Thoracic Body Wall & Vertebral Column Imaging Quiz Developed by: Sorcha McCaughley & Mark Brims Approved by: Alison King & Maureen Bain Supported by: The Chancellor’s Fund
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Thoracic Body Wall & Vertebral Column Imaging QuizDeveloped by: Sorcha McCaughley & Mark BrimsApproved by: Alison King & Maureen BainSupported by: The Chancellor’s Fund
Thoracic Body Wall & Vertebral Column Imaging Quiz
START!
Developed by: Sorcha McCaughley & Mark BrimsSupported by: The Chancellor’s Fund
Thoracic Body Wall
• Thoracic Inlet Q1• Diaphragm Q2• Ribcage Q3
Vertebral Column
• Typical Vertebra Q4 • Cervical Vertebrae Q5• Clinical Considerations
Q6
Thoracic Inlet Q1 • (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
Feline
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
Incorrect • 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.
Canine
Incorrect • No, the Thoracic Inlet is
not the Caudal boundary of the Thorax.
• The Caudal boundary is the Diaphragm.
• Try again!• Choose a new question.
Canine
Correct • 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.
Feline
Incorrect • 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 questio
n.
Incorrect • 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 questi
on.
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
Incorrect • 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 • 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 questio
n.
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
Correct • Yes! The Diaphragm
attaches to the Lumbar Vertebrae and Last Sternebra or Xiphoid.
• Try (ii)!• Choose a new question.
Feline
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.
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.
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.
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.
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
Correct • Yes! A dog has 13 pairs
of ribs!
• Here they are labelled in this x-ray.
• Try (ii)!• Choose a new question.
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.
Incorrect • No, the dog does not have 18 pairs of ribs.
• The horse has 18 pairs of ribs!
• Try again!• Choose a new question.
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.
Rib 5
T4 T5
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.
Rib 4
T3 T4
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
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.
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.
Incorrect • No, Rib 5 does have a distal attachment.
• It is Rib 13 that is the ‘Floating Rib’!
• Try again!• Choose a new question.
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.
AB
C
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
Vertebral Foramen
C1 or Atlas
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
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
Correct • Yes! (B) is the
Transverse Process!
• Here are more examples.
• Try (iii)!• Choose a new question.
Transverse Process
Transverse Process
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
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
Correct • Yes! (C) is the Dorsal
Spinous Process!
• Here are more examples.
• Try (iv)!• Choose a new question.
Spinous Process
Spinous Process
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
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
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.
Cervical Vertebrae Q5• (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
A
B
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
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
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
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.
Wings of Atlas
Atlas
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-Occipital
Atlanto-Axial
Occipito-Atlanto-Axial
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
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
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.
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.
Answer• The Spinal Cord is outlined after radiographic
contrast medium is injected into the Sub-Arachnoid Space .
• This can be achieved via the cisterna magna or in the lumbar region, as shown in this x-ray.
• This technique is called myelography and was used to assess the spinal cord before the advent of advanced imaging techniques such as MRI and CT.
• Back to the Start!
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