Thorax 1 - Thoracic Wall

Question 1

Contents of thoracic inlet (5)

Thoracic inlet formed by Rib 1, T1 and manubrium

Answer 1

Great vessels
Oesophagus
Trachea
Nerves + Lymph

Question 2

Costotransverse joint

Answer 2

Synovial joint between tubercle of the rib and transverse process of own vertebrae

Question 3

Articulations of rib

Answer 3

Vertebral column posteriorly w head and tubercle

Costal cartilages anteriorly

Question 4

Interchondral joints

Answer 4

8-10th CC attache cartilage above via these joints and ribs get anchorage to sternum and contribute to formation of smooth inferior costal margin

Question 5

Rib Attachments

Answer 5

1st CC - Manubrium
2nd CC - Manubriosternal joint (sternum angle)
3-7th CC - Sternum. (3-6 join body of sternum + 7 joins xiphisternal joint. These are sternocostal joints)
8-10th CC attach cartilage above by interchondral joints
11-12th floating and no attachment

Question 6

3 Sites on thoracic vertebrae which articulate w ribs

Answer 6

• Transverse costal facet at transverse process articulates with tubercle of rib
• Superior demifacet articulates with head of own rib
• Inferior demifacet articulates with head of rib below

Question 7

Symphysis + it’s composition

Answer 7

Fibrocartilganious fusion of 2 bones

Made of 2 structures: hyaline cartilage + intervertberal disc .

Question 8

Zygapophysial Joint

Answer 8

connects vertebrae together - superior articular process + inferior articular process of vertebral body above

Question 9

Intercostal Muscle Directions

Answer 9

External - down and laterally from lower border of rib to rib below
Internal -attachment starts anteriorly at sternum, travel at right angles to external from lower border of rib above to upper border of rib below
Innermost.

Question 10

Innervation of thoracic wall

Answer 10

Anterior rami of thoracic nerves T1-11 and subcostal nerve T12

Question 11

Intercostal Arteries

Answer 11

Posterior IC arteries are branches of posterior surface of thoracic artery

Anterior IC arteries run down chest wall and are branches of internal thoracic artery w arises from subclavian arteries (no anterior IC for last 2 IC spaces)

Question 12

IC Muscle blood supply

Answer 12

Anterior source: thoracic arteries + veins

Posterior source: aorta + azygous vein

Question 13

Chest Drain borders for safe triangle

Answer 13

Anterior border of lat dorsi
Lateral border of pectoralis major
Superior to horizontal level of nipple
4/5th ICC anterior to mid-axillary line

Question 14

2 Heads of Pec major

Answer 14

Clavicular head - orig from medial half of clavicle

Sternocostal head - orig from sternum +CC

Question 15

Pleural effusion

Answer 15

fluid in pleural cavity

Question 16

Contents of Mediastinum

GOTTT HeLP?

Answer 16

Great vessels
Oesophagus
Trachea
Thymus
Thoracic duct (+major lymph trunks)

Heart
Lymph nodes
Phrenic and vagus nerves (diaphragm + heart)