Thorax

Question 1

Which nerve supplies the pleura and intercostal muscles, and where are they located?

Answer 1

Intercostal nerves, located between the ribs.

Question 2

Which nerve supplies the muscles of the pharynx and larynx?

Answer 2

The vagus nerve.

Question 3

Which nerve innervates the diaphragm, and where does it arise?

Answer 3

Phrenic nerve, from C3, C4, and C5.

Question 4

What is the arrangement of the pulmonary artery and main bronchi in the hilum of the lung?

Answer 4

Right Anterior, Left Superior.

Question 5

At which vertebral level is the horizontal fissure of the right lung?

Answer 5

Follows 4th rib and costal cartilage from sternum to oblique fissure.

Question 6

At which vertebral level is the right oblique fissure?

Answer 6

Starts at spinous process of T4, crosses 5th intercostal space axillary, follows 6th rib and costal cartilage anteriorly.

Question 7

What is the vertebral level of the left oblique fissure?

Answer 7

Starts from between the spinous processes of T3 and T4, crosses 5th intercostal space laterally, follows 6th rib anteriorly.

Question 8

What is divided posteriorly by the superior margin of the scapulae?

Answer 8

The superior and inferior lobes of the lungs.

Question 9

Where is the azygous vein?

Answer 9

Right side of vertebral column, posterior mediastinum, empties into superior vena cava.

Question 10

Which vertebral level is the caval opening in the diaphragm, and what passes through?

Answer 10

C8 - inferior vena cava.

Question 11

Which vertebral level is the oesophageal hiatus in the diaphragm, and what passes through?

Answer 11

C10 - oesophagus and vagus trunks.

Question 12

Which vertebral level is the aortic hiatus in the diaphragm, and what passes through?

Answer 12

C12 - descending aorta.

Question 13

What is the function of the internal intercostal muscles?

Answer 13

Resist intercostal in-drawing.

Question 14

Where is the internal thoracic artery, and what artery does it arrive from?

Answer 14

The internal thoracic artery runs down the anterior thoracic wall along the side of the sternum, it arises from the subclavian artery.

Question 15

At which vertebral level is the carina?

Answer 15

T4/T5

Question 16

At which vertebral level is the inferior margin of the lung in the midline, midclavicular line, midaxillary line, and next to the vertebral column?
Where is the costodiaphragmatic recess?

Answer 16

Parasternally - T4
Midclavicular line - T6
Midaxillary line - T8
Vertebral column - T10
(Costodiaphragmatic recess is 2 vertebral levels lower, so T6, T8, T10, T12)

Question 17

Name the two pleural recesses (where two layers of parietal pleura become opposed).

Answer 17

Costodiaphragmatic recess

Costomediastonal recess

Question 18

What is a bronchopulmonary segment?

Answer 18

The smallest areas flung that can be isolated and removed without affecting the others.

Question 19

What is the stringy bit on the bottom of the lung hilum called?

Answer 19

Pulmonary ligament.

Question 20

What are the borders of the mediastinum?

Answer 20

Superior thoracic aperture to diaphragm, sternum to vertebral bodies.

Question 21

At what level is the margin between the superior and inferior mediastinum?

Answer 21

T4/T5 - the sternal angle (2nd rib)

Question 22

What is contained in the superior mediastinum?

Answer 22

Aortic arch and its branches, brachiocephalic veins, trachea, oesophagus, thoracic duct, vagus and phrenic nerves.

Question 23

What is contained in the anterior mediastinum?

Answer 23

Thymus gland (fibrofatty connective tissue in adults), lymph nodes, sternopericardial ligaments, internal thoracic vessels.

Question 24

What is contained in the middle mediastinum?

Answer 24

Pericardium, heart, phrenic nerve, deep cardiac plexus, pulmonary arteries, origin of great vessels.

Question 25

What is contained in the posterior mediastinum?

Answer 25

Oesophagus, vagus nerve, thoracic duct, descending thoracic aorta, azygous vein, hemiazygous and accessory azygous veins, lymph nodes.

Question 26

Where does the hemiazygous vein empty?

Answer 26

Superior vena cava

Question 27

Which lymph nodes do mediastinal structures track up to first?

Answer 27

Supraclavicular nodes.

Question 28

What is paroxysmal nocturnal dyspnoea?

Answer 28

Waking up in the middle of the night panting for breath because lying flat has allowed fluid to fill the lungs.

Question 29

What travels through the opening in the diaphragm at T8?

Answer 29

Caval opening - Inferior vena cava

Question 30

What travels through the opening in the diaphragm at T10?

Answer 30

Oesophageal hiatus - oesophagus, vagus nerve (anterior and posterior vagal trunks)

Question 31

What travels through the opening in the diaphragm at T12?

Answer 31

Aortic hiatus - aorta, azygous and hemiazygous vein, thoracic duct, sympathetic trunk

Question 32

Where in the mediastinum is the thymus gland?

Answer 32

Anterior part of the superior mediastinum, extending into the anterior mediastinum particularly in childhood.

Question 33

What lies behind the thymus gland?

Answer 33

Thymus -> left brachiocephalic vein -> aortic arch -> proximal brachiocephalic trunk and left common carotid artery -> fibrous pericardium

Question 34

What are the 6 layers in bronchial mucosa?

Answer 34

``` Pseudostratified ciliated columnar epithelium Lamina propria Smooth muscle Submucosa Hyaline cartilage Tunica adventitia ```