Download SESSION 11 - Posterior Mediastinum, Diaphragm, Thoracic Wall

SESSION 11 - Posterior Mediastinum, Diaphragm,
Thoracic Wall And Respiration
1. At what vertebral levels does the descending thoracic aorta begin and end?
2. Name three structures that are supplied by arteries from the descending
thoracic aorta.
3. From which segments of the spinal cord do the sympathetic nerves arise?
4. Do the splanchnic nerves emerge from the medial or lateral side of the
sympathetic chain?
5. Do the splanchnic nerves synapse in the sympathetic chain?
6. What is the name of the postganglionic sympathetic fibres that rejoin the
spinal nerves to be distributed with them?
7. What are the root values of the greater, lesser and least splanchnic nerves?
8. Where do these nerves pass through the diaphragm?
9. What vertebral level does the oesophagus pass through the diaphragm? What
three other structures pass through with it?
10. Which crus of the diaphragm loops around the lower oesophagus and from
where does this crus arise?
11. Name three factors that probably contribute to preventing reflux of stomach
contents into the oesophagus.
12. The lower oesophagus is the site of a potentially important portosystemic
anastomosis. Which systemic and portal venous tributaries are involved?
13. In a patient with portal hypertension, what symptoms might suggest problems
in the lower oesophagus?
14. What two veins contribute to the formation of the azygos veins?
15. Through which orifice in the diaphragm do the azygos veins ascend?
16. What two other structures pass through this orifice?
17. Does the azygos vein drain into the inferior or superior vena cava?
18. If the azygos vein drains the right posterior chest wall, what drains the left
posterior chest wall?
19. How long is the thoracic duct? What other four structures in the body are the
same length?
20. At what vertebral level does the thoracic duct cross from right to left? Where
does it finish?
21. If the thoracic duct ruptures in the chest, what is the resulting condition called?
22. If the right phrenic nerve passes through the inferior caval opening of the
diaphragm at T8, how does the left phrenic pass through it?
23. What are the attachments of the medial and lateral arcuate ligaments of the
diaphragm?
24. Which is the highest rib/costal cartilage to which the diaphragm is attached?
25. What happens to the domes of the diaphragm on inspiration?
26. What structure(s) pass(es) posterior to the medial arcuate ligament?
27. How do you categorise the rib movements in the upper and lower chest? How
do the costotransverse joints differ to allow these two different movements?
28. Does the third rib articulate with
(a) its own body only
(b) its own body and the body below
(c) its own body and the body above
29. Which is the last rib that has its costal cartilage attaching directly to the
sternum?
30. Which two ribs do not have a synovial joint on their transverse processes?
31. Does the transverse process of a typical thoracic vertebra articulate with
(a) the head of the same numbered rib
(b) the tubercle of the same numbered rib
(c) the head of the rib below
(d) the tubercle of the rib below
(e) the head of the rib above
(f) the tubercle of the rib above
32. To which veins do the anterior intercostal veins drain?
33. In the subcostal groove the neurovascular bundle lies in the following order
from above down:
(a) Artery - vein - nerve
(b) Vein - nerve - artery
(c) Nerve - artery - vein
(d) Vein - artery - nerve
(e) Nerve - vein - artery
34. Which intercostal muscle does not reach the sternum but instead has an area of
membrane?
35. The intercostal neurovascular bundle can be damaged during cannulation of
the pleural cavity. The bundle lies
(a) Outside the external intercostal
(b) Between the external and internal intercostal
(c) Between the internal intercostal and the innermost intercostals
(d) Just inside the innermost intercostals
36. Which intercostal muscle has fibres the direction of which could be likened to
putting your hands in your pockets?
37. Name five 'accessory muscles of respiration'. Which of these, if any, require
the arms to be fixed to aid respiration?
38. Classify the type of joint (fibrous, cartilaginous, synovial, etc)
(a) First chondromanubial (costosternal)
(b) Manubriosternal
(c) Third chondrosternal (costosternal)
(d) Fourth costochondrial
(e) Sternoclavicular
(f) Articulation between the 8th and 7th costal cartilages