Thorax 1: Intro and Overview

Question 1

What are the 4 muscles present in the pectoral region that overly the thoracic cage?

Answer 1

Pectoralis Major
Pectoralis Minor
Latissimus Dorsi
Serrates Anterior

Question 2

What are the attachments of Pec. Major?

Answer 2

Clavicle, Costal Cartilage, Sternum, anterior lip of the inter tubercular groove (humerus)

Question 3

What movements is Pec. Major responsible for?

Answer 3

Shoulder flexion and adduction

Question 4

Which ribs does Pec. Minor attach to?

Which Part of the Scapula does it originate from?

Answer 4

Ribs 3, 4 and 5

the Coracoid Process

Question 5

What is the function of Pec. Minor?

Answer 5

Stabilises the Scapula

Question 6

What are the muscle attachments of Lat. Dorsi?

Answer 6

Iliac Crest
Lower thoracic and Lumbar vertebral spines
floor of the inter tubercular groove (humerus)

Question 7

What movements does Lat. Dorsi facilitate?

Answer 7

shoulder extension and adduction

Question 8

Which ribs does SA attach to?

Were does SA originate from?

Answer 8

The upper 8 ribs

medial border of the scapula

Question 9

What movements is SA responsible for?

Answer 9

scapular protraction and rotation on shoulder abduction

Question 10

What is the structure of breast tissue?

Answer 10

glandular tissue in fibro fatty stroma

Question 11

Which ribs is the breast opposite to?

Where does the tail of the breast extend to?

Answer 11

ribs 2-6

the axilla

Question 12

Which vessels supply blood to the breast?

Answer 12

axillary artery

internal thoracic arteries

Question 13

How many breast ducts are there?

Answer 13

16 ducts converging on the nipple

Question 14

which lymph nodes does the breast drain to?
How is tumour spread described in relation to breast cancer?
Which nodes are associated with each classification of tumour spread?

Answer 14

• axillary and internal thoracic nodes
• level 1, 2 ,3
• 1 is anterior nodes, 2 is central nodes, 3 is apical nodes

Question 15

What are the 2 main functions of the thoracic wall?

Answer 15

Protection of major body organs

functions for respiratory movements

Question 16

What is the Pump Handle mechanism?

Answer 16

Rib elevation to push the sternum up and forward increasing the thoracic A-P diameter

Question 17

What is the Bucket Handle mechanism?

Answer 17

rib eversion to increase lateral diameter

Question 18

How do the intercostal muscles aid in inspiration?

How many layers are there and what are the layers?

Answer 18

Raise the ribs

3 layers: external, internal, innermost

Question 19

What process brings about exhalation?

What is responsible for this process?

Answer 19

Elastic Recoil

intercostal muscles acting in forced exhalation

Question 20

What structures form the thoracic inlet?

Answer 20

T1 vertebra, 1st rib and costal cartilage, manubrium of sternum

Question 21

What structures pass out through the inlet and their relation to each other?
What structures enter the inlet?

Answer 21

• Anterior to Posterior: Subclavian Vein, Subclavian artery, inferior trunk of brachial plexus
• trachea, oesophagus, R+L Vagus nerve, recurrent laryngeal nerve, R+L phrenic nerve

Question 22

What forms the thoracic outlet?

What structure closes it?

Answer 22

• T12 vertebra, 11th+12th ribs, costal cartilages of ribs 7,8,9 and 10 (costal margin), xiphoid cartilage
• diaphragm

Question 23

What are the 3 openings of the thoracic outlet?
What vertebra level do they open at?
What structures pass through each opening?

Answer 23

• caval opening, T8, IVC and R phrenic nerve
• Oesophageal opening, T10, Oesophagus, vagal trunks, L gastric vessels
• aortic hiatus, T12, Aorta, azygous vein, thoracic duct

Question 24

What is the function of the pleura and the pericardium?

Answer 24

allows movement, expansion and contraction, of organs

Question 25

What are the 4 types of parietal pleura in relation to the surfaces they are in communication with?
What is recess at the corner of the lung, and its level?

Answer 25

• cervical pleura, costal pleura, diaphragmatic pleura, mediastinal pleura
• costodiaphragmatic recess, T10

Question 26

What is the rib level of the lungs?

What is the rib level of the visceral pleura?

Answer 26

• Lungs start at rib 2 and extend down to rib 8 anteriorly, rib 10 laterally and posteriorly
• from rib 2 down to rib 10 anteriorly, rib 12 laterally and posteriorly

Question 27

What are the locations and landmarks of the 4 heart corners?

Answer 27

top right- 3rd R costal cartilage
top left- 2nd L CC
bottom right- 6th R CC
bottom left (apex)- 5th interspace mid clavicular line

Question 28

What does the term Mediastinum mean?

Answer 28

Structures in the the midline of the thorax between the left and right pleural cavities

Question 29

Where are the Superior and inferior mediastinum located?

Answer 29

Superior- between sternal angle 2nd CC and T4/5, behind the manubrium
inferior- inferior to the sternal angle and T4/5 extending to the thoracic outlet, diaphragm

Question 30

What structures are in the superior mediastinum and its subdivision?

Answer 30

• Superior: trachea and oesophagus, aortic arch and phrenic and vagus nerves on left, SVC on right
• Anterior behind the manubrium: thymus

Question 31

What structures lie in the 2 subdivisions of the inferior mediastinum?

Answer 31

• Middle: pericardium and the heart

- Posterior, structures behind the heart and pericardium: Aorta, oesophagus, thoracic duct, azygous vein