Anatomy Flashcards
The upper respiratory tract (URT) is made up of what structures?
- the right & left nasal cavities
- the oral cavity
- the naso, oro & laryngo pharynx
- the larynx
The lower respiratory tract (LRT) is made up of what structures?
- the trachea
- the right & left main bronchi
- lobar bronchi
- segmental bronchi
- bronchioles
- alveoli
What happens at the level of the C6 vertebra?
- the larynx becomes the trachea
- the pharynx becomes the oesophagus
Where can the trachea be palpated?
at the jugular notch of the manubrium
Where is the isthmus of the thyroid gland located?
it is anterior to tracheal cartilages 2-4
What is the function of the chest walls?
- protect the heart and lungs
- make the movements of breathing
- breast tissue for lactation
What is within the chest cavity?
- vital organs (viscera)
- major vessels and nerves
- the mediastinum and the right and left pleural cavities
What is contained in the pleural cavity?
Pleural fluid
Parietal pleura is…
in contact with the chest wall
Visceral pleura is…
in contact with the lung organs
The lung lobe is…
the area of the lung that each of the lobar bronchi supply with air
The bronchopulmonary segment is…
the area of lung lobe that each one of the segmental bronchi supply with air
How many bronchopulmonary segments does each lunch have?
10
Describe true ribs
- ribs 1-7
- attach via their costal cartilage to the sternum
Describe false ribs
- ribs 8-10
- attach via costal cartilage above to the sternum
Describe floating ribs
- ribs 11-12
- no attachment to sternum
What is a costochondrial joint?
a junction between bone and cartilage
What are the 3 layers of skeletal muscles located between the ribs and within the intercostal spaces?
- external intercostal muscles
- internal intercostal muscles
- innermost intercostal muscles
What is the function of intercostal muscles?
They make the chest wall expand during breathing by pulling adjacent ribs upwards and outwards
How many intercostal spaces are there?
11
What is a neuro-vascular bundle?
Each intercostal space carries a neuro-vascular bundle in the innermost intercostal muscle layers. They are made up of:
- a vein
- an artery
- a nerve
Which artery supplies blood to the posterior part of the intercostal spaces?
Thoracic aorta
Which vein drains blood from the posterior part of the intercostal spaces?
Azygous vein
Which artery supplies blood to the anterior part of the intercostal spaces?
Internal thoracic artery
Which veins drain blood from the anterior part of the intercostal spaces
Internal thoracic veins
Describe the diaphragm
- forms the floor of the chest cavity
- forms the roof of the abdominal cavity
- it is a skeletal muscle with an unusual central tendon
- it has openings to allow structures to pass between the 2 cavities
- arranged as 2 domes
- the right dome is superior (due to the presence of the liver)
The muscular part of the diaphragm attaches to what structures?
- the sternum
- the lower 6 ribs (7-12) & costal cartilages
- L1-L3 vertebral bodies
Which nerve supplies the muscular part of the diaphragm?
The phrenic nerve
Where does the phrenic nerve originate?
C3, 4 & 5
Where can the phrenic nerve found?
- in the neck on the anterior surface of scalenus anterior muscle
- found in the chest (thorax) descending over the lateral aspects of the heart
Give two functions of the phrenic nerve
- supplies somatic sensory and sympathetic axons to the diaphragm and fibrous pericardium
- supplies somatic motor axons to the diaphragm
What are the mechanics of inspiration?
- the diaphragm contracts and descends
- intercostal muscles contract, elevating ribs
- the chest walls pull the lungs outwards with them
What are the mechanics of respiration?
- the diaphragm relaxes and rises
- intercostal muscles relax, lowering ribs
- elastic tissue of lungs recoils
Give a description and function of the deep fascia in the anterolateral chest wall
it is fibrous and tough and therefore is used as a form of protection
Which muscle does the long thoracic nerve supply?
the serratus anterior
What is the function of the serratus anterior muscle?
it anchors the scapula to the ribs
Where does the pectoralis minor attach to?
it attaches betwwen the coracoid process of the scapula and ribs 3-5
The fibrous pericardium is covered by?
the fibrous pericardium is covered bilaterally with parietal pleura
Sectioned ribs and intercostal spaces are lined internally with?
parietal pleura
The domes of the diaphragm are covered superiorly with?
parietal pleura
Where will any abnormal fluid (pleural effusion) collect in an upright patient?
the costodiaphragmatic recess
What is the lowest extent of the pleural sac?
the costodiaphragmatic recess
Where can the costodiaphragmatic recess be located?
- between ribs 8-10, along the mid-axillary line
- between the diaphragmatic parietal pleura and the costal parietal pleura
What is the most inferior region of the costodiaphragmatic recess?
the costodiaphragmatic angle
What is auscultation?
listening to the sound of air moving through the larynx
Normal breath sounds are _______ in nature?
rustling / vesicular
The inferolateral section of each lung descends where during inspiration?
the costodiaphragmatic recess
What are carotid sheaths and what do they contain?
They are protective sheaths of cervical(neck) deep fascia which contain :
- The vagus nerve CN X
- The internal carotid artery
- The common carotid artery
- The internal jugular vein
What is the main muscle of quiet inspiration?
diaphragm
Which nerve supplies the diaphragm?
Phrenic nerve (originating from C3,4,5)
What are the accessory muscles of DEEP(forced) inspiration?
- Pectoralis Major
- Pectoralis Minor
- Sternocleidomastoid
The use of accessory muscles is a clinical sign of what?
Dyspnoea (difficulty breathing)
What are the accessory muscles for DEEP(forced) expiration?
- Left & Right Rectus Abdominis
- Left & Right External Oblique
- Left & Right Internal Oblique
- Left & Right Transverse Oblique
- Collectively known as the anterolateral abdominal wall muscles*
What is an aponeurosis ?
A flattened tendon
Where do the left aponeurosis and right aponeurosis of the external + Internal obliques meet ?
The midline known as the linea alba (white line)
What is the line called where muscle fibres of the obliques end and the aponeuroses begin?
The linea emilunaris (both right + left)
What is a Pneumothorax?
A pneumothorax is a collapsed lung, occurs when air leaks into space between parietal pleura and lung
What is the difference between a large and small pneumothorax ?
The space between lung and parietal pleura is less than 2cm in a small pneumothorax and greater than 2cm in a large pneumothorax
What kind of resonance will a pneumothorax give?
hyper-resonance
A pneumothorax can cause structures in the chest to shift, what is this known as?
Mediastinal Shift
A right side tension pneumothorax will cause mediastinal shift to which side
the left
What are the consequences of mediastinal shift?
- Deviated trachea to the side opposite the tension pneumothorax
- SVC compression leading to reduced venous return to the heart, causing hypotension(low arterial pressure)
2 ways to manage a large pneumothorax
- needle aspiration(thoracentesis)
- A chest drain
