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II. Osteology
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4. The Thorax
The skeleton of the thorax or chest (Figs. 112, 113, 114) is an osseo-cartilaginous cage, containing and protecting the principal organs of respiration and circulation. It is conical in shape, being narrow above and broad below, flattened from before backward, and longer behind than in front. It is somewhat reniform on transverse section on account of the projection of the vertebral bodies into the cavity.   1


FIG. 113– The thorax from behind. (Spalteholz.) (See enlarged image)
 
 
Boundaries.—The posterior surface is formed by the twelve thoracic vertebræ and the posterior parts of the ribs. It is convex from above downward, and presents on either side of the middle line a deep groove, in consequence of the lateral and backward direction which the ribs take from their vertebral extremities to their angles. The anterior surface, formed by the sternum and costal cartilages, is flattened or slightly convex, and inclined from above downward and forward. The lateral surfaces are convex; they are formed by the ribs, separated from each other by the intercostal spaces, eleven in number, which are occupied by the Intercostal muscles and membranes.   2
  The upper opening of the thorax is reniform in shape, being broader from side to side than from before backward. It is formed by the first thoracic vertebra behind, the upper margin of the sternum in front, and the first rib on either side. It slopes downward and forward, so that the anterior part of the opening is on a lower level than the posterior. Its antero-posterior diameter is about 5 cm., and its transverse diameter about 10 cm. The lower opening is formed by the twelfth thoracic vertebra behind, by the eleventh and twelfth ribs at the sides, and in front by the cartilages of the tenth, ninth, eighth, and seventh ribs, which ascend on either side and form an angle, the subcostal angle, into the apex of which the xiphoid process projects. The lower opening is wider transversely than from before backward, and slopes obliquely downward and backward, it is closed by the diaphragm which forms the floor of the thorax.   3


FIG. 114– The thorax from the right. (Spalteholz.) (See enlarged image)
 
  The thorax of the female differs from that of the male as follows: 1. Its capacity is less. 2. The sternum is shorter. 3. The upper margin of the sternum is on a level with the lower part of the body of the third thoracic vertebra, whereas in the male it is on a level with the lower part of the body of the second. 4. The upper ribs are more movable, and so allow a greater enlargement of the upper part of the thorax.   4


 

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The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) sponsors USMLE.
The Three Steps of the USMLE
Step 1 tests the important concepts of basic sciences basic to the practice of medicine. It also places special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of the sciences that provide a foundation for the safe and competent practice of medicine. It also tests the scientific principles required for maintenance of competence through lifelong learning.
Step 2 CK tests the medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision. It also includes emphasis on health promotion and disease prevention. Step 2 CK ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills.
Step 2 CS tests your capacity to practice and provide good medical service in real-life situations. It also tests your communication skills.
Step 3 tests your medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.