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Respiratory > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Origin of Pectoralis Major

Insertion of Pectoralis Major

A
  1. Clavicular Head

2. Bicipital groove of humerus

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2
Q

Origin of Pectoralis Minor

Insertion of Pectoralis Minor

A
  1. 3rd-5th ribs

2. Coracoid process of scapula

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3
Q

Zones of the parietal pleura

A

Cervical
Mediastinal
Diaphragmatic
Costal

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4
Q

Divide of upper and lower respiratory tract

A

Level of the C6 vertebra
Larynx > trachea
Pharynx > oesophagus

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5
Q

Function of the chest wall

A

Protects the visceral organs and allows breathing (breast tissue is an extension of the chest wall)

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6
Q

Pleural Cavity

A

The gap between the visceral and parietal pleura

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7
Q

Joint (rib and sternum)

A

The rib articulates with the sternum via costal cartilage: lateral aspect of the sternum

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8
Q

Joint (rib and sternum)

A

Head of the rib articulates with the body of the vertebra (same number)

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9
Q

Costal groove

A

On each rib there is a costal groove which is inferior to the deep surface of the ribs (intercostal neurovascular bundle)

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10
Q

Skeletal muscle layers of the ribs

A

3 layers (external, internal and innermost)

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11
Q

Diaphragm

A

Forms the lower part of the chest cavity and upper part of the abdominal cavity
Contains a central tendon
Arranged as left and right domes

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12
Q

Nerve supply of diaphragm

A

Supplied by the phrenic nerve (C3-5 anterior rami)

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13
Q

Attachment of the diaphragm

A

Muscular portion attaches peripherally to the sternum, lower 6 ribs, costal cartilage, L1-3 vertebra

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14
Q

Neurovascular bundles

A

Nerve: anterior ramus of spinal nerve (intercostal nerve)
Blood:
posterior = thoracic aorta, azygous vein
anterior = internal thoracic artery, internal thoracic vein

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15
Q

Phrenic Nerves

A

C3 -5 found in the neck on the anterior surface of the scalenus anterior muscle and in the thorax descending over the lateral aspects of the heart

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16
Q

Inspiration

A

Increase vertical and horizontal chest dimensions

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17
Q

Expiration

A

Reduce vertical and horizontal chest dimensions

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18
Q

Sternal angle

A

Level of Rib 2

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19
Q

Supply of the breast

A
  • Subclavian and internal thoracic artery/vein
    Unilateral drainage = lateral quadrants to the axillary nodes
    Bilateral drainage = medial quadrants of the breast to parasternal nodes (deep to sternal edges)
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20
Q

Costodiaphragmatic Recess

A

Most inferior part of the pleural cavity when upright
Between diaphragmatic and costal parietal pleura
Abnormal fluid in cavity drains into the recess

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21
Q

Stimulation of sensory receptors in throat - COUGH

A
  1. Deep inspiration using the diaphragm, intercostal and accessory muscles
  2. Adduction of the vocal cords to close rima glottidis
  3. Contraction of the anterolateral abdominal wall muscles to build up the intra-abdominal pressure
  4. The vocal cords suddenly abduct to open the rima glottidis
  5. Soft palate tenses (CN V) and elevates (CN X) to close off the entrance into the nasopharynx: direct the air through the oral cavity
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22
Q

Receptors stimulated in sneezing

A

CN V

CN IX

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23
Q

Receptors stimulated in coughing

A

CN IX

CN X

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24
Q

Carotid Sheath

A
  • Tubes of cervical deep fascia

- Contains the vagus nerve, internal and common carotid artery & internal jugular vein

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25
Q

Nerves from pleura and respiratory tree

A

Pulmonary visceral afferents meet the sympathetic and parasympathetic axons (pulmonary plexus)

26
Q

Nerve supply of glands and bronchial smooth muscle

A

Motor axons travel from the tracheal bifurcation along the respiratory tree

27
Q

Cervical Spinal Nerves

A

Found in the chest of the lateral aspects of the fibrous pericardium anterior to the lung root
Supply somatic sensory and sympathetic axons to the diaphragm and fibrous pericardium
Supply somatic motor axons to the diaphragm

28
Q

Intercostal Nerves

A

Anterior rami of spinal nerves T1-11

29
Q

Pectoralis Major

A

Attaches between the sternum/ribs and the humerus (it adducts and medially rotates the humerus)

30
Q

Pectoralis Minor

A

Can pull ribs 3-5 superiorly toward the coracoid process of the scapula

31
Q

Sternocleidomastoid

A

Attaches between the sternum and clavicle and the mastoid process of the temporal bone

32
Q

Scalenus anterior, medius and posterior

A

Attach between the cervical vertebra and ribs 1&2

33
Q

Adduction of the vocal cords

A

The vocal cords can approximate in midline closing the rima glottidis
All intrinsic muscles of the larynx = skeletal and attach between cricoid and thyroid cartilages
Muscles supplied by the somatic motor branch of CN X

34
Q

Right and Left Vagus Nerves

A

-These are mixed cranial nerves which connect with CNS at medulla oblongata
-Travel through the jugular foramen and descend through the neck (carotid sheath)
LARYNX
Sensory: somatic axons supply the mucosa lining
Motor: somatic axons supply the intrinsic muscles of the larynx
Descend posterior to the lung root (parasymp to chest organs), before passing through onto the oesophagus: on stomach split into parasympathetic branches

35
Q

Accessory Muscles of Deep Expiration

A

The diaphragm relaxes and the right and left anterolateral abdominal wall muscles contract forcefully increasing intra-abdominal pressure
The diaphragm is forced upward by the compressed abdominal contents, increases intra-thoracic pressure

36
Q

External Oblique

A 
The aponeurosis (flattened tendon) of the right and left midline linea alba
The linea semilunaris is where the muscle fibres end and the aponeurosis begins 
ATTACHMENT = the superficial aspects of the lower ribs (SUPERIOR), iliac crest (ANTERIOR), pubic tubercle (INFERIOR)
37
Q

Internal Oblique

A

The aponeurosis of the right and left blend at the midline linea alba
ATTACHMENT = the inferior border of the lower ribs (SUPERIOR), iliac crest and thoracolumbar fascia (INFERIOR)

38
Q

Transversus Abdominus

A

The aponeurosis of the right and left blend at the midline linea alba
ATTACHMENT = the deep aspects of the lower ribs (SUPERIOR), iliac crest and thoracolumbar fascia (INFERIOR)

39
Q

Rectus Abdominus

A

The rectus sheath is constructed from the oponeuroses of the other three muscles
Tendinous intersections divide each of the two long muscles into 3/4 smaller quadrate muscles

40
Q

Thoracoabdominal Nerves

A

Convey somatic motor, sensory and sympathetic nerves supplying abdominal part of the wall

41
Q

Subcostal nerve

A

T12 anterior ramus

42
Q

Iliohypogastric nerve

A

1/2 of L1 anterior ramus

43
Q

Ilioinguinal nerve

A

1/2 of L1 anterior ramus

44
Q

Pulmonary Consequences of Chronic Cough

A

Asthma - dynamic airway compression
Build up of trapped air in alveoli can lead to rupture of lung and visceral pleura: breach allows alveolar air to enter the pleural cavity

45
Q

Small Pneumothorax

A

<2cm gap between lung and parietal pleura filled with air: vacum is lost

46
Q

Large Pneumothorax

A

> 2cm gap between the lung and parietal pleura

47
Q

Tension Pneumothorax

A

The torn pleura can create a one-way valve that permits air entry to the pleural cavity upon inspiration but prevents air from leaving on expiration
Pneumothorax expands and lung collapses to the root, pressure can result in mediastinal shift (tracheal deviation)

48
Q

Management of large pneumothorax

A

Thoracentesis or the sitting of a chest drain

4th/5th intercostal space in the midaxillary line (trying to avoid intercostal neurovascular bundle

49
Q

Management of tension pneumothorax

A

Large gauge cannula inserted via the 2nd or 3rd intercostal space in midclavicular line on side of the tension pneumo

50
Q

Hernia

A

Any structure passing through each other and ending up in the wrong place

51
Q

Factors required for a hernia

A
  1. Weakness of one structure (commonly body wall)
    e. g. inguinal canal, umbilicus
  2. Increased pressure on one side of the weakness
    e. g. chronic cough increases the intra-abdominal pressure in the diaphragm and anterolateral abdominal wall
52
Q

Diaphragmatic Hernia

A

Usually occur at the areas of normal anatomical weakness

e.g. aortic, caval opening, posterior attachments, oesophageal, xiphoid attachments

53
Q

Paraoesophageal Hiatus Hernia

A

The herniated part of the stomach passes through the oesophageal hiatus to become parallel to the oesophagus and in the chest

54
Q

Sliding Hiatus Hernia

A

The herniated part of the stomach slides through the hiatus into the chest along with the gastro-oesophagela junction

55
Q

Inguinal region

A

The ‘groin’

Extends from the anterior superior iliac spine (ASIS) and the pubic tubercle

56
Q

Inguinal Ligaments

A

Attach between ASIS and pubic tubercle; medial halves form the floor of the inguinal canal and inferior border of the external oblique

57
Q

Inguinal Canal

A

4cm long passageway, inguinal canals pass through the anterior abdominal wall in the inguinal regions
Runs between a deep (superior) and superficial ring

58
Q

Inguinal Hernia

A

Form in the medial half of the inguinal region (unilateral or bilateral)
Weakness = the inguinal canal
Pressure Increase = intra-abdominal due to chronic cough/constipation/occupational lifting

59
Q

Female Inguinal Canal

A

The round ligaments pass through the inguinal canals into the labium majus

60
Q

Innervation of the intrinsic muscles of the larynx (which adduct the vocal cords)

A
  • Left and right recurrent laryngeal nerves (branches of vagus nerve)

Respiratory (5 decks)

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