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Block 3 - Resp > Anatomy 2 - Thorax: Internal Organisation And Lower Respiratory System > Flashcards

Anatomy 2 - Thorax: Internal Organisation And Lower Respiratory System Flashcards

1
Q

Thorac internal organisation

A
  • 3 compartments: 2 pulmonary cavities (contain lungs) and one mediastinum (contains heart, vessels, nerves, trachea, bronchi, oesophagus, lymphatics. Divided by pericardium
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2
Q

Mediastinum - Divisions

A
  • Superior mediastinum - above sternal angle
  • Infersios mediastinum - below sternal angle. Further divided into anterior mediastinum (in front of heart), middle mediastinum (At heart) and posterior mediastinum (behind heart)
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3
Q

Contents of superior mediastinum

A
  • thymus
  • braciocephalic vein
  • SVC
  • Aortic arch
  • brachiocephalic trunk
  • common carotid artery
  • subclavian artery
  • trachea
  • oesophagus
  • thoracic duct
  • vagus and phrenic nerve
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4
Q

Anterior mediastinum content

A
  • thymus (children)
  • fat (adults)
  • lymph nodes
  • ligaments between pericardium and sternum
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5
Q

Middle mediastinum contents

A
  • Heart
  • root of great vessels
  • pericardium
  • phrenic nerve
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6
Q

Posterior mediastinum content

A
  • bronchi
  • thoracic aorta and branches
  • oesophagus
  • bagal and sympathetic trunks
  • thoracic duct
  • azygos and hemiazygos veins
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7
Q

Upper respiratory system

A
  • nasal cavity
  • pharynx
  • larynx
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8
Q

Lower respiratory system

A
  • trachea
  • bronchi (bronchioles, alveoli)
  • lungs
  • pleura
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9
Q

Trachea

A
  • long (10-12cm) fibromuscular tube supported by cartilage, provides passage of air from pharynx to lungs
  • Extends along vertebral bodies from lower end of larynx through mediastinum to bifurcate into 2 principal bronchi at the carina (at the level of the sternal angle (TV4/5)
  • fibroelastic tissue allows for stretch and recoil during aspiration
  • 16-20 C-shaped hyaline cartilage rings that are completed by smooth muscle posteriorly which expands to let food pass throu oesophagus on swallowing
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10
Q

Trachea - visceral relationships

A
  • contained within the nech, the thoracic inlet ant the superior mediastinum
  • within superior mediastibum, trachea is related to Manubrium, aortic arch, brachiocephalic trunk, left common arotid, left brachiocephalic, thymus, oesophagus and left recurrent laryngeal nerve
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11
Q

Bronchi

A
  • the 2 cartilage ring-reinforced proncipal bronchi lie behind the heart in the posterior mediastinum and pass into each lung root before branching
  • right principal bronchus is shorter, wider and more vertical than the left
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12
Q

BRonchial tree

A
  • 1º principal bronchi divide into lobar (2º) bronchi: one for each lung lobe
  • Lobar bronchi divide into segmental (3º) bronchi - corresponds to various bronchopulmonary segments
  • segmental bronchi divide until they become cartilage-free terminal bronchioles
  • terminal bronchioles divide into respiratory bronchioles which develop into alveoli and alveolar sacs
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13
Q

How many alveolar sacs are they by lung?

A
  • 300 million
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14
Q

Bronchial tree: blood supply

A
  • bronchi and pulmonary arteries are paired and branch in unison
  • each intrasegmental pulmonary artery carry poorly oxygenated blood from heart and ends in a capillary plexus in the walls of the alveolar sacs and alveoli: where CO2 and O2 are exchanged
  • intersegmental pulmonary veins arise from pulmonary capillaries and carry well oxygenated blood back to the heart
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15
Q

Bronchopulmonary segments

A
  • make up the substane of the lung
  • the area of lung supplied by a segmental bronchus and its accompanying pulmonary branch
  • 10 in each lung
  • smallest functionally independent region of a lung that can be isolated and removed without affecting adjacent regions
  • surgically resectable, but malignancies may disrupt septa of segments making resection more complicated or more extensive
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16
Q

Lungs

A
  • covered by pleura
  • occupy pulmonary cavities
  • Apex extends into root of neck above 1st rib
  • Base rests on diaphragm
17
Q

Right lung

A
  • larger
  • shorter because liver pushes up
  • wider because heart on left
  • 3 lobes: Upper, middle, lower
  • 2 fissures: oblique, horizontal
  • related to: heart, IVC, SVC, subclavian vein, subclavian artery, azygos vein, oesophagus, 1st rib
18
Q

Left lung

A
  • smaller, longer, narrower
  • divides into 2 lobes: upper + Lower
  • 1 fissure: oblique
  • has a cardiac notch and lingula
  • related to: the heart, the aortic arch, the thoracic aorta, the brachiocephalic vein, the subclavian artery, the oesophagus, the 1st rib
19
Q

Pulmonary hilum

A
  • where structures enter and leave the lungs from
  • surrounded by a pleural sleeve
  • drapes inferiorly to create the pulmonary ligament
  • veins are anterior and inferior
  • arteries are superior
  • bronchi are posterior
  • pulmonary ligament inferior
  • lymph nodes are scattered
20
Q

What is the different organisation in left and right hilum dure to

A
  • due to twist in left pulmonary artery and left bronchus that results in left pulmonary artery being superior to bronchus rather than anterior
21
Q

Pleura

A
  • each lung has its own pleural sac
  • visceral plerau adheres to lungs and extends into fissure
  • Parietal pleura contacts the costal wall, diaphragm, mediastinum and into root of neck on apex (cupula)
  • serous pleural fluid keeps pleural layers clinging together
  • visceral pleara and parietal pleura are contibuous at hiulm and drape inferiorly to form pulmonary ligament
22
Q

Recesses

A
  • the lungs do not compeltely fill the parietal sacs - creates recesses
  • when 2 layers of parietal pleura contact each other
23
Q

Costodiaphragmatic recess

A
  • most clinically important
  • point of fluid collection
  • between inferior margin of lungs and inferior border of pleural cacvities
  • enlarge with expiration
  • deeper posteriorly, behind diaphragm
24
Q

Costomediastinal recess

A
  • largest on the left side over the heart at cardiac notch
25
Q

Pleural fluid

A
  • between the visceral and parietal layers of pleura
  • keeps themn clinging together under fluid surface tension
  • maintenance of this surface tension prevents lung from collapsing
  • if air or blood enters the pleural fluid, the surface tension is broken and then the lung can collapse
26
Q

Resp system arterial supply

A
  • respiratory parts (bronchioles and alveoli: pulmonary arteries from pulmonary trunk
  • condicting parts (trachea to bronchioles): bronchial arteries from thoracic aorta
27
Q

Respiratory system: venous drainage

A
  • respiratory parts: pulmonary veins

- conducting parts: bronchial veins to azygos system

28
Q

Trachea lymphatics

A
  • tracheobronchial nodes to bronchomediastinal trunk to junction of internal jugular and subclavian veins
29
Q

Visceral pleura and superficial lung lymphatic

A
  • subpleural lymphatic plexus to bronchomediastinal trunk to junction of internal jugular and subclavian veins
30
Q

Deep lung lymphatics

A
  • bronchopulmonary nodes to bronchomediastinal trink to junction of internal jugular and subclavian veins
31
Q

Phrenic nerve

A
  • motor innervation to diaphragm

- noxious innervation of parietal pleura

32
Q

Sympathetic trunk

A
  • Sympathetic asutonomic innervation

- causes bronchodilation, pulmonary blood vessel constriction, reduces secretion, inreases resp rate

33
Q

Vagus nerve

A
  • from brain
  • parasympathetic autonomic innervation
  • causes bronchoconstriction, dilation of blood vessels, increased secretion, decreased resp rate, non-noxious innervation of pleura
34
Q

Thoracic mechanism of respiration

A
  • when intercostal muscles pull a rib up, it moves the sternum forward, expanding the anterior posterior dimensions: pump handle
  • when intercostal muscles pull a rib up, it expands the lateral dimensions of the thoracic wall, flaring out the sides (bucket handles)
  • lungs recoil passively when thoracic muscles relac
35
Q

Thoracic muscles of respiration

A
  • diaphragm is primary muscle. Intercostal muscles only assist
36
Q

Quiet inspiration

A
  • contraction (descent) of the diaphragm and intercostal muscles of the thorax
  • lung expand
37
Q

Quiet expiration

A
  • relaxation of diaphragm and itnercostal muscles of the thorax
  • passive lung recoil
38
Q

Forced inspiration

A
  • add action of scalenes
  • pec major
  • minor and sternocleidomastoid muscles to elevate sternum more
39
Q

Forced expiration

A
  • add action of quadratus lumborum to fix 12th rib, anterolateral abdominal wall muscle to depress lower ribs and increae intra-abdominal pressure, internal intercostals to depress sternum deeper

Block 3 - Resp (44 decks)

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