Thoracic Wall

Question 1

Bones of the thoracic wall (4)

Answer 1

1. Thoracic part of the vertebral column
2. Sternum
3. Ribs
4. Costal cartilages

Question 2

Name 2 characteristics of the thoracic part of the vertebral column

Answer 2

1. concave forward

2. 12 vertebrae & IV discs

Question 3

What are the three parts of the STERNUM?

Answer 3

1. Manubrium
2. Body
3. Xiphoid Process

Question 4

What is the sternal angle (of louis)?

Answer 4

*an importnat surface landmark, lies at the level of THE SECOND COSTAL CARTILAGE (used to count all ribs)

the IV discs between the 4th and 5th thoracic vertebrae

the JUNCTION of the ascending aorta and the JUNCTION of the aortic arch and the descending thoracic aorta (all occur at the angle of louis)

the BIFURCATION of the trachea

the JUNCTION of the SUPERIOR MEDIASTINUM AND THE INFERIOR MEDIASTINUM

Question 5

Are sternal fractures common?

Answer 5

NO!!!!!

Question 6

What is the MOST COMMON SITE of a STERNAL FRACTURE?…. its the dislocation of WHAT?

What do you look for??

Answer 6

at the STERNAL ANGLE…

dislocation of manubriosternal joint (very painful)

• look for WIDENED FUZZY MEDIASTINUM ON CHEST X RAY

Question 7

What is the weakest part of the rib?

Answer 7

Just anterior to the angle

Question 8

What is a sternal fracture? (what type of injury/fracture)

Answer 8

Crush injury

Comminuted fracture

Question 9

Median Sternotomy (sternal splitting) … when does this happen?

Answer 9

During CABG and valve repair/replacement

Question 10

What is the most common site used for bone marrow biopsies?

Answer 10

Sternum

Question 11

What types of bones are HUGE producers of RBCs?

Answer 11

Long bones

Question 12

Sternal biopsy…. what is bone marrow biopsy?

Answer 12

• Wide bore needle attached to syringe
• needle inserted through thin cortical bone to
• underlying highly vascular spongy bone

Question 13

How are the 12 pairs of ribs attached?

Answer 13

They are attached posteriorly to the thoracic vertebrae

Question 14

TRUE RIBS:

what do they consist of

how many pairs?

where are they attached?

Answer 14

• costal groove, head, neck, tubercle, shaft & angle
• upper 7 pairs
• attached to the sternum by their costal cartilages

Question 15

FALSE RIBS:

which ribs?

where do they attach?

Answer 15

8th, 9th, 10th

• attahced anterior to eachother and to the 7th rib
• attached by means of their costal cartilages and small synovial joints

Question 16

Where is the most common place you see rib fractures?

Answer 16

JUST ANTERIOR TO THE ANGLE (WEAKEST PART OF THE RIB)

Question 17

What is the xiphoid process?

Answer 17

• smallest most variable part of the sternum
• ossified after age 40
• CPR can cause trauma

Question 18

What are the floating ribs?

Answer 18

11th & 12th pairs… have no anterior attachment