Anatomy of Breathing Flashcards
What components make up the upper respiratory tract?
Right and left nasal cavities
Oral cavity
Nasopharynx
Oropharynx
Laryngopharynx
Larynx
What components make up the lower respiratory tract?
Trachea
Right and left bronchi
Lobar bronchi
Segmental bronchi
Bronchioles
Alveoli
Which parts of the lower respiratory tract are in the lungs?
Lobar bronchi
Segmental bronchi
Bronchioles
Alveoli
At which spinal cord level does the larynx become the trachea?
C6
At which spinal cord level does the pharynx become the oesophagus?
What is the significance of C6 vertebral level in terms of the divisions of the respiratory and gastrointestinal tracts?
Larynx becomes trachea
Pharynx becomes oesophagus
At C6
Where can the trachea be palpated?
Jugular notch of the manubrium
Where is the isthmus of the thyroid gland in relation to the tracheal cartilages?
Anterior
Which tracheal cartilages is the isthmus of the thyroid gland lie infront of?
Tracheal cartilages 2-4
What is immediately superior and inferior to the thorax?
Superior - neck
Inferior - abdomen
What makes up the thorax?
Chest walls
Chest cavity
What is the function of the chest walls?
Protect the thoracic viscera
Make the movements of breathing
Lactation (in female breath tissue)
What is the function of the chest cavity?
Houses viscera
Contains major vessels and nerves
What two regions form the chest cavity?
Mediastinum and the right/left pleural cavities
Describe lung development
A lung bud pushes from the mediastinum into a preformed layer of pleura
What is the pleural cavity?
The space between the parietal and visceral pleura
What is the difference between parietal and visceral pleura?
Parietal pluera is in contact with the chest wall
Visceral pleura is in contact with the lung itself
Where does the reflection of pleura occur?
At the lung roots
What do the pleural layers do?
Secrete pleural fluid which lubricates the plueral cavity and provides surface tension
What is the function of pleural fluid?
Lubricates the pleural cavity and provides surface tension
What is a lung lobe?
An area of lung which one lobar bronchi supplies with air
What is a bronchopulmonary segment?
An area of lung that a segmentl bronchiole supplies with air
How many bronchopulmonary segments are there?
20
Each lung has 10
What bones form the thoracic skeleton?
12 pairs of ribs
Sternum
Clavicle
Scapula
12 thoracic vertebrae
How many lobes does the left lung have and what are they called?
2
Superior/upper lobe
Inferior/lower lobe
How many lobes does the right lung have and what are they called?
3
Superior/upper lobe
Middle lobe
Inferior lobe
How many lobar bronchi does the left lobe have?
2
How many lobar bronchi does the right lobe have?
3
What is a true rib?
A rib which articulates directly with the sternum via its costal cartilage
What is a false rib?
Ribs which articulate with the sternum indirectly via a shared costal cartilage
What is a floating rib?
A rib which doesn’t articulate with the sternum
How many pairs of ribs do we have?
12
Which ribs are true ribs?
1-7
Which ribs are false ribs?
8-10
Which ribs are floating ribs?
11 and 12
What does the head of the rib do?
Articulates with the body of the vertebra
What does the rib tubercle do?
Articulates with the transverse process of a vertebra
What is the rib angle?
Location where the body/shaft subtely changes direction
What and where is the costal groove of a rib?
Small groove in on the body of the rib where the intercostal neurovascular bundle runs
Inferior on the deep surface
How does a rib articulate with the sternum?
Via its costal cartilage
How do you know which rib articulates with which thoracic vertebrae?
Rib 1 articulates with T1
Rib 2 articulates with T2
…
Rib 12 articultes with T12
Name the numbered structures/features on a rib
- Costal groove
- Rib angle
- Body of the rib
- Rib tubercle
- Head of the rib
- Neck of the rib
Which part of the rib articulates with the vertebrae, the thick or thin part?
The thin part (head of the rib)
Name the numbered joints
- Sternocostal joint
- Costochondral joint
- Costovertebral joint
What is the general range of movement for the rib joints?
Limites movement
What is the name of the muscles which lie between the ribs and in the intercostal spaces?
Intercostal muscles
What are the 3 layers of intercostal muscle from superficial to deep?
External intercostal muscle (superficial)
Internal intercostal muscle
Innermost intercostal muscle (deep)
Where do the layers of intercostal muscles attach?
Between adjacent ribs
What does contraction of the intercostal muscles do?
Pulls the ribs outwards and upwards
What are the intercostal spaces?
The spaces between the ribs
How many intercostal spaces are there?
11
What runs in the intercostal spaces?
Intercostal neurovascular bundle
Between which layers does the intercostal neurovascular bundle run?
Between internal and innermost intercostal muscle
What innervates the intercostal spaces?
The anterior ramus of the correlating spinal nerve
Intercostal nerve
What supplies the posterior intercostal spaces with blood?
Posterior intercostal arteries arising from thoracic aorta
What drains the posterior intercostal spaces of blood?
Azygous vein
What supplies the anterior intercostal spaces with blood?
Branches of the internal thoracic arteries
What drains the anterior intercostal spaces of blood?
Internal thoracic vein
Where do the internal thoracic arteries run?
Course bilaterally down either side of the deep surface of the sternum
Where do the internal thoracic veins run?
Course bilaterally down either side of the deep surface of the sternum
Name the numbered structures
- Vertebral column
- Parietal pleura
- Layers of intercostal muscle
- Intercostal neurovascular bundle
- Internal thoracic artery and vein
- Sternum
- Intercostal neurovascular bundle
Which surface of the thoracic aorta do the bronchial arteries come off?
Anterior
What do the bronchial arteries supply?
Lungs
What is the main muscle of respiration?
Diaphragm
What forms the floor of the chest cavity?
Diaphragm
What forms the roof of the abdominal cavity?
Diaphragm
How do structures pass from the chest cavity to the abdominal cavity?
Through openings in the diaphragm
What is the name of the opening in the diaphragm which the aorta passes through?
Aortic hiatus
What type of muscle is the diaphragm?
Skeletal
What forms the centre of the diaphragm?
A central tendon
What shape is the diaphragm?
Arranged as two domes
Which dome of the diaphragm is more superior and why?
Right dome is superior
Due to presence of liver beneath it
What are the muscular attachments of the diaphragm?
Attaches to the:
- sternum
- lower 6 ribs and costal cartilages
- L1-L3 vertebral bodies
What supplies the muscular part of the diaphragm?
The phrenic nerve (C3,4 and 5 anterior rami)
What is the phrenic nerve?
Combined anterior rami of C3, C4, C5
Where can the phrenic nerve be found in the neck?
Anterior surface of the scalenus anterior muscle
Where can the phrenic nerve be found in the thorax?
Over the lateral aspects of the heart
What does the phrenic nerve supply with motor fibres?
Diaphragm
What does the phrenic nerve supply with sensory fibres?
Diaphragm
Fibrous pericardium
What does contraction of the diaphragm do?
Flattens out its dome shape which increases the lung volume vertically
What are the basic mechanisms of inspiration?
Diaphragm contracts pulling the lungs down
Intercostal muscles contract pulling the lungs upwards and outwards
This increases the lung volume and therefore decreases lung pressure
Air flows into the low pressure of the lungs along its concentration gradient
What are the basic mechanisms of exhalation?
Diaphragm and intercostal muscles relax
The elastic tissue present in the lungs recoil restoring its normal shape
The reduced volume increases the lung pressure which expels air
What is the function of the elastic tissue in the lungs?
Allows the lung to recoil to its original shape on exhalation
Name the numbered structures
- Right midclavicular line
- Midline (sternal line)
- Left midclavicular line
- Anterior axillary line
- Posterior axillary line
- Midaxillary line
- Axilla
- Costal margin
What is the costal margin?
Line that runs along the anteroinferior border of the ribcage
What is the surface of the female breast divided into?
4 quadrants
(superolateral, superomedial, inferolateral, inferomedial)
What is the areola?
Ring of pigmented skin around a nipple
What is the axilliary tail of the female breast?
Extension of tissue which extends the the axilla
What must an examination of the female breast involve?
All 4 quadrants
Nipple
Areola
Axilliary tail
Regional lymphatics
Name the numbered structures
- Pectoral fascia (deep fascia)
- Pectoralis major
- Pectoralis minor
- Rib
- Intercostal muscle
- Parietal pleura
To what lymph nodes do the lateral quadrants of the breast drain to?
Axillary nodes
To what lymph nodes do the medial quadrants of the breast drain to?
Parasternal nodes
Name the numbered structures/landmarks
- Jugular notch
- Clavicle
- Sternal angle
- Xiphoid process
- Costal margin
- Right and left pectoralis major
What is the delto-pectoral groove?
Gap between the deltoid and pectoralis major muscle
What runs in the deltopectoral groove?
Cephalic vein
Name the numbered structures
- Skin
- Superficial fascia
- Deep fascia
- Intercostal nerves
- Pectoralis major
- Cephalic vein
- Deltoid
- Clavicle
Name the numbered structures
- Pectoralis major
- Long thoracic nerve
- Latissimus dorsi
- Serratus anterior
What causes ‘winged scapula’ and why does it cause this?
Paralysis of serratus anterior
This muscle connects the scapula to the rubs
What nerve supplies serratus anterior?
Long thoracic nerve
What can injury to the long thoracic nerve cause and why?
Winged scapula
Long thoracic nerve supplies serratis anterior which anchors scapula to the ribs
Paralysis of this muscle (due to long thoracic nerve damage) causes winged scapula
Where are the attatchments of pectoralis minor?
The coracoid process of the scapula
Ribs 3-5
Name the numbered structures
- Ribs
- Sternum
- Intercostal muscles
- Intercostal nerve
- Anterior intercostal artery
- Anterior intercostal vein
- Right internal thoracic artery and vein
- Right subclavian artery and vein
What does the anterior intercostal vein drain into?
The internal thoracic vein
What is the anterior intercostal artery a branch of?
Internal thoracic artery
What is the costodiaphragmatic recess?
Most inferior region of the pleural cavity
Where is the costodiaphragmatic recess?
Between the diaphragmatic parietal pleura and the costal parietal pleura
What is the most inferior region of the costodiaphragmatic recess called?
Costophrenic angle
What is the clinical significance of the costophrenic angle?
If there is an abnormal fluid collection in the pleural cavity (pleural effusion) blunting of this angle would be seen on CXR
Name the numbered pleural layers and anatomical structures
- Cervical parietal pleura
- Costal parietal pleura
- Visceral pleura
- Costodiaphragmatic recess
- Costophrenic angle
- Diaphragmatic parietal pleura
- Mediastinal parietal pleura
- Mediastinum
What is the root of the lung?
The structures that connect the lung to the mediastinum
What structures are in the root of the lung?
Main bronchus
Pulmonary artery
2 pulmonary veins
Lymphatics
Visceral afferents
Sympathetic nerves
Parasympathetic nerves
What is the name of the most inferolateral aspect of the superior lobe of the left lung?
Lingula
Name the numbered structures
- Lung apices
- Horizontal fissure
- Superior/upper lobe
- Middle lobe
- Lingula
- Inferior/lower lobe
- Lung bases
- Oblique fissure
What is the apex of the lung?
Most superior part of the lung
What is the base of the lung?
Most inferior part of the lung
Name the cause of the numbered surface markings on the lungs
- Azygous vein
- Superior vena cava
- Heart
- Inferior vena cava
- Diaphragm
- Ribs
- Root of the lung
Name this structure and identify the numbered structures which form it
Root of the right lung
- Main bronchus
- Pulmonary arteries
- Lymph nodes (are black)
- Pulmonary veins
What lung is this and how do you know this?
Right lung
The surface marking of the heart is less obvious that it is on the left lung
You can see the surface marking of the superior vena cava and azygous vein
Which lung hilum is shown and how do you know this?
Right lung hilum
Two pulmonary arteries, the left lung hilum as only 1
What lung hilum is this?
The left lung hilum
It has one pulmonary artery and the right lung hilum has 2
What lung is this?
Left lung
Heart surface marking is very prominent and you can see the mark the aortic arch has made
Name the structures responsible for the numbered surface markings
- Ribs
- Aorta
- Heart
- Diaphragm
What is the difference between the medial surfaces of the left and right lungs?
The left lung has a more prominent cardiac surface marking compared to the right
The left lung has surface markings left by the aorta
The right lung has surface markings left by the vena cava and the azygous vein
What is the difference between the hilum of the left and right lung?
The left lung has one pulmonary artery whereas the right lung has two pulmonary arteries
Where are the lung apices?
Superior to the medial third of the clavicle
Where is the middle lobe of the right lung?
Between ribs 4 and 6
Which rib does the horizontal fissure of the right lung follow?
Rib 4
Where are the oblique fissures?
Rib 6 and rise to T3 vertebral level posteriorly
What vertebral level is the lung base on?
T11
