Thoracic Wall and Lungs

Question 1

Order of intercostal muscles and membrane

Answer 1

External Intercostal muscle (membrane on anterior side)
Internal Intercostal muscle (membrane on posterior side)
-V
-A
-N
Innermost intercostal membrane ( no membrane)

Question 2

Subcostal m.

Answer 2

Posterior thoracic cavity, connects every other rib

Question 3

Transverse thoracic m.

Answer 3

Anterior thoracic cavity, connects posterior surface of sternum to ribs 2-6

Question 4

Endothoracic Fascia

Answer 4

Cleavage plane allowing the surgeon to separate the parietal pleura from the thoracic wall, providing access to intrathoracic structures.

Question 5

Landmarks at T4-T5

Answer 5

Horizontal fissure right lung, Manubrium, branch of trachea into bronchi, aorta

Question 6

Landmarks at T7

Answer 6

4th rib, cardiac notch of right lung, oblique fissure of left lung, mid heart

Question 7

Landmarks at L2

Answer 7

Lower ribs, below liver, abdominal aorta

Question 8

Parts of rib

Answer 8

Costal groove
Angle
Tubercle
Anterior facet
Head
Neck
Inferior/Superior articular facet

Question 9

Right Bronchus

Answer 9

Shorter, wider , more veritical.

Aspiration of foreign bodies

Question 10

T4/T5 landmarks

Answer 10

Bifurcation of trachea

Eternal angle

Question 11

Lobes and their Fissures - Right lung

Answer 11

Superior/Middle/Inferior

Horizontal/Oblique

Question 12

Lobes and their Fissures - Left Lung

Answer 12

Superior/Inferior

Oblique

Question 13

Other features of left lung

Answer 13

Lingula

Cardiac notch

Question 14

Innervation of pleura

Answer 14

Visceral pleura - No Pain

Parietal pleura - Pain fibers

Question 15

Pulmonary arteries vs veins in the hilum

Answer 15

Pulmonary arteries tend to be superior to the pulmonary veins

Question 16

Structures in R and L Hila

Answer 16

pulmonary a., pulmonary v., bronchopulmonary lymph nodes, bronchus

Left hilar point often more superior

Question 17

Thoracentesis in Midaxillary Line

Answer 17

Between 9th and 10th rib (8th or 9th intercostal space)

To empty fluid buildup in Costodiaphragmatic recess
-Right lung between costal, diapgragmatic, and visceral pleura.

Question 18

Sternal angle

Answer 18

Landmark for second costal cartilage

Question 19

Cupola

Answer 19

The portion of the parietal pleura that extends above the first rib (aka cervical pleura)

Question 20

Phrenic Nerve

Answer 20

Path between the anterior medial aspect of the lung and the medastinum, anterior to hilum. Innervates diaphragm.

Question 21

Nerves at risk during mastectomy

Answer 21

Long thoracic
Intercostobrachial
Thoracodorsal

Greys Q.

Question 22

DRG

Answer 22

Contain nerve cell bodies for general somatic visceral afferent processes.

Grey’s Q.

Question 23

Intercostal Arteries Anastamosis

Answer 23

Anterior intercostal arteries anastomose with the posterior intercostal arteries

Question 24

Divisions of parietal pleura

Answer 24

Costal
Diaphragmatic
Medisastinal
Cervical (Cupola)

Question 25

Hemothorax

Answer 25

collection of blood in the space between the chest wall and the lung

Question 26

Rib Fracture

Answer 26

Weakest just anterior to its angle. Middle ribs most commonly fractured

Question 27

Supernumerary Ribs

Answer 27

Extra cervical ribs near C7 vertebrae. May compress spinal nerves C8 and T1, or the inferior trunk of BP

Question 28

Sternal fractures

Answer 28

Most likely sternal angle, dislocating manubriosternal joint

Question 29

Sternal Biopsy

Answer 29

Used for bone marrow need biopsy; wide and subcutaneous.

Question 30

Paralysis of Diaphragm

Answer 30

Damage to phrenic nerve = ipsilateral paralysis of half of diaphragm.

Question 31

Intercostal space incisions

Answer 31

Posterior thoracotomy incsisions made on posterolateral aspects of 5th to 7th IC spaces