Thoracic wall and lungs

Question 1

What are the openings of the thoracic cavity with their vertebral levels?

Answer 1

Caval opening for inf vena cava at t8
esophageal hiatus at t10
aortic hiatus at t12

Question 2

Special thoracic vertebrae. why?

Answer 2

t1- one full facet
t9-t12- no superior demi facet on t10, 1 full facet for ribs 10-12
t11-t12- no articular facets on transverse process

Question 3

What is the orientation for the transverse process of the thoracic vertebrae?

Answer 3

Superiorly- in the coronal plane
inferiorly- in the sagittal plane

Question 4

Special ribs. Why?

Answer 4

1 articular facet on ribs 1, 10, 11, 12
no tubercle on the neck of ribs 11, 12
broadened upper surface and impressions on rib 1

Question 5

Parts of the sternum

Answer 5

Manubrium, body, xiphoid process

Question 6

What level is the sternal angle?

Answer 6

2nd rib

Question 7

What level is the xiphoid process?

Answer 7

T6

Question 8

What are the true ribs?

Answer 8

1-7

Question 9

What are the false ribs?

Answer 9

Ribs 8-10, their costal cartilage fuses with the 7th rib costal cartilage to form the costal margin
ribs 11-12 are floating ribs

Question 10

What is the motion of the thoracic wall?

Answer 10

Superiorly- pump handle
inferiorly- bucket handle

Question 11

What is the somatic innervation of the thorax?

Answer 11

Cutaneous- spinal nerves are segmentally distributed
muscular- intercostal nerves are segmentally distributed, branches of the brachioplexus for the extrinsic thoracic wall and UE

Question 12

What is the visceral innervation of the thorax?

Answer 12

motor: sympathetic- T1-T4, follow the ventral rami to support the thoracic wall
parasympathetic- vagus nerve
Sensory: follows the visceral motor back to the spinal cord

Question 13

What is the blood supply for the thoracic wall?

Answer 13

Superior: supreme intercostal a.
posterior: posterior intercostal a.
anterior: internal thoracic a. anterior intercostal a. musculophrenic a. superior epsgastric a.

Question 14

What are the 3 parts of the axillary artery? (Screw The Lawyer, Save A Patient)

Answer 14

1. Superior thoracic artery
2. Thoracolumbar artery, Lateral thoracic artery
3. Subscapular artery, anterior circumflex humeral artery, posterior circumflex humeral artery

Question 15

Where does the internal thoracic vein and superior intercostal vein drain to

Answer 15

brachiocephalic vein

Question 16

where does the RIGHT intercostal vein drain?

Answer 16

Azygos vein and then into the Superior vena cava

Question 17

Where does the LEFT intercostal vein drain?

Answer 17

accessory hemiazygos vein then to azygos then into the superior vena cava

Question 18

Where do the thoracic extrinsic muscles drain?

Answer 18

the axillary veins

Question 19

What nerve innervates the pectoralis major?

Answer 19

lateral pectoral n. (c5-t1) and medial pectoral n. (c8-T1)

Question 20

What are the actions of the pectoralis major?

Answer 20

GH FLX, EXT, IR/ ADD

Question 21

What nerve innervates the pectoralis minor?

Answer 21

medial pectoral n.

Question 22

what are the actions of the pectoralis minor?

Answer 22

scapular depression, anterior tilt of scapula

Question 23

nerve innervation of subclavius

Answer 23

nerve to subclvius c5,c6

Question 24

nerve innervation to serratus anterior

Answer 24

long thoracic nerve c5-c7

Question 25

what are the actions of the serratus anterior?

Answer 25

scapular protraction, upward rotation of scapula, elevation of ribs

Question 26

what are the intercostal muscles and their muscle fiber directions?

Answer 26

External intercostal - hands in pocket
internal intercostal- opposite of external fibers
innermost intercostal- same as internal fibers

Question 27

what nerve innervates the diaphragm?

Answer 27

phrenic c3 c4 c5

Question 28

What are the deep thoracic muscles?

Answer 28

transversus thoracis, subcostals

Question 29

parts of the pleural cavity and their innervations

Answer 29

parietal: somatic sensory
costal- intercostal n
mediastinum- phrenic n
visceral: visceral sensory

Question 30

Lobes/ fissures of the lungs

Answer 30

RIGHT: 3 lobes- superior, middle, inferior
2 fissures- horizontal and oblique
LEFT: 2 lobes- superior and inferior
1 fissure- oblique

Question 31

where are the pulmonary arteries located? RALS

Answer 31

RIGHT- anterior to bronchi
LEFT- superior to bronchi

Question 32

Where does gas exchange occur

Answer 32

alveoli