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Thorax Anatomy > 2 - Pleurae, lungs and diaphragm > Flashcards

2 - Pleurae, lungs and diaphragm Flashcards

1
Q

The lungs are enclosed by the _____ and ______ that are continuous membranes. The former covers the lungs while the latter lines the pulmonary cavities.

A

Visceral pleura;

Parietal pleura

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2
Q

The pleural cavity contains _______.

A

Serous pleural fluid.

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3
Q

The pleural cavities are smaller/larger than the lung, forming ____________.
Potential accumulation of ?

A

larger; pleurae recesses;

blood - hemothorax
air- pneumothorax
fluid - hydrothorax

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4
Q

What is pleuritis? What can it cause?

A

Inflammation of the pleura;

accumulation of excessive fluid in the pleural recesses.

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5
Q

Which of the followings about the lungs are true?

A. The apex projects above the clavicle (above the superior thoracic aperture)

B. The base is also called the diaphragmatic surface.

C. Root of lungs refers to the structures protruding from the mediastinum, hilum refers to the holes on the lungs

A

All of the are correct. Remember them!

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6
Q

The ____ lung has 2 lobes while the ____ lung has 3 lobes.

What are the names of the lobes?

A

Left; Right

L: Upper and lower

R: Upper, middle and lower

Mnemonic: the letter “ L ” has 2 strokes, so the Left
lung has 2 lobes; the letter “ R ” has 3 strokes, so the Right lung has 3 lobes

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7
Q

What are the 2 surfaces and the 3 borders of the lung?

A

Costal surface and mediastinal surface;

Anterior, inferior and posterior surfaces

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8
Q

In additional to a oblique fissure like left lung, the right lung has a _______ fissure.

A

horizontal

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9
Q

Which 2 veins run runs adjacent to the

right lung and their grooves can be observed?

A
  1. Superior vena cava
  2. Azygos vein

***The azygos vein runs near the vertebral column at the back, and it arches over the right lung root to drain into the superior vena cava (remember, the azygos
vein forms an anastomosis between SVC and IVC!)

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10
Q

The groove of which organ can be seen in the right lung adjacent to the groove by the azygos vein?

A

Esophagus

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11
Q

In the left lung, the groove for _____ runs above and posterior to the left lung root.
Other than that, list the 2 features of the left lung that is absent in the right lung.

A

Aorta;

  1. Cardiac notch (forms the anterior border of cardiac impression)
  2. Lingula in the upper lobe* near the base
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12
Q

What is the vertebral level of the roots of lungs.

A

T5-T7

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13
Q

The roots of the lungs are where the parietal and visceral pleura meets.
What are the contents of each lung root?

A
  1. The main bronchus
  2. 2 pulmonary veins : most anterior and inferior **
  3. 1 pulmonary artery
    - in Left lung: Superior to main bronchus
    - in Right lung: Anterior to right main bronchus
  4. Lymphatics
  5. Lymph nodes
  6. Nerve

Mnemonic: RALS : Right Anterior; Left Superior

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14
Q

The ______ nerves pass anterior to the roots of the lungs while the ________ nerves pass posterior to the roots of the lungs.

A

Phrenic;

Vagus (parasympathetic innervation)

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15
Q

Phrenic nerve (C3-C5) which 3 main fibers?

A

Phrenic nerve supplies the diaphragm!

  1. Motor fibers of the diaphragm
  2. Sensory fibers to most of the diaphragm
  3. Sensory fibers to the pericardium and mediastinal pleura
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16
Q

At the _____ lung, horizontal fissure and oblique fissure meet at the level of intersection of?

A

Right;
Midaxillary line,
5&6th rib

17
Q

Oblique fissure meets the inferior border of lungs at

the level of intersection of?

A

Midclavicular line,

6th rib

18
Q

List the components of a bronchial tree with arrows.

A

Trachea > Primary bronchi > Secondary bronchi > Tertiary bronchi > Terminal bronchioles > Respiratory bronchioles > Alveolar sac

19
Q

The lung can be divided into _____ segments and

each segment is supplied by its own segmental artery

A

10

20
Q

A. Bronchial arteries are for gaseous exchange

B. The blood supplied by the bronchial arteries is drained by the
bronchial veins (into systemic circulation)

C. The remainder
blood is drained by the pulmonary veins (into pulmonary
circulation)

A

B and C only

A: Bronchial arteries belong to the systemic circulation, responsible for perfusing lung tissue

21
Q

The _____________ drains lymph from the right side of

head, neck and thorax, and right upper limb. The lymph then enters the _____________.

A

right lymphatic duct;

right subclavian vein

*The right
lymphatic duct enters bloodstream at the right venous angle
(site where right internal jugular vein and right subclavian
vein meet to form right brachiocephalic vein )

22
Q

The _________ drains lymph from the rest of the body. It originates from __________ and is the largest lymphatic
duct in the body. The lymph then enters the _____________.

A

Thoracic duct;

Cisterna chyli;

Left subclavian vein

*Cisterna chyli > thoracic duct > left subclavian vein

*The thoracic duct enters bloodstream at the
left venous angle (site where left internal jugular vein and
left subclavian vein meet to form left brachiocephalic vein )

23
Q

Thoracic duct:
begins at the cisterna chyli and enters thorax via _______ of diaphragm, ascends in ______mediastinum, ______ to esophagus, between _____and _____ , finally join left subclavian/ jugular veins

A 
aortic hiatus;
posterior;
posterior
Thoracic aorta (left) 
Azygos vein (right)
24
Q

What are the 2 networks involved in lymphatic drainage in the lungs? Briefly describe the sites where lymph are drained by these 2 networks.

A
  1. Peribronchial network
    - follows the bronchial tree, drains most of the lungs and bronchi
  2. Subpleural network
    - Drain peripheral lung area and visceral pleura
    - Lymph drains to tracheobronchial lymph nodes
    > paratracheal nodes
    >bronchomediastinal trunks
    > junction of subclavian and internal jugular veins
25
Q

Enlarged lymph nodes as in lung cancer patients may compress on the surrounding structures like ___________.

A

Partial as the right recurrent laryngeal nerve still supplies, which loops under the right subclavian artery.

Left recurrent laryngeal nerve, causes partial loss of voice.

26
Q

The left and right bronchi bifurcates at the ____ vertebral level.
List the 4 differences between them.

A

T4;

Differences:

  1. Right bronchi is shorter
  2. Right bronchi is larger in diameter
  3. Right bronchi more straight and steep
  4. Right bronchi enters hilum at T5 (higher level); left bronchi enters hilum at T6

*Foreign objects are more likely to fall into right main bronchus

27
Q

What are the 3 hiatuses in the diaphragm and their respective vertebral levels?

A

T8: Vena cava hiatus
T10: oesophageal hiatus
T12: aortic hiatus

Mnemonic: Levels of the 3 hiatus
○ “Vena cava” has 8 letters, caval opening is at T 8
level
○ “Oesophagus” (note the British spelling) has 10
letters, oesophageal hiatus is at T 10 level
○ “Aortic hiatus” has 12 letters, aortic hiatus is at T 12
level

28
Q

What do each hiatus in the diaphragm contains?

A
  1. Vena cava:
    - inferior vena cava
    - right phrenic nerve (T8/T9)
  2. Esophagus
    - esophagus
    - vagus nerve (T10)
    * V = 2 hand gesture =
  3. Aortic hiatus
    - descending aorta (artery)
    - azygos veins (T12/L1) (vein)
    - splanchnic nerves (nerve)
    - thoracic duct (lymph)
29
Q

Which dome of the diaphragm is higher? Why?

A

Right. Allow liver at the right to tuck in there.

30
Q

______ part of the diaphragm is flattened for the heart to sit on.

A

Central

31
Q

Which of the followings are true?

A. Diaphragm is a respiratory muscle.
B. The central tendon is at the middle part of the whole diaphragm.
C. The periphery of the diaphragm is muscular.
D. The diaphragm is innervated by the phrenic nerve.

A

A,C,D

B: the white part

32
Q

In another patient, if the right lung were to be removed, which blood vessel located
superior the the right hilum should be protected?

A

Azygos vein

33
Q

Where will the fluid/air accumulate during hydrothorax/hemothorax/pneumothorax? (be specific)

A

●Hydrothorax/hemothorax→ Costodiaphragmatic recess(lowest point of the pleural
cavity)
● Pneumothorax→ Apex of the lung Remember apex of the lung expand above the
thoracic inlet
● Fluid have higher density→ sink to the bottom; air have low density→ float to the top

Thorax Anatomy (3 decks)

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