3. Anatomy

Question 1

why does the nasal cavity have conchae?

Answer 1

to provide a large SA of nasal mucosa

Question 2

what plane does nasal cavity run in?

Answer 2

horizontal

Question 3

functions of paranasal sinuses

Answer 3

-mucus lubricates nasal passages
-lighten weight of head

Question 4

functions of larynx

Answer 4

-speech
-prevents food entering airway

Question 5

importance clinically of knowing the segmental bronchi

Answer 5

relate to pulmonary segments so can do a segmental resection of tumour

Question 6

3 articulations of each rib

Answer 6

1. superior articular facet
2. inferior articular facet
3. transverse articular facet

Question 7

what’s the mediastinum?

Answer 7

septum of pleural cavities

Question 8

2 movements of chest wall during breathing, and what they achieve

Answer 8

1. bucket handle- increases lateral dimension of chest
2. pump handle- increases AP dimension of chest

Question 9

contribution of diaphragm vs intercostal muscles to ventilation

Answer 9

70% vs 30%

Question 10

where does there diaphragm attach

Answer 10

edge of inferior thoracic aperture

Question 11

phrenic nerve roots to supply diaphragm (motor and sensory)

Answer 11

C3,4,5

Question 12

sensory innervation to pericardium

Answer 12

phrenic nerves C3,4,5

Question 13

what passes through the aortic hiatus?

Answer 13

thoracic duct

Question 14

name some accessory muscles of respiration

Answer 14

-pectorals
-SCM

Question 15

describe dual blood supply of thoracic wall. why could it be a problem?

Answer 15

-aorta
-internal thoracic artery and vein

increased risk of bleeding into intercostal space

Question 16

venous drainage of the thorax, and benefit of this

Answer 16

azygos system, allows us to drain all intercostal spaces, even ones at level of heart

Question 17

why is the innervation to the diaphragm from so high up?

Answer 17

diaphragm developed in neck, then descend down as the spine grew

Question 18

give reason why lung fissures are clinically relevant

Answer 18

-oblique fissure means majority of posterior lung is lower lobe
-transverse fissure can fill with fluid on chest X-ray

Question 19

where do majority of inhaled foreign bodies lodge, why?

Answer 19

right lower lobe, angle from trachea to right main bronchus is straighter

Question 20

divisions of the mediastinum and what they contain

Answer 20

superior: structures that communicate with neck via superior thoracic aperture

inferior:
-anterior: fat, thymus gland in children
-middle: heart, pericardium
posterior: aorta, oesophagus, azygos vein, thoracic duct

Question 21

big risk when opening sternum to do heart operation

Answer 21

pierce parietal pleura and cause pneumothorax

Question 22

in a pulmonary embolism, why might lung tissue not die?

Answer 22

some blood supply remains from bronchial arteries (branches of aorta)

Question 23

levels of superior dome of diaphragm on each side

Answer 23

4th ICS RHS
5th ICS LHS

Question 24

in a stab wound to left of trachea in neck, what structures could be damaged?

Answer 24

-apical pleura in supraclavicular fossa
-apex of lung
-IJV
-carotid vessels
-brachial plexus
-thoracic duct

Question 25

best auscultation location for R middle lobe?

Answer 25

nipple

Question 26

relationship of thoracic aorta to oesophagus

Answer 26

oesophagus on RHS, parallel

Question 27

best auscultation for left lower lobe pneumonia

Answer 27

posterior, left of midline

Question 28

anatomical landamarks separating the superior and inferior mediastinum

Answer 28

sup from superior thoriaci aperture to sternal angle
inf from sternal angle to diaphragm

Question 29

where do the airways sit at the hilum?

Answer 29

posteriorly

Question 30

tough structure from pulmonary trunk to aorta

Answer 30

ligamentum arteriosum

Question 31

conducting portion of airway
respiratory portion

Answer 31

nostrils to terminal bronchioles
respiratory bronchioles to alveoli

Question 32

epithelium in
-nasal cavity to secondary bronchioles
-terminal bronchioles
-respiratory bronchioles + alveolar ducts
-alveoli

Answer 32

-pseudostratified ciliated columnar + goblet cells
-simple columnar + club cells
-simple cuboidal + some club cells
-simple squamous/ type 1,2

Question 33

function of sub mucous glands in trachea

Answer 33

seromucous
-serous secretion humidifies inspired air
-mucous traps particles from air, moves them up towards pharynx by cilia to be swallowed, keeps lungs free of particles/bacteria

Question 34

club cells function

Answer 34

secrete component of surfactant

Question 35

how are bronchioles kept open?

Answer 35

surrounding alveoli

Question 36

connective tissue fibres on alveolar walls

Answer 36

-elastin
-reticular

Question 37

what do type 2 pneumocytes produce, what’s its function?

Answer 37

surfactant, reduces surface tension to prevent alveoli collapsing on expiration

Question 38

Why could pain arising from parietal pleura pf diaphragm be felt in shoulder tip?

Answer 38

Referred Pain
-phenric nerve is sensory to parietal pleura of diaphragm
-pain impulses in phrenic nerve enter spinal cord at C3,4,5, same roots as phrenic nerve
-somatic sensory nerves to shoulder tip also enter at C3,4,5 so body perceives pain from shoulder tip