Thorax

Question 1

What is the first rib to sternum joint?

Answer 1

Primary cartilaginous joint

Question 2

What are the ribs 2-7 joints to the sternum?

Answer 2

Synovial planar

Question 3

What is the weakest part of the rib?

Answer 3

Where it angles round

Question 4

What side of the ribs are broken?

Answer 4

Right

Question 5

What is a ‘stove in chest’ ?

Answer 5

Loose segment of rib caused by a break

• flail chest

Chest moves inward during inhale rather than out, it gets sucked in

Question 6

What muscles lie in between ribs?

Answer 6

Intercostal muscles

Question 7

What are the 3 types/layers of intercostal muscles?

Answer 7

External, internal and innermost

Question 8

What are the nerves of the ribs?

Answer 8

Anterior primary rami of thoracic nerves

Question 9

Where do you feel pain when intercostal nerves are irritated?

Question 10

How would you anaesthetise intercostal space?

Question 11

How would you prevent damage to the neurovascular bundle during posterolateral thoracotomy?

Question 12

When you breathe in, what is the movement of the ribs?

Answer 12

1. Superior and anterior movement
2. Elevation of lateral shaft of rib

Question 13

What ribs do the breast cover?

Answer 13

2nd to 6th

Question 14

What muscle do the breast lie over?

Answer 14

Pectoral is major

Question 15

What are lobules suspended by in the breast?

Answer 15

Coopers ligaments

Question 16

How many lobules are in the breast?

Answer 16

15-20

Question 17

What arteries supply the breast?

Answer 17

Internal thoracic

Lateral and thoracoacromial

Intercostal

(From the aorta)

Question 18

Why is a lesion in the breast critical?

Answer 18

Rich blood supply, can effect many systemic areas

Question 19

What nodes are associated with the breast?

Answer 19

Axillary
Parasternal
Abdominal

Question 20

What is the pleura?

Answer 20

Mesothelial lining of each hemithorax

Question 21

What is the visceral pleura?

Answer 21

Lines the lungs

Question 22

What is the parietal pleura?

Answer 22

Covers the internal surface of the thorax cavity

Question 23

What are the parts of the parietal pleura?

Answer 23

Costal
Diaphragmatic
Mediastinal
Cervical

Question 24

What produces serous fluid in the lung?

Answer 24

Capillary layer of serous fluid produced by the mesothelium

Question 25

What is the roe of the serous fluid?

Answer 25

Reduce friction

Question 26

What created cohesion between the lung and thoracic wall?

Answer 26

Surface tension

Question 27

What is pneumothorax?

Answer 27

- presence of free air or gas in the pleural cavity - collapse of the ipsilateral lung due to pressure change and disruption of surface tension - potential for mesiastinal shift

Question 28

What is pleural effusion?

Answer 28

Accumulation of fluid in the pleural space

Question 29

What is empyema?

Answer 29

Potential sequelete to exudative effusion

Question 30

How would you drain fluids in the pleural cavity?

Answer 30

Usually inserting wide-bore needle Between 4th and 5th ribs

Question 31

What is the danger of inserting the bore needle above the 7th rib posteriorly?

Answer 31

Danger of penetrating the diaphragm

Question 32

What is the mediastinum?

Answer 32

Space between two pleural sacs

Question 33

What does the superior mediastinum contain?

Answer 33

Great vessels Trachea Oesophageal Thoracic duct 2 vagi Left recurrent laryngeal nerve Phrenic neves

Question 34

Where does the superior mediastinum lie?

Answer 34

Just under the second rib

Question 35

What is in the anterior mediastinum?

Answer 35

Thymus or remnants

Question 36

What is in the middle mediastinum?

Answer 36

Contains heart , pericardium, vessels, bronchi and nerves

Question 37

What is in the posterior mediastinum?

Answer 37

Oesophagus Aorta Vagus nerve

Question 38

What is the relationship of the oesophagus to trachea, left bronchus and left atrium? And the clinical significance?

Answer 38

Question 39

What part of the heart does the vagus nerve touch?

Answer 39

Left atrium

Question 40

What nerves are associated with the right mediastinal surface?

Answer 40

Right vagus nerve and right phrenic nerve

Question 41

What nerves are associated with the left mediastinal surface?

Answer 41

Left phrenic nerve Left Angus nerve Left recurrent laryngeal nerve

Question 42

What side of the mediastinal surface can you see the azygous nerve?

Answer 42

Right

Question 43

What are floating ribs?

Answer 43

Attach posteriorly, not anteriorly

Question 44

Where does the azygos vein drain from?

Answer 44

Posterior thoracic wall

Question 45

What are the 3 opening in the diaphragm?

Answer 45

Aortic Oesophageal IVC

Question 46

What vertebrae is the aortic diaphragm opening?

Answer 46

T12

Question 47

What vertebrae is the oesophageal opening in the diaphragm?

Answer 47

T10

Question 48

What vertebrae is the IVC opening in the diaphragm ?

Answer 48

T8

Question 49

What opening of the diaphragm transmits the IVC and right phrenic nerve?

Answer 49

IVC

Question 50

Wat does the IVC transmit?

Answer 50

IVC and right phrenic nerve

Question 51

What does the oesophageal opining transmit?

Answer 51

Oesophagus Left gastric arterial branches and vein Two vagi

Question 52

What does the aortic opening of the diaphragm transmit?

Answer 52

Abd. Aorta Thoracic duct Azygos vein

Question 53

What is the lymph drainage system of the thoracic duct? (Left)

Answer 53

From the - cisterns chyli to the left brachiocephalic vein

Question 54

What does the cisterna chyli drain lymph from? (Left)

Answer 54

Abdomen and left thorax

Question 55

What drains the right thorax?

Answer 55

Right lymphatic duct

Question 56

Name A and B

Answer 56