Thorax

Question 1

Parts of the thorax

Answer 1

STERNUM
RIBS
THORACIC VERTEBRAE

Question 2

Parts of the Sternum

Answer 2

Manubrium
*Angle of Louis
Body
Xiphoid Process

Question 3

Also called the MANUBRIOSTERNAL JOINT

Answer 3

STERNAL ANGLE (ANGLE OF LOUIS)

2nd ribs articulate w/ the sternum

aortic arch begins and ends

trachea bifurcates into R/L primary bronchi

arch of the aorta arise from the ascending aorta and continues as the descending aorta

azygous vein drains into the SVC

Question 4

Articulates w/ the 2nd to 7th costal cartilages

Articulates w/ the xiphoid process at the XIPHISTERNAL JOINT

Answer 4

BODY OF THE STERNUM

Question 5

Lies at the level of T10 vertebra

Answer 5

XIPHOID PROCESS

Question 6

True ribs

Answer 6

1st - 7th

Question 7

False ribs

connected only to costal cartilages immediately above

Answer 7

8th - 10th

Question 8

Floating ribs

connected only to the vertebrae

Answer 8

11th - 12th

Question 9

Typical ribs

with head, neck, tubercle, body

Answer 9

ribs 3-9

Question 10

broadest and shortest of the true ribs

close relationship to the LOWER nerves of the BRACHIAL PLEXUS and Subclavian artery/ vein

Answer 10

1st RIB

Question 11

Parts of ribs

Answer 11

Head
*articulation w/ the corresponding vertebral body and vertebra immediately above

Neck

Tuburcle
*articulates w/ TRANSVERSE PROCESS of vertebra

Shaft/Body

• thin flat, curved
• (+) COSTAL GROOVE

Question 12

Twice as long as the 1st rib

(+) tuberosity for SERRATUS ANTERIOR

Answer 12

Rib 2

Question 13

Single articular facet for T 10

Answer 13

Rib 10

Question 14

Have a single articular facet

NO neck or tubercle

Answer 14

Ribs 11 and 12

Question 15

Rib fractures commonly occur at the weakest point of the rib which is

Answer 15

anterior to the angle of the rib

Question 16

Most commonly fractured ribs – pneumothorax and lung or spleen injury

Answer 16

Middle ribs (5th - 10th)

Question 17

Boundaries of Thoracic outlet/ Thoracic inlet

Answer 17

POST - 1st thoracic vertebra
LAT - medial border 1st rib
ANT - manubrium sterni

Question 18

The compression of the neurovascular structures in the thoracic outlet

pain, numbness, tingling or weakness and fatigue in the upper limb caused by pressure on the brachial plexus by the cervical rib

Answer 18

THORACIC OUTLET SYNDROME

atrophy of thenar and hypothenar eminences

atrophy of interosseous muscles

sensory deficits on the medial side of forearm and hand

diminished radial artery pulse upon moving the head to the opposite side

bruit over the subclavian artery

Question 19

Muscles of the thoracic wall that DEPRESS RIBS

Answer 19

Serratus posterior inferior
Internal intercostal
Transverse thoracis

Question 20

Elevate Ribs – INSPIRATION

Answer 20

INCREASED AP, transverse and vertical diameter

Question 21

Depress Ribs – EXPIRATION

Answer 21

DECREASED AP, transverse and vertical diameter

Question 22

Elevate the ribs and play a role in INSPIRATION during exercise or lung disease

Answer 22

External intercostal muscles

Question 23

Play a role EXPIRATION during exercise or lung disease

Answer 23

Internal intercostal muscles

Question 24

Primary Respiratory Muscles (INSPIRATION)

Answer 24

Diaphragm

External intercostal muscles

Question 25

Accessory Respiratory Muscles (INSPIRATION)

Answer 25

SCM Scalene muscle Pectoralis minor Serratus anterior

Question 26

Accessory Respiratory Muscles (EXPIRATION)

Answer 26

``` Internal intercostal muscles Transverse thoracis muscles External oblique muscle Rectus abdominis Internal oblique muscle ```

Question 27

Branch of the subclavian artery that descends just lateral to the sternum and terminates at ICS 6 by dividing into the superior epigastric a and musculophrenic a

Answer 27

INTERNAL THORACIC ARTERY/INTERNAL MAMMARY ARTERY ``` pericardiophrenic anterior intercostal anterior perforating branches musculophrenic superior epigastric artery ```

Question 28

Branch of internal thoracic artery and musculophrenic artery

Answer 28

anterior intercostal artery internal thoracic -- anterior -- ICS 1-6 musculophrenic -- anterior -- ICS 7 -9

Question 29

Branch of thoracic aorta

Answer 29

posterior intercostal artery ICS 3-11

Question 30

POSTERIOR INTERCOSTAL

Answer 30

1st 2 - superior intercostal of the costocervical trunk remaining branches - descending aorta

Question 31

ANTERIOR INTERCOSTAL

Answer 31

upper 6 - internal thoracic artery remaining - musculophrenic artery

Question 32

During thoracentesis the needle passes through

Answer 32

EXTERNAL intercostal -- INTERNAL intercostal -- innermost IC --- thoracic cavity

Question 33

During thoracentesis the needle is introduced into the pleural cavity into the

Answer 33

midaxillary line in the 8th ICS

Question 34

Needle passing through the entire depth of an ICS must penetrate 7 structural layers

Answer 34

``` skin superficial fascia deep fascia intercostal muscles endothoracic fascia extrapleural fatty layer parietal pleura ```

Question 35

Contents of an intercostal space

Answer 35

Vein Artery Nerve

Question 36

Drains the anterior part of the thorax

Answer 36

anterior intercostal vein -- internal thoracic vein -- brachiocephalic vein

Question 37

Ventral primary rami of T1-T11 and run into the COSTAL GROOVE

Answer 37

Intercostal nerve

Question 38

Ventral primary ramus of T12

Answer 38

Subcostal nerve

Question 39

Placed along the INTERNAL THORACIC ARTERY Drain into the junction of internal jugular and subclavian veins

Answer 39

Sternal or Parasternal (Internal Thoracic) Nodes

Question 40

Lie near the heads of the ribs Receive lymph from ICS and pleura Drain into the CISTERNA CHYLII or THORACIC DUCT

Answer 40

Intercostal Nodes

Question 41

Lie on the thoracic surface of the diaphragm Receive lymph from the pericardium, diaphragm and liver Drain into the sternal and posterior mediastinal nodes

Answer 41

Phrenic Nodes

Question 42

Thoracic duct empties into what vein

Answer 42

Left Brachiocephalic Vein

Question 43

Drains lymph from most of the body

Answer 43

Thoracic Duct

Question 44

Drains the right side of the of the head and neck, right upper extremity, right breast and right lung

Answer 44

Right Lymphatic Duct