Lecture 3: Thorax Q&A

What are the components of the skeleton?

* 12 ribs and associated costal cartilages * 12 thoracic vertebrae * Sternum

What are the cartilages and spaces found in the thoracic wall?

* Coastal cartilages, coastal margin, intercostal spaces and subcostal space

What characteristic features make up the thoracic vertebrae

* costal facets * transverse costal facets * spinous process

Name the components that make up the thoracic wall.

*Thoracic cage *Muscles between ribs *Skin, subcutaneous tissue, muscles, and fascia covering the anterolateral aspect

Name the general features of the thoracic vertebra

*have bodies *vertebral arches *7 processes for muscular and articular connections

Name the 3 major spaces of the thorax

1) Mediastinum 2) Right pulmonary cavities 3) Left pulmonary cavities

The central tendon his divided in what three parts?

1. Sternal 2. Costal 3. Lumbar

Contains 2 grooves on superior surface for subclavian vessels

1st rib

What ribs are associated with the true ribs?

1st-7th

What ribs are associated with the false ribs?

8th-10th

Typical ribs contain: A. Head, neck, tubercle, and body B. Transverse process, laminae, vertebra foreman C. Intrinsic and extrinsic back muscles

A. Head, neck, tubercle, and body

Vertically, what is found across the thoracic cage anteriorly and posteriorly? A) Clavicle, Sternum, and Thoracic vertebrae B) Sternum and Thoracic vertebrae C) Ribs and Costal cartilages D) Abdominal cavity and thoracic diaphragm

B) Sternum and Thoracic vertebrae

What are the 3 types of ribs? A) Short, Long, Heavy B) True, False, Floating C) Fasle, Floating, Short C) Long, Heavy, True

B) True, False, Floating

What part of the typical rib is thin, flat & curved and contain costal angles and grooves?

Body

What is located at the junction of the neck and body, articulated with transverse process of the corresponding vertebra? A. Head B. Body C. Tubercle D. Body

C. Tubercle

What is deep fascia suspended from the clavicle and investing the pectoralis minor muscle?

Clavipectoral fascia

What attaches to the internal surface of the inferior 6 costal cartilages and ribs also forming the right and left domes?

Costal

Musculotendinous bands arising from the superior 3 or 4 lumbar vertebral bodies (L1-L3 or L4), the anterior longitudinal ligament, and the IV disk

Crura of the diaphragm

Horizontally, what is found across the thoracic cage? A) Clavicle, Sternum and thoracic vertebrae B) Pancreas, Abdomen, and Lungs C) Abdominal cavity and Thoracic diaphragm D) Ribs and Costal cartilages

D) Ribs and costal cartilages

The main function of the IIM are to ______ ribs during forced _______.

Depress ribs during forced expiration.

What muscle has 11 pairs in the intercostal spaces (runs inferoanteriorly) and is deep to serratus anterior muscle?

External intercostal muscles

Attaches indirectly to the sternum through the costal cartilage of the rib above them.

False ribs

T/F: The 1st rib is the broadest, shortest, and most sharply curved. Has a single facet on head for articulation with T2.

False, A single facet on the head for articulation with T1.

T/F: The xiphoid process is located at the superior end at the level T1

False, the diploid process is the inferior end at the level of T10

T/F: The pectoral fascia forms 1/4th of the breast bed.

False, the pectoral fascia forms 2/3rd of the breast bed.

T/F: The superior surface is concave and faces the thoracic cavity

False, the superior surface is convex

These ribs do not connect to the sternum and end in the posterior abdominal musculature, these are known as_______.

Floating

Ribs 11 & 12 are considered ______.

Floating ribs

Intervertebral joints consist of

IV disk, ALL, PLL, Zygapophysical joints, ligaments flava, supraspinous and interspinous ligaments

Inferiorly branches of the abdominal aorta are known as

Inferior phrenic aorta

Which vein drains into the inferior vena cava?

Inferior phrenic veins

Between innermost and internal intercostal muscles are the neuromuscular bundle of intercostal nerves and vessels known as

Innermost intercostal muscles

What muscle has 11 pairs of intercostal spaces (runs posteriorly) and is deep to external intercostal muscles?

Internal intercostal muscles

What ligament is thickening fascia covering the quadratus lumborum muscle

Lateral arcuate ligament

Attach to medial and lateral arcuate ligaments (aponeurotic arches) and the three superior lumbar vertebrae

Lumbar

Name the parts of the sternum

Manubrium Body Xiphoid process

Thickening of fascia covering the psoas major muscle is known as what ligament?

Median arcuate ligament

What lodges the thoracic viscera, except the lungs?

Mediastinum

Superficial branches of the internal thoracic artery

Musculophrenic artery

Deep fascia associated with the pectorals muscle overlying the anterior thoracic wall.

Pectoral fascia

The most superficial artery are branches of the internal thoracic arteries

Pericardiacophrenic

What drains into the internal thoracic veins superioly?

Pericardiacophrenic, Musculophrenic, and Superior vein

In reference to the skeleton of the thoracic wall, general what do costal cartilages do?

Prolong ribs anteriorly, connecting them to the sternum Contribute to elasticity of the thoracic wall

The thoracic cage functions to:

Provide rigidity, protects thoracic and abdominal organs from external forces, resists negative internal pressures generated by lungs and inspiratory movements, attachment and support weight of upper limbs, and attachment for muscles of the upper limbs, abdomen, neck, back, and respiration.

The central portion of the thoracic wall is slightly depressed by the pericardium. Making the right dome higher than the left dome

Right dome (liver) Left dome (stomach)

Attachment for ASM( Anterior Scalene Muscle) and separates the subclavian grooves

Scalene tubercle

What are the characteristics of the 11th-12th ribs?

Single facet, No neck, and No tubercle

Attach anteriorly to the xiphoid process

Sternal

What type of biopsy is used to obtain bone marrow specimens for marrow transplants and for detection of metastatic cancer and blood dyscrasias

Sternal biopsy

Synovial joints between costal cartilage and the sternum are known as

Sternocostal joints

Superficial branches of the thoracic aorta

Superior phrenic artery

What type of fascia is found over the apices of the lung?

Suprapleural membrane (Sibson fascia)

What articulates with the tubercles of the ribs

Transverse costal facets

What. muscle extends super-lateral from the posterior surface of inferior sternum to the internal surface of costal cartilages 2-6

Transversus thoracis muscles

T/F: The inferior surface is concave and faces the abdominal cavity

True

What attaches directly to the sternum through their own costal cartilages?

True ribs

T/F: The 2nd rib is known for its tuberosity for serratus anterior muscle

True, 2nd rib attaches serratus anterior muscle via tuberosity (prominence marking on bone)

Apertures of the thoracic cage

allow passage of structures between the thorax and abdomen

Ligaments of the sternocostal joints radiate from costal cartilages to the sternum ________ and ________.

anteriorly and posteriorly

The costal facets of the thoracic vertebrae

articulate with the head of the ribs and usually occur in the superior and inferior pairs

Where is the body of the sternum located?

at the level of T5-T9

1st, 2nd and 11-12th ribs represent the _________ of the thoracic wall.

atypical ribs

Opening posterior to the diaphragm formed by the R & L crouch and the median arcuate ligament. Transmit the aorta, thoracic duct, and azygos/hemiazygos venous system a. caval opening b. aortic hiatus c. esophageal hiatus

b. aortic hiatus

Extension of right crus at the level of T10. Transmit the esophagus and vagus nerve a. aortic hiatus b. esophageal hiatus c. caval opening

b. esophageal hiatus

Thorax is located _______.

between the neck and abdomen

What muscle extend from rib tubercles to costochondral junctions? a. Internal intercostal muscles b. Transverse thoracis muscles c. External intercostal muscles d. Innermost intercostal muscles

c. External intercostal muscles

Aperture in the central tendon of the diaphragm, at the level of T8-T9. Transmits the inferior vena cava and right phrenic nerve. It widens during inspiration, dilating the IVC and facilitating venous return to the heart a. esophageal hiatus b. aortic hiatus c. caval opening

c. caval opening

Muscular fibers radiate from the periphery towards the _______.

central tendon

What forms a synchondrosis with the manubrium?

costal cartilage of the 1st rib

What passes through the inferior thoracic aperture?

esophagus, inferior vena cava (pass through the diaphragm) liver, spleen, and stomach

Costovertebral joints are synovial joints between

head of rib, superior costal facet of corresponding vertebra, inferior costal facet of vertebra superior to rib and adjacent IV disk

External intercostal muscles function to elevate ribs during forced _________.

inspiration

What are considered the joints of the thoracic wall?

intervertebral joints, Costovertebral joints, and Sternocostal joints,

Costal margin in reference to the thoracic wall....

is the inferior edge of thorax. Is formed by the attachment of the 8th-10th costal cartilage to the 7th costal cartilage

The manibrum consist of the

jugular notch, clavicular notches, and sternal angle

Where is the costal groove located

on the internal surface of body; protects the intercostal nerve and vessels

Which nerve travels in the neck over the anterior scalene muscle and in the thoracic cavity outside the pericardium ad pierce the diaphragm to innervate it

phrenic nerve (anterior ramin C4-C5)

Inferior thoracic aperture

posterior-lateral: T12 vertebral body and 11th & 12th pair of ribs anterior-lateral: joined costal cartilages of ribs 7-10 forming the costal margin anterior: xiphisternal joint

Superior thoracic aperture: slope anteriorly

posteriorly: T1 vertebra laterally: 1st pair of ribs and costal cartilages anteriorly: superior border of manibrium

The head contains 2 faces that are .....

separated by the crest of the head. (the ridge/ elevated portion.

What are intercostal spaces?

space between ribs and their cartilages. They contain muscles and membranes and intercostal nerves and vessels

Internal intercostal muscle extend from ______ to ______ of ribs.

sternum to angle

The space below the 12th rib _____.

subcostal space

The arteries of the thoracic cavity supply the ________ and ______ surfaces

superior(thoracic) and inferior (abdominal)

Generally, when fibers contract in the thoracic wall, they pull the central tendon inferiorly (down) expanding the thoracic cavity, increasing the lung size is mechanism that involve which muscle?

the diaphragm

EIM and IIM are innervated by which nerve

the intercostal nerve

The right and left pulmonary cavities contain _____________.

the lungs

What connects the head of the body at the level of the tubercle

the neck

What connects the vertebral bodies posteriorly and sternum anteriorly, except floating ribs?

the ribs

What protects the mediastinal viscera, particularly the heart?

the sternum

Endothoracic fascia is thin fiboareolar lining the ____________ internally.

thoracic cavity

What passes through the superior thoracic aperture?

trachea, esophagus, nerves and vessels supplying and draining the head, neck, and upper limbs

Costotransverse joints are synovial joints between

tubercle ribs and transverse costal facets of corresponding vertebra

Ribs 3-9 are known as

typical ribs

The floor of the thoracic diaphragm is invaginated inferiorly by _______________.

viscera of abdominal cavity

What is a costal angle in relation to the thoracic wall?

where ribs turn anterolateral

The ____________ indicates inferior median limit of thoracic cavity

xiphisternal joint