Anatomy

Question 1

What are the main components of the URT?

Answer 1

Right and left nasal cavities, oral cavity, pharynx (naso, oro and laryngo), larynx

Question 2

What are the main components of the LRT?

Answer 2

Trachea, right and left bronchi, lobar bronchi, segmental bronchi, bronchioles and alveoli

Question 3

What is at the level of C6 vertebra

Answer 3

The larynx becomes the trachea

The pharynx becomes the oesophagus

Question 4

Where is the isthmus of the thyroid gland located?

Answer 4

Anterior to tracheal cartilages 2-4

Question 5

Function of the chest wall

Answer 5

To protect the heart and lungs, to make the movements of breathing, and for lactation in breast tissue

Question 6

Function of chest cavity

Answer 6

To contain vital organs (viscera), major vessels and nerves.

Question 7

What makes up the chest cavity?

Answer 7

The mediastinum, right and left pleural cavities

Question 8

What are the two types of pleura?

Answer 8

Visceral (on lungs) and Parietal (on wall)

Question 9

What force causes the two pleura layers to stick together?

Answer 9

surface tension

Question 10

What are the lobes on the right lung?

And name the fissures present

Answer 10

Upper, middle and lower

Oblique and horizontal

Question 11

What are the lobes on the left lung?

And name the fissures present

Answer 11

Upper, lower (and lingula attatched to upper lobe)

Oblique

Question 12

What are the 10 segments of the lung supplied by each bronchi?

Answer 12

Bronchopulmanory segments

Question 13

How many of each rib type is there?

Answer 13

Ribs 1-7= true ribs
Ribs 8-10= false ribs (attached via shared costal cartilage- costal margin)
Ribs 11-12= floating ribs

Question 14

Name the parts of a rib posteriorly to anteriorly

Answer 14

Head, neck, tubercle, body, rib angle, costal grove, (sternocostal joint)

Question 15

What are the two synovial joints associated with the ribs?

Answer 15

costovertebral, sternocostal

Question 16

what is the “junction”/joint associated with the ribs?

Answer 16

Costochondral

Question 17

Name the three types of intercostal muscles?

Answer 17

external (striated ‘hands in pockets’)
internal (striated ‘hands on chest’
innermost

Question 18

Which nerve supplies the diagram?

Answer 18

Phrenic nerve (C3,4,5)

Question 19

What lies in the intercostal spaces?

Answer 19

Intercostal muscle & neurovascular bundle:

Question 20

Where does the intercostal nerve supply come from?

Answer 20

Anterior ramus of spinal nerve

Question 21

What is the anterior blood supply to intercostal space?

Answer 21

Internal thoracic artery and internal thoracic vein

Question 22

What is the posterior blood supply to intercostal space?

Answer 22

Thoracic aorta and Azygous vein

Question 23

What makes the diaphragm unique to other skeletal muscles?

Answer 23

It has an unusual central tendon

Question 24

How can the anatomical arrangement of the diaphragm be described?

Answer 24

Right and left domes- right being more superior

Question 25

Where does the diaphragm attach?

Answer 25

The sternum The lower 6 ribs and costal cartilages L1-L3 vertebral bodies

Question 26

Where is the phrenic nerve found?

Answer 26

In the neck: Anterior surface of the scalenus anterior surface In the thorax: Descending over the lateral aspects of the heart

Question 27

What is the function of the phrenic nerve?

Answer 27

supplies somatic sensory and sympathetic axons to the diaphragm and fibrous pericardium Supplies somatic motor axons to the diaphragm

Question 28

What are the 3 components of inspiration mechanics?

Answer 28

1. Diaphragm contracts and descends 2. Intercostal muscles contract and expand laterally 3. 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

Question 29

What are the 3 components of expiration mechanics?

Answer 29

1. Diaphragm relaxes and rises 2. Intercostal muscles relax and lower 3. elastic tissue of lungs recoils

Question 30

What type of lymph draining is present in breast tissue?

Answer 30

UNILATERAL from lateral quadrants to AXILLARY NODES BILATERAL from medial quadrants to PARASTERNAL NODES

Question 31

Where does the cephalic vein lie?

Answer 31

in the delto-pectoral groove

Question 32

what causes a winged scapula?

Answer 32

Injury of the long thoracic nerve

Question 33

What skeletal muscles lie inferior to the auxilla?

Answer 33

``` Latissimus dorsi Serratus anterior (anchors scapula to ribs) ```

Question 34

What is the most dependent part of the pleural cavity?

Answer 34

The costodiaphragmatic recess (at higher risk of pleural effusion or haemothorax)

Question 35

What structures make up the right lung hilum?

Answer 35

Main bronchi Pulmonary arteries (superior and anterior) Pulmonary veins (inferior and posterior) Pulmonary lymph nodes

Question 36

Which structures cause dents in the right lung?

Answer 36

Heart, diaphragm, superior vena cava, azygous vein

Question 37

What structures make up the left lung hulum?

Answer 37

Pulmonary artery (most superior) Main bronchi Pulmonary veins (lateral to bronchi) Pulmonary lymph nodes

Question 38

Which structures cause dents in the left lung?

Answer 38

heart, diaphragm, aorta, common carotid artery

Question 39

Where on the lung should be auscultated?

Answer 39

``` All 5 lung lobes The apices (top- space above clavicle) The bases (posterior) ```

Question 40

What are the two stages of coughing?

Answer 40

Stimulation of sensory receptors in the mucosa Rapid response of CNS

Question 41

what Cranial nerves are associated with coughing?

Answer 41

CN IX | CNX

Question 42

what cranial nerves are associated with sneezing?

Answer 42

CNV | CN IX

Question 43

what are the carotid sheaths?

Answer 43

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

Question 44

what do carotid sheaths contain?

Answer 44

Vagus nerve Internal carotid artery common carotid artery internal jugular vein

Question 45

Sympathetic and parasympathetic are both what type of nerves?

Answer 45

motor

Question 46

what picks up sensations in LRT?

Answer 46

Pulmonary visceral afferents

Question 47

via which nerve do the sensory signals travel up?

Answer 47

The vagus nerve

Question 48

What is the pulmonary plexus?

Answer 48

Sympathetic axons Parasympathetic axons visceral afferents

Question 49

what nerve controls the diaphragm?

Answer 49

Phrenic nerve (C3,4,5)

Question 50

what muscle does the phrenic nerve run anterior to?

Answer 50

scalenus anterior

Question 51

where can diaphragmatic/ liver pain be overted?

Answer 51

shoulders

Question 52

what caused the diaphragm to flatten then descend maximally in deep inspiration?

Answer 52

greater outflow of action potentials of a longer duration

Question 53

what are the anterior rami of spinal nerves T1-T11?

Answer 53

intercostal nerves

Question 54

what are the accessory muscles of deep inspiration?

Answer 54

1. Pectoralis major (attatches between sternum/ribs and humerus) 2. Pectoralis minor (can pull ribs 3-5 superiorly towards the coracoid process of the scapula) 3. sternocleidomastoid 4. Scalenus

Question 55

What is the space between the vocal chords?

Answer 55

Rima glottidis

Question 56

what supplies the intrinsic muscles of the larynx?

Answer 56

Somatic motor | Barnches of the vagus nerve

Question 57

what is the intrinsic muscles of the larynx's role in couging?

Answer 57

They adduct the vocal cords

Question 58

what is the vagus nerves' function in coughing?

Answer 58

supplies somatic sensory and somatic motor axons to the larynx

Question 59

what do the anterolateral abdominal wall muscles do in coughing?

Answer 59

Contract to forcefully increase intra-abdominal pressure

Question 60

what is the aponeurosis?

Answer 60

flattened tendon running from xyphoid process to pubic synthesis

Question 61

which oblique muscles lie inferior to the ribs?

Answer 61

internal obliques

Question 62

where are the transversus abdominus muscles?

Answer 62

deep to internal oblique

Question 63

where can the thoracoabdominal nerves be found?

Answer 63

7th to 11th intercostal nerves

Question 64

guarding function of abdominal muscles protects from what?

Answer 64

both external and internal dangers

Question 65

where can the subcostal nerve be found?

Answer 65

T12 anterior ramus

Question 66

where is the iliohypogastric nerve found?

Answer 66

half of L1 anterior ramus

Question 67

where is the ilioinguinal nerve?

Answer 67

half of L1 anterior ramus

Question 68

what can asthma lead to due to excess coughing?

Answer 68

rupture of lung/ visceral pleura

Question 69

how big is a small pheumothorax?

Answer 69

less than 2cm

Question 70

how big is a large pneumothorax?

Answer 70

greater than 2 cm

Question 71

what exams can diagnose a pneumothorax?

Answer 71

reduced ipsilateral chest expansion reduced ipsilateral breath sounds hyper resonace on percussion

Question 72

what is a tension pneumothorax?

Answer 72

one-way-valve that permits air to enter pleural cavity but not escape

Question 73

what is the level of the superior mediastinim?

Answer 73

level of sternal angle and T4/T5 vertebrae

Question 74

what is in the posterior mediastinum?

Answer 74

nerves

Question 75

what is in the middle mediastinum?

Answer 75

the heart

Question 76

what are some consequences of a mediastinal shift?

Answer 76

Trachial deviation away from side of a unilateral tension pneumothorax

Question 77

what does SVC compression lead to?

Answer 77

hypotension

Question 78

how do you manage a large pneumothorax?

Answer 78

1. needle aspiration 2. chest drain Both via the 4th or 5th intercostal space in midaxillary line

Question 79

what is the 'safe triangle' for chest drains?

Answer 79

Anterior border of laissimus dorsi Posterior border of pectoralis major Axial line superior to nipple

Question 80

what is the emergency management of tension pneumothorax?

Answer 80

via 2nd or 3rd intercostal space

Question 81

What are the two factors of a hernia?

Answer 81

1. weakness of structure (usually part of body wall) | 2. increased pressure on one side of that part of the wall

Question 82

What are some types of hernia?

Answer 82

``` Diaphragmatic hernia umbilical hernia inguinal hernia femoral hernia congenital diaphragmatic hernia incisional hernia ```

Question 83

what is the thing to remember holes in diaphragm?

Answer 83

I 8 10 eggs At 12

Question 84

what are two different hiatus hernia?

Answer 84

paraoesophageal hiatus | sliding hiatus hernia