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Respiratory Anatomy > Thoracic Cage & Wall > Flashcards

Thoracic Cage & Wall Flashcards

1
Q

Give reason: the thoracic inlet is oblique

A

Due to obliquity of 1st rib

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2
Q

Describe the structure of intervertebral foramen and structures passing through it.

A

Formed from articulation of seperior and infecrior notches (adjacent) of pedicle.
Spinal nerves and vessels pass through it

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3
Q

Contents of vertebral foramen

A

Spinal cord and meninges

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4
Q

Compare articular processes of thoracic vertebra.

A

Superior: project upwards, articular surface directed backwards.
Inferior: project downwards, articular surface directed forwards.

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5
Q

Type of joint between costal facets and heads of ribs.

A

Plane synovial

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6
Q

Type of joint between transverse process and tubercle of ribs.

A

Plane synovial joint

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7
Q

Vertebrae where their transverse process lacks facets.

A

11th & 12th

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8
Q

Each typical vertebra articulates with ……. & …….. .

A

The corresponding rib and the one below.

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9
Q

The thoracic vertebra resembling cervical v having complete superior facet.

A

First T.V.

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10
Q

Vertebra identical to typical except it lacks inferior demifacet

A

9th T.V.

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11
Q

Type of joints between articular processes.

A

Plane synovial joint

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12
Q

Lamina connected by ……. , spines connected by ……., their tips connected by …….. & transverse processes connected by …… .

A

Ligamentum flavum
Interspinous ligaments
Supraspinous liagment
Intertransverse ligament

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13
Q

True ribs are …..
False ribs are ……
Floating ribs are …….

A

1st-7th
8th-12th
11&12th

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14
Q

The free anterior end of floating ribs is

A

Embedded in the muscles of the abdominal wall

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15
Q

The crest of head of rib is connected to the IVD by ……. . The costo-vertebral joints are ……. .

A

Articular ligaments

Plane synovial

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16
Q

Structure attached to lateral part of tubercle of rib.

A

Lateral costo-transverse ligament

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17
Q

Site and contents of costal groove

A

Inner surface of rib, it contains vein, artery & nerve.

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18
Q

Neck of first rib is anteriorly related to ..

A
  1. Sympathetic chain with stellate ganglion
  2. Superior intercostal artery
  3. Ventral ramus of 1st thoracic nerve
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19
Q

Structures attached to inner surface of first rib

A

Scalenus anterior muscle

Suprapleural membrane

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20
Q

Lateral border of 1st rib gives attachment to

A

Serratus anterior

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21
Q

Mention structure present in grooves of upper surface of 1st rib

A

Anterior groove: subclavian vein

P. groove: subclavian artery + lower trunk of brachial plexus

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22
Q

Anterior to groove of subclavian vein there is ….. & ….. .

Posterior to groove of subclavian artery is …

A
  1. Costo-clavicular ligament, subclavius muscle

2. Scalenus medius muscle

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23
Q

Dagger-like rib

A

12th rib

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24
Q

Describe the clincal significance of lumbar rib

A
  • Confuse the identification of vertebral levels

- Interpreted as fractured transverse process of L1 vertebra

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25
Q

Cervical rib may lead to ….

A

Lower trunk lesion

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26
Q

Type of the following joints

  • 1st costal cartilage and manubrium
  • 2nd costal cartilage and manubrium
A
  • primary cartilagenous joint

- synovial joint

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27
Q

Type of the following joints:

  • sternoclavicular
  • manubrio-sternal
A
  • synovial saddle

- secondary cartilagenous

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28
Q

The superior boder of manubrium lies …..

A

Between T2 & T3

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29
Q

The sternal angle lies opposite …

A

IVD between T4 & T5

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30
Q

Importance of sternal angle.

A
  • Counting ribs in a living subject

- indicated level of tracheal bifurcation and termination and beginning of the large vessels

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31
Q

Muscles origination from anterior surface of manubrium

A

Sternocleidomastoid & pectoralis major

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32
Q

Posterior surface of manubrium gives origin to

A

Sternohyoid & sternothyroid

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33
Q

Posterior surface of manubrium forms anterior boundary of …… mediastinum

A

Superior

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34
Q

Relations of posterior surface of manubrium

A
  • Arch if aorta
  • brachiocephalic, left common carotid & left subclavian arteries
  • pleurae & lungs
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35
Q

Type of manubrio-sternal & xiphisternal joints

A

Secondary cartilagenous

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36
Q

Mention number and origin of sternebrae

A

3

Composite development of the sternum

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37
Q

Mmnetion muscle originating from anterior surface of sternal body

A

Pectoralis major

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38
Q

Posterior surface of sternal body forms boundary of ….. mediastinum

A

Anterior

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39
Q

Muscles arising from posterior surface of sternal body

A

Sternocostalis

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40
Q

Level at which sternal body is related to the heart

A

4th costal cartilage

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41
Q

2nd-7th sterno-costal joints are …

A

Synovial joints

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42
Q

Level of xiphisternal joint

A

IVD between T9 & T10

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43
Q

Mention supporting ligaments of following joints:

  1. Sterno-costal
  2. Costotransverse
A
  1. Intra-articular ligament

2. costotransverse ligament, lateral costotransverse ligament, superior costotransverse ligament

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44
Q

What occurs when the upper 6 ribs rotate?

A

Result in elevation and depression movements of the sternal ends of the ribs and the sternum causing pump-handle movements.

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45
Q

What happens with the gliding movement of 7th-10th ribs?

A

Elevation and depression of lateral-most proportions of these ribs in the transverse plane causing bucket-handle movement.

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46
Q

Type of costochondral joint & first sternocostal

A

Primary cartilagenous

47
Q

Type of joint between vertebral body and head of ribs 2nd to 9th

A

Synovial joint

48
Q

6th, 7th, 8th, 9th & 10th costal cartilages articulate by

A

Small synovial joints

49
Q

Muscles connecting ribs to vertebra

A

Levatores costarum
Serratus posterior superior
Serratus posterior inferior

50
Q

Extent of external intercostal

A

Tubercle of ribs post. to costochondral junction ant.

51
Q

Extent of inetrnal intercostal

A

From the sternum infront to thr angle of the rib behind

52
Q

Extent of innermost intecostal

A

Middle 2/4 of the intercostal space

53
Q

Internal & external relarions of innermost intercostal

A

I: Endothoracic fascia, parietal pleura
E: intercostal nerves and vessels

54
Q

The subcostales are well developend in ….. part of the thorax.

A

Lower & posterior

55
Q

Describe attachment and direction of transvesus thoracis muscle

A

Arise from lower half of posterior surface of the body of sternum to be inserted by 5 slips in costal cartilages 2nd to 6th
Upwards & laterally

56
Q

Mention the muscles of thorax corresponding to transversus abdominis

A

Innermost intercostals, subcostales & sternocostales

57
Q

Nerve supply of muscles of thorax

A

Intercostal nerves

58
Q

Mention action of the following muscles:

  1. External intercostals
  2. Internal and innermost
  3. Subcostales
  4. Sternocostales
A
  1. Inspiration (elevators)
  2. Expiration (depressors)
  3. Depresses the ribs
  4. Draws down costal cartilages
59
Q

Describe main role of thoracic muscles

A

Forced respiration

Support contents of the intercostal spaces

60
Q

Branches of typical intercostal nerves

A
  1. Rami communicantes
  2. Muscular branches
  3. Collateral branches
  4. Pleural sensory
  5. Lateral cutaneous (ant & post)
  6. Anterior cutaneous (med & lat)
61
Q

The larger branch of first intercostal shares in …… , unlike typical intercostals it doesn’t give …. .

A
  • Brachial plexus

- No lateral cutaneous branch

62
Q

The larger branch of first intercostal shares in …… , unlike typical intercostals it doesn’t give …. .

A
  • Brachial plexus

- No lateral cutaneous branch

63
Q

Mention the other name of 2nd intercostal nerve & area supplied by it.

A

Intercostobrachial nerve

The skin of the floor of axilla, upper part of medial side of arm

64
Q

The lower 5 intercostal nerves are atypical because ….

A

They pass between the costal slips of diaphragm

65
Q

Intercostal spaces where anterior int. arteries are absent and why

A

10th & 11th

Because they are incomplete anteriorly

66
Q

The 7th, 8th & 9th anterior intercostal arties are branches of ….

A

Musculophrenic artery

67
Q

The anterior intercostal arteies end by

A

Anastomosing with post. int. artery & its collateral branch

68
Q

Describe the origin of posterior intercostal arteries

A

1st & 2nd from superior interscostal which is a brach of costcervical (branch of 2nd part of subclavian)
3rd to 11th are branches of descending aorta

69
Q

The landmark at which the posterior intercostal artery passes between internal and innermost muscles & branch originating at that site.

A

Costal angle, collateral branch

70
Q

Branches of posterior intercostal arteries

A
  1. Dorsal branch
  2. Collateral branch
  3. Muscular branches
  4. Mammary branches
  5. Lateral cutaneous
  6. Right bronchial artery
71
Q

Structures supplied by dorsal branch of posterior intercostal

A

Spinal cord, vertebral column, muscles & skin of the back.

72
Q

Mammary branches arise from …… spaces

A

2nd, 3rd & 4th

73
Q

Right bronchial artery arises from

A

Right 3rd posterior

74
Q

The origin and termination of internal thoracic artery

A

O: 1st part of subclavian artery
T: 6th intercostal space dividea into musculophrenic & superior epigastric arteries

75
Q

Mention branches of internal thoracic artery

A
  1. Pericardiophrenic
  2. Pericardial
  3. Anterior intercostal
  4. Perforating branches
  5. Musculophrenic
  6. Superior epigastric
76
Q

Pericardiophrenic artery supplies

A

Diaphragm, pericardium, pleura

77
Q

Perforating branches which supply mammary glands are found in…… enlarge during …. .

A
  • 2nd, 3rd & 4th intercostal spaces

- lactation

78
Q

Describe course of superior epigastric artery.

A

Descends between costal and sternals origins of diaphragm, enters rectus sheath, supplies rectus abdominis, ends by anastomosing with inferior epigastric artery

79
Q

Venae comitantes of musculophrenic artery drain …. spaces

A

7th 8th 9th

80
Q

3rd-6th spaces venous drainage is

A

Venae comitantes of internal thoracic artery

81
Q

Internal thoracic vein forms at level of …. by union of …..

A

3rd costal cartilage

2 venase comitantes of internal thoracic artery

82
Q

Describe venous drainage of posterior intercostal vein on the right

A

1st right brachiocephalic
2nd&3rd superior intercostal–> arch of azygos
4th-11th azygos

83
Q

Describe venous drainage of posterior intercostal vein on the left

A

1st, left brachiocephalic
2nd&3rd form left superior intercostal which drain into left brachiocephalic
4th-8th end in superior hemiazgos
9th-11th end in inferior hemisazygos

84
Q

The sup hemiazygos crosses at the level of …. while the inf hemiazygos crosses at the level of ….

A

7th thoracic vertebra

8th thoracic vertebra

85
Q

Venae cominates of internal thoracic artery begin at level of …. by union of ……

A

6th intercostal space

Venae comitantes of musculophrenic & superior epigastric arteries

86
Q

Internal thoracic vein drains into

A

Brachiocephalic vein

87
Q

Describe origin of diaphragm

A
  • sternal origin, 2 slips from xiphoid process
  • costal origin, lower 6 costal cartilages and adjoining ribs
  • lumbar origin, by 2 crura & 2 aponeurotic arches (lateral & medial arcuate ligaments)
88
Q

Right crus arises from ….. , while left crus arises from …. .

A
  • upper 3 lumbar v.+IVDs

- upper 2 lumbar v.+ IVDs

89
Q

….. fibers of right crus embrace the esophagus

A

Medial

90
Q

Level of median arcutae liagment

A

IVD between T12 & L1, connecting the medial tendinous margins of the crura.

91
Q

Medial arcuate ligament covers ……., medially it is ……., laterally attached to …… .

A
  • upper part of psoas major
  • Continuous with lateral margin of corresponding crus.
  • tranverse process of L1
92
Q

Lateral arcuate ligament covers ……., medially attached to ……., laterally attached to …… .

A
  • Upper part of quadratus lumboru
  • transverse process of L1
  • lower margin of 12th rib
93
Q

3 leaflets if central tendon are ….. .

A

2 lateral & one middle

94
Q

Median part of central tendon is related to

A

Pericardium and the heart

95
Q

Structures related to left cupola but not the right

A

Fundus of the stomach & spleen

96
Q

Give reason: right cupola is higher than left cupola

A

Due to upward bulge of right lobe of liver

97
Q

Aortic opening at level of ……, structures passing through it are ….. .

A

T12 median plane

Aorta, thoracic duct & azygos vein

98
Q

Oesophageal opening at level of ……, structures passing through it are ….. .

A

T10, one inch to the left

Oesophagus, gastric nerves & oesophageal branches of left gastric vessels

99
Q

Caval opening at level of ……, structures passing through it are ….. .

A

T8, one inch to the right within central tendon

IVC, branches of right phrenic n, lymph vessels

100
Q

Give reason: the IVC is always patent

A

Because the central tendon is adherent to the wall of IVC

101
Q

Artery passing between sternal & costal origins of diaphragm

A

Superior epigastric artery

102
Q

Level at which the musculophrenic artery pierces the diaphragm

A

9th costal cartilage

103
Q

Lower 5 intercostal nerves pass through

A

2 slips of costal origin

104
Q

Structure behind medial & lateral arcuate ligaments

A

M: psoas major & sympathetic trunk
L: quadratus lumorum & subcostal nerves & vessels

105
Q

Structures oassing through minute opening in crura

A
  1. Greater & lesser splanchnic nerves via 2 openings in each crus.
  2. Hemiazygos vein (left crus)
106
Q

Arterial supply of diaphragm

A
  • pericardiophrenic
  • inferior phrenic
  • musculophrenic
  • twigs from 3 posterior intercostal arteries
  • twigs from descending aorta
107
Q

Forced expulsive acts of diaphragm

A

Coughing, vomiting, defecation, urination & parturition.

108
Q

Muscles fixing first rib during quiet inspiration

A

Scalene muscles

109
Q

During foced inspiration, ….. & ….. elevate 1st rib. While ….. acts on manubrium & clavicle.

A
  • scalenus anterior & medius

- sternocleidomastoid

110
Q

During forced inspiration, the scapulae are fixed by …,…&… . So…..&….can pull the ribs.

A
  • Trapezius, levator scapulae & rhomboid muscles.

- Serratus ant & pectoralis major

111
Q

….. fixes 12th rib in forced inspiration.

A

Quadratus lumborum

112
Q

Mention factors of passivity of quiet expiration

A

Elastic recoil of the lungs

Relaxation of the intercostal musckes & diaphragm

113
Q

Forced expiration is done by…&…. .

A

Muscles of ant abd wall + latissimus dorsi

114
Q

3rd-6th spaces anteriorly venous drainage is

A

Venae comitantes of internal thoracic artery

Respiratory Anatomy (3 decks)

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