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Bloc B - Respiration > Anatomy 2 Pleura Sept28 M1 > Flashcards

Anatomy 2 Pleura Sept28 M1 Flashcards

1
Q

two sides of pleura

A

visceral on lung side

parietal on chest side

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2
Q

Different names of parietal pleura depending on location

A

Cervical (on top)
Costal (middle)
Diaphragmatic (bottom)
Mediastinal (on interior side facing heart)

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3
Q

what mediastinal means and what sits in correspond region

A

comes from mediastinum, region where heart sits

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4
Q

T-F: parietal and visceral pleura are separate

A

F: are continuous

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5
Q

volume of fluid in pleural cavity

A

8-10 mL

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6
Q

Consequence of disruption of intrapleural pressure

A

dyspnea

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7
Q

pneumothorax def and what happens

A

hole in pleura, air enters it

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8
Q

hemothorax def

A

blood enters pleural cavity

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9
Q

What is mediastinal shift, when it happens and consequence

A

heart moves to side where lung collapsed. (happens in severe pneumothorax) Compromises hemodynamic stability

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10
Q

which pleura has nervous innervation and why

A

both

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11
Q

visceral pleura sensitivity what innervates it and where pain is referred

A

Autonomic innervation, insensitive to pain

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12
Q

innervation of parietal pleura

A

Intercostal nerves innervate cervical, costal and exterior portion of diaphragmatic pleura
Phrenic nerve innervates interior or diaphragmatic pleura and mediastinal pleura

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13
Q

Pain to parietal pleura: where it is referred

A

If sensed by intercostal nerves: refer to lateral thoracic and abdominal walls
sensed by phrenic nerve: refers to neck and shoulders

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14
Q

Parietal pleura: somatic or autonomic innervation

A

somatic

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15
Q

pain in diaphragm: where it is felt

A

neck and shoulder

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16
Q

name of pleural cavities (what we say instead of cavities) and how many

A

pleural recesses, two

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17
Q

pleural recesses location, name and direction of expansion

A 
costomediastinal recess (mediastinal, interior, expand on side)
costodiaphragmatic recess: below lung on above diaphragm (expand vertically)
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18
Q

lobes in right and left lung

A

right: superior, middle, inferior
left: superior inferior

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19
Q

fissures in right and left lung

A

right and left have oblique fissure to separate superior (+ middle in right) from inferior
right has horizontal fissure to separate middle and superior

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20
Q

name of surface on bottom of lung

A

diaphragmatic surface

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21
Q

two characteristic structures of left lung and where

A 
cardiac notch (on mediastinal surface in bottom)
lingula, bottom interior
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22
Q

name of top of the lung and where it is

A

apex. 2-4 cm above clavicle

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23
Q

which lung bigger and why

A

right bc heart sits more towards left so left smaller

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24
Q

impressions in right lung

A

posterior to anterior: esophagus, azygos vein, SVC

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25
Q

impressions in left lung

A

posterior to anterior: aorta, cardiac impression

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26
Q

impression def

A

characteristics created by fixation bc surfaces stick together

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27
Q

lines used as anatomy landmarks to find chest structures on each side

A

parasternal lines: on each side of sternum

mid-clavicular lines: vertical lines that cross middle of clavicle on each side

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28
Q

How to find horizontal fissure

A

is along rib 4 in right lung

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29
Q

how to find oblique fissure

A

at rib 6 and mid-clavicular lines crossing, then goes up, to the side and to the back

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30
Q

right lung lobes position in front

A

sup: rib 1-4
middle: rib 5-6
inf: rib 6 to the back

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31
Q

left lung lobes position in front

A

sup: rib 1-6
inf: rib 6 to the back

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32
Q

where to place stethoscope for auscultation of apex

A

above clavicle

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33
Q

where to place stethoscope for auscultation of superior lobe of RIGHT lung

A

between ribs 2 and 3 on front

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34
Q

where to place stethoscope for auscultation of middle lobe of right lung

A

below rib 4 on front

35
Q

where to place stethoscope for auscultation of inferior lobe of right lung

A

below rib 6, a little bit on the side

36
Q

at what level does the horizontal fissure cross the midaxillary line and what it shows

A

rib 5. Bc crosses rib 4 at the front, it shows that it doesn’t go as up as steep as the ribs

37
Q

Oblique fissure what it lines up to from back to front

A

Is at TIV, crosses ribs 4 and 5, and continues anteriorly along rib 6

38
Q

Which ribs crosses midaxillary line at inferior border of the lung

A

Rib 8

39
Q

Which ribs crosses midaxillary line at parietal pleura

A

rib 10

40
Q

name of pleural cavity between rib 8 and 10

A

costodiaphragmatic recess

41
Q

surface anatomy landmarks when looking at the back

A

paravertebral lines

42
Q

What ribs cross the inferior border at midclavicular line at midaxillary line and at paravertebral line

A

6, 8, 10

43
Q

What ribs cross the parietal pleura at midclavicular line at midaxillary line and at paravertebral line

A

8, 10, 12

44
Q

which lobes can we listen to from the back (for each lung)

A

right: sup and inf
left: sup and inf

45
Q

Tip to identify the oblique fissure easily when looking at patient from the back

A

Tell them to put both hands behind head. Oblique fissure goes along medial scapular border

46
Q

How to auscultate apex of lung from the back

A

Stethoscope near rib 1

47
Q

How to auscultate superior lobe of lung from the back

A

stethoscope between rib 3 and 4

48
Q

How to auscultate inferior lobe of lung from the back

A

stethoscope between rib 8 and 9

49
Q

Why trachea has cartilage rings

A

Keep airways open, no closing when kink when turning head

50
Q

Level at which trachea branches to become primary bronchi and name of this branching

A

Carina. T4-T5 level

51
Q

How many secondary bronchi in left and right lung

A

left: 2. Right: 3

52
Q

What is also on level of carina

A

sternal angle of rib 2

53
Q

Name of muscle found in trachea and function

A

Trachialis muscle. Allows trachea to contract and expand a little

54
Q

How many tertiary bronchi in each lung and how they subdivide within the secondary bronchi

A

10 per lung. Right lung: 3 sup 2 middle 5 inf.

Left lung 5 sup 5 inf

55
Q

Name of technique where take scope and look inside airways

A

bronchoscopy

56
Q

See 3 holes in bronchoscopy camera, what do we know?

A

We’re at superior lobe of right lung

57
Q

What tertiary bronchi correspond to

A

Correspond to numbered segments of the lung

58
Q

How many segments in each lobe

A

Right lung: 3 in sup, 2 in inf, 5 in inf

Left lung: 5 in sup, 5 in inf

59
Q

3 types of lung resections and def

A

Segmentectomy (remove lung segment)
Lobectomy (remove lung lobe)
Pneumonectomy (remove a lung)

60
Q

End portion of the branching of a segmental bronchus

A

Bronchiole

61
Q

Two portions of bronchiole

A

Terminal bronchiole and respiratory bronchiole

62
Q

What is the largest structure name for gas exchange

A

respiratory bronchiole

63
Q

how structure of bronchus changes as it branches more and more

A

less cartilage and more smooth muscle (in terminal and resp bronchioles)

64
Q

where do we find smooth muscle in the airways exactly

A

In terminal and resp bronchioles

65
Q

how many pulm arteries and veins

A

2 pulm arteries (one each side)

4 pulm veins (2 each side)

66
Q

What provides blood supply and venous drainage to the bronchi and lung tissues

A

Bronchial arteries and veins

67
Q

Hillum of the right lung

A

back to front: primary bronchus, pulm artery, pulm vein.

below: pulm vein

68
Q

hillum of the left lung

A

superior to inferior:
pulm artery, primary bronchus, pulm vein.
in front: pulm vein

69
Q

how to recognize primary bronchus on image (or macroscopically?)

A

grey bc of cartilage and more thick therefore

70
Q

pulmonary ligament location and function

A

below hillum of each lung. makes the hillum hang down to provide space for vessel, veins, bronchus to expand

71
Q

Nearest structure to trachea and lungs that provide nervous innervation + location

A

Anterior and posterior pulmonary plexuses. front and back of trachea

72
Q

Where pulmonary plexuses stem from (what they’re made of)

A

contribution from nerves from T2-T6 and going out of sympathetic chain and also of vagus nerve (PSS)

73
Q

Where SS info goes

A

bronchi and tracheobronchial tree

74
Q

5 lymphatic structures in or near the lungs

A 
Pulmonary nodes
Hilar (bronchopulmonary) nodes
Trachebronchial nodes
Paratracheal nodes
Bronchomediastinal trunk
75
Q

lymphatic system, give 2 functions

A

immune response, fat transport

76
Q

how recognize lymph nodes whe looking at mediastinal surface of lung

A

dark aggregates (are hilar lymph nodes)

77
Q

pulmonary nodes location and can see them or not

A

nodes at capillary level within lung, can’t see them

78
Q

hilar nodes location and can see them or not

A

where right primary bronchus enters lung, at hillum of the lung

79
Q

tracheobronchial nodes location

A

where primary bronchi meet trachea at the carina

80
Q

paratracheal nodes location

A

up on either side side of trachea

81
Q

Bronchomediastinal trunks description

A

Lymphatic vessels draining lymphatic circulation from pulmonary nodes, etc. back to heart

82
Q

left bronchomediastinal trunk termination

A

joins thoracic duct which then enters blood circulation at venous angle (angle between jugular vein, vertical and subclavian vein, horizontal)

83
Q

right bronchomediastinal trunk termination

A

joins directly circulation at venous angle (angle between jugular vein, vertical and subclavian vein, horizontal)

Bloc B - Respiration (36 decks)

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