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Anatomy 1 > 3) The Respiratory System > Flashcards

3) The Respiratory System Flashcards

1
Q

How is the scapula held in position?

A
  • It is embedded within muscle
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2
Q

How do substances enter and leave our rib cage?

A
  • Through two apertures located at the top and bottom of the rib cage
  • There is a superior aperture at the top which is smaller and angled
  • There is an inferior aperture at the bottom which is closed off by the diaphragm
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3
Q

How are any vessels travelling to or from the upper limb leave the ribcage?

A
  • They leave through the superior aperture and bend above the first rib
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4
Q

What are the boundaries that make up the superior aperture?

A
  • We have the T1 vertebra posteriorly
  • On the sides we have the medial border of the first ribs
  • And finally we have the superior border of the manubrium anteriorly
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5
Q

How is the diaphragm attached?

A
  • It has attachment to the vertebral column as well as an attachment to the ribs and coastal cartilages
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6
Q

How does the aorta travel past the diaphragm?

A
  • There is a hole posterior to the diaphragm called the aorta hiatus from which the aorta travels through
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7
Q

How does the oesophagus travel through the diaphragm?

A
  • The oesophagus travels through the oesophageal hiatus which is a hole found in the muscular component of the diaphragm
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8
Q

What are the boundaries of the inferior thoracic aperture?

A
  • The coastal margin (consisting of coastal cartilages of ribs 7-10) and the xiphoid process make up the anterior boundary
  • The floating ribs (ribs 11 and 12) make up the boundaries to the sides
  • The T12 Vertebrae makes up the posterior boundary
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9
Q

What does a typical thoracic vertebrae consist of?

A
  • Anteriorly there is the vertebral body which is a flat surface. It also consists of small indentations which articulate with the ribs
  • Posteriorly there is a spinous process which are directed vertically compared to other spinous processes
  • To the sides of the spinous process we have the transverse processes which articulate with the ribs
  • Towards the centre we find a vertebral foramen (hole) which is relatively smaller than those found in other regions and is the point at which the spinal chord passes through
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10
Q

What are found in between vertebrae?

A
  • Intervertebral discs
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11
Q

What are the different features of the vertebral body?

A
  • Articular facet for tubercle of superior rib
  • Superior articular demi-facet for head of superior rib (rib above vertebrae)
  • Inferior articular demi-facet for head of inferior rib (rib below vertebrae)
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12
Q

What are the two joints a rib makes with a thoracic vertebrae?

A
  • A costovertebral joint between vertebrae and rib. The rib interacts with the superior articular demi-facet of the vertebrae below and the inferior articular demi-facet of the vertebrae above.
  • A costotransverse joint between transverse process and rib
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13
Q

What are the features of a typical rib?

A
  • It articulates anteriorly with the sternum via the coastal cartilages
  • The junction between the coastal cartilage and the rib is the costochondral junction
  • The part of the rib leading away from the costochondral joint is the shaft/body of the rib. The inferior margin of the body is quite rough while the superior margin of the body is smooth
  • There is a groove on the inferior margin called the coastal groove where the neurovascular bundle (intercoastal artery, vein and nerve) runs. It protects this bundle from any damage
  • The rib then curve as it reaches posteriorly. This is called the angle
  • There is then a small bump before we reach the end, called the rib tubercle, which articulates with the transverse process of the thoracic vertebrae
  • After the tubercle the rib then narrows at the rib neck
  • Finally we reach the end of the rib, called the rib head, which articulates with the vertebral body
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14
Q

What are the atypical ribs of the body?

A
  • Ribs 1, 2 , 10, 11, 12

- They are atypical as they are flat and missing a lot of the components found in a normal rib

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15
Q

Why is rib 1 clinically important?

A
  • It is located very close to some very important nerves and vessels in the brachial plexus (a network of nerves) which go to the upper limb
  • These nerves can be compressed as they pass out of the superior thoracic aperture which can impede function of the upper limb
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16
Q

What are intercoastal muscles?

A
  • Muscles that sit between the ribs in the intercoastal spaces
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17
Q

How are intercoastal muscles arranged?

A
  • They are arranged into three layers going from deep to superficial
  • External intercoastal muscle: Outer/most superficial layer
  • Internal intercoastal muscle: Middle layer
  • Innermost intercoastal muscle: Inner/ deepest layer
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18
Q

Describe the structure of the external intercoastal muscle.

A
  • External intercoastal muscle are the most superficial (outer layer)
  • The direction of muscle fibres is anterior (forward) and medial (towards the midline of the body). This direction is called “Hands in Pockets”
  • They originate from the inferior border of a rib and ends at the superior border of the rib below
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19
Q

Describe the structure of the internal intercoastal muscle.

A
  • Internal intercoastal muscle are the middle layer
  • The direction of muscle is superiorly (upwards) and medially (towards the middle) which causes it to run perpendicular to the external intercoastal muscles.
  • It originates from the coastal groove of the rib above and ends at the superior border of the rib below
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20
Q

Describe the structure of the innermost intercoastal muscle.

A
  • Innermost intercoastal muscle is the deepest layer
  • They follow the same direction as the internal intercoastal muscles
  • They originate at the coastal groove of the rib and end at the superior border of the next rib (same as internal intercoastal muscle)
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21
Q

What does the parallel arrangement of the external and internal intercoastal muscle do for the intercoastal space?

A
  • It adds strength to the intercoastal space
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22
Q

How are the dimensions of the thoracic cage changed during respiration?

A
  • Vertical diameter (top to bottom): Changed by the contraction/relaxation of the diaphragm
  • Anteroposterior diameter (Front to back): Changed by downward sloping of ribs which are raised at the sternal end. Upon contraction they lift the anterior part of the ribs cage up. This is achieved by fixing the position of the first ribs are fixed through contraction of external intercoastal and parts of the internal intercoastal (the interchondral part)
  • Transverse diameter (left to right): Caused by articulation of ribs from sternum to vertebral column along with the angle of the ribs (ribs curving downwards) resembling bucket handles. As these handles are raised, until they are facing sideways, the transverse diameter increases
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23
Q

How is the diaphragm attached to the rib cage?

A
  • It is attached to the xiphoid process, the coastal margins and posteriorly to the lumbar vertebrae.
  • They attach to the lumbar vertebrae via tendinous extensions known as crura (singular is crus).
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24
Q

What occurs when the diaphragm contracts?

A
  • It pulls down its central tendon which increases the vertical diameter of the thorax
  • It is innervated by the phrenic nerve which comes from the spinal segments C3, C4 and C5
    “C3,4 and 5 keep the diaphragm alive”
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25
Q

Describe the structure of the crura.

A
  • These are tendinous extensions of the diaphragm which attach to the lumbar region of the spinal chord. There are two present: a right crus and a left crus
  • Right crus: Is longer and originates from L1-L3 and their intervertebral discs. Some of the fibres surround the oesophageal foramen. They act as a physiological sphincter by preventing contents of the stomach flowing back into the oesophagus
  • Left crus: Is shorter and originates from L1-L2 and their intervertebral discs
  • The aorta passes behind the crura in the aortic hiatus
26
Q

What does the upper respiratory tract consist of?

A
  • Nasal and oral cavities (which are connected)
  • Larynx which are cartilages on the upper part of the respiratory tract (in front of the pharynx)
  • Cervical vertebrae and discs
  • The pharynx (the upper part of the digestive tract). It is sub-divided into the nasopharynx (near the nasal cavity), the oropharynx (near the oral cavity) and the laryngopharynx (behind the larynx)
27
Q

What are nasal conchae?

A
  • Curved shelves of bones in the nasal cavity which divide the cavity into 4 air channels
  • The space below each conchae is the meatus
  • They increase surface area during inspiration which warms air coming in and traps any dust particles coming in
28
Q

What are the three different conchae called?

A
  • Superior conchae (top)
  • Middle conchae (middle)
  • Inferior conchae (bottom)
29
Q

What are sinuses?

A
  • Air filled spaces
30
Q

What are the sinuses near the nose called?

A
  • Paranasal sinuses.
31
Q

What are the subdivisions of the sinuses in the nose?

A
  • Ethmoidal cells (at the top of the nasal cavity)
  • Sphenoid sinuses (behind the ethmoidal cells)
  • Frontal sinuses (above ethmoidal cells not in nasal cavity)
  • Maxillary sinuses (located on either side of the nose)
  • They are named according to the bone they are connected to
32
Q

What are features of the paranasal sinuses?

A
  • They are lined by respiratory mucosa, ciliated and mucous secreting cells.
  • These trap any dust particles entering the upper respiratory tract
  • They open into the nasal cavity
  • The maxillary sinus is the largest and opens near the top of the nasal cavity
33
Q

What are the functions of the paranasal sinuses?

A
  • Lighten the weight of the head
  • Humidify and heat inhaled air
  • Increase resonance of speech
  • Protect vital structures in event of facial trauma
34
Q

What is the cause of a blocked nose?

A
  • Since the opening of the maxillary sinus is at the top, drainage of this sinus goes against gravity
  • Hence a build of mucus in this sinus, when we get a sickness, will be harder to drain
  • This leads to a blocked nose
35
Q

What are tonsils?

A
  • Collections of lymphatic tissue located in the pharynx

- Collectively they form a ringed arrangement (known as Waldeyer’s ring)

36
Q

What are the different tonsils?

A
  • Pharyngeal/Adenoid tonsils (at the back of the nasal cavity)
  • 2x Tubal tonsils (sits in the eustachian tube, the connection between pharynx and ear)
  • 2x Palatine tonsils (in the soft pallet on the top surface of the mouth at the back)
  • Lingual tonsil (beneath the tongue)
37
Q

What are the function of tonsils?

A
  • They are the first line of defence against pathogens entering through the upper part of the respiratory tract (entering through the nasopharynx or oropharynx)
38
Q

What is the eustachian tube?

A
  • It is the tube connecting the ear to the pharynx.
  • It equalises air pressure in the auditory canal by opening up
  • It also removes debris from the middle ear
39
Q

What is the larynx?

A
  • The upper part of the respiratory tract which sits anteriorly (in front of) to the pharynx
  • It consists of three large unpaired cartilages (Thyroid, Cricoid and Epiglottis) and three smaller cartilages. There is a fibroelastic membrane in between the cartilages
  • The larynx is suspended by the hyoid bone (found above the thyroid cartilage). The hyoid bone is not attached to any other bones and so is very mobile. It moves during sound production and swallowing
  • There are many intrinsic and extrinsic muscles which aid movement of larynx during breathing
40
Q

Describe the relationship of the three cartilages in the larynx.

A
  • The thyroid cartilage is a big broad cartilage which sits at the top of the larynx
  • The cricoid cartilage sits under the thyroid and is narrow anteriorly but becomes broader posteriorly
  • Epiglottis cartilage is a leaf shaped cartilage which can move and close the opening of the larynx during swallowing
41
Q

What is the purpose of the three smaller cartilages?

A
  • They move vocal folds during sound production
  • They also open and close the opening to the larynx
  • They act as attachment points for very important membranes and muscles
42
Q

What are vocal folds?

A
  • Vocal folds are the folds found at the top of the larynx (near the epiglottis)
  • There are true and false vocal folds however only true vocal folds take part in sound production
  • The false vocal folds act as a secondary sphincter to help close the larynx
  • False vocal folds are found closer to the epiglottis on the opening of the larynx
  • True vocal folds are found internal to the false vocal folds
43
Q

What are laryngeal ventricles?

A
  • (Also called laryngeal sinuses) Little gaps between the true and false vocal folds
  • They can become inverted into the larynx to cause snoring or noisy breathing
44
Q

Describe the full airway tract.

A
  • First we have the trachea which beings with the thyroid cartilage of the larynx in the oral cavity
  • It continues downward and eventually bifurcates (splits) at the carina into left and right main bronchi behind the arch of the aorta (at the sternal angle/ T4-T5)
  • The main bronchi then flow into the secondary (lobar) bronchi
  • The lobar bronchi bifurcates into the tertiary (segmental) bronchi
  • The segmental bronchi divides into the terminal bronchi
  • The terminal bronchi divides into bronchioles
  • These bronchioles then divide to form the final alveoli
45
Q

What is the carina?

A
  • The point at which the trachea bifurcates into the left and right main bronchi
46
Q

What is the difference in orientation between the main bronchi?

A
  • The right main bronchi is more vertically orientated
47
Q

Describe the shape of the trachea.

A
  • They are C-shaped cartilaginous rings which are incomplete posteriorly
  • The free ends of the cartilaginous rings are connected posteriorly by the trachealis muscle which runs down the posterior side of the trachea
48
Q

What is the pleura?

A
  • A smooth membrane that surrounds the lungs which secretes serous fluid
  • They consist of two membranes of epithelial cells that line and enclose the thoracic cavity.
  • The two membranes are continuous with one another
  • The parietal pleura lines the thoracic wall and the visceral pleura lines the lungs
  • Some of the pleura is reflecting between the lungs and the wall to form potential spaces
49
Q

Describe the development of the pleura.

A
  • Early on in development we have a laryngotracheal tube which gives rise to larynx and trachea. At the bottom of the tube we find lung buds which are developing.
  • The thoracic cavity (now called coelomic cavity) is lined by pleura.
  • As the lungs continue to develop from the buds they acquire the lining of the pleura.
  • The untouched pleura still lining the thoracic cavity is the parietal pleura and the part of the pleura interacting with the lungs is the visceral pleura.
  • Eventually the lungs become fully developed with the double layer of pleura with the pleural cavity in between inside the thoracic wall
50
Q

What are the different sub divisions of the parietal pleura?

A
  • Cervical pleura (Top part of the pleura)
  • Coastal pleura (Lines the inside of the ribs)
  • Diaphragmatic pleura (Lines the diaphragm)
  • Costodiaphragmatic recess (Space between the coastal and diaphragmatic pleura)
  • Mediastinal pleura (Lines the mediastinum/closest to the heart)
  • Pulmonary ligament (Found at the root of the lung where all the structures enter and leave)
  • Costomediastinal recess (Space between the coastal and mediastinal pleura)
51
Q

What is the role of the costodiaphragmatic recess?

A
  • A space found between the coastal pleura and the diaphragmatic pleura which is slightly bigger than the other space found in the pleural cavity
  • It fills during a deeper inspiration
52
Q

What is the pulmonary ligament?

A
  • A loose bit of pleura found at the root of the lung where all the structures enter and leave the lungs
  • It hangs down from the lung root and allows for the movement that occurs during respiration
  • This prevents the compression of vessels
53
Q

What is a fissure?

A
  • A narrow opening between two lobes of the lungs
54
Q

What are the different structures of the left lungs?

A
  • On the left there are two lobes:
  • Superior lobe (at the top)
  • Inferior lobe (at the bottom)
  • These lobes are separated by the oblique fissure
55
Q

What are the different lobes of the right lung?

A
  • On the right there are three lobes
  • Superior lobe (at the top)
  • Inferior lobe (at the bottom)
  • Middle lobe (in the middle)
  • The middle and inferior lobe is separated by the oblique fissure
  • The superior and middle lobe is separated by the horizontal fissure (more horizontally orientated)
56
Q

Why don’t we have three lobes on the left side of the lungs?

A
  • The apex of the heart projects towards the left so the development of third lobe was hindered
57
Q

What are the different surfaces of the lungs?

A
  • The apex is the top of the lung and projects over the first rib
  • The base lies directly opposite the apex
  • The coastal surface which is the surface of the lung further from the heart
  • The mediastinal surface which is the surface of the lung closest to the heart
58
Q

What are the different borders of the lungs?

A
  • Inferior border: Separates the base from the coastal and the mediastinal surface
  • Anterior and posterior border: Separates the coastal from the mediastinal surfaces
59
Q

What is the cardiac notch?

A
  • A notch (missing part of the lung) where the apex of the heart projects into
  • It is found in the left lung
  • It results in the formation of a lingula which is a tongue shaped piece of lung found underneath the cardiac notch
60
Q

What is the lung root?

A
  • A short, tubular collection of structures that attach the lung to the mediastinum
  • It is covered by a sleeve of mediastinal pleura that reflects onto the surface of the lungs
61
Q

What are the different structures in the lung root?

A
  • Pulmonary artery
  • 2x Pulmonary veins
  • Main bronchus
  • Bronchial vessels
  • Nerves and lymphatics
62
Q

How are vessels organised in the root of the lung?

A
  • Pulmonary arteries found superior (at the top)
  • Pulmonary veins found inferior (at the bottom)
  • Bronchi found posterior (at the back)
  • In the right root the lobar bronchus branches quite quickly whereas in the left side it branches in the lung itself

Anatomy 1 (8 decks)

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