Anatomy Flashcards
- What are the anatomical relationships of trachea?
It is a flexible tube that extends from Cervical 6 basically from our larynx to Thoracic 4 vertebrae in the mediastinum where it bifurcates دو شاخه می شود into the right and left main (principal) bronchus.
- Where is the location of trachea?
- Posteriorly
- Laterally
- Anteriorly
- Posteriorly: related to the oesophagus
- Laterally: to common carotid arteries and thyroid lobes
- Anteriorly: related to thyroid gland, infra hyoid muscles.
- What is the length of trachea? and what are its looks?
THE LENGTH RANGES FROM 9-11 cm.
The trachea I held open by 16-20 C shaped transverse cartilage hemi-rings embedded in its wall.
- Explain the posterior wall of trachea?
Also how much is the diameter of trachea in adults and babies?
THE POSTERIOR WALL of trachea is membranous, paries membranaceous. It is flat, formed by involuntary trachealis muscle.
In adults the trachea is approximately 2.5 cm in the diameter.
In infants it has a diameter of a pencil.
- What is the function of trachea?
It transports air to and from the lungs, and its epithelium propels debris-laden mucus toward the pharynx for exclusion محرومیت from the mouth.
- What is sceletotopy of the lungs?
General answer.
Each lung has a half cone shape, with a base, apex, two surfaces and three borders. The base sits on the diaphragm. The spec projects above the rib 1 and into the root of neck.
- What is sceletotopy of the right lung?
- Apex
- Anterior border
- Posterior border
- Inferior border
Right lung
- Apex:
Is located at the thoracic 1 vertebrae
3-5 cm up to the superior thoracic aperture
- Anterior border: Descends at the sternal line, then reaches the median sagittal plane and at the right medioclavicular line ends crossing the 6 rib.
- Posterior border: Corresponds with line that descends through the joints and heads of ribs.
- Inferior border: starts at the right medioclavicular line as it crosses the 6th rib.
Then the inferior border crosses the 7th rib at the anterior axillar line, the 8th rib at the median axillar line, the 8th rib at the posterior axillar line, the 10th rib at the scapular line and 11th rib at paravertebral line.
- What is sceletotopy of the left lung?
Say the main difference!
- Anterior border
- Inferior border
The borders of left lung are similar to the border of right lung with EXCEPTION OF INCISURA CARDIACA (cardiac notch)!
–> The left lung shares space with the heart, and has an indentation تورفتگی in its border called the cardiac notch of the left lung to accommodate this.
- Anterior border:
Descends at the sternal line then descend till the 4th rib, then goes horizontally along the 4th rib to the left medioclavicular line and descends to 6th rib. - Inferior border:
Is 1-1,5 cm more down the inferior border of the right lung.
- What are the drainage of paranasal sinuses?
- Frontal
Drains into the ethmoidal infundibulum, which opens into the semilunar hiatus of the middle nasal meatus.
- What are the drainage of paranasal sinuses?
- Anterior ethmoidal cells
Drain into the middle nasal meatus through the ethmoidal infundibulum.
- What are the drainage of paranasal sinuses?
- Middle ethmoidal cells
From ethmoidal bulla open directly into the superior meatus
- What are the drainage of paranasal sinuses?
- Posterior ethmoidal cells
Open directly into the superior meatus.
- What are the drainage of paranasal sinuses?
- Sphenoid sinus
Sphenoethmoidal recess receives the opening. The posterior cells open through sphenoethmoidal recess into the superior meatus.
- What are the drainage of paranasal sinuses?
- Maxillary sinus
The largest of sinuses and occupy the bodies of maxillae and communicates with the middle meatus through the semilunar hiatus.
- What are innervation of larynx and injury of laryngeal nerves during thyroidectomy?
- Superior laryngeal nerve
- Inferior laryngeal nerve
- Injury of laryngeal nerve
The nerves of the larynx are the superior and inferior laryngeal branches of the vagus nerve.
- Superior laryngeal nerve –> arises from the inferior vagal ganglion
- Inferior laryngeal nerve –> is the continuation of the recurrent laryngeal nerve
- Injury of laryngeal nerve –> Because the inferior laryngeal nerve, the continuation of the recurrent laryngeal nerve, innervates the muscles moving the vocal folds, paralysis of vocal folds results when the nerve is injured.
To avoid injury to the external branch of the superior laryngeal nerve (during thyroidectomy), the superior thyroid artery is ligated بسته شده and sectioned more superior to the gland, where it is not as closely related to the nerves.
- Eparteric bronchi, what are the definitions and examples?
Lobar bronchi
Eparterial bronchus (right main and right superior lobar bronchus) –> is a branch of the right main/principal bronchus given off about 2.5 cm from the bifurcation دوشاخه شدن of the trachea.
This branch supplies the superior lobe of the right lung and is the most superior of all secondary/lobar bronchi.
It arises ABOVE the level of pulmonary artery, and for this reason is named the eparietal bronchus.
- Hyparteric bronchi, what are the definitions and examples?
Lobar bronchi
Those bronchi that pass BELOW the pulmonary arteries, right middle and inferior lobar bronchi and left superior & inferior lobar bronchi.
- Arteries of nasal cavity:
–> the arterial supply of the medial and lateral walls of nasal cavity is from 5 sources.
-Anterior ethmoidal artery
From the ophthalmic artery
- Arteries of nasal cavity:
–> the arterial supply of the medial and lateral walls of nasal cavity is from 5 sources.
-Posterior ethmoidal artery
From the ophthalmic artery
- Arteries of nasal cavity:
–> the arterial supply of the medial and lateral walls of nasal cavity is from 5 sources.
-Sphenopalatine artery
From the maxillary artery
- Arteries of nasal cavity:
–> the arterial supply of the medial and lateral walls of nasal cavity is from 5 sources.
-Greater palatine artery
From the maxillary artery
- Arteries of nasal cavity:
–> the arterial supply of the medial and lateral walls of nasal cavity is from 5 sources.
-Septal branch of the superior labial artery
From the facial artery
- Venous anastomoses between in the external nose ophthalmic vein that drains into cavernous sinus and angular vein that drains into facial vein.
A rich submucosal venous plexus deep to the nasal mucosa drains into veins:
-Sphenopalatine, facial, ophthalmic
- Venous blood from external nose drains into —— via angular vein.
–> Facial vein
External nose is “danger area” –> Because the angular vein communicates with the cavernous sinus.
- The ways of the speed of infections from the nasal cavity:
Infections of the nasal cavity may spread to the:
Anterior cranial fossa through?
–> The cribriform plate
- The ways of the speed of infections from the nasal cavity:
Infections of the nasal cavity may spread to the:
Nasopharynx and ——?
Retropharyngeal soft tissues
- The ways of the speed of infections from the nasal cavity:
Infections of the nasal cavity may spread to the:
Middle ear through the ?
Auditory tube
- The ways of the speed of infections from the nasal cavity:
Infections of the nasal cavity may spread to the?
-Paranasal sinuses and lacrimal apparatus and conjunctiva
- Muscles of larynx
What is Cricothyroid innervated by?
External laryngeal nerve (CN X)
- Muscles of larynx
What are the rest innervated by?
Inferior laryngeal nerve (CN X)
- Muscles of larynx
ADDUCTOR (close rims glottis –> The rima glottidis is the opening between the true vocal cords and the arytenoid cartilages of the larynx.)
Principal adductor is the lateral cricoarytenoid muscle.
- Muscles of larynx
Abductor (open rima glottis) –> The rima glottidis is the opening between the true vocal cords and the arytenoid cartilages of the larynx.)
Sole abductor is the posterior cricoarytenoid muscle.
- Muscles of larynx
Sphincters (close the laryngeal inlet as a protective mechanism during swallowing)
–> The laryngeal inlet (laryngeal aditus, laryngeal aperture) is the opening that connects the pharynx and the larynx.
- Lateral cricoarytenoid muscle
- TRANSVERESE ARYTENOID MUSCLE
- Oblique arytenoid muscle
- Aryepiglottic muscle
- Terminal bronchioles
Where does the bronchial tree end at?
And explain what these bronchioles are.
–> at the terminal bronchioles.
Terminal bronchioles are small tubes (0.3-0.5 mm in diameter), which do not contain the cartilages and mucous glands (but ciliated epithelium remains).
- Terminal bronchioles
The terminal bronchioles gives rise to several generations of ——— bronchioles.
The respiratory bronchioles DO NOT HAVE ——.
- -> respiratory
- -> ciliated epithelium
- Terminal bronchioles
Each terminal bronchiole gives rise to several generations of respiratory bronchioles, and each respiratory bronchiole provides around HOW MANY alveolar ducts?
2-11
- Topographical relation of the pulmonary artery, pulmonary veins and principal bronchus in the hilum of lungs.
If the root is sectioned before the branching of the main bronchus and pulmonary artery, how will its general arrangement be?
- A pulmonary artery, superior most on the left side
- Superior and inferior pulmonary veins, anterior most and inferior most, respectively
- A main bronchus, superior most on the right side
- Bronchial vessels and nerves
What/where is the hilum of the lung?
What does it include?
The hilum of the lung is found on the medial aspect of each lung, and it is the only site of entrance or exit of structures associated with the lungs. That is to say, both lungs have a region called the hilum, which serves as the point of attachment between the lung root and the lung. Broadly speaking, this particular region of the lung can be described as a triangular, depressed area where a lot of anatomical structures enter and leave each lung.
–> Includes a region where bronchi, arteries, veins and nerves enter and exit the lungs.
- Pulmonary ligament
what is it?
*Mediastinum–> area between lungs
The pulmonary ligament is a double serosal sheath that extends from the medial surface of the lower lobe to the medias- tinum and from the hilus to the diaphragm. Along with the lung root, it serves to attach the lung to the mediastinum.
- Organotopy of the lungs
Apex pulmonic and cupula pleurae
Where is the apex located?
–> the apex is located within the pleural cupola that is covered by 1st rib, scalene muscles, and supra pleural membrane.
- Organotopy of the lungs
Apex pulmonic and cupula pleurae
What are apex pulmonic and cupola pleurae in contact with? what artery?
–> With subclavian artery
- Organotopy of the lungs
Apex pulmonic and cupula pleurae
What are they in contact with posteriorly?
–> brachial plexus, thoracic duct (on the left side), internal thoracic artery, phrenic nerve (provides the primary motor supply to the diaphragm).
- Organotopy of the right lung –> facies mediastinalis pulmonic and pleura mediastinalis
What are the major structures related to the right lung (mediastinal surface)?
- The heart (RA)
- Inferior vena cava
- Superior vena cava
- Oesophagus
- Right subclavian artery and vein arch over and are related to the superior lobe of right lung as they pass over the dome of cervical pleura and into axilla.
- Organotopy of the left lung –> facies mediastinalis pulmonic and pleura mediastinalis
What are the major structures related to the left lung (mediastinal surface)?
- The heart (LV)
- Aortic arch
- Descending thoracic aorta
- Left subclavian artery and vein arch over and are related to the superior lobe of the left lung as they pass over the dome pf cervical pleura and into the axilla.
- Blood supply of the lungs
How do the lungs get their blood supply?
-Each lung has a large pulmonary artery supplying bloody to it and two pulmonary veins draining/”taking” blood from it.
The right and left pulmonary trunk at the sternal angle carry venous blood for oxygenation.
- Blood supply of the lungs
Each pulmonary artery becomes part of the — of the corresponding lung and gives off its first branch to —- lobe before entering the hilum.
–> root
–> superior
- Blood supply of the lungs
Within the lung each artery descends posterolateral to the main bronchus and divides into lobar and segmental arteries.
The veins from the —- pleura drain into pulmonary veins and veins from the —pleura join systemic circulation.
- -> visceral
- -> parietal
- Blood supply of the lungs
What supplies the root of the lungs, the supporting tissues and visceral pleura?
–> bronchial arteries
They supply blood for nutrition of the structures making up the root of the lungs, the supporting tissues and visceral pleura.
- Blood supply of the lungs
The two left bronchial arteries usually arise DIRECTLY from where?
–> thoracic aorta
- Blood supply of the lungs
Where can “the single right bronchial artery” arise from?
–> aorta
Most commonly it arrises from the upper posterior intercostal arteries or from a common trunk with the left superior bronchial artery.
- Blood supply of the lungs
Explain the drainage of the blood to the lungs?
The bronchial veins drain only a part of the blood supplied to the lungs by the bronchial arteries.
The remainder of the blood is drained by the pulmonary veins, specifically that returning from the visceral pleura, the more peripheral regions of the lung and the distal components of the root of the lung.
- Blood supply of the lungs
Where does the right & left bronchial veins drain into?
R–> Drains into the azygos vein
L–> The left bronchial vein drains into the accessory hemiazygos vein or left
- Blood supply of the lungs
What is the parenchyma and stroma of the lungs supplied by?
Parenchyma–> Supplied by the vessels of the pulmonary circulation
Stroma–> Supplied by the bronchial arteries
- Lymphatic of the lungs
The superficial (sub pleural) lymphatic plexus lies deep to the ——– and drains the lung parenchyma and visceral pleura.
Lymphatic vessels from this plexus drain into the bronchopulmonary lymph nodes in where?
–> Visceral pleura
–> the hilum of the lungs
- Lymphatic of the lungs
Where is the deep lymphatic plexus located?
–> SUBMUCOSA OF THE BRONCHI AND IN THE PERIBRONCHIAL CONNECTIVE TISSUE
- Lymphatic of the lungs
The lymphatic vessels from the pulmonary lymph nodes continue to follow the bronchi and pulmonary vessels to the ——, where they also drain into the bronchopulmonary lymph nodes.
From them, lymph drains to the ——
Lymph from the tracheobronchial lymph nodes passes to the right and left ——.
These trunks terminate on each side at the venous angles.
- -> hilum of lung
- -> superior and inferior tracheobronchial lymph nodes (superior and inferior to the bifurcation of the trachea and main bronchi).
–> bronchomediastinal lymph trunks
- Costodiaphragmatic recess
The lungs do not completely fill the —- (excepted the forced inspiration). Thus the peripheral diaphragmatic pleura is in contact with the lowermost parts of the —-. The potential pleural spaces here are the costodiaphragmatic recesses.
- -> pleural cavities
- -> costal pleura
- Sceletopy of pleura
The borders of both pleurae trace from the pleural cupula through the ——- to the attachment of the 4th rib.
–> posterior surface of the manubrium of the sternum
- Sceletopy of pleura
On the right side, the anterior pleural border descends along the right sternal line and then it crosses at the right —– the 7th rib.
The inferior pleural border starts from the 7th rib at the right medioclavicular line, then it crosses 8 rib at the ——, 9th rib at the —–, 10th rib at the ——, 11 rib at the —-, 12 rib at the paravertebral line.
–> medioclavicular line
–> anterior axillar line
–> middle axillar line
–> posterior axillar line
–> scapular line
–> paravertebral line
- Sceletopy of pleura
On the right side, the anterior pleural border descends along the right sternal line and then it crosses at the right —– the 7th rib.
The inferior pleural border starts from the 7th rib at the right medioclavicular line, then it crosses 8 rib at the ——, 9th rib at the —–, 10th rib at the ——, 11 rib at the —-, 12 rib at the paravertebral line.
–> medioclavicular line
–> anterior axillar line
–> middle axillar line
–> posterior axillar line
–> scapular line
–> paravertebral line
