Anatomy Of Pleura & Lung & Respiratory System Development Flashcards

1
Q

The parietal & visceral pleura are continuous at the …… & leave a fold called ……

A

Pleural cuff, pulmonary ligament

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2
Q

The visceral pleura leaves the lung to become continous with parietal …..

A

Medially, around the hilum of the lung & for a short distance below it

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3
Q

Mention the divisions of parietal pleura

A

Cervical, costal, diaphragmatic & mediastinal

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4
Q

The cervical pleura is crossed anteriorly by …., & related posteriorly to …,…&…. .

A

Subclavian artery

Stellate ganglion, superior intercostal artery & ventral ramus of first thoracic nerve

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5
Q

Mention the attachments of Sibson’s fascia

A

Attached laterally to the inner border of the 1st rib and medially to the 7th cervical transverse process

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6
Q

…… separates the costal pleura from the thoracic wall.

A

Endothoracic fascia

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7
Q

Which divison of parietal pleura is continuous with visceral

A

Mediastinal pleura

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8
Q

The pleural recessses are represented by …….. which are opposed

A

Two layers of parietal peritoneum

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9
Q

Costomediastinal recess is opposition between ……, on left side overlies the ….. .

A

Costal pleura & mediastinal pleura

Heart

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10
Q

The costodiaphragmatic recesses are regions between ….&….

A

The inferior margin of the lungs & inferior margin of the pleural cavities

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11
Q

Describe innervation of parietal pleura

A

By somatic nerves (sensitive to pain, temp, pressure & touch)
The costal & peripheral diaphragmatic are supplied by intercostal nerves.
The mediastinal & central diaphragmatic are supplied by phrenic nerves.

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12
Q

Describe the nerve supply of visceral pleura.

A

Autonomic nerves from ant & post pulmonary plexuses, sensitive to stretch

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13
Q

Describe the blood supply/lymph drainage of parietal pleura

A

Intercostal, internal thoracic & musculophrenic vessels

Intercostal, parasternal, posterior mediastinal & diaphragmatic L.N.

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14
Q

Describe referred pain of pleurae

A
  • thoracic & abdominal wall if costal and peripheral parts of diaphragmatic pleura are inflammed.
  • lower neck & shoulder tip if the mediastinal and central part of diaphragmatic are inflammed.
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15
Q

Name the filling of pleural cavity with air, pus, air&pus, blood & fluid.

A

Pneumothorax, empyema, pyopneumothorax, haemothorax & hydrothorax (pleural effusion)

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16
Q

Describe the relations of the apex of lungs

A

Anterosuperiorly: suprapleural membrane outside cervical pleura & the subclavian artery.
Posteriorly: stellate ganglion, superior intercostal vessels & ventral ramus of 1st thoracic spinal nerve.

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17
Q

Relations of base of lung

A

Related to diaphragm separating:

  • right lung from right lobe of liver.
  • left lung from left lobe of liver, fundus of stomach & spleen
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18
Q

GR: the diaphragm extends higher on the right than on the left.

A

Due to the presence of the liver

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19
Q

The anterior border of left lung presents a notch at level of ….., extends opposite …..&….

A

4th costal cartilage

4th & 5th intercostal spaces

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20
Q

The tongue-shaped process of the left lung is the

A

Lingula

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21
Q

Posterior border of lungs is related to …. & occupies the …..

A

Heads of the ribs

Paravertebral gutter

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22
Q

The inferior border of lung extends in …. Recess

A

Costodiaphragmatic recess

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23
Q

The inferior border of lung is rounded …..

A

Medially

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24
Q

Compare the relations of costal & medial surfaces of the lung

A

Costal surface: related to costal pleural separating it from ribs, costal cartilage & intercostal spaces.
Medial surface: divided into posterior vertebral & anterior mediastinal parts.
-mediastinal: related to heart
-vertebral: sides of thoracic vertebrae, intervertebral discs, posterior intercostal vessels, splanchnic nerves & sympathetic chain.

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25
Q

Mention the lobes & fissures of right/left lungs

A

Right: Superior, middle & inferior lobes. Oblique & horizontal fissures.
Left: Superior & inferior lobes. Oblique fissure.

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26
Q

Fissures of the lung may be partially or completely obliterated by ….

A

Inflammatory adhesions

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27
Q

Mention structures related to right lung in front of the hilum.

A
  • Pericardium enclosing right atrium & part of right ventricle.
  • Inferior vena cava
  • Superior vena cava & brachiocephalic vein
  • Ascending aorta & thymus gland
  • Right phrenic nerve
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28
Q

Mention the structures related to right lung above the hilum

A

Arch of azygos vein

Trachea, right vagus & esophagus

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29
Q

Structures related to left lung in front of the hilum

A

Pericardium covering the left ventricle, left auricle & infundibulum of right ventricle.

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30
Q

Structures related to the left lung behind the hilum

A

Descending aorta & esophagus

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31
Q

Structures related to the left lung above the hilum

A
  • The arch of the aorta (left vagus nerve, left superior intercostal vein, left phrenic nerve)
  • left common carotid & subclavian
  • eosphagus, thoracic duct, left recurrent laryngeal
  • pulmonary trunk & remains of thymus
  • left phrenic nerve
32
Q

Enumerate structures in the root of the lung

A

Principal bronchus, pulmonary artery, pulmonary veins, pulmonary autonomic plexus, bronchial arteries, bronchial veins & bronchopulmonary L.N.

33
Q

The most posterior & inferior structures of the hilum

A

P: bronchus
I:inferior pulmonary vein

34
Q

Branches of the main bronchus

A

Ep-arterial & hyparterial bronchi

35
Q

Describe the position of the pulmonary artery in the hilum of right lung

A

Anterior & in-between branches of main right bronchus

36
Q

Bronchial vessels lie on the ……… aspect of the bronchus.

A

Posterior

37
Q

Describe the arterial supply of the lungs

A

Two branches of descending aorta to the left lung

A branch to right lung from posterior intercostal artery/3rd right intercostal space or left suo bronchial art.

38
Q

Describe the venous return of the lungs

A

2 veins on each side

  • drain into azygos on the right
  • drain into hemiazygos or left superior intercostal vein on the left
39
Q

Ant & post pumonary plexuses are formed by…. .

They supply …..

A

Sym, fibers from 2nd-5th segments of sym chain
Para, from vagus
Bronchial tree, lung substance & visceral pleura

40
Q

Compare right & left lungs

A

R: larger, shorter, wider, straight, three lobes, two bronchi.
L: smaller, longer, narrower, two lobes, one bronchus.

41
Q

Define the bronchopulmonary segment

A

The anatomic, functional & surgical unit of the lung.

42
Q

Describe the structures associated with each bronchopulmonary segment.

A

Segmental bronchus, segmental artery, lymph vessels, autonomic nerves, intersegmental veins.

43
Q

Lymphatic drainage of the lung

A

Bronchopulmonry lymph nodes

44
Q

Functions of sym & para in the lung

A

Para: motor to smooth muscles, secretory to the mucous glands of the bronchial tree.
Sym: bronchodilator, inhibitory to the mucous gland of the bronchial tree.

45
Q

The area in which the two pleurae touch

A

From the sternal angle to the 4th costal cartilage

46
Q

On the left side, the pleura deviates laterally till the level of ….

A

6th costal cartilage

47
Q

Describe the extension of the inferior margin of the pleura

A

Begins behind 6th costal cartilage desacend to 8th rib (midclavicular), then to 10th rib midaxillary then ascend to cross 12th rib to end 2 cm lateral to 12th thoracic spine.

48
Q

The posterior margin of pleura extends from ….. to ….

A

T12 to C7

49
Q

The elements of thoracic wall which come in contact with pericardium.

A

Left part of the sternum

5th & 6th costal cartilages

50
Q

The inferior border of the lung end …… than that of the pleura

A

2 ribs higher

51
Q

Describe the extension of inferior border of lung.

A

Crosses 6th rib midclavicular, 8th rib midaxillary, crosses 10th rib to end 2 cm lateral to 10th thoracic spine.

52
Q

Compare surface anatomy of oblique & horizontal fissures.

A

O: begins opposite 3rd thoracic spine (level of medial end of scapular spine) to the inferior border of lung at 6th costochondral junction.
H: begins opposite 4th costal cartilage to join oblique fissure at the midaxillary line.

53
Q

Mention the week when the olfactory placodes appear and the next steps of their development

A

5th week
They form the olfactory pit (nasal sac)
Then its margins proliferate forming medial/lateral nasal prominences

54
Q

Describe the development of parts of the external nose

A
  1. Frontal prominence gives dorsum of the nose
  2. Lateral nasal prominence will give the ala of the nose
  3. Medial nasal prominence will give the nasal septum
55
Q

Mention the mechanism of deepening of the nasal pits

A

Partly by growth of the nasal folds & partly by penetration into the underlying mesenchyme

56
Q

The primitive nasal cavities communicate with the stomodeum throigh …

A

Primitive internal naris (choanae)

57
Q

The chonchae developmas …. while the paranasal sinuses develop as ….

A

Elevations on the lateral wall of the nasal cavity

Diverticula from the lateral wall of the nose

58
Q

Describe the development of the paranasal sinuses

A
  • The maxillary & ethmoid sinuses are present at birth, but are small; the development of the former is nit completed until the eruption of all adult teeth; while the latter is developed by about 8 years.
  • The frontal & sphenoid sinuses develop postnatally; the former during the 7th year & the latter around the 2nd year.
59
Q

The devepment of laryngeotracheal tube begins at

A

Middle if the 4th week

60
Q

The direction in which the larygeo-tracheal groove fuses

A

Caudo-cranial direction

61
Q

The division of laryngeo-tracheal tube results in formation of:

A

A. Dorsal part will give the pharynx & esophagus

B. Ventral part called larygeo-tracheal tube

62
Q

Derviatives of the laryngeo-tracheal tube and those of the surrounding splanchnic mesoderm.

A
  1. L/T tube gives lining epithelium of larynx, trachea, bronchial tree & alveoli.
  2. M: gives cartilagenous plates, smooth muscles, connective tissue & blood vessels (bronchial & pulmonary)
63
Q

The communication between the laryngo-tracheal tube & the pharynx

A

The laryngeal inlet

64
Q

The copula (median elevation) gives …

A

Epiglottis

65
Q

The period in which the laryngeal inlet becomes obliterated & the structures formed during racanalization.

A

8th-10 weeks

True & false vical cords

66
Q

Describe the divisons of the lung bud

A

Each lung bud forms a main bronchus, divides into secondary (lobar) bronchi, which divide into tertiary (segmental) bronchi each is surrounded by splanchnic mesoderm to form a broncho-pulmonary segment.
Repeated dichotomous division give 17 orders of division giving terminal bronchioles, by 6th month.
Further division occurs up to 8 years with 7 more orders of division. Total of 24 orders

67
Q

Parietal pleura is dervied from …. while visceral pleura is derived from ….

A

Somatic mesoderm

Splanchnic mesoderm

68
Q

Mention anomalies of respiratory system

A

Esophageal atresia & tracheo-esophageal fistula, surfactant deficiency, agenesis, hypoplasia, variation in lobe number, accessory lung, ectopic lung lobes & congenital lung cyst.

69
Q

GR: occurrence of tracheo-esophageal fistule & most common variety.
Mention its effect intra-uterine

A

Incomplete fusion of tracheo-esophageal folds
Atresia of upper portion of esophagus & fistula of its lower portion with trachea.
Polyhydraminos

70
Q

The major cause of RDS.

A

Hyaline membrane disease

71
Q

Hormones which increase surfactant production

A

Cortisone & thyroxine

72
Q

The parts contributing to development of diaphragm

A

Septum transversum, pleuroperitoneal membranes, dorsal mesentery of the esophagus & lateral body walls.

73
Q

During 4th week of development, the septum transversum lies opposite ……

A

3rd to 5th cervical somites

74
Q

The somites migrate into developing diaphragm during the ….

A

5th week

75
Q

The most common congenital anomaly of the diaphragm

A

Congenital diaphragmatic hernia

76
Q

GR: CDH is more common on the left side.

A

Due to earlier closure of the right pleuroperitoneal opening