1.1 Resp anatomy ppt Flashcards
Respiratory system is divided into 2 at the level of the vocal cord what is it divided into ? & what does each contain
- URT: nasal cavity, paranasal sinuses, pharynx, larynx above vocal cords
- LRT: larynx below the vocal cords, trachea, bronchi, bronchioles
How is the respiratory system separated functionally ?
conduction & respiratory zone
Conduction portion contains what ?
Respiratory portion contains what ?
- What does thoracic cage protect ?
- what does it provide attachment for ?
boundaries of thoracic cavity :
1. posteriorly
2. anteriorly
3. laterally
4. inferiorly
How does thoracic cavity communicate with the following structures ?
1. root of the neck
2. abdomen
- opening = superior thoracic aperture
- inferior thoracic aperture (closed by diaphragm )
3 features of typical thoracic vertebrae ?
- medium-sized body that increases in size from superior to inferior
- vertebral foramen is circular
- spinous processes oriented
inferiorly and posterior
Typical thoracic vertebrae articular with ribs how?
- 2 demi facets
- costal facet
2 demi facets :
1. where ?
2. articulate with what ?
- superior and inferior on either side of vertebral body
- heads of the ribs
costal facet on transverse process articualtes with what ?
tubercle of corresponding rib
What is the sternal angle ?
a clinically useful feature of the manubriosternal joint is that it can be palpated easily
Sternal angle marks the site of what ?
articulation of rib II with the sternum
why is RIb I not palpable ?
It lies inferior to the clavicle and is embedded in tissues at the base of the neck
What are the 3 types of ribs ?
- true (ribs 1-7 , connect directly to sternum via corresponding costal cartilages)
- flase (ribs 8-10, attached anteriorly to each other and to the 7th rib by means of their costal cartilages)
- floating (ribs 11 & 12 , end free in the abdominal musculature)
Typical ribs ?
1st rib features ?
- broad,
- has tubercle for scalenus anterior muscle on upper surface
- grooves for the subclavian vessels and lower trunk of brachial plexus.
2nd rib features ?
- thinner and longer than 1st rib;
- roughened upper surface for serratus anterior.
10th rib features ?
- head has a single facet for articulation with its own vertebra.
11th & 12th rib features ?
- short and do not articulate anteriorly;
- heads have single facets for vertebral articulation.
Joints of the ribs are mostly what ?
synovial joints
Joints of the ribs …. (lecture mentions)
Usual rib fractures happen where and are due to what ?
- middle ribs
- crush injuries/ direct trauma
complications of rib fractures ?
soft tissue injury from broken fragments risk of damage to lungs, spleen or diaphragm
what is flail chest ?
If 2+ fractures occur in 2+ adjacent ribs, the affected area is not under control of the thoracic muscles - paradoxical movement during lung inflation and deflation
What does flail chest impair & what happens to the blood ?
- impairs expansion of the ribcage
- decreases oxygen content of the blood
From skin to pleura what is the order ?
- skin
- superficial fascia
- intercostal muscles (external then internal)
- endothoracic pleura
- pleura (plarietal then visceral)
what are the 3 intercostal muscles supplied by intercostal nerves of the intercostal space ?
- external intercostal (inspiration)
- internal intercostal (expiration)
- innermost intercostal (expiration)
How is neurovascular bundle in the subcostal groove of the ribs arranged from above downward ?
Vein , Artery , Nerve
VAN
what is structure of diaphragm ?
dome shaped, musculo-tendinous
Functions of diaphragm ?
- separates thoracic cavity from abdominal cavity
- contraction & relaxtion - alters volume of thoracic cavity and lungs
- primary muscle of inspiration and expiration
- help raise intrathoracic / abdominal pressure
Attachments of the diaphragm ?
a sternal part - from the xiphoid process.
* a costal part - lower six ribs and their costal
cartilages.
* a vertebral part - crura and arcuate ligaments
* all three insert into a central tendon, which is shaped like three leaves
why is the right dome of the diaphram higher than the left ?
liver positioning
3 openings of the diaphram ?
- caval aperture (T8)
- oesophageal aperture (T10)
- Aortic aperture (T12)
Nerve supply of the diaphragm ?
- right & left phrenic nerves
- cervical plexus
- C3,C4,C5
What does the shoulder and diaphragm share ?
common nerve supply
phrenic and supraclavicular nerves have shared cerical origins - C3, C4
what is Kehr’s sign ?
left shoulder pain that is caused by the irritation of the phrenic nerve on the inferior surface of the diaphragm due to bleeding from a splenic rupture
Primary blood supply to the diaphragm ?
inferior phrenic arteries: branch directly
from the abdominal aorta
Apart from inferior phrenic arteries what else supplies blood to the diaphragm ?
- superior phrenic (thoracic aorta branches)
- pericardiacophrenic and musculophrenic (internal thoracic branches)
How can someone have diaphragmatic hernia ?
- congenital - diaphragm doesn’t develop properly - results in a hole in the diaphragm
- acquired - penetrating injuries and blunt force trauma
what is the mediastinum ?
region between the lungs, extending from the sternum to the bodies of the vertebrae & from the superior thoracic aperture to the diaphragm
2 layers of the pleural cavity ?
- Visceral layer– against the organs within the cavity
- Parietal layer– against the wall of the cavity
Thin layer of pleural fluid in between pleural cavity allows for what ?
- parietal and visceral parts to slide on one another
- movement of the lung against chest wall
- Surface tension of pleural fluid keeps lung surface in contact with thoracic wall
- When thorax expands, the lung expands with it and fills with air
If air collects in pleural cavity what is it called ?
pneumothorax
If fluid collects in pleural cavity what is it called ?
pleural effusion
If blood collects in pleural cavity what is it called ?
haemothorax
If pus collects in pleural cavity what is it called ?
empyema
Lung positions
Right lung
left lung
Hilum of the lung, each lung has what ?
- main bronchus
- pulmonary artery
- 2 pulmonary veins
- bronchial vessels
- nerves
- lymphatics
Surface markings of lungs and pleura
oblique fissue surface markings ?
(between upper and lower lobes)
- from spinous process of T4 posteriorly
- to the 6th costal cartilage anteriorly
horizontal fissure surface marking ?
(right lung)
from the mid-axillary line anteriorly along the 4th rib
Trachea starts below the ..1… of the larynx and divides at the level of …2…
- cricoid cartilage
- sternal angle
Difference between right and left main / primary bronchi ?
right is shorter , wider, more vertical
lobar bronchi / secondary ?
right 3
left 2
segmental bronchi / tertiary - supplies what ?
a bronchopulmonary segment (subdivision of the lobe of the lung surrounded by CT)
segmental bronchi / tertiary - accompanied by what ?
a branch of pulmonary artery, adjacent bronchopulmonary segments share tributaries of the pulmonary veins.
