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OS 205 Removals Review > Thoracic Cage and Breast > Flashcards

Thoracic Cage and Breast Flashcards

1
Q

Level of Thoracic Inlet

A

T1. Duh.

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2
Q

Level of Thoracic Outlet

A

T11 or T12. Duh.

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3
Q

Neurovascular connections of the thorax

A

Neck, Upper Ex, Abdomen

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4
Q

Most important landmark of the thorax where all ribs are counted from

A

sternal angle

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5
Q

Primary functions of the thorax

A

1) Protect lungs and heart
2) RBC formation
3) Blood aeration via expansion of thoracic cage

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6
Q

Type of joint of sternal angle of Louie

A

synchondrosis

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7
Q

At around which intercostal space is the sternal angle of Louie located?

A

2nd

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8
Q

Surface landmarks of the thorax

A

jugular notch of the manubrium
sternal angle of Louie/manubriosternal junction
sternoclavicular joint
xiphoid process

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9
Q

T or F: In infants, thoracic cage AP>Transverse diameter

A

False. It is more or less equal. The infant’s thoracic cage is barrel-shaped.

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10
Q

T or F: The transverse diameter of an adult’s thoracic cage is greater than its AP diameter

A

True

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11
Q

The cavity of the thorax is divided into:

A

Mediastinum and the Pleurae

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12
Q

T or F: Full size of the lung is achieved during expiration

A

False. It is during inspiration

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13
Q

Main components of the thoracic cage

A

Muscle and bone. However, it is also osteocartilaginous which prevents it from getting damaged during proper CPR

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14
Q

Boundaries of the Triangle of Auscultation

A

1) Inf. Traps
2) Superior Lats
3) Vertebral border of Scapula
4) Rhomboid major (floor)

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15
Q

Where can the space between the 6th and the 7th ribs (aka 6th ICS) be located?

A

Triangle of Auscultation

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16
Q

Level of Jugular/Suprasternal Notch

A

T2

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17
Q

What can be found at T9?

A

Inferior border of the heart, xiphisternal joint on the OPPOSITE side

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18
Q

T or F: Inserting a needle on the xiphoid cartilage will damage the diaphragm and heart

A

False. This is just right below the inferior border of the heart. No danger here.

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19
Q

The subcostal angle is used in reference for what?

A

The edge of the liver, which is 2cm below this.

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20
Q

Which ribs’ costal cartilages form the costal margin?

A

7th-12th

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21
Q

T or F: On the manubrium, the notch is for the 1st costal cartilage (CC), while the depression is for the 2nd CC

A

False. Depression: 1st CC :: Notch: 2nd CC

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22
Q

The adult length of the manubrium

A

17cm

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23
Q

T or F: The manubrium slopes downward and forward

A

True

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24
Q

T or F: The manubrium is concave anteriorly and convex posteriorly

A

False. It is convex anteriorly, and concave posteriorly.

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25
Q

What major vein runs from the upper left to the lower right side beneath the manubrium? What vein does this connect to?

A

Left brachiocephalic to Right brachiocephalic

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26
Q

What do the L and R brachiocephalic veins form?

A

The superior vena cava

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27
Q

The transverse facets of the body of the sternum articulates with what?

A

3rd-5th CCs

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28
Q

Vertebral level length of the body of the sternum

A

T5-T9

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29
Q

T or F: The xiphoid is cartilaginous in the youth and ossified in the adult

A

True

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30
Q

Which ribs are true?

A

1-7

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31
Q

Which ribs are false?

A

8-10

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32
Q

Which ribs are floating?

A

11-12

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33
Q

Which ribs may be palpated?

A

2-10

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34
Q

T or F: female nipples are located at the 4th ICS

A

False. This is not always the case as female breasts vary in size and shape. However, male nipples are consistently located at the level of the 4th ICS

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35
Q

Where is the apex beat of the heart located?

A

5th ICS, approx. 7-9cm from the midsternal line

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36
Q

What is the axillary fold?

A

It is the area between the ant. fold by the pecs major, and the post. fold by the lats dorsi

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37
Q

Where is the cephalic vein located?

A

At the delto-pectoral groove

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38
Q

1st most prominent spine/spinous process

A

C7 aka vertebra prominens

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39
Q

Level of the superior angle of the scapula

A

T2

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40
Q

Which part of the scapula is subcutaneous?

A

Spine

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41
Q

Level of the inferior angle of the scapula

A

opposite T7

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42
Q

T or F: The thoracic inlet is oblique

A

True

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43
Q

T or F: The thoracic outlet is oblique

A

True

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44
Q

What closes the thoracic outlet?

A

The diaphragm

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45
Q

Atypical vs Typical Ribs: How many facets does a typical rib have?

A

2

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46
Q

Atypical vs Typical Ribs: Which rib is atypical and most sharply curved?

A

1st

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47
Q

Atypical vs Typical Ribs: Which atypical rib has a prominent tubercle?

A

1st

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48
Q

Atypical vs Typical Ribs: Which atypical rib has a small tubercle?

A

11th

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49
Q

The shallow grooves on the 1st rib are for?

A

The subclavian artery and vein

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50
Q

The eminence of the 2nd rib serves as an attachment for what?

A

1st and 2nd digitation of the serratus ant.

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51
Q

WHich atypical rib has an ill-defined angle?

A

11th

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52
Q

T or F: The 12th rib is longer than the 1st

A

False. It is shorter

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53
Q

Which part of the rib articulates with the vertebral transverse processes?

A

The tubercle

54
Q

Part of the rib that is the broadest

A

Neck

55
Q

Rib Ossification (order and events)

A

“7-14-25”
7 weeks: 1 center of ossification
14 weeks: 2ndary center of ossification
25 weeks: Fusion of 2ndary centers of ossification

56
Q

What does the sternochondral joint consist of?

A

Synchondroses joints basically attached to the sternum; Rib 1. Ribs 2-7 are also attached to the sternum but they are SYNOVIAL

57
Q

A joint that is basically just the connection of the costal cartilage and the actual rib bone

A

Costochondral

58
Q

The costotransverse joint consists of: rib tubercle + _________
surface of transverse process of inferior
verterbrae to which head is joined

A

anterior

59
Q

What kind of movement does the capitular joint produce?

A

Gliding

60
Q

The 2 movements of the ribs and sternum

A

1) Water bucket handle

2) Water pump handle

61
Q

Pecs Major controls w/c ribs?

A

1-6

62
Q

Pecs minor controls w/c ribs?

A

2-5

63
Q

Scalenes control w/c ribs?

A

1-2

64
Q

What other muscle controls ribs 1-2?

A

SCMs

65
Q

How many ext. intercostals are there?

A

11

66
Q

What is the direction of the ext. intercostals?

A

inferomedially (btw, ext. intercostals are those fascia-like muscles that cover the intercostal spaces)

67
Q

Innervation of intercostals

A

branches of the intercostal nerve

68
Q

How many internal intercostals?

A

11 din

69
Q

The spleen corresponds to which ribs?

A

9th-11th

70
Q

Under which cases and where would the pain be located when the spleen is ruptured?

A

Trauma to 7th-11th ribs and abdominal pain

71
Q

Where is the apex beat located?

A

5th intercostal space

72
Q

T or F: The superficial fascia contains blood and lymphatic vessels

A

True

73
Q

T or F: The deep fascia serves as a barrier to infection

A

True

74
Q

T or F: The deep fascia is devoid of fat

A

True

75
Q

Percussion of lungs produces what kind of sound?

A

Resonant

76
Q

Percussion of the heart produces what kind of sound?

A

Dull

77
Q

Where is the neurovascular bundle of the rib located?

A

Lower border of the rib. Therefore DO NOT insert a needle in this area.

78
Q

What is the use of thoracentesis?

A

Drain fluid from lungs, but SMALL AMOUNT ONLY

79
Q

What are the structures you will pass by IN ORDER when you insert a needle in the 6th ICS for thoracentesis?

A

skin, subcutaneous layer, serratus ant., ext. intercostals, int. intercostals, pleural cavity

80
Q

What is the use of the Tube Thoracostomy?

A

Drain fluid from lungs but LARGE AMOUNT

81
Q

What is the proper way to do a tube thoracostomy?

A

30 degrees from horizontal angle, xiphisternal space, directed to the left shoulder, then aspirate

82
Q

How much amount in the pericardial spacewould cause the heart to stop?

A

50cc

83
Q

A precess wherein a needle is inserted in the pericardial cavity

A

Pericardiocentesis

84
Q

T or F: The sternal puncture aka bone marrow biopsy via sternum has been abandoned

A

True. Due to its proxmity to the heart

85
Q

In a chylothorax, what is ruptured? What enters the pleural cavity?

A

Thoracic duct. Lymph and emulsified fat

86
Q

T or F: In tension pneumothorax, air enters the lungs

A

False. It escapes the lungs and enters the pleural cavity and causes the lungs to collapse

87
Q

Paradoxical breathing is present in what thoracic condition?

A

Multiple rib fracture. Aka “flail chest” Btw, paradoxical breathing means that instead of the normal expansion of the chest during inhalation, it contracts. A depression is seen in the affected area.

88
Q

The long axis of the spleen is located along which rib and its specific area

A

10th, long shaft

89
Q

Shape of the breast in nullipara

A

smooth and conical

90
Q

Shape of breast in multipara

A

pendulous and elongated

91
Q

Shape of breast in old age/emaciated individuals

A

flattened discs with irregular surfaces

92
Q

Where are males’ mamary glands found?

A

intercostal spaces

93
Q

Rib landmarks for female breasts

A

2nd-6th ribs

94
Q

T or F: The breast lies in the deep fascia of the ant. surface of the thorax

A

False. It lies in the superficial fascia

95
Q

How much of the mammary gland overlies the deep pectoral fascia of the pecs major?

A

2/3

96
Q

How much of the mammary gland overlies the fascia of the serratus major?

A

1/3

97
Q

What separates the breast from the pecs maj?

A

Retromammary space

98
Q

What kind of tissue is found in the retromammary space?

A

connective tissue

99
Q

T or F: The gland tissue is thicker in the periphery of the breast than in the center

A

False. It is thicker in the center

100
Q

How many lobes of pyramidal tissue is present in an average breast?

A

15-20

101
Q

Place in correct order from inner to outer: lobes, lobules, lactiferous ducts, mammary papilla, alveoli

A

alveoli, lactiferous ducts, lobule, lobe, mammary papilla

102
Q

T or F: The Suspensory Ligaments of Cooper are attached to the superficial layer of the deep fascia

A

False. It is attached to the DEEP layer of the SUPERFICIAL fascia, and gives the breast its posture

103
Q

What does the varying amounts of fat around the glandular lobe give the breast?

A

Its shape

104
Q

When does the branching of the alveoli and ducts occur?

A

In puberty

105
Q

When are breasts considered mature?

A

After pregnancy, at onset of milk secretion. During pregnancy, the glands enlarge and undergo rapid multiplication (hyperplasia and hypertrophy)

106
Q

Cells in the center of the alveolus undergo fatty degeneration and are eliminated in the first milk as _______?

A

Colostrum corpuscles

107
Q

What are the reservoirs of milk (converging beneath the areola)

A

Tubulactiferi/ Galactophores

108
Q

T or F: Muscular fibers are present in galactophores

A

False

109
Q

T or F: Galactophores have a mucus lining

A

True

110
Q

How many lactiferous ducts are there?

A

15-20

111
Q

Are there sebaceous glands in the nipple?

A

Yes there are

112
Q

What do you call the normal extension of the breast tissue towards or into the axilla?

A

Axilla of Spence

113
Q

What do you call the median area between the breasts aka “curbs”?

A

Sinus Mammarium

114
Q

What causes the rough surface of the areola?

A

Tubercles of Montgomery

115
Q

Lymph from the nipple, areola, and lobules drains to ____?

A

Subareolar plexus

116
Q

Lymph drainage of the lateral and inferior portions of the breast (75%)

A

Along thoraco-acromial and lat. thoracic vessels towards pecs nodes and eventually to axillary nodes

117
Q

Lymph drainage of medial portion

A

Parasternal nodes/int. thoracic nodes along int. thora. artery

118
Q

T or F: Lymph from the medial portion can cross to the opposite breast

A

True

119
Q

Lymph drainage of the small superior portion

A

Supraclavicular nodes

120
Q

T or F: Inferior phrenic nodes may also receive some lymphatic drainage

A

True

121
Q

Veins anastomosing around the base of the nipple is also known as the_______?

A

Circulus venosus

122
Q

Innervation of breasts

A

4th-6th lat and inf. cutaneous nerve branches of the intercostal nerve

123
Q

T or F: Breast innervation is parasympathetic.

A

False. It is sympathetic.

124
Q

The cutting of this nerve causes cutaneous anesthesia in the inner side of the arm and axilla

A

Intercostobrachial n. (think: intercostals + brachial)

125
Q

This nerve is usually preserved during axillary dissection but may be sacrificed if it gets in the way

A

Thoracodorsal n. (nerve to lats dorsi)

126
Q

Where do supernumerary nipples or accessory breast develop?

A

Along the milkline from axilla to groin

127
Q

What is athelia?

A

Absence of nipple

128
Q

T or F: Fibroadenoma is malignant

A

False. It is benign. A solid, solitary movable mass. Painless to tender on palpation

129
Q

A palpable mass that is hard, immobile, and painful upon palpation, presenting with bloody or watery nipple discharge

A

Malignant. May be intraductal carcinoma or breast cancer

130
Q

Predisposing factors to carcinoma

A

Radiation, family history, hormonal-endogenous or exogenous env., previous benign heart disease

OS 205 Removals Review (3 decks)

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