Thorax/Abdomen

Question 1

How many ribs are connected directly to the sternum through their own costal cartilages?

Answer 1

ribs 1-7 (aka true ribs)

Question 2

False ribs are what number ribs?

Answer 2

8-12

11-12 are also floating

Question 3

The 7th rib articulates with what vertebra(e)?

Answer 3

6th and 7th

- attaches on the transfers process of 7, costovertebral joints of 6 and 7

Question 4

What part of the rib attaches to the costovertebral joints?

Answer 4

head of rib

Question 5

What is the pump-handle movement of the thoracic wall?

Answer 5

anterior to posterior movement

Question 6

What is the bucket-handle movement of the thoracic wall?

Answer 6

Lateral expansion

Question 7

What is the primary muscle of inspiration?

Answer 7

diaphragm

- contraction of the diaphragm increases the vertical dimension of the thoracic cavity

Question 8

What should your differential diagnosis be when a patient tells you they have chest pain?

Answer 8

• Lay them down, does rest or changed body position affect symptoms?
• ask about type of pain: crushing, deep, burning could indicate MI

Question 9

What do the intercostal muscles do?

Answer 9

both internal and external elevate the ribs with forced inspiration

Question 10

What muscles depress the ribs?

Answer 10

transverse thoracis, and potentially some of the internal intercostal muscles

Question 11

OINA: serratus anterior

Answer 11

origin: anterior surfaces of ribs 1-8/9
insertion: medial border of scapula
innervation: long thoracic n. (C5-7)
action: protraction and upward rotation of scap (allowing abd at >90deg)

Question 12

What are the muscles of inspiration?

Answer 12

1) diaphragm
2) external/internal intercostals
3) sternocleido/scalenes (accessory muscles)

Question 13

What are the muscles of expiration?

Answer 13

1) abdominals (rectus, ext/int oblique, transversus)
2) internal intercostals
3) transverse thoracis

Question 14

What nervous system controls the cardiac muscle of the heart?

Answer 14

autonomic NS

Question 15

What parts of which bones make up the costotransverse joint?

Answer 15

tubercle of rib to the TP of the same # as rib

Question 16

Which ribs utilize the bucket handle? Which the pump handle?

Answer 16

bucket handle = 7-10

pump handle = 2-5

Question 17

What structures can cause thoracic outlet syndrome?

Answer 17

1) tight scalenes compressing subclavian a.

2) extra rib compressing vessels in area

Question 18

Where does the lymph system drain to?

Answer 18

drains into the subclavian a., bilaterally (via R lymphatic duct and thoracic duct (which is left))

Question 19

What are the two pleural layers of the lungs? Describe them

Answer 19

Parietal pleura = thick lining that attaches to thoracic wall, diaphragm, etc

Visceral pleura = directly adhered to lungs, giving them a smooth surface to move in cavity

Question 20

Which lung has 3 lobes?

Answer 20

R

Question 21

What structures pass through the root of the lung?

Answer 21

pulmonary arteries/veins, bronchi

Question 22

T/F: Inflammation of the parietal pleura is painful.

Answer 22

true

Question 23

The trachea exists through what vertebral levels?

Answer 23

C6-T4

T4 is at sternal angle

Question 24

Which primary bronchi is more likely to get food trapped in it from a young child aspirating?

Answer 24

R lobe = it’s wider and shorter

Question 25

What does your larynx do?

Answer 25

it houses your voice box

Question 26

Where is your thyroid located?

Answer 26

in neck, just inferior to larynx

Question 27

Describe differences between internal/external oblique AOIs:

Answer 27

Internal Oblique = ipsilateral rotation; comes from iliac crest up to 10-12 ribs
External Oblique = contralateral rotation; comes from ribs 5-12 to linea alba/pelvis

Both are innervated by thoraco-abdominal n. (T6-12), do ips. side bend and trunk flexion

Question 28

Transverse abdominus AOIs:

Answer 28

O: internal surfaces of 7-12 costal cartilages, iliac crest, TL fascia
I: linea alba into internal oblique’s aponeurosis
N: thoraco-abdominal nerves (T6-12)
A: compress/support abdominal viscera

Question 29

Rectus abdominus AOIs:

Answer 29

O: pubic symphysis and pubic crest
I: xiphoid and 5-7 cost cartilages
N: Thoraco-abdominal nerves (T6-12)
A: flexes trunk

Question 30

The anterior layer of thoracolumbar fascia thickes to form what ligament?

Answer 30

iliolumbar ligament