Thoracic Wall

Question 1

‘Suprasternal’ Jugular Notch

Answer 1

T2-T3

below the clavicle

Question 2

Sternal angel

Answer 2

T4-T5 ribs 1-2

Manubrial sternal joint

Question 3

Xiphoid process

Answer 3

T9-T11
bottom of the sternum
joint ossifies at 40 years old

Question 4

Root of spine of scapula

Answer 4

spine of T3 but level of T4

Question 5

Inferior angel of scapula

Answer 5

T7-T8

Rib 8

Question 6

serratus posterior superior

Answer 6

elevates rib cage

Question 7

serratus posterior inferior

Answer 7

depresses rib cage

Question 8

Levator Costarum

Answer 8

elevates ribs
Transverse process C7-T11 to costal tubercle and costal angel
12 pairs of fan shaped muscles

Question 9

Thoracic muscles/ intercostal muscles

Answer 9

All innervated by intercostal nerves from ventral primary rami of spinal nerve
internal intercostal muscles, innermost intercostal muscles, subcostal muscles, and transverse thoracis

Question 10

External intercostal muscles

Answer 10

elevate ribs 
'pocket' muscles 
Origin- tubercle 
Insert- costochondral junction 
Extend to sternum as external intercostal membrane

Question 11

Internal intercostal muscles

Answer 11

Fibers run opposite of external
Lateral border of sternum to costal angle
costal portion- depresses
Chondral/ costal cartilage portion- elevates

Question 12

Innermost intercostal muscles

Answer 12

3rd muscular layer
elevate and depress ribs
Found internally on posterolateral thoracic wall

Question 13

Subcostal muscles

Answer 13

3rd muscular layer posteriorly
Muscle crosses more than one intercostal space
elevates ribs

Question 14

Transverse Thoracis

Answer 14

3rd muscular layer anteriorly
lower sternum to internal surface of 2nd-6th costal cartilage
depresses ribs

Question 15

Where does the anterior intercostal artery terminate?

Answer 15

6th intercostal space because it branches into superior epigastric and musculophrenic artery

Question 16

Musculophrenic artery

Answer 16

supplies 7th and 9th spaces

branch from anterior intercostal artery

Question 17

Where is the neurvascular bundle located for intercostal spaces?

Answer 17

between 2nd and 3rd muscular layer

Question 18

How many intercostal spaces are there?

Answer 18

11 spaces

Question 19

How many pairs of intercostal nerves are there?

Answer 19

11 pairs the 12th pair is the subcostal nerve

Question 20

Posterior intercostal arteries

Answer 20

all 11 come from thoracic aorta

Question 21

Superior intercostal artery

Answer 21

part of posterior intercostal arteries
comes from costocervical trunk
only supplies 1st and 2nd intercostal spaces

Question 22

Intercostal nerves are also called?

Answer 22

thoracic nerves

Question 23

Thoraco-Abdominal Nerves start and end where?

Answer 23

T7-T11

started as intercostal nerves and go onto anterior abdominal wall

Question 24

Costodiaphragmatic Reflection

Answer 24

Where visceral pleura meets parietal pleura

Question 25

sternoclavicular joint

Answer 25

between top of sternum and clavicle | synovial saddle joint

Question 26

Manubriosternal joint

Answer 26

between manubrium and body of the sternum | cartilaginous and immovable

Question 27

xiphisternal joint

Answer 27

between body of sternum and xiphoid process cartilaginous and immovable ossifies at 40 years of age

Question 28

True ribs

Answer 28

ribs 1-7 | directly attach to the sternum

Question 29

False ribs

Answer 29

ribs 8-10 | cartilage indirectly attaches to sternum

Question 30

Floating ribs

Answer 30

ribs 11-12 | Don't attach to sternum but attach to thoracic vertebrae

Question 31

Costovertebral Joints

Answer 31

superior articular/costal facet- vertebral body above the rib level Inferior articular/costal facet- vertebral body at same level

Question 32

Transverse articular/costal facet

Answer 32

transverse process of vertebra at same level

Question 33

1st sternocostal joint

Answer 33

behind 1st rib, connects to sternum cartilaginous and immovable ossifies

Question 34

sternocostal joint

Answer 34

attaches to lateral part of sternum where movement occurs Ribs 2-7 synovial plane-type joint slightly moveable

Question 35

costochondral joints

Answer 35

between ribs and costal cartilage | cartilaginous and immovable

Question 36

Forced expiration muscles

Answer 36

intercostal muscles | all abdominal muscles

Question 37

Forced inspiration muscles

Answer 37

diaphragm intercostal muscles SCM scalene muscle

Question 38

Breast blood supply

Answer 38

Branches from Pectoralis Thoracoacromial Trunk Lateral Thoracic artery- off axillary artery Internal Thoracic artery- off common carotid artery

Question 39

Breast Lymphatics

Answer 39

Axillary Lymphatic | Parasternal and clavicular nodes

Question 40

Axillary lymphatics

Answer 40

75% of lymphatic drainage 1. central axillary nodes 2. apical axillary nodes

Question 41

Parasternal and Clavicular Nodes

Answer 41

25% of lymphatic drainage | connects to other breast

Question 42

Anatomy of the Breast

Answer 42

superficial fascia deep fascia retromammary space suspensory (Cooper's) ligament