heart.

37
Q

What are the anterior and posterior attachments of the mediastinum?

A
  • Anteriorly: The sternum.

- Posteriorly: The vertebral column.

38
Q

What penetrates the mediastinum at the lateral borders?

A

The hilum of the lung.

39
Q

Where is McBurney’s point and what is its significance?

A

The point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus where the appendix attaches to the caecum.

40
Q

What separates the mediastinum into superior and inferior cavities?

A

The sternal angle / angle of louis.

41
Q

What is contained within the inferior mediastinum?

A

The pericardial sac and its contents (the heart is not located within the superior mediastinum).

42
Q

List the divisions of the inferior mediastinum and their locations relative to the pericardial sac.

A
  • Anterior to the pericardial sac is the anterior inferior mediastinum.
  • Within the pericardial sac is the middle inferior mediastinum.
  • Posterior to the pericardial sac is the posterior inferior mediastinum.
43
Q

Which structure only exists in the mediastinum in children?

A

The thymus gland.

44
Q

Describe the layers of the pericardium.

A
  • The outermost layer is the fibrous pericardium.

- The innermost layer is the serous pericardium.

45
Q

Describe the layers of the serous pericardium.

A
  • Parietal pericardium.

- Visceral pericardium.

46
Q

List the boundaries of the heart.

A

Anteriorly:

  • The sternum, which is slightly shifted to the right of the heart.
  • The thymus in children.

Posteriorly:

  • The trachea.
  • The oesophagus.
  • The descending aorta.

Inferiorly:

The central tendon of the diaphragm.

47
Q

Which of the lungs is narrower than the other?

A

The left lung is narrower.

48
Q

List superior and inferior boundaries of the lungs.

A
  • Superiorly: The apices extend 1-2cm above the clavicles.

- Inferiorly: Rises and falls between the 9th and 12th ribs.

49
Q

Describe the segmentation of the lungs.

A
  • Lobes are major divisions of the lungs and are separated by fissures.
  • Segments are minor divisons of the lungs.
  • Secondary lobules are minor divisions of segments.
50
Q

How are the left and right lungs segmented into lobes?

A
  • The right lung has 3 lobes (upper, middle and lower).
  • The left lung has 2 lobes (upper and lower).
  • The right lung has 2 fissures (oblique and horizontal).
  • The left lung has 1 fissure (oblique).
51
Q

How many broncho-pulmonary segments supply the right and left lungs?

A
  • 10 segments supply the right lung.

- 8 segments supply the left lung.

52
Q

List the muscles associated with the ribs.

A
  • Intercostals (external, internal and innermost).
  • Transversus thoracis.
  • Levatores costarum.