anatomy of resp system Flashcards
The thoracic inlet is bounded by x4
The first thoracic vertebra (T1) posteriorly.
The first pair of ribs laterally.
The costal cartilage of the first rib
the superior border of the manubrium anteriorly.
The thoracic outlet is bounded by
12th thoracic vertebra posteriorly.
11th and 12th pairs of ribs laterally.
Costal cartilages of ribs 7 through 10 and xiphisternal joint anteriorly
where does manubrium sit in relation to vertebrae
T2-T3
where does the sternal angle sit in relation to the vertebrae
T4-T5
first rib articular facet
only 1 point
ribs articulate with vertebrae
of same number and the one above
(ABOVE WILL BE SMALLER NUMBER)
rib 5 attaches to T5 and T4
with head of rib to the body of vertebra
name of joint between rib and vertebra
costovertebral
what type of joint is th costovertebral
synovial plane
the tubercle of rib articulates with
transeverse process of vertebra of same number
name of tubercle to transverse process joint
costotransverse
what type of joint is costotransvers
synovial plane
first sternocostal joint type
(between first rib and vertebrae)
primary cartilaginous
what vertebral level is the xyphoid process
9th
what level is sternomanubrial joint
5th
main sternalcostal joint type
synovial plane
true ribs
1 - 7
false ribs
8-10
floating ribs
11 + 12
how to get intercostal space number
same number as rib above
where is neurovascuar bundle found
costal groove
chest wall dermatomes correspond with
intercostal space at and below dermatome
7 major lymph nodes
- root of the upper limb (axillary)
- root of the lower limb (superficial and deep inguinal)
- around the pectoralis major muscle/breast (pectoral)
- bifurcation of trachea in thorax (tracheobronchial)
- the hilum of the lungs (bronchomediastinal)
- around root of arteries in the abdomen and pelvis (lumbar/pelvic)
- and as superficial and deep groups in head and neck (superficial cervical and deep
cervical)
where can lymph nodes often be found
large veins
where does most breast lymph drain
anterior (pectoral) group of axillary lymph nodes (the sentinel node/s)
what vertebrae does the left crura attatch
L1-L2
what vertebrae does the right crura attatch
l1- l3
which costal cartilages does the diaphragm attach
lower 6
what part of the sternum does the diaphragm attach to
xyphoid process
where does hiatus for inferior vena cava occur
T8-9
where does hiatus for oesophogus vena cava occur
T10
where does hiatus for aorta occur
T12
main nerve supplying diaphragm motor and sensory
phrenic
sensory nerve supplying peripheral diaphragm
intercostal nerves
spinal root values of phrenic nerve
C3 C4 C5
“keep the diaphragm alive”
damage to phrenic nerve
will cause paralysis of of dome of diaphragm
but can be compensated by intercostal muscles
upper respiratory tract includes
nose
pharynx
larynx
whats the larynx
a set of cartilages, membranes and ligaments which produce sound from expired air
(“voice-box”) and protects the inlet to the respiratory system.
larynx placement
continuous inferiorly with the trachea at C6.
anteriorly related to the pharynx (= “throat”).
lower respiratory tract includes
trachea, the primary bronchi and their branches, the
bronchioles, and alveoli,
LRT sympathetic
pulmonary plexuses located at the termination of the main bronchi,
LRT parasympathetic
from the vagus nerve
LRT sensory fibres reach the spinal cord via
both the sympathetic
and parasympathetic nerves
LRT blood supply
bronchial arteries arising from the thoracic aorta and intercostal arteries,
while the bronchial veins drain to the azygos venous
system
trachea position
inferior continuation of the larynx at C6
through the thoracic inlet, to vertebra T4 (sternal angle), where it bifurcates into the left and
right main bronchi.
Name the muscle that completes the tracheal ring posteriorly
trachialis muscle
The keel-shaped cartilage ring at the bifurcation of the trachea called the
carina
Lying immediately lateral to the trachea in the neck are the
common carotid arteries
The nerve lying immediately lateral to the trachea on both sides is the
vagus nerve
what provides motor and sensory inervation to larynx
recurrent laryngeal nerves (branches of vagus)
At what vertebral level does the trachea divide into the two main bronchi?
t4-5
bronchi that most often aspirates
right
While the left main bronchus enters the lung before giving off its branches,
the right main bronchus gives off a superior branch just before entering the right lung.
This branch is known as the eparterial or superior lobar bronchus (the inferiorly placed main bronchus then being called the hyparterial bronchus).
bronchiole structure
NO cartilage or glands
increased smooth muscle and elastic fibres
Hilum
the area on the medial surface of the lung through which structures enter or leave the lung
root
The structures which enter and leave the lung at the hilum are known collectively as the root of the
lung
right lung only features
middle lobe (wholly anteriorly situated between the transverse and oblique fissures)
transverse fissure
superior lobar (eparterial) bronchus. (The inferior bronchus is then called the hyparterial bronchus)
left lung only features
cardiac impression
aortic impression
cardiac notch
lingula
lymphatic drainage of lungs
drain into the bronchopulmonary lymph nodes
From here, lymphatics pass to the tracheobronchial nodes
which drain eventually into the thoracic duct (left) and right lymphatic duct
Which layer of the pleura is sensitive to pain?
parietal
Which nerve(s) supplies pain sensation to the pleura
intercostal
the………………………………………………………. pleura lies on the superior surface of the
diaphragm
diaphragmtic
the……………………………………………………. pleura lines the inner surfaces of the ribs and
sternum
costal
the ………….. covers the apex of the lungs in the root of the neck
apical pleura
the …….. lines the structures situated between the two pleural cavities - the
mediastinum
mediastinal pleura
whats pleural reflection
parietal pleura lining one surface of the chest wall
changes its direction to line another surface,
name of pleural reflection from inner surface of the ribs onto the superior surface of the diaphragm
costodiaphragmatic
name of pleural reflection from
the inner surface of the ribs posteriorly to lie on either side of the pericardium of the heart –
costomediastinal
whats a pleural recess
where the parietal pleura is more widely separated from the visceral pleura during expiration
has same name as reflection
usueful for aspiration
innervation of parietal pleura
phrenic nerve supplies the mediastinal and diaphragmatic parietal pleura over the domes.
the periphery is supplied by the lower 6 intercostal nerves
visceral pleura innervation
only autonomic innervation
pulmonary plexus -sympathetic and parasympathetic - vagus
At which vertebral level does the trachea start and end?
C6
T4
At which vertebral level does the trachea bifurcate into the 2 main bronchi
T5
Structure of extrapulmonary tubes (trachea and
bronchi outside of the lung),
lumen to outside of tube:
Mucosa, Submucosa, Smooth Muscle and Cartilage, Adventitia
mucosa is made of
respiratory epithelium and a thin loose
connective tissue layer called the lamina propria
connetive tissue type in trachea and bronchi
lamina propia
Which type of cartilage (hyaline, fibro-, elastic) is found in the respiratory tract?
hyaline
Which connective tissue fibre (collagen, fibrous, elastic, reticular) predominates in the respiratory tract?
fibrous
what type of epithelium is respiratory epithelium and cell types
cilated collumnar
cilliated cells and goblet cells
What is the name given to the smooth muscle found in the posterior wall of the trachea
trachealis
What type of cartilage is found in the trachea and what shape does it form?
cricoid
horseshoe
what is diagnostic for tertiary (intrapulmonary) bronchus
The presence and the
discontinuous arrangement
of the hyaline cartilage
epithelium in bronchioles
low columnar (larger bronchioles) or cuboidal (smaller bronchioles)
bronchiole surfactant producing cells
Clara (Club) cells
Proportionately significant increase of which tissue is in a bronchiole
smooth muscle
alveoli cell types
Type 1- squamous gas diffusion
Type 2- surfactant
macrophages
what landmarks does the sternal angle help show
bifurcation of trachea
level of second costal cartilage (2nd rib)
what order do intercostal vessels sit
VAN
vein on top
artery
nerve
where do intercostal vessels sit
between internal and innermost
intercostal nerves are
the ventral ramus of spinal nerves
where should needle be inserted in ribs to drain pleura
at top end to avoid nerves
where does the oblique fissure occur
rib 6
horizontal fissure on right lung occurs at
rib 4
phrenic nerve values
C3, C4, C5
phrenic nerve values
C3, C4, C5
The inferior border of the lung corresponds to which rib in the midaxillary line?
Rib 8
The inferior border of the plaura
rib 12
