Thoracic Anatomy Quiz

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Questions and Answers

Which of the following pairs of structures are correctly matched with their categories?

  • Trachea - Viscera (correct)
  • Left subclavian artery - Muscles
  • Thymus - Vessels
  • Sternothyroid - Nerves

Which structure is not considered a large vessel passing through the thoracic inlet?

  • Right and left brachiocephalic veins
  • Brachiocephalic artery
  • Left common carotid artery
  • Right internal thoracic artery (correct)

Which of the following statements accurately describes the role of the phrenic nerves?

  • They provide sensory innervation to the thoracic wall.
  • They are involved in the blood supply to the lungs.
  • They innervate the diaphragm and assist in respiration. (correct)
  • They control the muscles of the neck.

Which anatomical structure serves as a boundary or support within the thoracic cavity?

<p>Manubrium sterni (D)</p> Signup and view all the answers

Which of the following nerves is not part of the listed nerves associated with the thoracic inlet?

<p>Left cervical nerve (A)</p> Signup and view all the answers

What is the primary structural component defining the posterior aspect of the thoracic cage?

<p>Twelve thoracic vertebrae (C)</p> Signup and view all the answers

Which ribs are classified as floating ribs?

<p>Eleventh and twelfth ribs (A)</p> Signup and view all the answers

What type of joints facilitate thoracic cage movements during breathing?

<p>Costovertebral and costotransverse joints (B)</p> Signup and view all the answers

Which ribs directly connect to the sternum via cartilage?

<p>Only the upper seven ribs (B)</p> Signup and view all the answers

Which term describes the ribs that attach to the superior rib cartilage?

<p>Vertebrochondral ribs (D)</p> Signup and view all the answers

What forms the costal margin?

<p>The costal cartilages of the seventh to tenth ribs (B)</p> Signup and view all the answers

What is a characteristic of the anterior ends of the eleventh and twelfth ribs?

<p>They are defined as floating ribs (B)</p> Signup and view all the answers

How many ribs are considered false ribs?

<p>5 (A)</p> Signup and view all the answers

What anatomical structure creates a partition at the inlet of the thorax?

<p>Sibson's fascia (B)</p> Signup and view all the answers

Which of the following best describes the angle of the thoracic inlet?

<p>Approximately 45° (A)</p> Signup and view all the answers

Which describes the relationship of Sibson's fascia in relation to other structures?

<p>Fused to the cervical pleura and related to lung apex (D)</p> Signup and view all the answers

What is the primary function of Sibson's fascia at the thoracic inlet?

<p>To stiffen the thoracic inlet during breathing (B)</p> Signup and view all the answers

Which of the following dimensions characterizes the thoracic inlet?

<p>Transverse diameter of 10-12.5 cm (B)</p> Signup and view all the answers

What potential symptoms can arise due to a cervical rib exerting traction on the brachial plexus?

<p>Abnormal sensations along the ulnar border of the forearm (C)</p> Signup and view all the answers

What is the main result of coarctation of the aorta in terms of arterial changes?

<p>Enlargement of the posterior intercostal arteries (A)</p> Signup and view all the answers

Which anatomical structure is primarily associated with thoracic inlet syndrome?

<p>First thoracic nerve (B)</p> Signup and view all the answers

What anatomical component forms the boundary of the inferior aperture of the thorax anteriorly?

<p>Infrasternal angle between the two costal margins (C)</p> Signup and view all the answers

What structural change occurs due to a tortuous intercostal artery?

<p>Notching in the ribs, primarily their posterior parts (B)</p> Signup and view all the answers

How does a cervical rib affect the upper limb's muscular function?

<p>It leads to wasting of small hand muscles supplied by T1 (A)</p> Signup and view all the answers

What separates the thoracic cavity from the abdominal cavity?

<p>The diaphragm (C)</p> Signup and view all the answers

Which of the following notches is associated with vascular compression due to a cervical rib?

<p>Notching in the ribs (C)</p> Signup and view all the answers

What is the primary function of the thorax?

<p>Increase and decrease intrathoracic pressure (B)</p> Signup and view all the answers

At what level does the tenth rib lie?

<p>Third lumbar vertebra (A)</p> Signup and view all the answers

Which costal cartilage attaches to the sternal angle?

<p>Second costal cartilage (C)</p> Signup and view all the answers

Where is the apex beat typically located?

<p>Left fifth intercostal space (B)</p> Signup and view all the answers

What is the anatomical position of the nipple in adult males?

<p>Fourth intercostal space, 10cm from the midsternal line (C)</p> Signup and view all the answers

The thoracic vertebrae can be palpated along which line?

<p>Posterior median line (A)</p> Signup and view all the answers

Which of the following structures forms the anterior portion of the thorax?

<p>Sternum (C)</p> Signup and view all the answers

What line passes vertically through the midinguinal point?

<p>Midclavicular line (D)</p> Signup and view all the answers

Which opening in the diaphragm is responsible for the passage of the inferior vena cava?

<p>Vena Caval Opening (D)</p> Signup and view all the answers

What effect on contraction is associated with the passage of structures through the oesophageal opening?

<p>Constriction (A)</p> Signup and view all the answers

Which vessel passes through the diaphragm at the level of the 9th costal cartilage?

<p>Musculophrenic Artery (B)</p> Signup and view all the answers

Which of the following structures does NOT pass through any opening in the diaphragm?

<p>Pulmonary arteries (D)</p> Signup and view all the answers

Which opening is located behind the median arcuate ligament?

<p>Aortic Opening (B)</p> Signup and view all the answers

What is the primary structure that passes through the rounded opening of the diaphragm?

<p>Thoracic Duct (A)</p> Signup and view all the answers

Which rib does NOT have a costal cartilage that attaches to the sternum?

<p>Rib 11 (D)</p> Signup and view all the answers

The diaphragm separates which two body cavities?

<p>Abdominal and thoracic (C)</p> Signup and view all the answers

What is the significance of the sternal angle in anatomical assessments?

<p>It is used as a point for counting ribs. (D)</p> Signup and view all the answers

At which vertebral level is the suprasternal notch located?

<p>At the lower border of the second thoracic vertebra. (C)</p> Signup and view all the answers

Which structures surround the sternal angle, making it a critical landmark?

<p>The descending aorta and trachea bifurcation. (B)</p> Signup and view all the answers

What anatomical structure marks the formation of the xiphisternal joint?

<p>The connection between the xiphoid process and the body of the sternum. (B)</p> Signup and view all the answers

What key anatomical feature can be palpated in the suprasternal notch?

<p>The trachea. (C)</p> Signup and view all the answers

The xiphisternal joint is located at which anatomical reference point?

<p>The junction of the costal margins. (D)</p> Signup and view all the answers

Which of the following is NOT a function of the thoracic cage?

<p>Facilitating abdominal organ mobility. (C)</p> Signup and view all the answers

The sternal angle corresponds anteriorly to which anatomical feature?

<p>The second costal cartilage. (C)</p> Signup and view all the answers

What causes rib fractures in adults?

<p>Indirect violence at the ribs' angle (A)</p> Signup and view all the answers

Which of the following accurately describes the shape of the thorax in infants under two years old?

<p>Circular (B)</p> Signup and view all the answers

During which physiological process does the diaphragm descend?

<p>Inhalation (C)</p> Signup and view all the answers

Why is the thoracic cavity often perceived as smaller than its physical dimensions?

<p>Narrow upper part and encroachment by the abdomen (C)</p> Signup and view all the answers

What role does the diaphragm play in inspiration?

<p>It descends to increase vertical diameter (B)</p> Signup and view all the answers

What anatomical feature primarily protects the upper two ribs?

<p>Clavicle (C)</p> Signup and view all the answers

Which characteristic distinguishes thoracic respiration in adults from that in infants?

<p>Adults have both abdominal and thoracic respiration (C)</p> Signup and view all the answers

What common condition results from spasmodic contractions of the diaphragm?

<p>Hiccups (A)</p> Signup and view all the answers

Flashcards

Thoracic Inlet

The superior opening of the thoracic cavity, connecting it to the neck. It's shaped like a kidney and measures about 10-12.5 cm wide and 5 cm front to back.

Thoracic Inlet: Anterior Boundary

The front boundary of the thoracic inlet is the upper edge of the manubrium sterni (breastbone).

Thoracic Inlet: Posterior Boundary

The back boundary of the thoracic inlet is the upper surface of the first thoracic vertebra (back bone).

Thoracic Inlet: Lateral Boundaries

The sides of the thoracic inlet are formed by the first rib on each side, together with its cartilage.

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Sibson's Fascia (Suprapleural Membrane)

A membrane that partially separates the chest from the neck, covering each half of the thoracic inlet. It acts like a stabilizer for the neck during breathing.

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Trachea

The windpipe; carries air to and from the lungs.

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Esophagus

The tube that carries food from the mouth to the stomach.

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Lung Apices

The topmost portion of the lungs, extending into the neck.

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Thymus

A gland located in the chest that plays a role in immune system development, particularly in children.

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What is the thorax?

The thorax, also known as the thoracic cage, is a bony and cartilaginous structure that protects the heart and lungs.

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What are costal cartilages?

The costal cartilages are flexible attachments between the ribs and the sternum, allowing for chest expansion during breathing.

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What are the ribs and their relationship to the scapula?

The ribs form the sides of the thorax and are numbered from 1 to 12, with the lowest rib being the 12th. The scapula (shoulder blade) overlaps ribs 2-7 on the back.

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What are thoracic vertebrae?

The thoracic vertebrae are bones that make up the spine's thoracic region. They are located in the middle of the back.

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What is the sternum?

The sternum, also known as the breastbone, forms the front part of the thorax. It is made of three parts: the manubrium, the body, and the xiphoid process.

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What is the nipple's location?

The nipple is a landmark on the chest, typically located in the fourth intercostal space in men.

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What is the apex beat and where is it found?

The apex beat is a visible and palpable pulse caused by the heart's contraction. It is typically located in the left fifth intercostal space.

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Where is the trachea located?

The trachea is a tube that carries air to and from the lungs. It can be felt in the suprasternal notch, located between the clavicles.

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Posterior Thoracic Cage

The posterior wall of the thoracic cage is made up of 12 thoracic vertebrae interconnected by intervertebral discs.

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Lateral Thoracic Cage

The 12 ribs and their associated cartilages create the lateral walls of the thoracic cage.

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True Ribs

The upper seven ribs connect directly to the sternum via costal cartilages, forming the "true ribs."

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False Ribs

The eighth, ninth, and tenth ribs attach indirectly to the sternum by connecting to the cartilage of the superior rib, forming "false ribs."

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Floating Ribs

The last two ribs, the eleventh and twelfth, do not articulate with the sternum, hence the term "floating ribs."

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Costal Margin

The costal cartilages of the seventh, eighth, ninth, and tenth ribs create a sloping edge at the lower margin of the thoracic cage.

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Joints of the Thoracic Cage

The articulations of the thoracic cage - costovertebral, costotransverse, manubrio-sternal, and chondrosternal joints - enable breathing movements.

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Floating Ribs (Anterior)

The anterior ends of ribs 11 and 12 are free-floating and are also known as floating or vertebral ribs.

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What is a cervical rib?

A rib that attaches to the seventh cervical vertebra (C7), found in about 0.5% of people.

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How does a cervical rib affect the brachial plexus?

The brachial plexus is a network of nerves that supplies the arm. When a cervical rib is present, it can put pressure on this plexus.

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What is coarctation of the aorta?

A condition where the aorta, the main artery carrying blood from the heart, narrows.

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How do intercostal arteries change in coarctation?

When the aorta is narrowed, blood flow to the body is restricted. The body compensates by increasing the size of the intercostal arteries, which normally supply the spaces between the ribs.

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What happens to the ribs in coarctation?

The enlarged intercostal arteries can leave small indentations, or notches, on the ribs.

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What is thoracic inlet syndrome?

A condition where the subclavian artery and the first thoracic nerve are compressed as they pass between the first rib and the clavicle.

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What is the inferior aperture of the thorax?

The inferior aperture is the opening at the bottom of the rib cage that connects the chest cavity to the abdomen.

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What is the diaphragm's role in the inferior aperture?

The diaphragm is a large, dome-shaped muscle that separates the chest cavity from the abdomen. It plays a vital role in breathing.

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Vena Caval Opening

A large opening in the diaphragm that allows the inferior vena cava, right phrenic nerve, and lymph vessels of the liver to pass through.

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Esophageal Opening

A large opening in the diaphragm that allows the esophagus, both vagal trunks, and left gastric vessels to pass through.

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Aortic Opening

A large opening in the diaphragm that allows the aorta, thoracic duct, and azygos vein to pass through.

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Space of Larrey

A smaller opening in the diaphragm that allows the superior epigastric artery to pass through.

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Diaphragm Contraction: Effect on Thoracic Cavity

The diaphragm contracts and flattens, increasing the volume of the thoracic cavity and facilitating inhalation.

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Diaphragm Relaxation: Effect on Thoracic Cavity

The diaphragm relaxes and moves upward, reducing the volume of the thoracic cavity and facilitating exhalation.

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Effect of Diaphragm Contraction on Vena Caval Opening

Structures passing through the vena cava opening dilate with each contraction of the diaphragm.

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Effect of Diaphragm Contraction on Esophageal Opening

Structures traversing the esophageal opening constrict with each contraction of the diaphragm.

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Thorax Shape

The chest is a truncated cone, narrow at the top and broad at the bottom. The diaphragm separates the thoracic cavity from the abdominal cavity.

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Respiration in infants vs. adults

In infants, the ribs are horizontal and their respiration is driven by the diaphragm (abdominal breathing). In adults, the ribs are oblique, allowing for both abdominal and thoracic breathing.

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Diaphragm function

The diaphragm descends during inspiration, increasing the vertical diameter of the thoracic cage, allowing for more air intake.

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What are hiccups?

Hiccups are caused by involuntary contractions of the diaphragm while the glottis is closed, making a characteristic sound.

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Rib fracture location

The angle of the rib is its weakest point, where fractures are most common in adults.

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Rib fractures in children

Rib fractures are less common in children due to the highly elastic nature of their chest walls.

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Rib fracture protection

The upper two ribs are protected by the clavicle, and the lower two ribs are more free to move, which makes the middle ribs most susceptible to injury.

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Thorax shape in different species

The anteroposterior diameter of the chest is greater than the transverse diameter in quadrupeds. However, in infants, the thorax is circular, while in adults, it is oval with a greater transverse diameter.

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Suprasternal Notch (Jugular Notch)

The uppermost part of the chest, located right above the superior border of the manubrium, between the clavicles. It marks the beginning of the trachea.

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Sternal Angle (Angle of Louis)

A prominent bony ridge on the sternum, approximately 5 cm below the suprasternal notch, marking the junction between the manubrium and the body of the sternum. It's crucial for counting ribs.

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Xiphisternal Joint

The point where the xiphoid process connects with the body of the sternum. It marks the lower end of the sternum and the junction of the costal margins.

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Thoracic Cage

The bony structure that protects the chest cavity, formed by the ribs, sternum, and thoracic vertebrae. It supports the rib cage.

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Thoracic Cavity

The space enclosed by the thoracic cage, containing vital organs like the lungs and heart.

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Sternum (Breastbone)

The central structure of the chest, made of three parts: manubrium, body, and xiphoid process. It is responsible for protecting the heart.

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Ribs

The curved bones that form the sides of the chest, attached to the vertebrae in the back and the sternum in the front. They help protect vital organs and allow breathing.

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Study Notes

Thorax Overview

  • The thorax (Latin for chest) forms the upper part of the trunk.
  • It encloses and protects vital organs like the heart and lungs.
  • It is separated from the abdomen by the diaphragm.
  • The thorax is composed of bones, cartilage, and muscles.

Thoracic Inlet

  • The narrow upper opening of the thorax.
  • Formed by the superior border of the first rib, the first thoracic vertebra, and the upper border of the manubrium sterni.
  • Approximately 5 cm wide.
  • The superior thoracic aperture is continuous with the neck.

Thoracic Outlet

  • Formed by the inferior border of the 1st rib, the clavicle and the superior margin of the first thoracic vertebra.
  • Structures that pass through:
    • Subclavian artery
    • Subclavian vein
    • Phrenic nerves

Thoracic Cage Shape and Construction

  • The shape of the thorax in the transverse section is reniform (bean-shaped) or kidney shaped depending on the individual.
  • The thorax is wider in its superior aspect.
  • Children's thorax is more circular and has a relatively shorter transverse diameter.
  • The width of the thorax increases with age

Soft Tissue Landmarks

  • Nipple: Position varies between sexes (typically located at the level of the fourth intercostal space, 9cm medially to the midclavicular line).
  • Apex Beat: Located at the level of the left fifth intercostal space.
  • Trachea: Located midway between the two clavicles.

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