Thorax (Exam#2) Flashcards
Give the vertebral level of the jugular/suprasternal notch
Lower border of T2
Give the vertebral and costal levels of the sternal angle (of Louis)
Between T4-T5 posteriorly, and 2nd costal cartilage (CC) anteriorly.
Give the vertebral level of the xiphisternal joint
T9
Give the costal levels of the costal margin (lower border of chest/thorax)
7th-10th costal cartilages
Give the intercostal space (ICS) level and vertebral level of the nipple
4th ICS, T4-T5
Give the costal level of the apex of the heart
Left 5th ICS, 1/2 inch medial to the midclavicular line.
The transverse thoracic plane lies between which two vertebral levels?
T4-T5
p.78 Moore
Which rib(s) attach ENTIRELY to the manubrium?
1st rib only; the 2nd rib attaches at the sternal angle and, thus, attaches to both the manubrium and the body of the sternum.
At which joint is the angle of Louis formed?
Manubriosternal joint
At which vertebral levels is the body of the sternum located?
T5-T9
p.78 Moore
At what vertebral level is the xiphoid process located?
Its inferior end lies at T10
What three thoracic viscera can the xiphoid process be a midline marker for, i.e. what three organs can be found at the midline using the xiphoid process as a landmark?
- Xiphoid process ≈ T10 vertebral level*
1. ) Superior limit of the liver
2. ) Central tendon of the diaphragm
3. ) Inferior border of the heart
p. 78 Moore
What bony landmark indicates the inferior limit of the central part of the thoracic cavity projected onto the anterior body wall?
Xiphisternal joint: Junction between the body of the sternum and the xiphoid process.
- ) What bony landmark can be used to locate the infrasternal angle (aka _______ angle)?
- ) What forms the infrasternal angle?
- ) aka Subcostal angle –Xiphisternal joint.
2. ) Formed by the apex of the right and left costal margins.
Give the borders of the thoracic cage (superior, inferior, lateral, anterior, posterior).
Superior: Thoracic inlet and suprapleural membrane. Inferior: *Thoracic diaphragm* Lateral: 12 ribs and their cartilage. Anterior: Sternum. Posterior: 12 thoracic vertebrae.
What are the borders of the superior thoracic aperture (anterior, posterior, lateral)?
Anterior: Superior border of manubrium
Posterior: T1
Laterally: 1st pair of ribs and their cartilage.
What structures pass through the superior thoracic aperture (10)?
- Trachea
- Esophagus
- Phrenic nerves
- brachial plexus (lower trunk)
- internal thoracic artery
- brachiocephalic artery
- subclavian artery and vein
- thoracic duct,
- Anterior scalenes
- T1 and C8 anterior rami
What are the borders of the inferior thoracic aperture (anterior, anterolateral, posterior, posterolateral)?
- Anterior: Xiphisternal joint.
- Anterolateral: Joined costal cartilages of ribs 7-10 (costal margins).
- Posterior: T12.
- Posterolateral: 11th and 12th pair of ribs.
p. 79 Moore
The domes of the diaphragm rise to the level of which intercostal space?
4th ICS
p.79 Moore
Describe the articulation between the head of the ribs and the costal facets of the thoracic vertebrae, give an example.
The head of the rib articulates with the superior costal facet of the corresponding (same numbered) vertebrae (i.e. inferior articular facet of the head of the rib articulates with the superior costal facet of the vertebrae at the same level).
The superior articular facet of the head of the rib articulates with the inferior articular facet of the vertebrae superior to it (i.e. one number lower).
e.g. The head of the 6th rib articulates with the superior costal facet of T6, and the inferior costal facet of T5.
Describe the articulation between the tubercle of the ribs and the thoracic vertebrae, give an example.
The tubercle of the ribs articulate with the transverse costal facet of the corresponding (same numbered) vertebrae.
e.g. The tubercle of the 6th rib articulates with the transverse costal facet of T6.
Describe the relative length of the ribs in order of increasing number.
Length increases from 1 to 7, then decreases.
Explain the borders of the superior mediastinum.
The superior mediastinum extends inferiorly from the superior thoracic aperture to the horizontal plane that includes the sternal angle anteriorly and passes approximately through the junction (IV disc) of T4 and T5 vertebrae posteriorly, often referred to as the transverse thoracic plane.
Moore p.128
What are the contents of the middle mediastinum (5)?
The middle mediastinum includes the
1.) pericardium, heart, and the roots of its great vessels (Fig. 1.34)—
2.) ascending aorta,
3.) pulmonary trunk
4.) SVC (PVs)—passing to and from the heart –
5.) Phrenic nerve
Moore p.128