Anatomy Flashcards
What are the main components of the URT?
Right and left nasal cavities, oral cavity, pharynx (naso, oro and laryngo), larynx
What are the main components of the LRT?
Trachea, right and left bronchi, lobar bronchi, segmental bronchi, bronchioles and alveoli
What is at the level of C6 vertebra
The larynx becomes the trachea
The pharynx becomes the oesophagus
Where is the isthmus of the thyroid gland located?
Anterior to tracheal cartilages 2-4
Function of the chest wall
To protect the heart and lungs, to make the movements of breathing, and for lactation in breast tissue
Function of chest cavity
To contain vital organs (viscera), major vessels and nerves.
What makes up the chest cavity?
The mediastinum, right and left pleural cavities
What are the two types of pleura?
Visceral (on lungs) and Parietal (on wall)
What force causes the two pleura layers to stick together?
surface tension
What are the lobes on the right lung?
And name the fissures present
Upper, middle and lower
Oblique and horizontal
What are the lobes on the left lung?
And name the fissures present
Upper, lower (and lingula attatched to upper lobe)
Oblique
What are the 10 segments of the lung supplied by each bronchi?
Bronchopulmanory segments
How many of each rib type is there?
Ribs 1-7= true ribs
Ribs 8-10= false ribs (attached via shared costal cartilage- costal margin)
Ribs 11-12= floating ribs
Name the parts of a rib posteriorly to anteriorly
Head, neck, tubercle, body, rib angle, costal grove, (sternocostal joint)
What are the two synovial joints associated with the ribs?
costovertebral, sternocostal
what is the “junction”/joint associated with the ribs?
Costochondral
Name the three types of intercostal muscles?
external (striated ‘hands in pockets’)
internal (striated ‘hands on chest’
innermost
Which nerve supplies the diagram?
Phrenic nerve (C3,4,5)
What lies in the intercostal spaces?
Intercostal muscle & neurovascular bundle:
Where does the intercostal nerve supply come from?
Anterior ramus of spinal nerve
What is the anterior blood supply to intercostal space?
Internal thoracic artery and internal thoracic vein
What is the posterior blood supply to intercostal space?
Thoracic aorta and Azygous vein
What makes the diaphragm unique to other skeletal muscles?
It has an unusual central tendon
How can the anatomical arrangement of the diaphragm be described?
Right and left domes- right being more superior
Where does the diaphragm attach?
The sternum
The lower 6 ribs and costal cartilages
L1-L3 vertebral bodies
Where is the phrenic nerve found?
In the neck: Anterior surface of the scalenus anterior surface
In the thorax: Descending over the lateral aspects of the heart
What is the function 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 3 components of inspiration mechanics?
- Diaphragm contracts and descends
- Intercostal muscles contract and expand laterally
- Chest wall pulls the parietal pleura out with it, which moves visceral pleura due to the surface tension- bringing about negative pressure so air will travel in
What are the 3 components of expiration mechanics?
- Diaphragm relaxes and rises
- Intercostal muscles relax and lower
- elastic tissue of lungs recoils
What type of lymph draining is present in breast tissue?
UNILATERAL from lateral quadrants to AXILLARY NODES
BILATERAL from medial quadrants to PARASTERNAL NODES
Where does the cephalic vein lie?
in the delto-pectoral groove
what causes a winged scapula?
Injury of the long thoracic nerve
What skeletal muscles lie inferior to the auxilla?
Latissimus dorsi Serratus anterior (anchors scapula to ribs)
What is the most dependent part of the pleural cavity?
The costodiaphragmatic recess (at higher risk of pleural effusion or haemothorax)
What structures make up the right lung hilum?
Main bronchi
Pulmonary arteries (superior and anterior)
Pulmonary veins (inferior and posterior)
Pulmonary lymph nodes
Which structures cause dents in the right lung?
Heart, diaphragm, superior vena cava, azygous vein
What structures make up the left lung hulum?
Pulmonary artery (most superior)
Main bronchi
Pulmonary veins (lateral to bronchi)
Pulmonary lymph nodes
Which structures cause dents in the left lung?
heart, diaphragm, aorta, common carotid artery
Where on the lung should be auscultated?
All 5 lung lobes The apices (top- space above clavicle) The bases (posterior)
What are the two stages of coughing?
Stimulation of sensory receptors in the mucosa
Rapid response of CNS
what Cranial nerves are associated with coughing?
CN IX
CNX
what cranial nerves are associated with sneezing?
CNV
CN IX
what are the carotid sheaths?
protective tubes of cervical deep fascia that attach superiorly to bones at base of the neck and blend inferiourly with the fascia of the mediastinum
what do carotid sheaths contain?
Vagus nerve
Internal carotid artery
common carotid artery
internal jugular vein
Sympathetic and parasympathetic are both what type of nerves?
motor
what picks up sensations in LRT?
Pulmonary visceral afferents
via which nerve do the sensory signals travel up?
The vagus nerve
What is the pulmonary plexus?
Sympathetic axons
Parasympathetic axons
visceral afferents
what nerve controls the diaphragm?
Phrenic nerve (C3,4,5)
what muscle does the phrenic nerve run anterior to?
scalenus anterior
where can diaphragmatic/ liver pain be overted?
shoulders
what caused the diaphragm to flatten then descend maximally in deep inspiration?
greater outflow of action potentials of a longer duration
what are the anterior rami of spinal nerves T1-T11?
intercostal nerves
what are the accessory muscles of deep inspiration?
- Pectoralis major (attatches between sternum/ribs and humerus)
- Pectoralis minor (can pull ribs 3-5 superiorly towards the coracoid process of the scapula)
- sternocleidomastoid
- Scalenus
What is the space between the vocal chords?
Rima glottidis
what supplies the intrinsic muscles of the larynx?
Somatic motor
Barnches of the vagus nerve
what is the intrinsic muscles of the larynx’s role in couging?
They adduct the vocal cords
what is the vagus nerves’ function in coughing?
supplies somatic sensory and somatic motor axons to the larynx
what do the anterolateral abdominal wall muscles do in coughing?
Contract to forcefully increase intra-abdominal pressure
what is the aponeurosis?
flattened tendon running from xyphoid process to pubic synthesis
which oblique muscles lie inferior to the ribs?
internal obliques
where are the transversus abdominus muscles?
deep to internal oblique
where can the thoracoabdominal nerves be found?
7th to 11th intercostal nerves
guarding function of abdominal muscles protects from what?
both external and internal dangers
where can the subcostal nerve be found?
T12 anterior ramus
where is the iliohypogastric nerve found?
half of L1 anterior ramus
where is the ilioinguinal nerve?
half of L1 anterior ramus
what can asthma lead to due to excess coughing?
rupture of lung/ visceral pleura
how big is a small pheumothorax?
less than 2cm
how big is a large pneumothorax?
greater than 2 cm
what exams can diagnose a pneumothorax?
reduced ipsilateral chest expansion
reduced ipsilateral breath sounds
hyper resonace on percussion
what is a tension pneumothorax?
one-way-valve that permits air to enter pleural cavity but not escape
what is the level of the superior mediastinim?
level of sternal angle and T4/T5 vertebrae
what is in the posterior mediastinum?
nerves
what is in the middle mediastinum?
the heart
what are some consequences of a mediastinal shift?
Trachial deviation away from side of a unilateral tension pneumothorax
what does SVC compression lead to?
hypotension
how do you manage a large pneumothorax?
- needle aspiration
- chest drain
Both via the 4th or 5th intercostal space in midaxillary line
what is the ‘safe triangle’ for chest drains?
Anterior border of laissimus dorsi
Posterior border of pectoralis major
Axial line superior to nipple
what is the emergency management of tension pneumothorax?
via 2nd or 3rd intercostal space
What are the two factors of a hernia?
- weakness of structure (usually part of body wall)
2. increased pressure on one side of that part of the wall
What are some types of hernia?
Diaphragmatic hernia umbilical hernia inguinal hernia femoral hernia congenital diaphragmatic hernia incisional hernia
what is the thing to remember holes in diaphragm?
I 8 10 eggs At 12
what are two different hiatus hernia?
paraoesophageal hiatus
sliding hiatus hernia
