Anatomy Flashcards
What is the function of the lungs?
To oxygenate blood
How many lobes does the RIGHT lung have?
3
How many lobes does the LEFT lung has?
2 “ Left has Less Lobes and Lingula”
Where does the trachea bifurcate into the left and right main bronchi?
At the Carina
Functions of the Respiratory System
1.Provides tissue for gas exchange
2.Moves air in and out the body
3.Protects the body from dehydration, entry of pathogens and temperature fluctuations
4.Produces sound ( vocalization)
What are the bones of the nasal cavity?
Nerdy - Nasal bone
Medical - Maxilla
Students - Sphenoid
are often
Very - Vomer
PaLE - Palantine, Lacrimal , Ethmoid
What are the paranasal sinuses?
Some - Sphenoidal sinus
Medical- Maxillary sinus
students
Eat - Ethmoidal sinus
Fries- Frontal sinus
What epithelium lines the paranasal sinuses?
Psuedostratified Columnar Epithelium w Goblet cells
What is the blood supply of the nose?
External and Internal Carotid artery
What is the innervation of the nose?
Olfactory Nerve ( CN 1) - Olfaction
Trigeminal Nerve (CN 5) - General Sensation
Facial Never (CN 7) - Serous glands
What’s a next name for Nosebleeds?
Epistaxis
What are the 6 Paired bones of the facial skeleton?
I-Inferior nasal conchae
Love -Lacrimal
Zinger-Zygomatic
Patty -Palatine
Not- Nasal
Meal deal- Maxillary
“ I Love Zingers & Patty Not Meal deal”
What are the two single bones of the facial skeleton?
Mandible
Vomer
What is the Nasion?
It is the junction between frontal and nasal bones
Which three bones are the orbital margin formed by?
Frontal , Maxillary and Zygomatic
Which structure is bounded by the nasal bones and maxillae?
Anterior nasal aperture
What are the four processes of the maxilla bone?
Zygomatic
Frontal
Alveolar
Palatine
“ZFAP”
What are the functions of the zygomatic bone?
They help to form sides and floor of orbits and make up the prominence of the cheeks
Which bones extend from Extend from the zygomatic process of temporal bone to zygomatic process of maxilla?
Zygomatic bones
Which bones can be described as L shaped with horizontal and perpendicular plates?
Palatine Bones
Where are lacrimal bones located ?
Located on the medial aspect of the orbit between ethmoid and maxillary bones.
What is the name of the structure that has a dilated portion of nasolacrimal duct that conveys tears from
eyes to nasal cavity?
Lacrimal sac
What are the vertical portions of the mandible called?
Rami
Fill in the blank “ Each ramus of the mandible has 2 parts that projects upwards: The ________ process is ________ and the ________ is _________”
Coronoid process is anterior & Condylar process is posterior
True or False? The pterygopalatine fossa can act as a natural conduit for the spread of inflammatory and neoplastic diseases in head and neck.
TRUE!!
True or False? Only the sympathetic preganglionic fibers of the nerve of the pterygoid canal synapse at the pterygopalatine ganglion, while the parasympathetic postganglionic fibers travel through it.
FALSE!! Only PARASYMPATHETIC nerves synapse at the pterygopalatine ganglion, while the sympathetic postganglionic fibers travel through it.
Which three bones of the skull forms the wall of the pterygopalatine (sphenopalatine) fossa ?
Palantine
Sphenoid
Maxilla
“PMS forms sphenopalatine fossa”
What is the anterior wall of the sphenopalatine process formed by?
It is formed by the posterior surface of the maxilla
AM- Anterior wall- maxilla
The sphenoid bone forms which wall of the Sphenopalatine process?
Posterior wall and roof
PS- posterior wall - sphenoid bone
What is the medial wall of the sphenopalatine process formed by?
Lateral surface of Palatine bone
MP - medial wall -palatine
What are the neuromuscular structures that pass through the pterygopalatine fossa?
Maxillary nerve (CN V2)
Pterygopalatine ganglion
Terminal (third) part of the maxillary artery
Veins, as well as their associated branches
True or false? The maxillary nerve V2 gives motor innervation?
FALSE!! It is purely sensory
What is the origin of the Maxillary nerve?
- . It originates as the second division of the trigeminal ganglion in the cranial cavity
What structure does the Maxillary nerve travels through to enter the pterygopalatine fossa?
Foramen rotundum
At the pterygopalatine fossa, what structures do the maxillary nerve give rise to?
Zygomatic nerve
Posterior superior alveolar nerve
Two ganglionic branches
What is the name given to maxillary nerve after its main trunk continues through the infraorbital fossa?
Infraorbital nerve
Where is the pterygopalatine ganglion located?
At the pterygopalatine fossa, it sits inferior to the maxillary nerve (V2)and anterior to the opening of the pterygoid canal.
Where does the parasympathetic root of the pterygopalatine ganglion derive from?
Nervus intermedius (a branch of facial nerve CN VII) through greater petrosal nerve
Where does the maxillary artery originate from?
It originates near the neck of the mandible, travels through the pterygomaxillary fissure via the infratemporal fossa, and enters the pterygopalatine fossa as the terminal part/third of the maxillary artery
What are the branches of the third part of maxillary artery?
Infrorbital
Posterior superior alveolar
Sphenopalatine
Greater palatine
Pharyngeal
artery of pterygoid cana
Fill in the blanks “ ________ serves as a gateway for seven openings that communicate with the orbit, the nasal cavity, the oral cavity, the middle cranial fossa, and the infratemporal fossa.”
Pterygopalatine fossa
What is located on posterior wall of pterygopalatine fossa, between foramen rotundum and palatine canal. Communicates with middle cranial fossa and from there, it transmits nerve, artery, and vein of pterygoid canal?
Pterygoid canal
Where is the Pterygomaxillary fissure located?
Located between anterior and posterior wall of pterygopalatine fossa. Communicates with infratemporal fossa.
What is the function of the palatine canal?
It communicates with the oral cavity via the greater palatine and the lesser palatine canals, which transmit the greater palatine and lesser palatine nerves, respectively
Which structure transmits the greater palatine artery?
Palatine canal
Which two two neurovascular structures does the Pterygomaxillary fissure transmit?
Posterior superior alveolar nerve
Maxillary artery
What is the nerve supply for the skin of the external part of the nose?
External nasal nerve
Infratrochlear branch of nasociliary nerve
Nasal branches of infraorbital nerve
What is the blood supply for the skin of the nose?
. External nasal artery from anterior ethmoidal artery
. Dorsal nasal artery (terminal branch of ophtalmic artery) at root. Divides
into two branches: one anastomosing with angular artery, terminal branch of the facial artery
:one anastomosing with fellow artery on opposite side and with lateral nasal branch.
. Lateral nasal branch of facial artery
Where are the vocal folds located?
Vocal folds located just below where the tract of the pharynx splits into
trachea and esophagus.
What is located posteriorly to the thyroid gland and anteriorly to pharynx?
The larynx
What are the three unpaired cartilages?
Thyroid Cartilage
Cricoid cartilage
Epiglottic Cartilage
CET are unpaired
What are the paired cartilages?
Arytenoid Cartilage
Corniculate Cartilage
Cuniform Cartilage
“ ACC are paired with rich ppl”
What is known as the laryngeal prominence?
The Adams Apple (larger in males)
What structure is located superior to laryngeal prominence?
Superior thyroid notch
Fill in the blank “ Inferior horn articulates with cricoid cartilage through ________”
Cricothyroid joint
What structure connects superior border of thyroid cartilage to hyoid bone?
Thyrhyoid membrane
Which cartilage has an oblique ridge/line running from superior to inferior tubercles?
Thyroid cartilage
Where is the arch for the cricoid cartilage located?
Anteriorly
“Arch for anterior”
Where is the lamina of the cricoid cartilage located?
Posteriorly
Which cartilage is located posterior to the tongue and hyoid bone?
Epiglottic cartilage
Where is the Arytenoid cartilage located?
Located on superior border of lamina of cricoid cartilage
Fill in the blanks “Each arytenoid cartilage has a muscular process for attachment of ______ and vocal process for attachment of______.”
Intrinsic laryngeal muscles and Vocal ligaments
Which cartilage is described as Club-shaped pieces of elastic cartilage located anterior to corniculate cartilages?
Cuneiform cartilages
Which cartilage is described as horn-shaped pieces of elastic cartilage located at apex of each arytenoid cartilage?
Corniculate cartilages
What are the two joints of the Larynx?
Cricothyroid joint
Cricoarytenoid joint
What types of joints are the Cricothyroid joint and Cricoarytenoid joint?
Synovial joint
Which joint is located at the superior border of lamina of cricoid?
Crycoarytenoid joint
Which joint is located between inferior horn of thyroid cartilage and side of arch of cricoid cartilage?
Cricothyroid joint
What is the purpose of the cricoarytenoid joint?
Allows rotatory and lateral gliding movements
Which nerve passes behind the Cricothyroid joint becoming inferior laryngeal nerve?
Recurrent Laryngeal nerve
True or False? Thyroid, cricoid, and arytenoid cartilages all contain elastic cartilages.
FALSE!! They all contain hyaline cartilage
( tic TAC has hyaline cartilage)
What type of cartilage does Corniculate , Epiglottic ,Cuniform cartilages all have?
Elastic cartilage
What are the Extrinsic Membranes in the Larynx?
Thyrohyoid membrane
Cricotracheal membrane
What type of ligament is cricothyroid ligament?
Intrinsic
What are the extrinsic ligaments of the Larynx?
Hyoepiglottic ligament
Thyroepiglottic ligament
True or False? The Quarangular Membrane that extends between epiglottis and arytenoid cartilage is an Intrinsic membrane?
TRUE!!
Which structure connects the epiglottis to hyoid bone in the Larynx?
Hyoepiglottic ligament
Which structure connects lower border of cricoid cartilage to first cartilaginous ring of trachea?
Cricotracheal membrane
Which structure is not apart of the larynx, but anchors the larynx to the hyoid bone?
Thyrohyoid membrane
True or False? The Thyrohyoid membrane is perforated by the recurrent laryngeal nerve and inferior laryngeal vessels.
FALSE!! It is perforated by SUPERIOR LARYNGEAL NERVE and superior laryngeal vessels
Fill in the blank “ Thyroepiglottic ligament connects epiglottis to ____”
Thyroid cartilage
What structure is the anterior border of the Quadrangular membrane in the Larynx attached to?
Side of lower half of epiglottis
What structure is the posterior border of the Quadrangular membrane in the Larynx attached to?
Anterolateral surface of arytenoid
What is the function of suprahyoid muscles in the Larynx?
They elevate the larynx
What is the function of infrahyoid muscles in the Larynx?
They depress the larynx
What are the suprahyoid muscles (Extrinsic muscles) of the Larynx?
G- Geniohyoid muscles
G- Genioglossus muscles
Don’t- Digastric muscles
Sell- Stylohyoid muscles
My- Mylohyoid muscles
House - Hyoglossus muscles
“ GG Don’t Sell My House”
What are the Infrahyoid muscles(Extrinsic) of the larynx?
Thyrohyoid muscles
Omohyoid muscles
Sternothyroid muscles
Sternohyoid muscle
“TOSS”
What are the intrinsic muscles of the Larynx that act on the inlet( Opening connecting larynx to pharynx)
Aryepiglottic muscle
Oblique arytenoids
Assisted by transverse arytenoid and thyroepiglottic muscles
What type of muscles are Posterior cricoarytenoids, Lateral cricoarytenoids ,Oblique and transverse arytenoids, Thyroarytenoids and cricothyroids, Vocalis?
Muscles affecting the vocal ligaments
What are the sub divisions of Intrinsic Muscles?
Respiratory muscles (They move the vocal cordsapart and serve breathing)
Phonatory muscles (They move the vocal cords together and serve the production of voice)
Which muscle is the main respiratory muscle?
Posterior cricoarytenoid muscles
Which Phonatory muscles are Adductors?
Transverse Arytenoid
Oblique Arytenoid
Lateral Cricoarytenoid
“TOL”
The cricothyroid muscles and thyroarytenoid muscles are descibed as ?
Tensors
True or False? The Vocalis muscle is known as a vocal fold relaxer.
TRUE!!
Which intrinsic muscle of the Larynx is the ONLY muscle that is not supplied by the recurrent laryngeal nerve?
Cricothyroid Muscle ( It is supplied by the External laryngeal nerve (branch of the superior laryngeal nerve branch of the Vagus nerve which comes off of the Subclavian artery)
Which muscle is the ONLY muscle to open the rima glottidis?
Posterior cricoarytenoid muscle
What is the origin (inferior attachment of the posterior crycoarytenoid muscle)?
The posterior surface of lamina of cricoid cartilage
What is the insertion(superior attachment) of the posterior crycoarytenoid?
Muscular process of arytenoid cartilage
What is the Innervation for all Intrinsic muscles of the Larynx except the cricothyroid?
Inferior Laryngeal nerve (Branch of the Recurrent Laryngeal Nerve )
Which muscle has its origin being the lateral border and muscular process of arytenoid cartilage and its insertion on the opposite side?
Transverse Arytenoid
What is the origin and insertion for the Oblique Arytenoid muscle?
Origin - Muscular process of arytenoid cartilage
Insertion - Apex of contralateral arytenoid cartilage
Which muscle has its origin (inferior attachment) at the arch of cricoid cartilage and where is it’s insertion ( superior attachment)
Lateral cricoarytenoid muscle
Insertion - muscular process of arytenoid cartilage
What is the origin of the Cricothyroid muscle?
Anterolateral part of cricoid cartilage
What is the insertion of Cricothyroid muscle?
Inferior horn of thyroid cartilage
What is the Innervation and Blood supply of the Cricothyroid cartilage?
External laryngeal nerve & Cricothyroid artery and vein
Which muscle has its origin at the angle of thyroid laminae & cricothyroid ligament and its insertion at the Anterolateral arytenoid surface?
Thyroarytenoid muscle
What is the blood supply of All intrinsic muscles of the larynx?
Superior& Inferior Thyroid arteries
What is the function of the vocalis muscle?
Tenses anterior part and relaxes posterior part of vocal ligament
What is the origin & Innervation of the Vocalis muscle
Origin: Lateral surface of vocal processes of arytenoid cartilage
Insertion: Anterior part of ipsilateral vocal ligament
What is the space between the vocal folds known as ?
The rima glottidis
What type of epithelium is the Vocal folds?
Non-keratinised stratified squamous epithelium
What is Reinke’s space?
T his watery, amorphous layer is rich in glycosaminoglycans. Due to its fluidity, the epithelium is able to vibrate freely above it to create sound
Which Intrinsic muscle of the larynx produces a high pitch?
Cricothyroid muscle
Which Intrinsic muscle of the larynx produces a low pitch?
Thyroartytenoid muscle
What is another name for vestibular folds?
False vocal cords
What are the three parts of the laryngeal cavity?
1)Vestibule: superior to vestibular folds
2)Ventricle: depression between vestibular and vocal folds may extend in a recess called saccule
3)Infraglottic cavity: inferior to vocal folds and continuous with trachea
What happens when there is an injury to one of the recurrent laryngeal nerves?
It produces hoarseness; if both are damaged the voice may or may not be preserved, but breathing becomes difficult
Damage to which nerve causes a weakened phonation because vocal cords cannot be tightened?
External laryngeal nerve - (this supplies the crycothyroid muscles which causes tension of the vocal cords )
Which nerve supplies sensory innervation to mucosa superior to vocal folds?
Internal branch of superior laryngeal nerve
What are the three layers of the Pharyngeal wall?
1)Buccopharyngeal fascia: adventitia of pharynx continuous with connective tissue covering buccinator muscle
2)Muscular layer: outer circular part and inner longitudinal part
3)Mucous membrane
How long is the pharynx?
12-14cm
What are the three divisions of the Pharynx?
Nasopharynx
Oropharynx
Laryngopharynx
Where is the nasopharynx located?
The nasopharynx is found between the base of the skull and the soft palate.
Through what structure does the Nasopharynx communicate with the nasal cavities?
The nasal choanae
Where are adenoid tonsils found?
In the posterosuperior nasopharynx
Which division of the pharynx is located between the superior border of the epiglottis and inferior border of the cricoid cartilage?
Laryngopharynx
Where is the Oropharynx located ?
The oropharynx is located in the middle part of the pharynx , located between the soft palate and the superior border of the epiglottis
What tonsils are found in the Oropharynx?
Lingual tonsils
Palatine tonsils
What structures are found in the Oropharynx?
Posterior 1/3 of tongue
Palatine Tonsils
Lingual tonsils
Superior Constrictor Muscle
“ ppls of the Oropharynx”
Which muscles are found in the Laryngopharynx?
Middle and Inferior pharyngeal constrictors
What nerve mostly innervates the muscle of the pharynx?
Vagus nerve
Which muscle of the Pharynx is NOT supplied by the Vagus nerve?
Stylopharyngeous muscle
Which muscle of the Pharynx is NOT supplied by the Vagus nerve?
Stylopharyngeous muscle
Which nerve is the Stylopharyngeous muscle innervated by?
Glossopharyngeal nerve
What are the boundaries of the superior thoracic aperture (thoracic inlet)?
Manubrium of sternum
Right and left first ribs
Body of T1
What are the structures passing through the thoracic inlet?
Trachea
Oesophagus
Major blood vessels
Vagus nerves
Phrenic nerves
Thoracic duct
What are the boundaries of the inferior thoracic aperture ( thoracic outlet)
Xiphisternal joint
Costal margin
Ribs 11 and 12
Body of T12
What are the structures passing through the opening diaphragm ?
Aorta
Inferior vena cava
Oesophagus
Vagus nerves
Azygos system
Thoracic duct
What is the superior boundary of the mediastinum?
Superior thoracic aperture
The sternum serves as which border of the Mediastinum?
Anterior
What is the Inferior border of the mediastinum?
Diaphragm
Fill in the blanks “ The ______ border of the mediastinum is the bodies of vertebrae T1 to T12”
Posterior
What is the lateral border of the mediastinum ?
Mediastinal parietal pleurae (left and right)
At what level does the imaginary transverse plane at level of sternal angle intersects the intervertebral disk ?
Between T4-T5
True or False?The plane of sternal angle separates superior mediastinum from lateral mediastinum.
FALSE!! It separates superior mediastinum from inferior mediastinum
What are the parts in which the pericardium divides the inferior mediastinum into ?
Anterior Mediastinum
Middle Mediastinum
Posterior Mediastinum
Where can parts of the thymus be found in children?
Anterior mediastinum
The pericardium, the heart and the roots of great vessels can be found in which mediastinum?
Middle mediastinum
What structures are found in the Posterior mediastinum?
Oesophagus, vagus nerves, sympathetic trunks, azygos system of veins, thoracic duct, thoracic aorta
What are the things that occur at Plane of sternal angle (T4-T5)
Superior border of pericardium
Division between superior and inferior mediastinum
Bifurcation of trachea
End of ascending aorta
Beginning and end of arch of aorta
Beginning of thoracic aorta
Arch of azygos vein
What are the structures giving off by the arch of the aorta?
L- Left common carotid artery
L- Left subclavian artery
B- Brachiocephalic trunk
What are the blood vessels passing through the Superior mediastinum?
Arch of the Aorta
Ligamentum arteriosum (remnant of ductus arteriosus): from left pulmonary artery to concavity of aortic arch
Brachiocephalic veins
Superior vena cava
True or False? The Nasopharynx is supplied by the Pharyngeal Plexus.
FALSE!! The Nasopharynx is supplied by the Pharyngeal Nerve NOT plexus.
From what levels do the Phrenic nerves arise?
C3,C4,C5 - “keeps the diaphragm alive”
At what level does the right phrenic nerve pass through vena cava hiatus opening in diaphragm ?
T8
True or False? Two thirds of fibers are motor to diaphragm, other one third are sensory to diaphragm and pleura and pericardium.
TRUE!!
Which one of the vagus nerves are in contact with the trachea?
Right vagus nerve
What are the structures found within the anterior mediastinum?
Thymus (or remnants)
Sternopericardial ligaments
Few lymph nodes
Branches of internal thoracic vessels
What are the blood supply of the Thymus?
Branches of inferior thyroid and internal thoracic arteries
What do efferent channels of the Thymus drain into?
Parasternal, tracheobronchial and brachiocephalic nodes
What germ layer does the Thymus develop from?
Endoderm of third branchial pouch
What are the structures of the Posterior mediastinum?
Oesophagus
Vagus nerves
Thoracic aorta
Azygos vein (on the right side)
Hemiazygos and accessory hemiazygos veins (on the left side)
Thoracic duct and lymph nodes
At what level does the thoracic aorta begin?
Begins at lower border of T4
At what level does the oesophagus pass through the diaphragm?
At level of T10
What is the blood supply of the Oesophagus?
Upper oesophagus: inferior thyroid arteries
Middle portion: oesophageal branches from aorta and bronchial arteries
Lower part: oesophageal branches of left gastric artery
What is the nerve supply of the upper part of the oesophagus?
By recurrent laryngeal nerves and by sympathetic fibers from middle cervical ganglia
What is the nerve supply of the middle and lower part of the oesophagus?
By thoracic sympathetic trunks and greater splanchnic nerve.
The region of mediastinum where lung is connected to trachea and heart is called ?
The root of lung
The region of lung where bronchi and pulmonary vessels enter or leave is known as?
Hilum
Which lung has a cardiac notch ?
Left lung
What are the contact impressions of contact impressions on mediastinal surface of right lung?
Cardiac impression
Esophagus impression
Arch of azygos vein impression
Superior vena cava impression
What are the contact impressions of contact impressions on mediastinal surface of left lung?
Cardiac impression
Aortic arch impression
Thoracic aorta impression
In the right lung, how does one distinguish the main bronchus from pulmonary vessels?
The cartilage in bronchus
True or False? In the right lung, Right superior lobar bronchus (eparterial) passes inferior to right pulmonary artery.
FALSE!!! Right superior lobar bronchus (eparterial) passes SUPERIOR to right pulmonary artery.
In the left lung , what structures does the Hilum contain?
Lymph nodes, lymph vessels, autonomic nerve fibers, bronchial vessels
What are the blood supplies to the Kiesselbach’s area?
Anterior ethmoid artery
Sphenopalatine artery of maxillary artery
Septal branch of superior labial artery
Greater palatine artery
What is the name of the hairs found in the nasal cavity called?
Vibrissae
What bone is the Later wall of the nasal cavity made of?
Maxilla
What is another name for conchae?
Turbinates
What bone forms the posterior border of the nasal septum?
Vomer
Fill in the blank “ The floor of the nasal cavity is the _____ surface of the _______”
Upper & Hard Palate
What are the bones forming the structure of the hard palate?
Palatine process of maxilla and horizontal plate of palatine bone
What are the three structures forming the Roof of the nasal cavity?
Central part: cribriform plate of ethmoid
At the front: nasal spine of frontal bone and nasal bones
At the back: sphenoid body
Fill in the blanks “The frontal, maxillary and anterior ethmoidal sinuses open into the _____ . The location of this opening is marked by the ________.
Middle Meatus & Semilunar hiatus
True or False? The limen nasi is ridge between vestibule and nasal cavity proper.
TRUE!!!
Where do the posterior ethmoid cells drain into?
Into the superior meatus
What is the Torus Tubarius?
It is the swelling above pharyngeal opening of the Eustachian tube formed by the tubal cartilage
What is the location most susceptible to have a nasopharyngeal carcinoma?
Pharyngeal Recess
What is the most common area for epistaxis(Nose bleeds)
Kiesselbach’s Plexus (Little Area)
What structure does the nasolacrimal duct opens into?
The inferior meatus
What is the main blood supply of the nasal cavity ?
Sphenopalatine branch of maxillary artery
True or False? Superior and posterior ethmoidal branches of maxillary artery enter nose from orbit and supply roof and upper parts of lateral wall and septum.
FALSE!!! Anterior and Posterior ethmoidal branches of the ophthalmic artery
What is the nerve supply for the vestibular area of nasal cavity?
Infraorbital nerve
Fill in the blanks .” Respiratory area of lateral wall supplied at front by __________nerve (from orbit) in upper part and in lower part by ________ nerve
Anterior ethmoidal nerve (upper part)
Anterior superior alveolar nerve ( lower part)
What nerve supplies the upper back part of the lateral wall of the nasal cavity?
Lateral posterior superior nasal branches of pterygopalatine ganglion
What nerve supplies the lower back part of he lateral wall of the nasal cavity?
Posterior inferior nasal branches of greater palatine nerve
Which sinus is not present at birth?
Frontal sinus
What are the branches of the External Carotid Artery?
Superior thyroid artery
Ascending pharyngeal artery
Lingual artery
Facial artery
Occipital artery
Posterior auricular artery
Maxillary artery
Superficial temporal artery
“Some Anatomists Like Freaking Out Poor Medical Students”
- same smn as uwiss ‘ as sally ‘
True or False? The frontal, maxillary and anterior ethmoidal sinuses open into the middle meatus by the semilunar hiatus
TRUE!!
Which two bones make up the nasal septum?
Vomer and Perpendicular plate of ethmoid bone
What is the direction for External intercostal muscles?
Downward and forward
“Hands in pockets”
What is the direction for Internal intercostal muscles?
Downwards and backwards
“Hands on tits”
What structure separates the thoracic cavity from the abdominal cavity?
Diaphragm
True or False, In the diaphragm the left dome is higher than the right dome?
FALSE!! Right dome is higher than the left dome
To what region does the right dome of the diaphragm extend to during Expiration?
As far as the nipple (fourth Space)
To what region does the left dome of the diaphragm extend to during Expiration?
To the Fifth rib
At what level is the central tendon of the diaphragm found?
The level of the xiphisternal joint at T8 level (6th CC)
What are the subdivisions of the Peripheral part of the diaphragm?
Sternal
Costal
Lumbar
For the costal part of the diaphragm , where do the muscles attach?
To the inferior 6th ribs and their costal cartilages
Which muscular part of the diaphragm are formed by two crurae?
Lumbar part
Fill in the blanks. “ The sternal part of the diaphragm has two small bundles of muscle fibers that attach to_______ surface of _________”
Posterior & Xiphoid process
What is the diaphragmatic crura?
Crura are strong tendons attached to the anterolateral surfaces of upper lumbar vertebrae.
True or False? The right crus is fixed to the upper 3 lumbar vertebrae and the discs while the left crus to upper 2 lumbar vertebrae.
TRUE!!
At what level, does the tendinous fibres of each crus unite with one another to form the medial arcuate ligament?
At T 12
What is the medial arcuate ligament?
It is a thickening of the psoas fascia and it extends from the side of body of L1 or L2 to anterior surface of transverse process of L1.
Which ligament extends from the anterior surface of transverse process of L1 to middle of lower margin of 12th rib.
Lateral arcuate ligament
Fill in the blanks. “ The middle arcuate ligament bridges anterior surface of ______ muscle while the lateral arcuate ligament bridges the anterior surface of the _______ muscle .
Middle - Psoas Major muscle
Lateral- Quadratus lumborum muscle
What is the shape given to the central tendon?
Trefoil shape
At what levels are the different openings in the diaphragm?
Vena cava foramen - T8
Oesophagus opening- T10
Aortic Hiatus opening- T 12
Which nerve passes through the central tendon along with the Inferior Vena cava?
Right phrenic nerve
Where on the diaphragm can the oesophageal opening be found?
2.5 cm to LEFT of midline behind 7th left costal cartilage.
What other structures run through the oesophageal opening?
Vagus nevre, esophageal branches of left gastric artery, veins and lymphatics
Fill in the blank . “ The Venous drainage for the oesophageal opening in the diaphragm passes caudally to _________and cranially to
_________.
Portal Venous system (caudally)
Azygous system (cranially)
Where is the vena cava opening in the diaphragm located?
Right of midline, behind 6th costal cartilage
Passing through the diaphragm, which structure passes behind the medial arcuate ligament.
Sympathetic Trunk
Fill in the blank, When passing through the diaphragm, the left phrenic pierces _____”
The muscle of the left dome.
What nerve does the Pleural and peritoneal coverings of peripheral part of diaphragm receive sensory fibers from?
(proprioceptive to periphery of diaphragm
LOWER intercostal nerves( T5-11)and subcostal nerve
Which part of the diaphragm does the phrenic nerve supply sensory innervation for?
(proprioceptive to central diaphragm)
Abdominal (parietal peritoneum) and thoracic (parietal pleural) surfaces of diaphragm
What type of muscle fibres make up 55% of the diaphragm?
Slow twitch , fatigue-resistant (type I) fibres
What is the blood supply of the costal margin of the diaphragm?
Lower five intercostal and the subcostal arteries
What is the blood supply to the cura of the diaphragm?
Right and Left phrenic arteries from abdominal aorta.
What are the four sources that give rise to the diaphragm?
Pleuroperitoneal membrane
Oesophageal mesentery
Lateral body wall mesoderm
Septum Transversum
Diaphragm are developed from POLS
What part of the diaphragm does the septum transverse gives rise to?
Central Tendon
Fill in the blank. “ Prior to its descent from neck the transverse septum became invaded by muscle cells derived from _______”
3rd, 4th and 5th Cervical myotomes
What is the function of the Pleuroperitoneal membrane?
It closes the connection between thoracic and abdominal parts of coelom.
Fill in the blanks. “The pleuropericardial folds(membranes) fuse with each other to form _____”
Fibrous pericardium
What is the most common cause of congenital diaphragmatic hernia ?
Bochdalek’s foramen
- it is the failure of pleuroperitoneal membrane development
True or False? Bochdalek’s hernia normally develops on the right side.
FALSE, It is normally on the left side.
Where is Morgan’s foramen located?
This is at junction of costal and xiphoid origin
What are the two types of congenital diaphragmatic hernia?
Bochdalek’s hernia
Morgagni’s foramen
What are the two types of Acquired diaphragmatic hernia?
Sliding type
Paraesophageal (rolling) type
