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Respiratory > Anatomy > Flashcards

Anatomy Flashcards

1
Q

At which point does the upper respiratory tract become the lower?

A

The beginning of the trachea

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2
Q

At which vertebral level does the upper respiratory tract become the lower?

A

C6

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3
Q

Where can the trachea be palpated?

A

Jugular notch of the manubrium

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4
Q

What are the two types of pleura?

A
  1. Visceral

2. Parietal

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5
Q

What is the space between the visceral and the parietal pleura called?

A

Intrapleural space

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6
Q

How many lobes make up each lung?

A

Left-2

Right- 3

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7
Q

How many bronchopulmonary segments does each lung lobe have?

A

10

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8
Q

Why can small sections of lung easily be removed through surgery?

A

Each bronchopulmonary segment has its own innervation, lymphatic and blood supplies
Little damage is done to surrounding bronchopulmonary segments when one is operated on

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9
Q

How many pairs of ribs are there in the thoracic skeleton?

A

12

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10
Q

What are the three type of ribs and what rib number does each type represent?

A
  1. true 1-7
  2. False 8-10
  3. Floating 11-12
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11
Q

What are the three components of the sternum?

A
  1. Manubrium
  2. Body
  3. Xiphoid process
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12
Q

What happens at the sternal angle?

A

Bronchi bifurcate

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13
Q

Which parts of the rib articulate with the vertebrae?

A

head and the tubercle

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14
Q

What is a costal groove?

A

This is a groove on the ribs in which a neurovascular bundle is located

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15
Q

What is a costochondral joint?

A

A joint from rib to sternum

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16
Q

What are sternocostal joints?

A

Synovical joints from sternum to ribs

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17
Q

Where do costalvertebral joints occur?

A

Where the ribs articulate with the sternum

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18
Q

What are the three layers of intercostal muscles?

A
  1. External
  2. Internal
  3. Innermost
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19
Q

How many intercostal spaces are there?

A

11

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20
Q

Each intercostal spaces contains what?

A

A neurovascular bundle (nerve, artery and vein)

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21
Q

A neurovascular bundle is found between which layers of muscle?

A

Internal and innermost intercostal muscle layers

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22
Q

In a neurovascular bundle, where does the nerve supply originate?

A

Anterior rams of the spinal nerves

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23
Q

Blood supply to the intercostal spaces is both posterior and anterior, which vessels are utilised in each situation?

A

Anterior- internal thoracic artery, internal thoracic vein

Posterior- thoracic aorta, azygous vein

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24
Q

Why is the right “dome” of the diaphragm larger than the left?

A

Due to the liver

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25
Q

Which type of muscle composes the diaphragm?

A

Skeletal

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26
Q

The phrenic nerve is composed of which spinal nerves?

A

C3,4,5

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27
Q

The diaphragm is innervated by which nerve?

A

Phrenic (C3,4,5 keep the diaphragm alive)

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28
Q

Where in the neck is the phrenic nerve found?

A

Anterior surface of the scalenus anterior muscle

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29
Q

Where in the thorax is the phrenic nerve found?

A

It depends over the anterior surface of the external pericardium of the heart

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30
Q

What does the phrenic nerve supply to the diaphragm?

A 
Somatic sensory and sympathetic axons (to diaphragm and fibrous pericardium)
Motor neurones (to diaphragm)
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31
Q

What is the root of the breast tissue called?

A

Axillary tail

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32
Q

What is the name of the surrounding tissue close to the nipple?

A

Areola

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33
Q

Lymph drainage from breast tissue is split into which two main areas?

A
  1. Axillary nodes- lateral quadrants (unilateral)

2. Parasternal nodes- medial quadrants (bilateral)

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34
Q

Where are sensory nerves located?

A

Within superficial fascia

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35
Q

The deltoid muscle and the pectoralis major do not join completely so between them is a groove. What is the name of this groove?

A

Delto-pectoral groove

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36
Q

Which vein runs within the delta-pectoral groove?

A

Cephalic vein

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37
Q

The long thoracic nerve innervates which muscle?

A

Serratus anterior muscles

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38
Q

The function of the serrates anterior muscles is too?

A

Anchor the scapular to the body

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39
Q

What are the 4 different names of the parietal pleura (based on location)?

A
  1. Cervical- above the ribs
  2. Costal
  3. Diaphragmatic
  4. Medistinal
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40
Q

What is the most inferior part of the intrapleural cavity?

A 
Costodiaphragmstitic recess
(costophrenic angle- most inferior point)
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41
Q

What is the term given to the most superior part of the lungs?

A

Apex

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42
Q

What is the name of the middle projection of the left lobe?

A

Lingula

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43
Q

How are the lung lobes separated ?

A

Fissues

oblique- superior and inferior, and horizontal- middle and superior - only in right lung

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44
Q

What are hila and what are they composed of?

A

Lung roots
They are made up of pulmonary arteries, veins and lymph nodes
Main bronchi

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45
Q

Why must all 5 lobes be listened to when auscultating?

A

They are all supplied by different lobar bronchi

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46
Q

What is an example of a high pitched and low pitched sound heard during auscultation?

A

High- wheezing

Low- - rhonchi (rattling/snoring)

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47
Q

Coughing involves stimulation of sensory receptors in the mucosa. Which may such receptors be located?

A
  • Oropharynx
  • Larynopharynx
  • Larynx
  • Respiratory tree
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48
Q

Describe how a cough is produced

A
  • Sensory (afferent) nerves stimulated
  • Deep inspiration by CNS using diaphragm (phrenic nerves) and intercostal muscles (intercostal nerves)
  • Adduction of vocal cord occurs- closes rima glottidis (vagus nerves)
  • Contraction of anterolateral abdominal wall muscles stimulated by intercostal nerves
  • Increased into-abdominal pressure
  • Vocal cord abduct abruptly opening rima glottidis
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49
Q

What is the name of the space between the vocal cords?

A

Rima glottidis

50
Q

The glossopharyngeal nerve (CN IX) carries afferent sensory signals from where?

A

Oro and nasopharynx

51
Q

Information from the laryngopharynx and the larynx is relayed to the brain by which nerve?

A

Vagus nerve (CN X)

52
Q

What nerve innervates the nasopharynx that when stimulated will cause a sneeze?

A

Trigeminal nerve (CN V)

53
Q

What are carotid sheaths and what do they carry?

A

They are protective tubes of deep fascia

They carry the vagus nerve, the internal carotid artery, the common carotid artery and the internal jugular vein

54
Q

Where are the attachments for the carotid sheaths?

A

Superiorly- Bones at the base of the skull

Inferiorly- blend with fascia of superior mediastinum

55
Q

Where do pulmonary visceral afferent travel from?

A

Visceral pleural and lower respiratory tree to the pulmonary plexus

56
Q

What is the pulmonary plexus?

A

A network of intertwines sympathetic axons, parasympathetic axons and visceral afferents (associated with the lungs)
The plexus is located at the bifurcation of the trachea

57
Q

What changes in the lower respiratory tract can sympathetic and parasympathetic nerves initiate?

A
  • Change level of mucous production

- change dilation of airways

58
Q

How is sensory information relayed from visceral afferent passed oat the pulmonary plexus and why is this significant?

A

Via the vagus nerve
This means the vagus nerves receives sensory information for both the upper and lower respiratory tracts meaning a cough can be initiated by either signal

59
Q

Where can the phrenic nerve be found?

A

In the neck on the anterior scalenus muscle

Lateral aspect of the pericardium

60
Q

The phrenic nerve supplies which nerve where?

A

Sensory and sympathetic- diaphragm and fibrous pericardium

Somatic motor to diaphragm

61
Q

What are the three types of intercostal muscles?

A
  1. External
  2. Internal
  3. Innermost
62
Q

What are the four sets of accessory muscles of deep inspiration?

A
  1. Pectoralis major
  2. Pectoralis minor
  3. Sternocleidomastoid
  4. Scalenus anterior, medium and posterior
63
Q

Where does the pectorals major attach?

A

Between the sternum and the ribs and also the humerus

64
Q

The pectoralis major allows for which movements?

A

Adduction and rotation of the humerus

Full ribs upwards and outwards when the upper limb position is fixed (facilitates deep inspiration)

65
Q

Where is the pectorals minor located and where does it attach?

A

Deep to the pectorals major

Attaches at the coracoid process of the scapula and ribs 3-5 that can be pulled superiorly upon contraction

66
Q

Where dos the sternocleidomastoid muscle attach?

A

Between the sternum and clavicle

Also as the mastoid process of the temporal bone

67
Q

Where does the scalenus muscle group attach?

A

Between cervical vertebrae and ribs 1 and 2

68
Q

What happens when intrinsic muscles in the larynx move the cartilage?

A

The vocal cords will close since they are attached

The intrinsic muscles are innervated by motor components of the vagus nerve

69
Q

Where does the vagus nerve arise from?

A

The medulla oblongata

70
Q

Where does the vagus nerve exit the base of the skull?

A

Through the jugular foramen

71
Q

In the chest the vagus nerve lies ______ to the lung root and supplies ______ axons to the chest organs and pulmonary plexus

A

Posteriorly

Parasympathetic

72
Q

The ____ ____ forms what on the oesophagus

A

Vagus nerve

Plexus

73
Q

What happens when the vagus nerve reaches the stomach ?

A

it forms another plexus where it supplies the foregut and the midgut

74
Q

How is the action of the diaphragm different in passive breathing versus forces expiration with a cough?

A

Passive breathing - just relaxes
Forced expiration - right and left anterolateral abdominal wall muscles contract compressing abdominal organs and pushing the diaphragm upwards aiding forced expiration

75
Q

What are three anterolateral muscles int he chest wall?

A
  1. External oblique
  2. Internal oblique
  3. Transversus abdominus
76
Q

In what direction do the muscle fibres in the external oblique muscle pass?

A

The same direction as the external intercostal muscles

77
Q

Where does the external oblique muscle attach both superiorly and inferiorly ?

A

Superiorly- superficial aspect of the lower ribs

Inferiorly- iliac breast and pubic tubercle

78
Q

The external oblique muscles blends into what?

A

A flat tendon called aponeurosis

79
Q

What is the point at which the muscle fibres end and aponeurosis begins called?

A

Linea semilunari

80
Q

When two aponeuroses meet as with the right and left external oblique muscles, what is the point at which they (aponeuroses ) meet called?

A

Linea alba

81
Q

The linea alba for the external oblique muscle is located on the _____ surface of the body?

A

Anterior

82
Q

In which direction do the muscle fibres from the internal oblique muscles run?

A

In the same direction as the internal intercostal muscles

83
Q

Where does the internal oblique muscle attach both superiorly and inferiorly?

A

Superiorly - lower border- inferior part - of the lower rib

Inferiorly - iliac crest and thoracolumbar facia

84
Q

Where do the aponeuroses for the internal oblique muscles come together?

A

The anterior side of the body at the lineament alba

85
Q

In which direction do the muscle fibres in the transversus abdominus travel?

A

In the axil plane

86
Q

Where are the attachments for the transverse abdominus?

A

Superiorly- distal aspects of lower ribs

Inferiorly- iliac crest and thoracolumbar fascia

87
Q

What is the rectus sheath?

A

An encapsulation of the rectus abdomen muscles formed from the aponeuroses of the external and internal oblique muscles and the transversus abdominus

88
Q

What is the unique about the internal oblique aponeuroses in relation to the rectus abdominus?

A

The aponeuroses splits in half, with one half going posterior to the rectus abdominus and one half going anterior to it

89
Q

Thoracoabdominal nerves are extensions of what nerves?

A

Intercostal nerves

90
Q

Why do the 7th to 11th intercostal nerves terminate early?

A

Their associated ribs do not join in the midline

91
Q

The intercostal nerves (7-11) terminate early since the ribs associated do not join in the midline- but what happens to the intercostal nerves from there?

A

They become thoracoabdomina nerves and remains between the internal oblique and transversus abddonminus

92
Q

After leaving the intercostal space, what does the T12 intercostal nerve become?

A

The subcostal nerve

Supplies the lower abdomen

93
Q

Which nerve(s) originates from the L1 anterior ramus?

A

iliohypogastric nerve

ilioinguinal nerve

94
Q

The anterolateral abdominal wall muscles have many functions including what?

A
  • maintaining posture
  • supporting cerebral column
  • help flex the vertebral column for movement
  • guarding - protect organs
  • contract to increase intraabdominal pressure for defecation, micturition labour and forced expiration
95
Q

Build up of air trapped in alveoli due to a chronic cough can cause what?

A

Rupture of the pleura leading to a pneumothorax

96
Q

During a pneumothorax, why does the lung collapse?

A

The vacuum of the pleural space is lost and this can no longer hold the lung in position due to the surface tension
The lung tissue recoils due to its elastic nature

97
Q

What is the classification of a large pneumothorax ?

A

A gap of greater than 2cm results between the lung and the parietal pleura
(a small pneumothorax is when this gap is less than 2cm)

98
Q

On examination, what signs may lead to a diagnosis of pneumothorax?

A
  • reduced ipsilateral chest expansion
  • reduced ipsilateral breath sounds due to absence of lung tissue
  • hyper-resonance- due to absence of lung tissue and increased air space
  • deviated trachea
99
Q

On a chest X-Ray, how may a pneumothorax present?

A
  • absent lung markings around the peripheries

- the lung edge is visible

100
Q

What is the four sections is the mediastinum split into?

A
  1. Anterior
  2. Posterior
  3. Superior
  4. Middle- houses the heart
101
Q

What section of the mediastinum houses the heart?

A

middle

102
Q

At which anatomical landmark does the middle mediastinum become the superior mediastinum?

A

At the level of the sternal angle

103
Q

What can cause mediastininal shift and what are some of the consequences?

A

Tension pneumothorax

  • tacheal deviation
  • SVC compression
  • Hypotension- reduced venous return
104
Q

What can be done to allow excess air out of the pleural cavity (during a pneumothorax for example)

A

needle aspiration

thoracentesis(pleural tap)

105
Q

Where may be an appropriate location for a chest drain in pneumothorax management?

A

the middle of the 4th and 5th intercostal space in the midaxillary

106
Q

Why is a chest drain inserted in the middle of an intercostal space?

A

To avoid the neurovascular bundles superiorly and inferiorly

107
Q

What is the “safety triangle” in relation to pneumothorax management?

A

AN area where a chest drain can be inserted, or needle aspiration can occur
There are no organs to puncture in this area
It is composed of three points:
1. Anterior border of the latissimus dorsi
2. Posterior border of the pectorals major
3. Axial line superior to the nipple

108
Q

To realise air in an emergency during a tension pneumothorax, where is a large gage cannula inserted?

A

The pleural cavity at the 2nd/3rd intercostal space in the mid- clavicular line
This is the level of rib 2 at the sternal angle

109
Q

What is a hernia?

A

When any body structure passes through another to end up inane incorrect location, a hernia is formed

110
Q

To develop a hernia, two factors must be present, what are these?

A
  1. Weakness of one structure

2. Increased pressure on one side of the weak body wall

111
Q

What are the two main types of oesophageal hernia?

A
  1. Paraoesophageal hiatus hernia

2. Sliding hiatus hernia

112
Q

What is the point at which the oesophagus becomes the stomach?

A

The gastro oesophageal junction

113
Q

How do sliding hiatus herniae differ from paraoesophageal hiatus herniae?

A
  • Sliding- whole stomach moves, gastro oesophageal junction moves
  • Paraoesophageal- portion of the stomach herniates out, gastro oesophageal junction remains in the correct location
114
Q

Where is the inguinal region?

A

The region found between the anterior superior iliac spines and the pubic tubercles

115
Q

What are the inguinal ligaments formed from?

A

The inferior border of the external oblique aponeuroses

116
Q

The medial halves of the inguinal ligaments form what in the inguinal canals?

A

The floor

117
Q

Inguinal canals form channels between _____ and ______ ______.

A

Deep

Superficial structure

118
Q

What and where are the two openings in the inguinal canals?

A
  1. The deep ring- intra-abdominal- midpoint of the inguinal ligament
  2. The superficial ring- superficial- V-shaped part of the external oblique apononeurosis lying superolateral to the pubic tubercle
119
Q

In relation to herniation, what does the inguinal canal allow for?

A

Abdominal structures can herniate through the canal and move to more superficial areas

120
Q

How is the inguinal canal formed?

A

During embryonic development

Descent of either the testes or round ligament of the uterus

Respiratory (12 decks)

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