Thoracic Body Wall & Vertebral Column Imaging Quiz

1. Thoracic Body Wall & Vertebral Column Imaging Quiz Developed by: SorchaMcCaughley & Mark Brims Approved by: Alison King & Maureen Bain Supported by: The Chancellor’s Fund

2. Thoracic Body Wall & Vertebral Column Imaging Quiz START! Developed by: Sorcha McCaughley & Mark Brims Supported by: The Chancellor’s Fund

3. Thoracic Body Wall Thoracic Inlet Q1 Diaphragm Q2 Ribcage Q3 Vertebral Column Typical Vertebra Q4 Cervical Vertebrae Q5 Clinical Considerations Q6

4. Thoracic Inlet Q1 Feline • (i) Which boundary of the Thoracic Cavity is formed by the Thoracic Inlet? • Cranial • Lateral • Caudal • (ii) Which bone forms the dorsal boundary of the Thoracic Inlet? • 2nd thoracic vertebra • 7th cervical vertebra • 1st thoracic vertebra • (iii) What forms the ventral boundary of the thoracic inlet? • 2nd sternebra • Xiphoid • Manubrium

5.  Correct  • Yes! The Thoracic Inlet is the Cranial border of the Thorax! • It is shown here in these x-rays. • Try (ii)! • Choose a new question. Feline Canine

6.  Incorrect  Canine • No, the Thoracic Inlet is not the Lateral boundary of the Thorax. • The Ribs (arrows) and Muscles make up the Lateral boundaries. • Try again! • Choose a new question.

7.  Incorrect  Canine • No, the Thoracic Inlet is not the Caudal boundary of the Thorax. • The Caudal boundary is the Diaphragm. • Try again! • Choose a new question.

8. Yes! The dorsal boundary of the Thoracic Inlet is formed by the 1st Thoracic Vertebra! It is shown here in these x-rays. Orange = Cervical vertebrae Blue = 1st Thoracic vertebra Try (iii)! Choose a new question.  Correct  Feline

9. No, the 2nd Thoracic Vertebra does not form the dorsal boundary of the Thoracic Inlet . The 2nd Thoracic vertebra is shown in this x-ray Try again! Choose a new question.  Incorrect 

10. No, the 7th Cervical Vertebra does not form the dorsal boundary of the Thoracic Inlet . The 7th Cervical vertebra is shown in this x-ray Try again! Choose a new question.  Incorrect 

11.  Correct  • Yes! The ventral boundary of the Thoracic Inlet is formed by the Manubrium or 1st Sternebra! • This is shown in this x-ray. • Try (iv)! • Choose a new question. Feline

12. No, the ventral boundary of the Thoracic Inlet is not formed the 2nd sternbra. The 2nd sternebra is shown in this x-ray. Try again! Choose a new question.  Incorrect 

13. No, ventral boundary of the Thoracic Inlet is not formed the Xiphoid. The Xiphoid or last sternebra is shown in this x-ray. Try again! Choose a new question.  Incorrect 

14. Diaphragm Q2 • (i) What are the attachments of the Diaphragm? • Thoracic vertebrae & Sternebrae • Lumbar vertebrae & Xiphoid • Abdominal wall • (ii) During which stage of respiration does the diaphragm flatten caudally towards the abdomen? • Inspiration • Expiration Canine

15.  Correct  Feline • Yes! The Diaphragm attaches to the Lumbar Vertebrae and Last Sternebra or Xiphoid. • Try (ii)! • Choose a new question.

16.  Incorrect  • No, the Diaphragm does not attach to the Thoracic Vertebrae and Sternebrae. • The Diaphragm forms the caudal boundary of the thoracic cavity so these structures are located too far cranial • Try again! • Choose a new question.

17.  Incorrect  • No, the Diaphragm does not attach to the Abdominal Wall. • Remember: the Diaphragm is the most important muscle involved in respiration and needs to be securely attached to bone! • The abdominal wall is composed of muscle and soft tissue only. • Try again! • Choose a new question.

18.  Correct  • Yes! The Diaphragm flattens caudally during Inspiration. • When the Diaphragm contracts during inspiration, it flattens. This increases the volume of the thoracic cavity which draws air into the lungs. • Try Q3 on the Ribcage! • Choose a new question.

19.  Incorrect  • No, the Diaphragm does not flatten caudally during expiration. • Remember: during expiration, the volume of the thoracic cavity reduces and air is moved out of the lungs. The Diaphragm relaxes and becomes dome shaped , bulging cranially into the ribcage. • Try again! • Choose a new question.

20. Ribcage Q3 • (i) How many pairs of ribs does a dog have? • 14 • 13 • 18 • (ii) Which of these is one of the proximal articulations of Rib 5? • Head of Rib  Cranial Costal Fovea of Thoracic Vertebra 5 • Head of Rib  Cranial Costal Fovea of Thoracic Vertebra 4 • Tuberculum  Transverse Process of Thoracic Vertebra 6 • (iii) What is the distal articulation of Rib 5? • Costal Arch • No attachment – ‘Floating Rib’ • Inter-sternal Cartilage Canine

21.  Correct  • Yes! A dog has 13 pairs of ribs! • Here they are labelled in this x-ray. • Try (ii)! • Choose a new question.

22.  Incorrect  • No, the dog does not have 14 pairs of ribs. • Pigs can have 14-16 pairs of ribs! • Try again! • Choose a new question.

23.  Incorrect  • No, the dog does not have 18 pairs of ribs. • The horse has 18 pairs of ribs! • Try again! • Choose a new question.

24.  Correct  • Yes! The Head of Rib 5 articulates with the Cranial Costal Fovea of Thoracic Vertebra 5! • The Head of Rib 5 also articulates with the Caudal Costal Fovea of Rib 4. • The Heads of Ribs 11-13 only articulate with the Cranial Costal Fovea of their corresponding Vertebrae. • Try (iii)! • Choose a new question. T4 T5 Rib 5

25.  Incorrect  • No, the Head of Rib 5 does not articulate with the Cranial Costal Fovea of Thoracic Vertebra 4. • It is the head of rib 4 that articulates with the cranial costal fovea of T4 and also the caudal costal fovea of T3. • Try again! • Choose a new question. T3 T4 Rib 4

26.  Incorrect  • No, the Tuberculum of Rib 5 does not articulate with the Transverse Process of Rib 6. • The Tuberculum of Rib 5 articulates with the Transverse Process of Rib 5! • Try again! • Choose a new question. T5 Rib 5

27.  Correct  • Yes! The distal attachment of Rib 5 is to the Inter-Sternal Cartilage! • This is true of Ribs 1-9 • The Inter-Sternal Cartilage is not usually visible on x-rays as it is not a bony structure. • Ribs 10-12 attach to the Costal Arch and Rib 13 is a ‘Floating Rib’. • Move on to the Vertebral Column! • Choose a new question.

28.  Incorrect  • No, the distal attachment of Rib 5 is not to the Costal Arch. • Ribs 10-12 attach to the Costal Arch! • Try again! • Choose a new question.

29.  Incorrect  • No, Rib 5 does have a distal attachment. • It is Rib 13 that is the ‘Floating Rib’! • Try again! • Choose a new question.

30. Typical Vertebra Q4 • (i) What is A? • Vertebral Foramen • Obturator Foramen • Intervertebral Foramen • (ii) What is B? • Dorsal Spinous Process • Vertebral Arch • Transverse Process • (iii) What is C? • Transverse Process • Dorsal Spinous Process • Body of Vertebra • (iv) Do you know where in the spine this vertebra is from? How can you tell? • Answer. C B A

31.  Correct  • Yes! (A) is the Vertebral Foramen! • Here are more examples. • Remember – the spinal cord runs through here • Try (ii)! • Choose a new question. Vertebral Foramen C1 or Atlas Vertebral Foramen

32.  Incorrect  • No, (A) is not the Obturator Foramen. • Remember: the Obturator Foramen is found in the Pelvis! • Try again! • Choose a new question. Obturator Foramen

33.  Incorrect  • No, (A) is not the Intervertebral Foramen. • The Intervertebral Foramen is shown in this x-ray. • Remember : it is located between adjacent vertebra • Try again! • Choose a new question. Intervertebral Foramen

34.  Correct  • Yes! (B) is the Transverse Process! • Here are more examples. • Try (iii)! • Choose a new question. Transverse Process Transverse Process

35.  Incorrect  • No, (B) is not the Dorsal Spinous Process. • The Dorsal Spinous Process is shown in these x-rays. • Try again! • Choose a new question. Spinous Process Spinous Process

36.  Incorrect  • No, (B) is not the vertebral Arch. • The Vertebral Arch is shown in these x-rays. • Try again! • Choose a new question. Vertebral Arch Vertebral Arch

37.  Correct  • Yes! (C) is the Dorsal Spinous Process! • Here are more examples. • Try (iv)! • Choose a new question. Spinous Process Spinous Process

38.  Incorrect  • No (C) is not the Transverse Process. • The Transverse Process is shown in these x-rays. • Try again! • Choose a new question. Transverse Process Transverse Process

39.  Incorrect  • No, (C) is not the Body of the Vertebra. • The Body of the Vertebra is shown in these x-rays. • Try again! • Choose a new question. Vertebral Body Vertebral Body

40. Answer • This Vertebra is from the Thoracic region of a cat. • You can tell because of the long dorsal spinous process, the very short transverse processes and the presence of ribs (arrow)! • Try Cervical Vertebrae Q5! • Choose a new question.

41. Cervical Vertebrae Q5 A • (i) What is A? • C2 • C1 • (ii) What is another name for B? • Axis • Atlas • (iii) Which of the following allows ‘universal ’ movement between the skull and the vertebral column? • Atlanto-Occipital Joint • Atlanto-Axial Joint • Occipito-Atlanto-Axial Complex B

42.  Correct  • Yes! A is the first cervical vertebra or C1! • Here are x-rays of C1 • Try (ii)! • Choose a new question. C1 Transverse processes or ‘Wings’ of C1

43.  Incorrect  • No, A is not C2 which is the 2nd cervical vertebra! • These x-rays show C2. • Try again! • Choose a new question. C2 C2

44.  Correct  • Yes! B is the 2nd cervical vertebra or C2 which is also known as the Axis! • These x-rays show the Axis. • Try (iii)! • Choose a new question. Axis Axis

45.  Incorrect  • No, B is not also known as the Atlas. • These x-rays show the Atlas. • Remember: It is the 1st cervical vertebra or C1 that is known as the atlas. • Try again! • Choose a new question. Atlas Wings of Atlas

46.  Correct  • Yes! It is the Occipito-Atlanto-Axial Complex that allows universal movement. • The combination of flexion between the skull & C1 + rotation between C1 & C2 allows full movement of the skull relative to the vertebral column while protecting the spinal cord from damage • Try Clinical Considerations Q6! • Choose a new question. Atlanto-Axial Atlanto-Occipital Occipito-Atlanto-Axial

47.  Incorrect  • No, the Atlanto-Occipital Joint does not allow ‘universal’ movement • Movement at this joint is restricted to flexion and extension • Remember: this is the ‘yes’ joint as it allows nodding of the head! • Try again! • Choose a new question. Atlanto-Occipital joint

48.  Incorrect  • No, the Atlanto-Axial Joint does not allow ‘universal’ movement • Movement at this joint is restricted to lateral rotation • Remember: this is the ‘no’ joint as it allows shaking of the head! • Try again! • Choose a new question. Atlanto-Axial

49. Clinical Considerations Q6 • Do you know what space the needle is in? • Answer. • What structure is outlined when radiographic contrast medium is injected into the subarachnoid space? • Answer.

50. Answer • The needle is in the Cisterna Magna. • A Cerebro-Spinal Fluid sample can be taken from this area. • Radiographic contrast medium can be injected to help visualise soft tissue structures not normally seen in x-rays. • Try (ii)! • Choose a new question.