Thoracic Wall/Diaphragm And Breast

Question 1

What is the vertebral level of the superior thoracic aperture?

Answer 1

T1

Question 2

What is the border of the inferior thoracic aperture?

Answer 2

Follows costal margins and thoracic diaphragm. Separates the thoracic cavity to abdominal pelvic cavity

Question 3

What is the palpable bony structure at T3

Answer 3

Jugular notch

Question 4

What is the palpable bony structure at T4/5

Answer 4

Sternal angle. Also bifurcation of trachea

Question 5

What is the palpable bony structure at T9/10?

Answer 5

Xiphisternal joint

Question 6

At what level is the inferior border of scapula (different male and female)

Answer 6

Female: T6
Male: T7

Question 7

What is the vertebral level of the most medial border of the scapula spine?

Answer 7

T3

Question 8

What are the three main blood vessels of the thoracic wall?

Answer 8

• internal thoracic arteries
• anterior intercostal arteries
• posterior intercostal arteries

Question 9

Why does each intercostal space have its own blood supply?

Answer 9

Because it helps with respiration

Question 10

What is an anastomosis?

Answer 10

• two arteries form none direct connection and supply area

- advantage is that doesn’t matter if one artery is blocked off

Question 11

How does the internal inferior surface accommodate for the VAN complex?

Answer 11

There is a costal groove on each internal inferior surface

Question 12

What is the VAN complex?

Answer 12

• vein
• artery
• nerve
  Always run in that order along each intercostal grove

Question 13

What are the three main veins that drain into the superior vena cava?

Answer 13

• Azygos
• hemiazygous
• accessory hemiazygous veins

Question 14

What are the tributes?

Answer 14

They are small veins coming into a larger vein

Question 15

What is the body of the breast?

Answer 15

Base of the breast and apex

Question 16

What is the axillary tail?

Answer 16

Extension of the base towards and into axillary

- formed by glandular tissue

Question 17

What is the retromammary space?

Answer 17

Loose connective tissue plan between the breast and deep pectoral fascia

Question 18

4 main internal features of the female breast?

Answer 18

• is drained by one major lactiferous ducts
• contains numerous lobules
• contains branches and sub-branches of a major lactiferous duct
• is separated by and contain varying amounts of adipose tissue and general connective tissue

Question 19

What are the suspensory ligaments?

Answer 19

• fibrous connective tissue bands attaching between the skin and deep fascia of pectoralis major
• located between lobules
• denser superior to inferior

Question 20

What is the diaphragm?

Answer 20

Muscular tissue often separating areas

Question 21

Where is the summit of the left dome? (During expiration)

Answer 21

• 5th intercostal space

- T10

Question 22

Where is the summit of the right dome? (During expiration)

Answer 22

• 4th intercostal space

- T9 (this side sits higher due to liver)

Question 23

What are the parts of the thoracic diaphragm?

Answer 23

• central tendon
• right crus
• oesophageal hiatus
• left crus
• caval foramen
• aorta hiatus

Question 24

What vertebral level is the right crus?

Answer 24

L1-L3

Question 25

What vertebral level is the left crus?

Answer 25

L1-L2

Question 26

What vertebral level is the caval foramen?

Answer 26

T8/9

- branches of phrenic nerves

Question 27

What vertebral of the oesophageal hiatus?

Answer 27

T10

- vagus nerve

Question 28

What vertebral level is the aortic hiatus?

Answer 28

T12

• thoracic duct
• inferior intercostal lymphatic trunk
• azygous and hemiazygos veins

Question 29

How is the thoracic diaphragm innervated?

Answer 29

• phrenic nerves

- intercostal nerves

Question 30

What passes through the superior thoracic aperture

Answer 30

• apex of lungs
• common carotid artery
• oesophagus
• trachea
• internal jugular veins
• subclavian vein and artery