Anatomy Flashcards
at level c6 vertebrae
Larynx becomes trachea
Pharynx becomes oesophagus
Thorax
Chest Walls and Chest Cavity
Chest walls
Protect heart and lungs
Make movement of breathing
Breast tissue
Chest Cavity
Within chest walls
Contains vital organs
Contains major vessels and nerves
Consists of mediastinum and right and left pleural cavities
Embryonic Lung Development
- Lung Bud
- Pushes from mediastinum
- Covered in pleura
- Parietal pleura on wall
- Visceral pleura on lungs
- Reflect on lung roots
Lung lobe
Area of lung that each of the lobar bronchi supply with air
Right - upper, lower, middle
Left - Upper, lower
Lobes separated by fissures
Bronchopulmonary segment
Area of lung lobe that each of the segmental bronchi supply with air
Each lung has 10 segments
Costovertebral joints
Limited movement
Muscles of breathing
External intercostal muscles
Internal intercostal muscles
Innermost intercostal muscles
Intercostal spaces
11 pairs
Each contains a neurovascular bundle between internal and innermost intercostal muscle
Nerve supply of intercostal space
anterior ramus of spinal nerve
Posterior blood supply of intercostal spaces
Arterial = thoracic aorta Venous = azygous vein
Anterior blood supply of intercostal spaces
Arterial = internal thoracic artery Venous = internal thoracic vein
Phrenic nerves that keep diaphragm alive
C3,4,5
Where is the middle lobe auscultated
Between right ribs 4 and 6
Site of lung apex
Superior to the clavicle
Where is the lung base auscultated
T11 vertebrae
Contains hyaline cartilage and is surrounded by the arch of the azygous vein
Right main bronchus
Anatomy of coughing
- Sensors throughout resp tract
- CNS responds rapidly
- Deep inspiration
- Adduction of vocal cords to close rima glottis
- Contraction of abdominal wall muscles
- Build up of pressure
- Vocal cords abduct to open rima glottides
- Soft palette tenses and elevates to close off entrance to nasopharynx (cough not sneeze)
Cranial nerves involved in sneezing
CN V, CN IV
Cranial nerves involved in coughing
CN IX, CN X
Carotid sheaths
Protective tubes of cervical deep fascia Contain: vagus nerve internal carotid artery common carotid artery internal jugular vein
Motor axons travel from
Tracheal bifurcation
Along branches of resp tress
Supply mucous glands and all bronchiolar smooth muscles
Pulmonary visceral afferents travel from
Visceral pleura
Resp tree
To plexus
Follow vagus nerve to medulla of brainstem
Pectoralis major
Attaches between sternum/ribs and humerus
Pectoralis minor
Can pull ribs 3-5 superiorly towards scapula
Sternocleidomastoid
Attaches between sternum and mastoid process of temporal bone
Scalenus anterior, medis, posterior
Attach between cervical vertebrae and ribs 1 and 2
Recruitment of accessory muscle suggests
Dyspnoea
difficulty breathing
Intrinsic muscles of larynx
Skeletal
Between cartilages
Supplied by motor
Left and right vagus nerves
Connect with CNS at medulla Pass through jugular foramen Descend through neck within carotid sheath Descend posterior to lung root Pass through diaphragm on the oesphagus Divide on surface of stomach
Subcostal nerve
T12 anterior ramus
Iliohypogastric nerve
half of L1 anterior ramus
Ilioinguinal nerve
Other half of L1 anterior ramus
Asthma dynamic airway compression can lead to
Rupture of lung and visceral pleura
Causing Pneumothorax
Pneumothorax Examination
Reduced ipsilateral chest expansion
Reduced ipsilateral breath sounds
Hyper-resonance
Pneumothorax investigations
Absent lung markings peripherally
Lung edge visible
Tension Pneumothorax
Torn pleura creates a one way valve that permits air to enter pleural cavity but prevents it from leaving
With each inspiration more air enters
Pneumothorax expands and lung collapses towards root
Eventually build up of air in pleural cavity applies tension to mediastinal structures
What may cause mediastinal shift
Tension pneumothorax
Consequences of mediastinal shift
Tracheal deviation away from side affected
How does tension pneumothorax cause hypertension
SVC compression
Reduces venous return to heart
Management of pneumothorax
- Needle aspiration
- Chest drain
BOTH 4th of 5th INTERCOSTAL SPACE MIDAXILLARY LINE
Management of tension pneumothorax
Insertion of IV cannula, 2nd intercostal space, midclavicular line
2 factors required for hernia formation
- weakness of one structure
2. increased pressure on one side of wall
Paraoesophageal hiatus hernia
herniated part of stomach passes through oesophageal hiatus to become parallel to oesophagus and and in chest
Sliding hiatus hernia
Herniated part of stomach slides through oesophageal hiatus into chest WITH gastro-oesophageal junction
Inguinal hernia
Form in medial half of inguinal region
Weakness in inguinal canal
Pressure in antra-abdomen
Direct inguinal hernia
‘Finger’ of peritoneum forced through inguinal canal into scrotum
‘Finger’ of peritoneum forced through deep ring and out of superficial ring into scrotum
Differentiate between inguinal hernias
- Reduce hernia
- Occlude the deep ring with fingertip pressure
- Ask patient to cough
- If hernia is direct = lump reappears
