Important Mcqs and VIVA Points 

Total Page：16

File Type：pdf, Size：1020Kb

Important MCQs and VIVA Points Juglar notch is present at lower border of T2 vertebrae. Sternal angle is present at 2nd costal cartilage. Azygous vein arches over the root of right lung. Upper seven ribs are called as true ribs. The costal cartilage of 8 9 10 ribs merge and form vertebro chondral ribs. 11 and 12 ribs are floating ribs. Weakest point of ribs is its angle. Transverse diameter of thorax is greater than vertical diameter of thorax in adults. Thoracic inlet syndrome is due to the compression of subclavian artery and 1st thoracic nerve by sclaneu anterior or cervical rib. 1st rib have large tubercle and upper surface have many grooves. 11th and 12th ribs have pointed ends with no tubercle And neck Sternum is a flat bone. www.themedicalglobe.com / www.mgElearning.net Page 1 of 4 Joint between manubrium and sternum is secondary cartilagenous Joint of xiphisternum is primary cartilagenous. Typical ribs are 3-9. Typical vertebrae are 2-8. 1st thoracic vertebrae have horizontal spine. Costovertebral and intervertebral joint is plane synovial joint. Costochondral joint is primary cartilagenous joint. At costovertebral joint both movements occue that is pump handle and bucket handle movement. The tubercle has a smooth articular part for articulating with the corresponding transverse process of the vertebra and a rough nonarticular part for attachment of the costotransverse ligament The surface of the 1st rib has two transversely directed shallow grooves, anterior and posterior to the scalene tubercle, for the subclavian vein and the subclavian artery respectively The sternoclavicular joint is a saddle-type synovial joint IMP SEQ’S Thoracic inlet with its contents Thoracic outlet and its contents Joints of thoracic wall www.themedicalglobe.com / www.mgElearning.net Page 2 of 4 Movement of thoracic wall i.e pump handle and bucket handle Chest pain Flail chest Supernumerary ribs Thoracic outlet syndrome Sternal anomalies Copyright: Medical Globe 2020 www.themedicalglobe.com / www.mgElearning.net Page 3 of 4 www.themedicalglobe.com / www.mgElearning.net Page 4 of 4.

Copy Link

Recommended publications

The Structure and Function of Breathing
CHAPTERCONTENTS The structure-function continuum 1 Multiple Influences: biomechanical, biochemical and psychological 1 The structure and Homeostasis and heterostasis 2 OBJECTIVE AND METHODS 4 function of breathing NORMAL BREATHING 5 Respiratory benefits 5 Leon Chaitow The upper airway 5 Dinah Bradley Thenose 5 The oropharynx 13 The larynx 13 Pathological states affecting the airways 13 Normal posture and other structural THE STRUCTURE-FUNCTION considerations 14 Further structural considerations 15 CONTINUUM Kapandji's model 16 Nowhere in the body is the axiom of structure Structural features of breathing 16 governing function more apparent than in its Lung volumes and capacities 19 relation to respiration. This is also a region in Fascla and resplrstory function 20 which prolonged modifications of function - Thoracic spine and ribs 21 Discs 22 such as the inappropriate breathing pattern dis- Structural features of the ribs 22 played during hyperventilation - inevitably intercostal musculature 23 induce structural changes, for example involving Structural features of the sternum 23 Posterior thorax 23 accessory breathing muscles as well as the tho- Palpation landmarks 23 racic articulations. Ultimately, the self-perpetuat- NEURAL REGULATION OF BREATHING 24 ing cycle of functional change creating structural Chemical control of breathing 25 modification leading to reinforced dysfunctional Voluntary control of breathing 25 tendencies can become complete, from The autonomic nervous system 26 whichever direction dysfunction arrives, for Sympathetic division 27 Parasympathetic division 27 example: structural adaptations can prevent NANC system 28 normal breathing function, and abnormal breath- THE MUSCLES OF RESPIRATION 30 ing function ensures continued structural adap- Additional soft tissue influences and tational stresses leading to decompensation.
[Show full text]
Paravertebral Block: Anatomy and Relevant Safety Issues Alberto E Ardon1, Justin Lee2, Carlo D
Paravertebral block: anatomy and relevant safety issues Alberto E Ardon1, Justin Lee2, Carlo D. Franco3, Kevin T. Riutort1, Roy A. Greengrass1 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, 2Department of Anesthesiology, Olympia Anesthesia Associates, Providence St. Peter Hospital, Olympia, WA, 3Department of Anesthesiology and Pain Management, John H. Review Article Stroger Jr. Hospital of Cook County, Chicago, IL, USA Korean J Anesthesiol 2020;73(5):394-400 Paravertebral block, especially thoracic paravertebral block, is an effective regional anes- https://doi.org/10.4097/kja.20065 thetic technique that can provide significant analgesia for numerous surgical procedures, pISSN 2005–6419 • eISSN 2005–7563 including breast surgery, pulmonary surgery, and herniorrhaphy. The technique, although straightforward, is not devoid of potential adverse effects. Proper anatomic knowledge and adequate technique may help decrease the risk of these effects. In this brief discourse, we discuss the anatomy and technical aspects of paravertebral blocks and emphasize the im- Received: February 10, 2020 portance of appropriate needle manipulation in order to minimize the risk of complica- Revised: March 5, 2020 tions. We propose that, when using a landmark-based approach, limiting medial and later- Accepted: March 15, 2020 al needle orientation and implementing caudal (rather than cephalad) needle redirection may provide an extra margin of safety when performing this technique. Likewise, recog- Corresponding author: nizing a target that is not in close proximity to the neurovascular bundle when using ultra- Alberto E Ardon, M.D., M.P.H. sound guidance may be beneficial. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 Keywords: Anatomy; Paravertebral; Postoperative pain; Regional anesthesia; Safety; Trun- San Pablo Rd, Jacksonville, FL 32224, USA cal nerve block.
[Show full text]
Ligaments of the Costovertebral Joints Including Biomechanics, Innervations, and Clinical Applications: a Comprehensive Review W
Open Access Review Article DOI: 10.7759/cureus.874 Ligaments of the Costovertebral Joints including Biomechanics, Innervations, and Clinical Applications: A Comprehensive Review with Application to Approaches to the Thoracic Spine Erfanul Saker 1 , Rachel A. Graham 2 , Renee Nicholas 3 , Anthony V. D’Antoni 2 , Marios Loukas 1 , Rod J. Oskouian 4 , R. Shane Tubbs 5 1. Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies 2. Department of Anatomy, The Sophie Davis School of Biomedical Education 3. Department of Physical Therapy, Samford University 4. Neurosurgery, Complex Spine, Swedish Neuroscience Institute 5. Neurosurgery, Seattle Science Foundation Corresponding author: Erfanul Saker, [email protected] Abstract Few studies have examined the costovertebral joint and its ligaments in detail. Therefore, the following review was performed to better elucidate their anatomy, function and involvement in pathology. Standard search engines were used to find studies concerning the costovertebral joints and ligaments. These often- overlooked ligaments of the body serve important functions in maintaining appropriate alignment between the ribs and spine. With an increasing interest in minimally invasive approaches to the thoracic spine and an improved understanding of the function and innervation of these ligaments, surgeons and clinicians should have a good working knowledge of these structures. Categories: Neurosurgery, Orthopedics, Rheumatology Keywords: costovertebral joint, spine, anatomy, thoracic Introduction And Background The costovertebral joint ligaments are relatively unknown and frequently overlooked anatomical structures [1]. Although small and short in size, they are abundant, comprising 108 costovertebral ligaments in the normal human thoracic spine, and they are essential to its stability and function [2-3].
[Show full text]
Netter's Musculoskeletal Flash Cards, 1E
Netter’s Musculoskeletal Flash Cards Jennifer Hart, PA-C, ATC Mark D. Miller, MD University of Virginia This page intentionally left blank Preface In a world dominated by electronics and gadgetry, learning from ﬂ ash cards remains a reassuringly “tried and true” method of building knowledge. They taught us subtraction and multiplication tables when we were young, and here we use them to navigate the basics of musculoskeletal medicine. Netter illustrations are supplemented with clinical, radiographic, and arthroscopic images to review the most common musculoskeletal diseases. These cards provide the user with a steadfast tool for the very best kind of learning—that which is self directed. “Learning is not attained by chance, it must be sought for with ardor and attended to with diligence.” —Abigail Adams (1744–1818) “It’s that moment of dawning comprehension I live for!” —Calvin (Calvin and Hobbes) Jennifer Hart, PA-C, ATC Mark D. Miller, MD Netter’s Musculoskeletal Flash Cards 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 NETTER’S MUSCULOSKELETAL FLASH CARDS ISBN: 978-1-4160-4630-1 Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this book may be produced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system, without permission in writing from the publishers. Permissions for Netter Art figures may be sought directly from Elsevier’s Health Science Licensing Department in Philadelphia PA, USA: phone 1-800-523-1649, ext. 3276 or (215) 239-3276; or e-mail [email protected].
[Show full text]
Basic Biomechanics
Posture analysis • A quick evaluation of structure and function • Doctor views patient from behind (P-A) and from the side (lateral) • References points of patient’s anatomy relative to plumb (a position of balance) 9/3/2013 1 Posture analysis • Lateral View – Knees (anterior, posterior, plumb, genu recurvatum) – Trochanter (anterior, posterior, plumb) – Pelvis (anterior, posterior, neutral pelvic tilt) – Lumbar lordosis (hypo-, hyper-, normal) – Mid-axillary line (anterior, posterior, plumb) – Thoracic kyphosis (hyp-, hyper- normal) – Acromion (anterior, posterior, plumb) – Scapulae (protracted, retracted, normal) – Cervical lordosis (hypo-, hyper-, normal) – External auditory meatus (anterior, posterior, plumb) – Occiput (extended, neutral, flexed) 9/3/2013 2 Posture analysis • Posterior – Anterior View – Feet (pronation, supination, normal) – Achilles tendon (bowed in/out, normal) – Knees (genu valga/vera, normal - internal/external rotation) – Popliteal crease heights (low, high, level) – Trochanter heights (low, high, level) – Iliac crest heights (low on the right/left, normal) – Lumbar scoliosis (right/left, or no signs of) – Thoracic scoliosis (right/left, or no signs of) – Shoulder level (low on the right/left, or normal) – Cervical scoliosis (right/left, or no signs of) – Cervical position (rotation, tilt, neutral) – Mastoid (low on the right/left, or normal) 9/3/2013 3 …..poor postures 9/3/2013 4 Functional Anatomy of the Spine • The vertebral curvatures – Cervical Curve • Anterior convex curve (lordosis) develop in infancy
[Show full text]
MULTIPLE OSSIFIED COSTAL CARTILAGES for 1ST RIB Raghavendra D.R
International Journal of Anatomy and Research, Int J Anat Res 2014, Vol 2(4):744-47. ISSN 2321- 4287 Case Report DOI: 10.16965/ijar.2014.538 MULTIPLE OSSIFIED COSTAL CARTILAGES FOR 1ST RIB Raghavendra D.R. *1, Nirmala D 2. *1 Post graduate student, Department of anatomy, J J M Medical College, Davangere, Karnataka, India. 2 Associate Professor, Department of anatomy, J J M Medical College, Davangere, Karnataka, India. ABSTRACT Costal cartilages are flattened bars of hyaline cartilages. All ribs except the last two, join with the sternum through their respective costal cartilages directly or indirectly. During dissection for 1st MBBS students in the Department of Anatomy, JJMMC, Davangere, variation was found in a male cadaver aged 45 –50 years. Multiple ossified costal cartilages for 1st rib were present on left side. There were 3 costal cartilages connecting 1st rib to manubrium. There were two small intercostal spaces between them. The lower two small costal cartilages fused together to form a common segment which in turn fused with large upper costal cartilage. The large upper costal cartilage forms costochondral joint with 1st rib. All costal cartilages showed features of calcification. The present variation of multiple ossified costal cartilages are due to bifurcation of costal cartilage. It may cause musculoskeletal pain, intercostal nerve entrapment or vascular compression. Awareness of these anomalies are important for radiologists for diagnostic purpose and for surgeons for performing various clinical and surgical procedures. KEYWORDS: Costal cartilage, bifurcation of Rib, Sternum. Address for Correspondence: Dr. Raghavendra D.R. Post graduate student, Department of anatomy, J J M Medical College, Davangere, 577004, Karnataka, India.
[Show full text]
1 the Thoracic Wall I
AAA_C01 12/13/05 10:29 Page 8 1 The thoracic wall I Thoracic outlet (inlet) First rib Clavicle Suprasternal notch Manubrium 5 Third rib 1 2 Body of sternum Intercostal 4 space Xiphisternum Scalenus anterior Brachial Cervical Costal cartilage plexus rib Costal margin 3 Subclavian 1 Costochondral joint Floating ribs artery 2 Sternocostal joint Fig.1.3 3 Interchondral joint Bilateral cervical ribs. 4 Xiphisternal joint 5 Manubriosternal joint On the right side the brachial plexus (angle of Louis) is shown arching over the rib and stretching its lowest trunk Fig.1.1 The thoracic cage. The outlet (inlet) of the thorax is outlined Transverse process with facet for rib tubercle Demifacet for head of rib Head Neck Costovertebral T5 joint T6 Facet for Tubercle vertebral body Costotransverse joint Sternocostal joint Shaft 6th Angle rib Costochondral Subcostal groove joint Fig.1.2 Fig.1.4 A typical rib Joints of the thoracic cage 8 The thorax The thoracic wall I AAA_C01 12/13/05 10:29 Page 9 The thoracic cage Costal cartilages The thoracic cage is formed by the sternum and costal cartilages These are bars of hyaline cartilage which connect the upper in front, the vertebral column behind and the ribs and intercostal seven ribs directly to the sternum and the 8th, 9th and 10th ribs spaces laterally. to the cartilage immediately above. It is separated from the abdominal cavity by the diaphragm and communicates superiorly with the root of the neck through Joints of the thoracic cage (Figs 1.1 and 1.4) the thoracic inlet (Fig.
[Show full text]
Rib Mobilizations Kat Hayes, SPT
Rib Mobilizations Kat Hayes, SPT A) Anatomy a. 12 Thoracic Vertebrae i. Superior facet facets anteraior/lateral ii. Inferior facet facets posterior/medial iii. Plane of motion alows more lateral flexion but limited due to ribs iv. T2-10 have a superior and inferior demifacet where rib articulates with two vertebrae b. 12 Ribs i. Costovertebral facet 1. T2-10 rib head has an inferior and superior facet to articulates with 2 vertebrae 2. T1, T11-12 articulates with only one costal facet 3. Kinematics: gliding and rotation ii. Costotransverse Joint 1. Tubercle of rib articulates with on transverse processes 2. Kinematics: gliding wih some rotation c. Sternum i. Ribs 1-7 attach at sternum via costochondral joint ii. Ribs 8-10 articulate to costal cartilage iii. Ribs 11, 12 are not attached B) Young et al. mapped referral patterns for costotransverse joint patterns a. 8 asymptomatic male subjects b. Received consecutive, same day injections to either right T2,4,6 or to their left T3,5,7 c. OmnipaqueTM was injected using fluoroscopy into joint d. Subects were asked to desribe the pian using given descriptors and also VAS including description of referred pain C) Indications a. Rib or Thoracic hypomobility b. Pain c. Shallow breathing D) Contraindications a. Rib fracture b. Osteoperosis c. Hypermobility d. Malignancy e. Systemic inflamitory disease f. Ligamentous laxity E) Precautions a. Pulmonary Disease b. Severe Scoliosis c. Spinal fussion d. Pregnancy F) Assessment a. While patients sitting, assess breathing patern and palpate ribs for movement during inhilation/exhalation i. Are they a chest or belly breather ii.
[Show full text]
Spondyloarthropathies and Reactive Arthritis
RHEUMATOLOGY SPONDYLOARTHRITIS ROBERT L. DIGIOVANNI, DO, FACOI PROGRAM DIRECTOR LMC RHEUMATOLOGY FELLOWSHIP [email protected] DISCLOSURES •NONE SERONEGATIVE SPONDYLOARTHROPATHIES SLIDES PREPARED BY GENE JALBERT, DO SENIOR RHEUMATOLOGY FELLOW THE SPONDYLOARTHROPATHIES: • Ankylosing Spondylitis (A.S.) • Non-radiographic Axial spondyloarthropathies (nr-axSpA) • Psoriatic Arthritis (PsA) • Inflammatory Bowel Disease Associated (Enteropathic) • Crohn and Ulcerative Colitis • +/- Microscopic colitis • Reactive Arthritis (ReA) • Juvenile-Onset SpA • Others: Bechet’s dz, Celiac, Whipples, pouchitis. THE FAMOUS VENN DIAGRAM: SPONDYLOARTHROPATHY: • First case of Axial SpA was reported in 1691 however some believe Ramses II has A.S. • 2.4 million adults in the United States have Seronegative SpA • Compare with RA, which affects about 1.3 million Americans • Prevalence variation for A.S.: Europe (0.12-1%), Asia (0.17%), Latin America (0.1%), Africa (0.07%), USA (0.34%). • Pathophysiology in general: • Responsible Interleukins: IL-12, IL17, IL-22, and IL23. SPONDYLOARTHROPATHY: • Axial SpA: • Radiographic (Sacroiliitis seen on X- ray) • No Radiographic features non- radiographic SpA (nr-SpA) • Nr-SpA was formally known as undifferentiated SpA • Peripheral SpA: • Enthesitis, dactylitis and arthritis • Eventually evolves into a specific diagnosis A.S., PsA, etc. • Can be a/w IBD, HLA-B27 positivity, uveitis SHARED CLINICAL FEATURES: • Axial joint disease (especially SI joints) • Asymmetrical Oligoarthritis (2-4 joints). • Dactylitis (Sausage
[Show full text]
The M. Transversus Thoracis in Man and Monkey
Okajimas Fol. anat. jap., 48: 103-137, 1971 The M. Transversus Thoracis in Man and Monkey By Jun-ichiro Satoh Department of Anatomy, Faculty of Medicine, Nagasaki University, Nagasaki, Japan Received for publication, December 2, 1970— Of the Mm. thoracis proprii and profundi in man, the muscles that run across the ribs in the most inner layer of the thoracic wall have been termed the Mm. subcostales by Eisler. Of these, the group of muscles located in the mid-anterior chest are the Mm. transversi thoracis while those in the posterior chest are the Mm. subcostales in the narrow sense. The purpose of the present report is to describe the M. transversus thoracis in man and monkey, especially the nerve supply to these muscles which has not yet been documented in detail. The material of study consisted of bodies of adult Japanese (24 cases), Crab-eating monkey (Macaca irus, 15 cases) and Formosan mon- key (Macaca cyclopis, 15 cases). The condition on both sides of the body was examined with magnifying lenses having an illumination attach- ment. Findings I. Mm. transversi thoracis in man In man, the Mm. transversi thoracis were found to be flat, narrow muscles which are multiform being quite variable in shape. In the region of the lateral edge of the sternum, especially at the xiphoid process, they were united each other so that the muscles particularly the lower ones, frequently form so-called muscular digitation, the tip being the attachment to the rib (figures 1 and 2). 1. This muscle arose by tendon from the rib in the area of the costo- chondral joint, that is, from the region extending from the lateral tip of the costal cartilage to the bony rib.
[Show full text]
The Vertebral Column Is 33 Vertebrae Held Together by Ligaments and Muscles, with Intervertebral Discs in Between
The vertebral column is 33 vertebrae held together by ligaments and muscles, with intervertebral discs in between. The vertebral column provides support and upright posture (attenuates loads) for the body. It is also a site for many muscle attachments. There are natural curves in the spine to help with the support and posture, as well as increasing the flexibility of the spine. The 33 vertebrae are divided into 5 sections, with each group having unique features designed for specific purposes. The groups are: cervical (7), thoracic (12), lumbar (5), sacrum (5), and coccyx (4). All vertebrae have a body, 2 transverse processes, a spinous process, superior/inferior articulating facets, lamina, pedicle, and a vertebral foramen. 1 There are anterior convex curves in the cervical and lumbar spines. Posterior concave curves occur in the thoracic and sacral-coccygeal spines. The curves of the spine may increase/decrease as the body’s center of gravity shifts (ex: pregnancy, weight gain/loss, trauma)—this is a result of trying to maintain in the upright position, the brain over the body’s center of gravity. 2 Scoliosis—excessive lateral curvature; side to side Kyphosis—hunchback; excessive curvature of thoracic Lordosis—swayback ; excessive curvature of lumbar 3 C1 and C2 are shaped differently than the other 5 cervical vertebrae to permit the head to rotate. C1 (atlas) = holds up the world (head) and is missing a body; it articulates with the occipital bone as well as rotating around the odontoid process (dens) of the C2 vertebrae (atlantoaxial joint). The atlantoaxial joint is what type of joint?? C2 (axis) = odontoid process projects up C3-C7 = the body is small and all the processes are short and blunted.
[Show full text]
Student Workbook Answer Pages Italicized Page Numbers After the Answers Indicate Where the Informa- Matching 5) Deep Fascia Tion Can Be Found in Trail Guide
Student Workbook Answer Pages Italicized page numbers after the answers indicate where the informa- Matching 5) deep fascia tion can be found in Trail Guide. 1) N adipose—p. 17 6) adipose (fatty) tissue 2) F aponeurosis—p. 13 7) superficial fascia 3) D artery—p. 16 8) skin 4) H bone—p. 10 9) deep fascia Introduction 5) E bursa—p. 16 Tour Guide Tips #1, p. 1 6) B fascia—p. 14 1) bony landmarks—p. 2 7) G ligament—p. 13 2) Even though the topography, 8) I lymph node—p. 17 Navigating shape and proportion are unique, 9) A muscle—p. 11 Regions of the Body, p. 6 the body’s composition and struc- 10) J nerve—p. 17 1) pectoral tures are virtually identical on all 11) K retinaculum—p. 15 2) axillary individuals.—p. 2 12) L skin—p. 10 3) brachial 3) To examine or explore by touch- 13) M tendon—p. 13 4) cubital ing (an organ or area of the body), 14) C vein—p. 16 5) abdominal usually as a diagnostic aid—p. 4 6) inguinal 4) locating, aware, assessing—p. 4 Exploring Textures #1, p. 3 7) pubic 5) directs movement, depth.—p. 4 1) epidermis 8) femoral 6) • read the information 2) dermis 9) facial • visualize what you are trying 3) arrector pili muscle 10) mandibular to access 4) sweat gland 11) supraclavicular • verbalize to your partner what 5) hair follicle 12) antecubital you feel 6) blood vessels 13) patellar • locate the structure first 7) muscle fibers 14) crural on yourself 8) endomysium 15) cranial • read the text aloud 9) perimysium 16) cervical • be patient—p.
[Show full text]