Anatomy - Block Ii - Thorax & Abdomen

Front 1

Name the major contents of the mediastinum

Back 1

the heart, great vessels, the descending esophagus, & trachea

Front 2

Which ribs are considered true ribs?

Back 2

The 1st 7 ribs are considered true ribs because they articulate with the body of the sternum itself by way of their condyl cartilages

Front 3

Which ribs are considered false ribs?

Back 3

ii. The 8th, 9th, 10th are all considered false ribs because the cartilages fuse together to join with the 7th rib to articulate with the inferior aspect of the body of the sternum.

Front 4

Which ribs are floating ribs?

Back 4

iii. 11th and 12th are floating ribs. They don’t have connecting cartilages that connect with the sternum. However, they do have cartilaginous ends. They float freely in the lateral aspects of the abdominal aspects of the wall.

Front 5

Which ribs are considered to be atypical ribs?

Back 5

The 1st, 2nd, 11th, and 12th are all considered atypical ribs. The 11th and 12th don’t articulate with the sternum.

Front 6

What type of joint is the sternoclavicular joint?

Back 6

A saddle joint

Front 7

Name the three parts of the sternum

Back 7

manubrium, body, and zyphoid process.

i. Manubrium: Opposite the 3rd and 4th thoracic vertebrae.

ii. The sternum: is opposite the 5th through the 9th

iii. Zyphoid process: Opposite of T10. Made of cartilage and gradually ossifies as we age.

Front 8

What are two names for the angle between the body of the manubrium?

Back 8

sternal angle, or sternal angle of Louis

Front 9

Which muscles attach to the rib cage? Which are accessory muscles of respiration?

Back 9

pectoralis major,
pectoralis minor
part of the serratus anterior
latissimus dorsi
scalene muscles

All except the latissimus dorsi.

Front 10

What passes through the superior aperature into the thorax?

Back 10

esophagus , vagus nerves, great vessels, trachea

Front 11

What are the boundaries of the superior aperature?

Back 11

It is bounded posteriorly by the 1st thoracic vertebrae, the 1st two ribs, and superior border of manubrium

Front 12

What are the boundaries of the inferior aperature?

Back 12

It is bounded by the inferior borders of the 11th and 12th ribs, the costal cartilages anteriorly, and by the zyphoid process

The diaphragm covers the inferior aperture of the thoracic cage

Front 13

What passes through the inferior aperature?

Back 13

the inferior vena cava, the abdominal aorta, other nerves, and lymphatics

Front 14

What attaches to the rough area of the rib's tubercle?

Back 14

The rough area of the tubercle is for the costal transverse ligament which holds that joint* in place

*articulation with the transverse process of thoracic vertebrae

Front 15

What is the ribs weakest point?

Back 15

The rib is weakest just anterior to the angle, and thus is the most likely place for a fracture to occur.

Front 16

What does the costal groove contain?

Back 16

intercostal vein, artery, and nerve in that order.

Front 17

How could a removed rib grow back?

Back 17

Sometimes a rib is taken out during surgery for access to the lung (s). The rib should grow back in place because the periosteum, which contains bone-generating cells, will regenerate itself.

Front 18

What do you call the superior most aspect of the manubrium?

Back 18

jugular notch

Front 19

What type of joint exists between the 1st rib and the clavicle?

Back 19

synovial joint

Front 20

What type of joint exists between the 1st rib and the body of the sternum?

Back 20

cartilaginous joint

Front 21

What type of joints exist at the articulation for the costal cartilages

Back 21

synovial joints

Front 22

How many intercostal spaces make up the thorasic wall? What muscles are in them?

Back 22

Eleven intercostal spaces

External intercostal muscles: run from the rib above it anteriorly and inferiorly to attach to the rib below. When contracted, they elevate the ribs.

Internal intercostals (deep to external): compresses the ribs.

Innermost intercostal muscle: The intercostal vein, artery, and nerve run in a groove on the inferior aspect of the rib and run between the Internal intercostal & Innermost intercostal muscles.

Front 23

The intercostal nerve is a ______ ramus.

Back 23

primary

Front 24

Name the fascial lining which separates the muscles of the posterior and anterior thoracic wall from the pleura of the lungs.

Back 24

endothoracic fascia

Front 25

Name 2 muscle groups that elevate the ribs. Name 1 muscle group that depresses the ribs.

Back 25

1. The external intercostals
2. The condyl part of the internal intercostals

The internal intercostals

Front 26

Name the 2 arterial supplies to the thorasic wall.

Back 26

Thorasic aorta and the internal thorasic (branch of the subclavian) which descends and becomes the musculophrenic as it reaches the diaphragm.

Front 27

Which artery is frequently used in cardiac bypass surgery so that they may use it directly with the cardiac arteries?

Back 27

internal thorasic

Front 28

Name the congenital condition in which the aorta is constricted. Blood coming out of the heart will not be able to pass down inferiorly and as a result, the intercostal arteries and the internal thoracic take over and become enlarged so that blood may get to the descending aorta.

Back 28

coarctation of the aorta

Front 29

What veins form the right superior intercostal vein?

Back 29

2nd, 3rd, 4th intercostal veins

Front 30

Name two things that drain into the superior vena cava?

Back 30

The azygos and the right superior intercostal veins

Front 31

At which thorasic vertebrae does the Hemiazygos vein cross the midline to join the azygous vein?

Back 31

8th

Front 32

Name the two major layers of the thorasic pleura.

Back 32

1. Visceral pleura: The part of the pleura that surrounds the lung itself is called the.

2. Parietal pleura: The part of the pleura that lines the cavity.

Front 33

Name 4 parts of the parietal pleura

Back 33

1. Diaphragmatic pleura
2. Mediastinal pleura
3. Costal pleura
4. Cervical portion of pleura, superiorly.

Front 34

Name the pleura that covers the lung itself.

Back 34

Visceral or pulmonary pleura

Front 35

During a thoracentesis a needle is put posteriorly and laterally into the ___, ___, or ___ intercostal space and fluid is aspirated from the ________________.

Back 35

the 6th, 7th, or 8th

Costodiaphragmatic Recess

Front 36

Name an indication that a pt has an occult cancer. (Occult cancer is a small cancer that may give rise to clinically evident distant metastases before it is itself clinically detectable)

Back 36

hyponatremia (low sodium)

Too little sodium is almost always an indication that the pt. has an occult cancer

Front 37

Name a disease that is usually caused by cancer. What does the pt. present with psychiatric symptoms?

Back 37

paraneoplastic limbic encephalitis.

Tt attacks certain structures in the CNS called the limbic lobes. Anti-HU antibodies attack only the limbic structures. This attack on thelimbic structures results in a psychiatric presentation.

Front 38

Name a potential effect of squamos cell carcinoma?

Back 38

Horner syndrome

Front 39

Name the mechanism of Horner syndrome and some of the symptoms associated with it.

Back 39

Compression the cervical chain ganglia, resulting in the classic triad of: miosis (constricted pupil), partial ptosis, and anhidrosis (loss of hemifacial sweating).

Front 40

What is a pleural effusion?

Back 40

1.Absence of breath sounds

2.Serous fluid present. Normally clear appearance. Can be serosanguineous fluid with blood present.

3.In patients with bilateral pleural effusions, one may do a thoracentesis to look for malignant cells. Billateral pleural effusions contain malignant cells that can diagnose which stage the cancer is in.

Front 41

What is the term for air in the lungs?

Back 41

Pneumothorax

Primarily iatrogenic in nature (inflicted by doctor). When passing a catheter through for a central line, the lung can collapse. You have punctured the space between the parietal pleura and the visceral pleura, and air has been introduced into that space.

Front 42

What is the term for infection between the parietal pleura and the visceral pleura?

Back 42

Pleuracy

Extremely painful. The lungs don’t move smoothly as they expand. In metastatic cancer patients, physicians go through the pleura and put in talcum poweder. Allows the lungs to expand and not collapse.

Front 43

What do you call blood in the pleural space?

Back 43

Hemothorax