Anatomy- Thorax

Front 1

The body or centrum of what thoracic vertebrae are flattened on the left side why?

Back 1

1. from T6 down
2. due to descending aorta

Front 2

What are the bony landmarks on the thoracic vertebrae?

Back 2

1. body
2. pedicle
3. transverse processes
4. spinous process
5. articular processes
6. laminae

Front 3

What procedure give you access to the spinal cord?

Back 3

laminectomy

Front 4

The intervertebral foramina are formed by what and what is their purpose?

Back 4

1. formed by vertebral notches of the vert. above and below the foramina
2. these are the exit points for the spinal nerves

Front 5

When does the ossification of the ribs begin?

Back 5

around 9th prenatal week

Front 6

When does the epiphyseal head and tubercle of ribs fuse?

Back 6

by year 24

Front 7

What is the are the three types of ribs and where do they occur?

Back 7

1. vertebrosternal (R1-7)
2. vertebrochondral (R8-10)
3. floating ribs (R11,12)

Front 8

How does the head of the rib articulate with the vertebrae and what are the exceptions?

Back 8

1. articulates with sides of bodies of 2 vert. from same and superior levels
2. except R1, 11, and 12

Front 9

What attaches the heads of ribs to the intervertebral disc?

Back 9

interarticular ligament

Front 10

What does the articulating tubercle of the rib attach to and what is this called?

Back 10

1. attaches to transverse process of the same vertebra
2. costotransverse joint

Front 11

What do the superior costotransverse joints (R1-7) permit and what do the inferior joints (R8-10) permit?

Back 11

1. superior- permit rotation of the rib
2. inferior- permit gliding movement for the articulated rib

Front 12

What ligaments attach to the costotransverse joint and where do they attach?

Back 12

1. medial costotransverse ligament-neck of rib
2. lateral costotransverse ligament- tubercle of rib
3. superior costotransverse ligament- descends from superior transverse process to crest of inferior rib

Front 13

What are the costovertebral articulations?

Back 13

1. joint of head of rib
2. joint of tubercle of rib

Front 14

What 2 ligaments make up the sternocostal articulation?

Back 14

1. intraarticular ligament
2. radiate sternocostal ligament

Front 15

Interchondral joints occur between what costal cartilages?

Back 15

Costal cartilages of 7,8, and 9

Front 16

What is contained in the sternum and why is it significant?

Back 16

1. contains red bone marrow
2. used in sternal punctures in diagnosing blood diseases

Front 17

What is the superior portion of the manubrium?

Back 17

jugular (suprasternal notch)

Front 18

What articulates with the manubrium?

Back 18

1. clavicles
2. R1 and 1/2 of R2

Front 19

What muscles attach to the sternum?

Back 19

1. pectoralis major
2. sternocleidomastoid
3. sternohyoid
4. sternothyroid muscles

Front 20

The sternal angle is what kind of joint and is at the same level as what?

Back 20

1. cartilaginous joint
2. same levels as 2nd rib, T4,5 vert., carina, aorta crossing from right to left, 2nd intercostal space

Front 21

What is the carina?

Back 21

bifurcation of trachea

Front 22

What is important about the 2nd intercostal space?

Back 22

1. used for listening to aortic (right) and pulmonary(left) valves

Front 23

How does the body of the sternum develop and what happens if it doesn't develop properly?

Back 23

1. from sternal bars
2. failure to fuse will result in a hole or bifid xiphisternum

Front 24

When does the body of the sternum fuse?

Back 24

3rd trimester of uterine life

Front 25

What does the body of the sternum articulate with?

Back 25

1. 1/2 of R2 and R3-7

Front 26

What muscles attach to the body of the sternum?

Back 26

1. pectoralis major
2. transversus thoracis

Front 27

What dermatome is at the same level as the xiphoid process?

Back 27

6th thoracic dermatome on anterior surface of body

Front 28

What is the thoracic inlet?

Back 28

where viscera and vessels from head, neck, and upper limb enter into thorax

Front 29

What closes the thoracic outlet? What pierces it and what innervates it?

Back 29

1. closed by diaphragm
2. pierced by inferior vena cava, aorta, and esophagus
3. innervated by phrenic nerves (C3,4,5)

Front 30

What does paraplegic, quadriplegic, and pentaplegic mean?

Back 30

1. para- 2 limb paralysis
2. quadri- 4 limb paralysis
3. penta- (involvement of diaphragm; lesion affecting C3,4,5)

Front 31

How do the external intercostal muscles project and what action are they active in?

Back 31

1. project inferiorly in a post. to ant. direction
2. most active in inspiration

Front 32

How do the internal intercostal muscles project and what action are they active in?

Back 32

1. project superiorly in a post. to ant. direction
2. important in experation

Front 33

Where does the transversus thoracis attach?

Back 33

1. back of the sternum and xiphoid
2. insert onto costochondral junctions from R3-6

Front 34

T or F: The innermost intercostal muscles bridge more that one intercostal space?

Back 34

True

Front 35

What forms a neurovascular bundle in the intercostal space and what does this bundle lie between?

Back 35

1. intercostal vein, artery, and nerve
2. lies between internal intercostals and innermost intercostals

Front 36

What type of nerves are the intercostal nerves?

Back 36

mixed nerves containing both motor and sensory fibers

Front 37

What does the dorsal rami of the intercostal nerves do?

Back 37

1. innervate back muscles between angle of ribs and spinous processes
2. cutaneous branches innervate the overlying skin

Front 38

What do the ventral rami of the intercostal nerves do?

Back 38

1. innervate intercostal muscles, periosteum of the ribs and skin of the thorax (dermatome)

Front 39

What nerve levels innervate the abdominal wall?

Back 39

T7,8,9,10, and 11

Front 40

What nerve level is the subcostal nerve?

Back 40

T12

Front 41

What nerve levels innervate the region above the pubis?

Back 41

T12 (subcostal nerve) and L1

Front 42

The intercostal vessels bifurcate in the intercostal spaces and have branches running where?

Back 42

1. in the intercostal groove
2. collateral branches above the body of the subjacent rib

Front 43

The posterior intercostal arteries of the first 2 intercostal spaces arise from what and what do the rest arise from?

Back 43

1. first 2 arise from costocervical trunk (branch from subclavian artery)
2. all others arise from thoracic aorta

Front 44

The posterior intercostal veins drain into what?

Back 44

1. azygos vein (right)
2. hemiazygos (left)
3. some drain into brachiocephalic veins

Front 45

What do the anterior intercostal arteries and veins arise from?

Back 45

internal thoracic vessels

Front 46

What do the anterior intercostal vessels anastomose with and where do they do it?

Back 46

1. anastomose with post. vessels
2. happens in intercostal spaces around midclavicular line

Front 47

What supplies the skin over the sternum?

Back 47

1. perforating branches of the anterior intercostal vessels

Front 48

What is the internal thoracic artery a branch of?

Back 48

subclavian artery

Front 49

What does the internal thoracic artery run between?

Back 49

between transversus thoracis and the sternum

Front 50

What does the internal thoracic artery split into and when does it do it?

Back 50

1. splits into: superior epigastric artery (enters rectus sheath) and musculophrenic artery (follows attachment of diaphragm to the ribs)
2. happens around the xiphisternal joint

Front 51

The internal thoracic artery also sends branches to what areas?

Back 51

1. thymus
2. bronchi
3. pericardium

Front 52

Parasternal lymph nodes drain what?

Back 52

drain anterior region and also the medial aspect of the breast

Front 53

When would you need to examine the parasternal lymph nodes?

Back 53

if tumor is found in medial 1/2 of breast