Questionnaire
1. The boundaries of the thoracic inlet are:
a. Posterior the body of the first thoracic vertebra
b. Anterior the superior border of the manubrium of the sternum
c. Posterior the spinous process of the first thoracic vertebra
d. Anterior the xifoid process of the sternum
e. Lateral the medial surface of the first rib
2. The boundaries of the thoracic outlet are:
a. Posterior the body of the seventh thoracic vertebra
b. Posterior the body of the twelfth thoracic vertebra
c. Anterior the xifoid process of the sternum
d. Anterior and lateral the joined cartilage of the seventh to twelve ribs
e. Lateral the medial surface of the seventh rib
3. The intrinsic muscles of the thorax are:
a. Transversus thoracis
b. Serratus anterior
c. Serratus posterior superior
d. Levatores costarum
e. Supracostalis
4. What are the actions of the intrinsic muscles of the thorax?
a. Only depress the ribs
b. Only elevate the ribsc. Depress and elevate the ribs
d. Their main action is to stiffen the thoracic wall
e. Lateral movements of the thoracic wall
5. The innervation of the intrinsic muscles of the thorax is done by:
a. Posterior rami of the thoracic spinal nerves for all of them
b. Intercostal nerves for all of them
c. Branches of the anterior rami of the thoracic spinal nerves for all of them
d. Branches of the posterior rami of the thoracic spinal nerves for all of them
e. Posterior rami of the thoracic spinal nerves only for levatores costarum
6. What are the characteristics of the intercostals muscles?
a. The external intercostals muscles are thinner then the internal intercostals muscles
b. They are innervated by the lateral thoracic nerve
c. There are twelve pairs that extend from the inferior margin of one rib to the superior margin of the one inferior to it
d. There are eleven pairs that extend from the inferior margin of one rib to the superior margin of the one inferior to it
e. The external intercostals muscles fibbers have a postero-anterior direction while the muscular fibbers of the internal intercostals have an antero-posterior direction
7. What are the attachments of the transversus thoracis muscles?
a. Originates from the posterior surface of lower sternum
b. Insertion on the internal surface of costal cartilages 2–6
c. Origin superior borders of 2nd or 3rd ribs
d. Insertion on the transverse processes of T7–11
e. Insertion on the superior borders of 2nd or 3rd ribs
8. What are the attachments of the serratus posterior superior muscle?
a. Its main point of attachment is on the lateral surface of the first six ribs just lateral to their angles
b. Its main point of attachment is on inferior segment of the nuchal ligament then the spinous processes of the seventh cervical and superior two or three thoracic vertebrae
c. Muscular fibbers have a descending path till the angles of the second-fifth ribs where they attach
d. Muscular fibbers have a descending path till the costal cartilages of the second-fifth ribs where they attach
e. The fibbers have an ascending path till the nuchal line where they attach
9. The extrinsic muscles of the thorax are:
a. Serratus posterior
b. Serratus anterior
c. Pectoralis major
d. Trapezius
e. Intercostals
10. What are the attachments of the serratus anterior muscle?
a. Anterior from the external surface and superior border of the first eight to ten ribs
b. Anterior from the first five costal cartilages
c. Lateral and posterior to the lateral border of the scapula
d. Lateral and posterior to the posterior (dorsal) surface of the scapula
e. Lateral and posterior to the medial border of the scapula
11. The innervation of the serratus anterior muscle is done by:
a. Medial pectoral nerve
b. Lateral pectoral nerve
c. Long thoracic nerve
d. Axillary nerve
e. Musculocutaneous nerve
12. When does ‘winging’ of the scapula happen?
a. When the serratus anterior muscle is very contracted
b. When the serratus anterior muscle is paralysed
c. When the pectoralis major muscle is very contracted
d. When the pectoralis minor muscle is very contracted
e. When the pectoralis major muscle is paralysed
13. What are the attachments of the trapezius muscle?
a. Superior it attaches to the medial third of the superior nuchal line of the parietal bone
b. Superior it attaches to the medial third of the superior nuchal line of the occipital bone
c. Superior it attaches to the spinous processes of the vertebras C7 till T12
d. Medial it attaches to the spinous processes of the vertebras C7 till T12
e. Inferior on the lateral surface of the ribs
14. The innervation of the trapezius muscle is done by:
a. Vagus nerve
b. Intercostal nerves
c. Branches from the posterior rami of C3 and C4
d. Accessory nerve
e. Branches from the anterior rami of C3 and C4
15. What are the attachments of the pectoralis major muscle?
a. Superior it attaches at the level of the medial half of the anterior surface of the clavicle
b. Superior it attaches at the level of the acromion process of the scapula
c. Medial it attaches at the level of the first seven costal cartilages
d. Lateral it attaches at the level of the lateral lip of the intertubercular sulcus of the humerus
e. Lateral it attaches at the level of the medial lip of the intertubercular sulcus of the humerus
16. The innervation of the pectoralis major muscle is done by:
a. Long thoracic nerve
b. Lateral pectoral nerve
c. Intercostal nerves
d. Accessory nerve
e. Medial pectoral nerve
17. What are the attachments of the pectoralis minor muscle?
a. Medial can attach on the superior margins and lateral surfaces of the third, fourth and fifth ribs
b. Medial can attach on the superior margins and lateral surfaces of the second, third and fourth ribs
c. Lateral at the level of acromion process of the scapula
d. Lateral at the level of coracoid process of the scapula
e. Lateral at the level of the spine of the scapula
18. The relations of the pectoralis minor muscle are:
a. Posterior with pectoralis major muscle
b. Lateral with the lateral pectoral nerve
c. Posterior with the lateral pectoral nerve
d. Anterior with the lateral pectoral nerve
e. Posterior with serratus anterior muscle
19. The relations of the pectoralis minor muscle are:
a. Anterior with pectoralis major muscle
b. Lateral with the external intercostal muscles
c. Posterior with the axilla
d. Anterior with the lateral pectoral nerve
e. Posterior with the brachial plexus
20. The innervation of the pectoralis minor muscle is done by:
a. Branches of the medial pectoral nerve
b. Branches of the lateral pectoral nerve
c. Vagus nerve
d. Intercostal nerves
e. Accessory nerve
21. The manubrium of the sternum has the following features:
a. Jugular notch located on the inferior border, median located
b. Clavicular notches located on the superior border, lateral to the jugular notch
c. Costal facets for the articulation with the first three ribs
d. Costal facet for the articulation with the first rib and a demifacet for the articulation with the second rib
e. Only the first costo-sternal articulation is a fibrous synarthrosis
22. The body of the sternum has the following features:
a. The junction between the body and the xiphoid process, the Louis angle
b. On the lateral border, there are four articulated facets for the second till the fifth rib
c. On the lateral border, there are four articulated facets for the third till the sixth rib and a demifacet for articulation with the second rib
d. The junction between the manubrium and the body, the Louis angle
e. On the lateral border, inferiorly there is the articulation with the seventh rib
23. What muscles attach on the sternum?
a. Pectoralis minor
b. Pectoralis major
c. Anterior scalene muscle
d. Transversus thoracis
e. The aponeuroses of internal oblique
24. What are the features of the first rib?
a. It has a superior and inferior surface
b. It has a superior and inferior border
c. The superior surface is marked by two grooves
d. On the superior border there is a tubercle, scalene tubercle
e. Through the groove located anterior to the scalene tubercle travels the subclavian vein
25. What are the features of a typical rib?
a. Concave surface facing laterally
b. Convex surface facing laterally
c. The head of the rib is located at the level of the sternal end
d. The neck of the rib is located at the level of the vertebral end
e. On the inferior border, located medial to it there is a groove for the intercostal bundle
Answers
1. a, b
2. b, c
3. a, c
4. c, d
5. b, c
6. d, e
7. a, b
8. b, c
9. b, c, d
10. a, e
11. c
12. b
13. b, d
14. d, e
15. a, c, d
16. b, e
17. a, b, d
18. d, e
19. a, c, e
20. a, b
21. a, d, e
22. c, d, e
23. b, d, e
24. a, c, e
25. b, d, e
