Thoracic Wall
How many true ribs, false ribs, and floating ribs make up the rib cage?
True: 7- 1st through 7th ribs
False: 3- 8th through 10th ribs
Floating: 2- 11th through 12th
Depending on the person the 10th rib may be false or floating
How many lobes does each lung have?
Right - 3
Left - 2
What determines whether the heart is considered left or right dominant?
Whether the posterior interventricular artery branches off of the RCA or LCA
The Mediastinum is compartmentalized into what three sections?
Superior mediastinum
Middle mediastinum
Posterior mediastinum
A client is suffering from an obstruction in their esophagus at the level of the esophageal hiatus of the diaphragm. The esophageal hiatus is at what vertebral level?
T10
I ate (inferior vena cava, T8), ten eggs (T10, esophagus), at noon (aorta, T12)
What are the three parts of the sternum?
Manubrium
Body of sternum
Xiphoid process
What are the names of the fissures of the left and right lungs?
Right: horizontal fissure and oblique fissure
Left: Oblique fissure
___________ is where the heart and the pericardium are housed?
Middle mediastinum
What is the ligamentum ateriosum (ductus arteriosus)?
Patent vessel during development that allows blood to bypass the lungs by shunting blood from the pulmonary trunk to the arch of the aorta.
Your patient presents to the ICU with a massive blockage in the inferior vena cava. The heart can still receive venous return because a vessel that is directly connected to the superior vena cava. What is this vessel?
Azygos vein
What joint is an important anatomical landmark known as the "sternal angle"
Manubriosternal joint
What two structures are unique to the left lung?
Lingula- at the inferior portion of the upper lobe, that is said to
be the remnant of the third lobe
Cardiac notch- where the heart is situated in relation to the
lung
What is the order of a signal being sent through the conducting system of the heart? (5 steps)
1. SA node
2. AV node
3. AV bundle
4. Left and Right bundle branches
5. Purkinje fibers
What are the branches of the aortic arch?
Brachiocephalic artery
L. common carotid
L. subclavian artery
the ABCS
True or False: Splanchnic nerves found in the posterior mediastinum carry only sympathetic fibers of the autonomic nervous system
True
What are the three types of muscles that make up the intercostal spaces and elevate/depress ribs during
breathing?
External intercostal m. (run anterior-inferiorly) “hands in pockets”
Internal intercostal m. (run posterior-inferiorly)
Innermost intercostal m. (run more vertically, but like the internal intercostal m.
The trachea bifurcates at what spinal level?
T4
True or false: The right ventricle has a thicker wall in comparison to the left
False, the left is thicker due to shunting of blood out to systemic circulation versus pulmonary circulation.
True or False: The left recurrent laryngeal nerve recurs on the aortic arch
True
Then it ascends into the tracheoesophageal groove
Your patient presents to the ER with a stab wound at T4. He is rushed into emergency surgery because of what structure being at risk of penetration?
Descending Aorta
Descending aorta starts at T4
What are the layers of the thoracic wall from most superficial (skin) to most deep (lung)?
Hint there are 10 including skin and lung
1. Skin
2. Subcutaneous tissue
3. External intercostal muscle
4. Internal intercostal muscle
5. Neurovascular Plane
6. Innermost intercostal muscle
7. Endothoracic Fascia
8. Parietal Pleura
9. Visceral Pleura
10. Lung
In the neurovascular plane the orientation is such that the intercostal vein is most superior, followed by
the intercostal artery, and lastly the intercostal nerve is most inferior.
The parietal pleura has four different names based on their immediate relationships, what are these four names?
1. Costal pleura
2. Cupula
3. Diaphragmatic Pleura
4. Mediastinal Pleura
What is the function of coronary ostia in the aortic valve?
This is where blood is shunted from the aortic valve to the circulation of the heart
What are the layers of the heart from most superficial to deep before hitting myocardium?
1. Fibrous pericardium
2. Parietal later of serous pericardium
3. pericardial fluid (in cavity)
4. Visceral layer of serous pericardium
5. Myocardium
Your client is experiencing dysfunction in esophageal peristalsis following a stroke. Because of this, a swallow study is ordered. The esophagus is at risk of constriction at several areas in the body. Which of the following areas could a potential obstruction form?
Where the esophagus is crossed by the arch of the aorta
Junction of the esophagus and the pharynx
Where the esophagus is crossed by the bronchus
All of the above
All of the above