Ribs & Sternum | Thorax Anatomy MCQs Explained | NEET PG, FMGE, 1st MBBS | DR SUMIT GUPTA

Added: 2026-05-24

[00:00:00]Hello students, in today's video I'm going to discuss about the clinical scenario-based MCQ on the ribs and the sternum. So let's see one by one. So this is the first question. A 28-year-old man sustains his stab injury just anterior to first rib. So which area is there? If you'll see this question, the key point is anterior to the first rib near the root of the neck.

[00:00:29]Clear? Now you all know that now we are dealing with the posterior aspect of first strip. Now during surgical exploration multiple structure lies anterior to the neck of first rib.

[00:00:42]Clear? They are found to be damaged. So which of the following structure is most medially? Now dear students when you will have the first rib. Now in this image you can see that in front of the neck you will have four structure 1 2 3 and four. So when you will go from medial to lateral the most medial structure is sympathetic chain. Clear?

[00:01:05]Then you will have the vein then you will have artery and then you will have the nerve. So which is the most medial structure? Answer is sympathetic chain.

[00:01:14]That is your option B. Now we'll move to the next question. The next question is a patient with chronic obstructive pulmonary disease show increased side to side expansion of the thoracic cage during inspiration. That means here the question is about that to increase the transverse diameter of the chest wall.

[00:01:37]Now which of the ribs are responsible or which movement is responsible? So when you will dealing with the transverse diameter. Now in this image you can see that transverse diameter means side by side diameter because of the movements of the ribs like a bucket handle. So when the handle is going up and down it is increasing the side by side uh diameter or you can say transverse diameter. So it is known as bucket handle movement. Answer is B. Now we'll move to the next question that a 30-year-old man takes a deep breath during spyometry testing. Increase in the entroposterior diameter. Now the diameter is changed. Which diameter?

[00:02:22]Entroposterior diameter of the thorax during inspiration due to which mechanism. Now again when you will see this image. Now in this image you can see that this is your anterior and posterior aspect. So this is known as AP diameter. Now in this AP diameter your sternum is basically moving and this is because of uh it is very similar to the movement of your pump handle. So in the pump handle your pump is moving and uh up and down here the sternum is moving up and down and it is known as pump handle movement which is responsible for the increasing of entroposterior distance. Clear? Now we'll move to the next question. A 12 year old child present with the chest wall pain following trauma. Clear? Now X-ray shows injury at the junction between the first rib and its costal cartilage. So here in this image this is your first rib.

[00:03:23]Clear? And this is its first costal cartilage. So this junction we are talking about this junction which type of joint involved. So this is a example of primary cartilagenous joint. So it is a directly knowledge based question.

[00:03:39]This is a primary cartilagenous joint which is known as costtochondral joint.

[00:03:45]Clear? So this is about the first rib.

[00:03:48]Now we move to the next question. During cataric dissection a rib is found to articulate with only one thoracic vertebrae instead of two. Generally when you will have the typical rib the head of typical rib is having two facets to articulate with the two vertebral bodies. But here the question is it is articulating with only one thoracic vertebrae. So which is most likely being examined that means when you will have the ribs which rib is articulating with the one vertebral body. So these all are articulating with the two vertebral bodies and the first rib is having only a round head on the neck and it articulate with the T1. So answer is A.

[00:04:35]Clear? Now we move to the next question.

[00:04:38]Okay. Now here also you can examine this that here the head is having round. Now this round head articulate with the T1.

[00:04:47]But generally when you will have a typical rib, typical rib is having the head with the two facets. Clear? The lower facet is larger. Lower facet is larger. Then you will have the tubacle which is also having the facet for the transverse process. And when you will see the articulation here you can see that this these two facets are articulating with the two vertebral bodies. Clear? But this round head of the first rib articulate with one body only. Now the next question is a fracture involve the tubercal of typical rib. Where is the fracture? Tubercal of a rib. Now this injury may disrupt articulation with which vertebral structure. That means here in this image you can see that this is the tubercal. So the question is that the tubercal articulate with which part of the vertebrae? Now here you can see this is the vertebrae.

[00:05:44]Now here this is known as transverse process. Now this is the facet on the transverse process and these facets which are known as costal facets on transverse process articulate with the tubercal and we are dealing with the tubercal. So where it is the answer transverse process of above vertebrae transverse process of vertebrae below transverse process of the corresponding vertebrae body of the adjacent vertebrae. So this is not the answer.

[00:06:09]Now all the three are having the name transverse process. But again this become a tricky question because in this image if you can see this transverse process articulate with the same rib or upper rib or below rib in the same way it is the uh not ri here the it is vertebrae clear. So you have to be cautious enough that the same number of rib articulate with the costal facet of same number of vertebrae. Clear? So where is the answer? Answer is corresponding vertebrae. Answer is C. So the transverse process of the corresponding vertebrae that means if it is a fourth rib then it is the fourth thoracic vertebrae. Clear? Now we'll move to the next question. A thoracic surgeon identify a rib articulating with the transverse process of thoracic vertebrae during posterior thoracictomy.

[00:07:07]That means what you are able to understand that articulation of the transverse process of a thoracic vertebrae which of the rib it must be that means we are dealing with the rib which does not or you have to keep this thing in mind that the ribs which are having the absence of tubercles. So here the 11th and 12th these both are having no tubercles. So when tubercal is absent but obviously these both ribs are not going to articulate with the transverse process because transverse process of the vertebrae articulate with the tubercal but these both are not having the tubercal that means they are not going to articulate with the transverse process. So this is the question that you identify a rib articulating with the transverse process that means it is a first rib because when you will see the first rib first rib is having the tubercal and it articulate with the uh costal facet of transverse process of t1. So this is the answer first rib the 11th and 12th cannot be the answer because they are not having the tubercal so they cannot articulate with the transverse process. And the question is about identify the rib which is articulating uh with the transverse process. So for the transverse process what is the prerequisite presence of a tubercal. Now a medical student asked to identify thoracic vertebra during osteology viva. Which feature is most characteristic of thoracic vertebrae? So how to identify the thoracic vertebrae?

[00:08:51]Tell the first or most important characteristic feature. So heart-shaped vertebral body is not the characteristic feature of all the 12 vertebraes.

[00:09:01]Oblique spinus process presence of costal facet. Yes, this is the characteristic feature because this feature separates the thoracic vertebraes from cervical lumbar and sacral area. So when we are dealing about the most characteristic feature then you should always first say presence of costal facets. Now we'll move to the next question. A patient has injury to the head of the typical rib the lower larger facet of the head uh normally articulate with which part of the vertebral body. So you know that I just shown you that this is the head and this head is having the two facets which are divided by a crest. Clear? Now when you will see the facet you know that this lower facet is larger. Clear? And this larger facet articulate with which part of vertebral body. So here is inferior demifacet superior demifacet of corresponding vertebraes. Inferior demifacet of vertebrae above superior demifacet of vertebrae below. So here the first knowledge should be that this lower larger part always articulate with the upper or superior facet upper or superior demi facet on the vertebral body. That means these two options are not the answer because they are inferior. Now when suppose this is a uh fourth rib clear? Now this fourth rib is going to articulate with the third vertebral body and fourth vertebral body. Clear? So this is the T3 and this is the T4. So this fourth rib lower larger facet articulate with the corresponding vertebral body. So superior demi facet of corresponding vertebral body. The superior demifacet of vertebral below. No. If it is uh the third then it should not be the answer.

[00:10:58]So it is not matching actually it is superior demiaet because here the T4 will come and this superior demi facet of T4 articulating with the lower larger facet of fourth. Clear? So this is the answer. Now we'll move to the next question. During osteology examination a vertebral is identified as a lumbar vertebrae. Now which of the following structure is formed by the costal element of the lumbar vertebrae? Now dear students whenever you are having the side part or the lateral projection of a vertebrae we always deal with the two component costal element and transverse element. Now in the thoracic region you all know that we are having ribs that means the costal element develops as a rib but in the cervical lumbar and sacral region the ribs are absent and they are become the part of transverse process somewhere. So here we are dealing with the lumbar vertebrae.

[00:11:57]So which part of the lumbar ver vertebrae is actually representing the lumbar ribs which are actually absent.

[00:12:04]So answer is transverse process. The transverse process of lumbar vertebrae is not a true transverse process. It is basically the rudimentary ribs which we are labeled as a transverse process.

[00:12:16]Clear? So answer is C. Transverse process. Now we'll move to the next question. During osteological examination of a typical cervical vertebrae, it is a cervical vertebrae.

[00:12:28]Which of the following structure is determined the true transverse element?

[00:12:32]Now here you have to understand this thing that whenever we are dealing again the uh uh your ribs and your transverse processes you will find that in the cervical region the posterior part of forom and transverserium is actually the transverse element which is posterior part or posterior wall of the foram and transversarium represent the your transverse element. Clear? Now we'll move to the next question.

[00:13:02]A 30-year-old man sustained a fracture of the shaft of first rib. Now, which of the following correctly match the structure with the grooves on superior surface of first rib? Now, here when you will have the first rib. Now, this is your first strip. Clear? Now, in this first rib, suppose this is your scalenial tubercal. Clear? Now, behind the tubercal and in front of the tubercal, you are having the grooves.

[00:13:28]Now here you will have the attachment of a muscle is known as scalanous anterior which will go on the scalenial tubercal.

[00:13:36]Now we know that the scalenial tubercal muscle that means scalinous anterior divide the subclavian artery into the three part. So if you want to divide this artery into the three part the artery should be on the posterior side then and then this muscle can divide. So this anterior groove is for the vein and this posterior is for the artery and along the artery you will find the nerve also. So you have to find out the anterior groove for the artery. No, this anterior groove is for the vein. So anterior groove is for the vein. It could be the answer. Anterior groove for the nerve. No. Anterior groove for the artery. No. So answer is this B where you will have the anterior groove for the vein. Yes. Anterior is for subclav vein. posterior for the artery and the lower trunk. So answer is B. Clear? Now we'll move to the next question. Which of the following rib does not have a tubercal? I just told you that floating ribs are identified by the feature absence of tubercal. So this 11th is the floating rib. It does not have the tubercal. That's why it does not articulate with the transverse process.

[00:14:45]Now which of the following is not an example of primary cartilagenous joint?

[00:14:51]So costtochondral costtochondral I just told you it is a joint between the costal cartilage and shaft of the uh rib. So it is example of primary cartilagenus. First sternocooccal. Now the first sternocooccal is exception. It is the only primary cartilagenous.

[00:15:09]Remaining sternocooccostal are plain sinovial. So it is again example of primary cartilage. Zifisternal is also primary cartilagenous. Costtovertebral that means the joint between the head of the rib and the body of the vertebrae that is costtovertebral. It is a kind of sinovial joint. So it is not a primary cartilagenous joint. Now we'll move to the next question. A 45year-old man presents after a road traffic accident with multiple ri fracture. On examination, a segment of anterior chest wall moves inward during inspiration and outward during expiration. Now see, you have to keep this thing in mind that it goes inside during inspiration. But normally what will happen when you will take the inspiration the chest wall will bulge out. That means when I am taking the inspiration, this part should come out. But here it is going in and there is a outside movement when it is he is doing expiration. Now this is a reversal. It is known as paradox. What is that? It is known as paradox respiration. So this paradox respiration is a classically seen in the flyer chest. So why it happens? Because there is a multiple ribs fracture or you can say the rib is fractured at multiple sides. So the segment is now become free from anterior and posterior attachment and it is behave like a independent part. Now this independent part of the fractured area show the paradoxical movement that means reversal of the movement. So it is a characteristic of your flyal chest. So dear students, this is all about this session where I am able to uh deliver the important clinical scenario- based questions which may be asked in your university exams or in your competitive exams. But again the important thing is that whenever you are attempting these questions please use your knowledge because if the scenario will change definitely the option is going to change or the answer will change. So this is all for the session. You can scan uh I think today is not possible. So this is all for the session. I hope you will like the session. Thank you and bye-bye.