Thorax S1M3

  1. What is pectus Excavatum
    Concave anterior wall deformity of the chest
  2. Pectus Carinatum
    Protrusion of the sternum and costal cartilages
  3. Flial Chest
    Trauma induced uncoupling of the chest from the wall of the rib cage, often caused by multiple rib fractures.
  4. What happens when one breaths with a flial chest
    There is paradoxical motion upon respiration with the trauma site protruding inward on inspiration and outward on expiration due to the loss of intra pleural pressure
  5. What is a thoracic outlet syndrome and what can it potentially effect
    This is a condition when structures like the Ulnar nerve, radial nerve, and subclavian vessels are compressed
  6. What are the true ribs and their characteristics
    1-7 They attach directly to the sternum
  7. What are the false ribs
    8-10 they are connected to the rib above them by cartilage
  8. What are the typical ribs and their features
    3-9 They have a head, neck, tubercle, and a body
  9. Why are the the 12th and 11th ribs atypical
    They have no neck, no tubercle, and only one facet on their head
  10. What is the weakest part of the ribs
    The portion just anterior to the angle
  11. What is the difference between a rib dislocation and a rib separation
    • Dislocation is a seperation from the sternum
    • Separation is a disconnection from the costal cartilage
  12. What is the angle of luis used for in a clinical setting
    To find the second rib
  13. The sternum is located where in regard to the vertebrae
  14. Where is a Xiphoid process located in relation to the vertebrae
  15. How can the Xiphoid be used as a landmark
    It is the location of the inferior border of the heart, the superior border of the liver, and the location of the central tendon of the diaphragm.
  16. Ankylosing Spondylitis
    Chronic inflammation of the joints of the axial skeleton, in many cases it limits the spinal range of motion
  17. What muscles are involved in normal inspiration
    • External intercostals
    • Serratus posterior superior
    • Levator costorum
  18. What are the muscles involved in forced inspiration
    • External intercostals
    • Scalenes
    • Sternocleidomastoid
  19. What are the muscles involved with forced expiration
    • Internal intercostals
    • Abdonimals
    • Serratus posterior inferior
  20. What does the contraction of the diaphragm cause
    It reduces the dome resulting in an increase in the the vertical dimension for inspiration
  21. When there is paralysis to one of the phrenic nerves (C3,4,5), what is likely to effected
    Paralysis of one of the domes of the diaphragm, causing it to move superiorly in inspiration instead of inferiorly like normal
  22. Where does the lymph go above the clavicle and below the clavicle
    • Above - Inferior jugular lymph nodes
    • Below - Parietal lymph nodes drain in to the axillary lymph nodes
  23. What levels of the vertebrae is the manubrium located
  24. What is the order of structures from external to the internal intercostal space
    • Skin
    • Superficial fascia
    • External intercostal muscles
    • Internal intercostal
    • Innermost intercostals
    • Endothoracic fascia
    • Parietal pleura
  25. What arteries branch from the descending aorta to feed the thoracic wall
    • Posterior intercostals
    • Subcostal artery
  26. What branches from the subclavian artery to feed the thoracic wall
    • Superior intercostal from costocervical trunk
    • Internal Thoracic artery
  27. Where do the anterior intercostal arteries branch from
    Internal thoracic arteries
  28. Where does the Lateral thoracic artery branch from
    Axillary artery
  29. The posterior intercostal arteries feed what
    3-11 intercostal spaces
  30. Where do the most posterior intercostal veins feed
    Azygos veins which is formed by the union of the lumbar veins
  31. What are the typical intercostal nerves and why
    3-6 they run in between the innermost innercostal muscles and the internal intercostals
  32. The 7-11 intercostal nerves continue on to become what
    Thoracoabdominal nerves
  33. How is the parietal pleura attached to the inside of the thoracic wall
    Endothoracic fascia
  34. What are the four different parietal pleurae
    • Cervical
    • Costal
    • Mediastinal
    • Diaphragmatic
  35. What and where is the sibson fascia (supra pleural membrane)
    It is located on the cervical pleura and is made of Endothoracic pleura
  36. What is the name of the endothoracic pleura attaching the diaphragm to the parietal pleura
    Phrenico-pleural fascia
  37. Visceral pleura is insensitive to pain but parietal pleura on the mediastinal and costal refer pain where
    • Mediastinal - Neck and the shoulder
    • Costal - Thoracic and abdominal wall
  38. What is pleuritis
    This is an inflammation of the pleurae that is painful and audible as one breaths
  39. Where is a pericardiocenthesis performed
    Between the fifth an sixth intercostal space near the sternum. Care should be taken to to damage the thoracic artery
  40. What is the importance of the sibson fascia
    It is a protection from wounds on the supraplueral membrane
  41. What are the three places in the inferior section of the thoracic wall where the pleura extends past and is therefore more available for trauma
    • Right part of the infrasternal angle
    • Right costovertebral angle
    • Left costovertebral angle
  42. Pleurodesis
    Obliteration of a pleural cavity by disease such as pleuritis, this may not effect function
  43. What is atelectasis and what is a method of treatment for it
    Spontaneous lung collapse, fusion of the parietal and visceral pleura to prevent lung collapse
  44. The jugular notch of the manubrium is located where in respect to the vertebrae
  45. The right azygos vein drains where
    Superior vena cava
  46. The left hemizygos and accesory hemiazygos drain where
    Into the right azygos vein
  47. Where does pleura become visceral pleura
    At the hilum of the lung
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Thorax S1M3