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ESA 3 - Respiratory System > Anatomy of Respiratory System > Flashcards

Anatomy of Respiratory System Flashcards

1
Q

What is the bony thorax made up of?

A
  • The thoracic vertebrae posteriorly
  • The ribs and intercostal spaces laterally
  • The sternum and costal cartilages anteriorly
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2
Q

What happens to the thoracic cage superiorly?

A

It is continuous with the neck, at the thoracic inlet

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3
Q

What happens to the thoracic cage inferiorly?

A

The diaphragm separates it from the abdominal cavity

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4
Q

How many ribs are there?

A

12

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5
Q

What do the ribs articulate with posteriorly?

A

The vertebral column

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6
Q

How do the ribs articulate with the vertebral column?

A

Via the costo-vertebral joints

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7
Q

What do the ribs articulate with anteriorly?

A
  • Ribs 1-7 are connected to sternum
  • Ribs 8-10 are connected to costal cartilage alone
  • Ribs 11-12 have ends free in the abdominal muscles
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8
Q

How do ribs 1-7 connect to the sternum?

A

Via costal cartilages

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9
Q

What are ribs 11 and 12 known as?

A

Floating ribs

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10
Q

What ribs are considered ‘typical’?

A

3-9

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11
Q

What do typical ribs have?

A
  • Head
  • Neck
  • Tubercle
  • Shaft
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12
Q

What does the head of the rib have?

A

Two articular facets

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13
Q

What are articular facets at the head of the rib for?

A

Articulation with the body of the corresponding vertebrae, and the vertebrae above

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14
Q

What does the neck of the rib do?

A

Connects the head of the rib with the body

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15
Q

At what level does the neck of the rib connect the head and the body?

A

The level of the tubercle

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16
Q

What does the tubercle of the rib contain?

A

One articular facet

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17
Q

What is the purpose of the articular facet of the tubercle of the rib?

A

For articulation with the transverse processes of the corresponding thoracic vertebrae

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18
Q

What shape is the shaft of the rib?

A

Thin, flat, curved

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19
Q

What happens at the angle of the rib?

A

The shaft twists forward to form its characteristic curve

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20
Q

What does the shaft contain?

A

A costal groove

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21
Q

Where is the costal groove located?

A

Close to the lower border of the shaft of the rib

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22
Q

What does the costal groove do?

A

Protects the intercostal vessels and nerve

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23
Q

Label this diagram of a typical rib

A
  • A - Crest of head
  • B - Superior articular facet
  • C - Tubercle
  • D - Angle
  • E - Cup for costal cartilage
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24
Q

What are the typical features of most thoracic vertebrae?

A
  • Independant
  • Have bodies, vertebral arches and seven processes
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25
What are the 7 processes of the thoracic vertebrae for?
Muscular and articular connections
26
What are the characteristic features of thoracic vertebrae?
* Bilateral costal facets *(demifacets)* * Costal facets * Spinous processes
27
Where do the demifacets of thoracic vertebrae occur?
On the vertebral bodies, *usually occuring in inferior and superior pairs*
28
What is the purpose of the vertebral body demifacets?
Articulation with the heads of ribs
29
Where are the costal facets of thoracic vertebrae found?
On the transverse processes
30
What is the purpose of the costal facets of thoracic vertebrae?
Articulation with the tubercles of the ribs
31
Which ribs are atypical? ## Footnote *With respect to costal facets*
The inferior two or three, *as they do not articulate with costal facets*
32
Describe the spinous process of thoracic vertebrae?
Long, inferiorly slanting
33
What connects ribs with thoracic vertebae?
Costovertebral joints
34
What kind of joints are costovertebral?
Synovial
35
When does movement take place at the costovertebral joints?
Movement of the ribs during **respiration**
36
What does the costovertebral joint consist of?
* Joint of the rib head * Costotransverse joint
37
What articulates at the joint of the rib head?
The head of the rib articulates with the corresponding vertebrae, and the vertebrae above
38
What articulates at the costotransverse joint?
The articular facet of the tubercle of the rib and the transverse process of the corresponding vertebrae
39
Which ribs are atypical?
1, 2 and 10
40
Describe the shape of the first rib
Broadest, shortest, and most sharply curved rib
41
Describe the features of the first rib
* **Single articular facet** for articulation with the T1 vertebrae * **Two transversely directed grooves** crossing its superior surface for the subclavian vessels * The grooves are seperated by the **scalene tubercle**
42
Label this diagram of the first rib
* A - Single facet on head * B - Tubercle * C - Scalene tubercle * D - Grooves for... * di - Subclavian vein * dii - Subclavian artery
43
Describe the features of the second rib
* **Two articular facets** for articulation with the bodies of T1 and T2 vertebrae * Rough area on its upper surface, the **tuberosity for serratus anterior**
44
Label this diagram of the second rib
* A - Head * B - Neck * C - Tubercle * D - Tuberosity for serratus anterior * E - Body
45
Describe the features of the 10th-12th ribs
Single articular facet *(like 1st rib)* for articulation with a single vertebrae
46
Describe the features of the 11th and 12th rib?
Short, with no neck or tubercle
47
What does each intercostal space contain? ## Footnote *Regarding muscles*
3 muscles
48
What are the 3 muscles of the intercostal spaces?
1. External intercostals 2. Internal intercostals 3. Innermost intercostals
49
When are external intercostals used? ## Footnote *During breathing*
Inspiration
50
In which direction do the fibres of the external intercostal muscles run?
Downwards and anteriorly from above rib, to the one below
51
What is the action of the external intercostal muscles?
Elevate the ribs in a 'bucket handle' type movement, to increase anteroposterior and transverse diameters of the chest
52
What are the external intercostal muscles responsible for during quiet respiration?
30% of chest expansion
53
When are the internal intercostal muscles used? ## Footnote *During breathing*
During forced expiration
54
In which direction do the fibres of the internal intercostal muscles run?
Downwards and posteriorly, from above rib to the one below
55
What is the action of the internal intercostal muscles?
Pulls rib down from the position of chest expansion
56
When are the innermost intercostals used?
During forced expiration
57
What are the innermost intercostal muscles similar to?
Internal intercostals, *but less well developed*
58
What is the nerve supply of the intercostal muscles?
Intercostal nerves
59
Label this diagram
* A - Anterior ramus *(intercostal nerve)* * B - Muscular branch * C - Internal intercostal muscle * D - External intercostal muscle * E - Internal intercostal muscle * F - Lateral cutaneous branch * G - Innermost intercostal muscle * H - Transversus thoracis muscle * I - External intercostal membrane * J - Posterior ramus * K - Sympathetic trunk * L - Sternum
60
What is the main muscle of inspiration?
The diaphragm
61
What is the result of contraction of the diaphragm?
Descent
62
What does the diaphragm contraction account for during quiet respiration?
70% of chest expansion
63
Where are the openings in the diaphragm?
* T8 - Vena Cava * T10 - Oesophagus * T12 - Aorta *(Aortic hiatus)*
64
What is the diaphragm made up of?
1. Vertebral part 2. Costal part 3. Sternal part
65
What does the vertebral part of the diaphragm arise form?
The crura and the Arcuate ligaments
66
What does the costal part of the diaphragm arise from?
The inner aspects of the 7-12 costal cartilages
67
What does the sternal part of the diaphragm arise from?
The deep surface of the xiphisternum
68
What is the nervous supply of the diaphragm?
From the phrenic nerve, *C3, 4, 5.* *Remember, C3, 4, 5, keeps you alive*
69
What is the motor function of the phrenic nerve?
Supplies the diaphragm
70
What is the sensory function of the phrenic nerve?
Supplies both sides of the diaphragm, and the mediastinal/diaphragmatic part of the parietal pleura
71
What lies in the intercostal groove of the rib?
The intercostal vein, artery and nerve *In that order- remember VAN*
72
Where do the intercostal vein, artery, and vein? ## Footnote *Which part of the rib*
Along the lower border
73
What is the clinical importance of the intercostal vein, artery and nerve running along the lower border of the rib?
Important to remember when carrying out pleural aspiration or insertion of a chest drain, *when the needle should be inserted at the upper border of the rib to avoid injury*
74
Label this diagram
* A - Subcostal muscle * B - Posterior intercostal vein and artery * C - External intercostal muscle * D - Internal intercostal muscle * E - Innermost intercostal muscle * F - Intercostal nerve * G - Collateral nerve and vessels * H - Costal groove
75
How many intercostal nerves are there?
12
76
Where do the intercostal nerves originate from?
The anterior rami of the thoracic spinal nerves T1 - T12
77
What do the intercostal nerves supply?
The intercostal muscles in the corresponding space, the parietal pleura, and the overlying skin
78
What does each intercostal space contain? ## Footnote *Regarding arteries*
An anterior intercostal artery *(except the last two)*
79
What do the anterior intercostal arteries anastomose with?
A posterior intercostal artery
80
What do the intercostal arteries supply?
The intercostal muscles, parietal pleura, and overlying skin
81
How do the anterior intercostal arteries arise?
Brachiocephalic/aortic arch → Subclavian → Internal thoracic/musculophrenic → anterior intercostal
82
What do the posterior intercostal arteries arise from?
* **1st- 2nd spaces;** Brachiocephalic/aortic arch → Subclavian → Costocervical trunk → Superior intercostal → Posterior intercostal * **Other spaces;** Thoracic aorta → Posterior intercostal
83
What does each intercostal space contain? *Regarding nerves*
Two anterior and one posterior vein *accompanying the arteries*
84
How do the anterior intercostal veins drain?
Via the Internal Thoracic Vein, into the right subclavian vein
85
How do most posterior intercostal veins drain?
Via the Azygous vein on the right, and the Hemiazygous on the left, into the superior vena cava
86
Label the veins on this diagram
* A - Right internal jugular * B - Left brachiocephalic * **C - Right subclavian** * D - Right brachiocephalic * E - Right superior intercostal * **F - Superior vena cava** * G - Left superior intercostal * **H - Azygous** * **I - Posterior intercostal** * J - Accessory hemiazygous * **K - Anterior intercostal** * **L - Hemiazygous** * **M - Internal thoracic** * N - Subcostal * O - Right renal * P - Inferior vena cava
87
What is the pleura?
A serous membrane
88
What does the pleura consist of?
A single layer of mesothelial cells, with a thin layer of underlying connective tissue
89
What does the parietal plerua line?
The inside of each hemithorax
90
What does the hemithorac consist of?
The bony thoracic cage, diaphragm, and mediastinal surface
91
What does the perietal pleura become continuous with?
The visceral pleura
92
Where does the parietal pleura become continuous with the visceral plerua?
At the hilum of the lung
93
What does the visceral pleura line?
The outside of the lung
94
Where does the visceral pleura extend?
Between the lobes of the lung, into the depth of the oblique and horizontal fissures
95
What is the blood supply of the pleura?
Via the intercostal and internal thoracic arteries and veins
96
What is the innervation of the perietal pleura?
Both somatic *(Intercostal and Phrenic nerves)* and autonomic
97
What is innervation of the visceral pleura?
Autonomic ## Footnote *No somatic innervation*
98
What is the pleural cavity *(or space)*?
A potential space between the two layers of pleura that are continuous at the hilum
99
What are both layers of pleura covered with?
A common film of fluid
100
What is the fluid covering the layers of pleura produced from?
The parietal surface
101
What is the fluid covering the layers of pleura absorbed by?
The parietal lymphatic vessels
102
What does the pleural fluid allow?
The two layers to slide on one another, *thus in health the pleura allows movement of the lung against the chest wall while breathing*
103
What does the surface tension of the pleural fluid provide?
The cohesion that keeps the lung surface in contact with the thoracic wall
104
What is the result of the surface tension of the pleural fluid keeping the lung surface in contact with the thoracic wall?
When the thorax expands in inspiration, the lung expands along with it and fills with air
105
Do the lungs occupy all the available space in the pleural cavity?
No, *even in deep inspiration*
106
Label this diagram
* A - Pleural cavity * B - Collapsed lung * C - Visceral pleura * D - Perietal pleura * E - Thoracic wall *lined with endothoracic fascia* * F - Phrenicopleural fascia *(part of endothoracic fascia* * G - Mediastinum *(contains heart)* * H - Diaphragm * J - Visceral pleura * K - Parts of parietal pleura * ki - Diaphragmatic part * kii - Costal part * kiii - Medistinal part * kiv - Cervical pleura * L - Suprapleural membrane * M - Hilum of lung *(site of entry of root of lung)* * Orange - Visceral pleura * Purple - Perietal pleura * Blue - Costal pleura * Green - Diaphragmatic pleura * Red - Mediastinal pleura * Yellow - Cervical pleura * Solid - Fascial membranes *(Suprapleural and mediastinal fascia, fibrous pericardium)* * Dotted - Endothoracic fascia
107
What are the lines of pleural reflection?
The relatively abrupt lines along which the perietal pleura changes direction *(reflects)* as it passes from one wall of the pleural cavity to another
108
How many lines of pleural reflection are there?
3 on each side
109
Name the lines of pleural reflection
1. Sternal 2. Costal 3. Diaphragmatic
110
Label this diagram
* A - Common carotid artery * B - Internal jugular artery * C - Subclavian artery * D - Subclavian vein * E - 1st rib * F - 4th rib * G - Horizontal fissure * H - Right lung *(covered with visceral pleura)* * I - 6th rib * J - Oblique fissure * K - Right vertebral line of pleural reflection * L - Costal attachment of diaphragm * M - 10th rib * N - Vertebral attachment of diaphragm * O - Vertebrae *(T12)* * P - Left costal line of pleural reflection * Q - Lingula *(of superior lobe)* * R - Apex of heart * S - Bare area of pericardium * T- Oblique fissure * U - Cardiac notch of left lung * V - Left lung *(covered in visceral pleura)* * W - Right and left sternal lines of pleural reflextion * X - Apex of left lung covered by cervical pleura *(pleural cupula)* * **Red - Lines of *(parietal)* pleural reflection** * **Yellow - Outline of heart *(pericardium)***
111
What does each lung have?
* An apex * A base * Lobes * Three surfaces * Three borders
112
Where does the apex of each lung extend?
Above the level of the 1st rib into the neck
113
What is the base of the lung?
A concave, inferior surface
114
Where is the base of the lung?
Resting on the diaphragm
115
How many lobes does the lung have?
* Left has two * Right has three
116
What are the lobes of the lungs created by?
One *(left)* or two (*right)* fissures
117
What are the surfaces of the lungs?
1. Costal 2. Mediastinal 3. Diaphragmatic
118
What are the borders of the lungs?
* Anterior * Inferior * Posterior
119
What divides the right lung into it's three lobes?
A right oblique and horzontal fissure
120
What divides the left lung into its two lobes?
A single left oblique fissure
121
What are the lobes of the right lung named?
1. Superior 2. Middle 3. Inferior
122
What are the lobes of the left lung named?
1. Superior 2. Inferior
123
What is the hilum of the lung?
A wedge-shaped area on the mediastinal surface of each lung
124
What is the function of the hilum of the lung?
It is a passageway through which structures forming the roots of the lung enter or exit
125
What do the roots of the lung consist of?
* Bronchi * Pulmonary arteries * Superior and inferior pulmonary veins * Pulmonary plexus of nerves and lymphatics
126
Label this diagram
* A - Horizontal fissure * B - Superior lobe * C - Middle lobe * D - Inferior lobe * E - Oblique fissure * F - Lingula * G - Inferior lobe * H - Cardiac notch * I - Superior lobe * J - Oblique fissure
127
Where does the trachea begin?
At the lower border of the cricoid cartilage in the neck
128
How does the trachea terminate?
By dividing into the right and left main bronchi at the level of sternal angle
129
What holds the trachea open?
By **C-shaped cartilage rings**, supported posteriorly by the trachealis muscle
130
What is the trachea lined with?
Pseudostratified ciliated epithelia
131
What is the carina?
The angle between the right and left main bronchi
132
How does the right main bronchus differ from the left?
It is shorter, wider and more vertical
133
What is the consequence of the differences between left and right bronchi?
Any inspired objects are more likely to fall into the right main bronchus
134
How long is the right main bronchus?
2.5cm
135
What happens to the right main bronchus before reaching the hilum of the lung?
It gives off its upper lobar branch
136
How long is the left main bronchus?
5cm
137
Where does the left main bronchus pass?
Below the arch of the aorta, *anterior to the descending aorta and oesophagus*
138
What do the left and right main bronchi divide into?
Lobar bronchi, *one for each lobe*
139
What do the lobar bronchi divide into?
Segmental bronchi
140
What do the segmental bronchi branch into?
Sub-segmental bronchi
141
What do the sub-segmental bronchi divide into?
Bronchioles
142
What do the bronchioles divide into?
Terminal bronchioles
143
What do the terminal bronchioles divide into?
Alveolar ducts
144
What do the alveolar ducts divide into?
Alveoli
145
What blood vessels service the lung?
Each lung has a pulmonary artery supplying blood to it, and two pulmonary veins draining blood from it
146
What do the pulmonary arteries arise from?
The pulmonary trunk
147
Where do the pulmonary arteries arise from the pulmonary trunk?
At the level of the sternal angle
148
What do the pulmonary arteries carry?
Low-oxygen blood to the lungs
149
What is the purpose of the pulmonary arteries carrying low-oxygen blood to the lungs?
For oxygenation
150
What course do the pulmonary arteries take?
They become part of the **root of each lung** before splitting into **lobar arteries**, and subsequently **segmental arteries**
151
How are the arterie and bronchi related in each lung?
They are **paired**, branching simulataneously and running parallel courses
152
Name the pulmonary veins
* Superior * Inferior
153
What do the pulmonary veins do?
Carry oxygen-rich blood back to the heart
154
Where is the middle lobe vein found?
In the right lung
155
What is the middle lobe vein a tributary of?
The right superior pulmonary vein
156
How are the pulmonary veins related to the pulmonary arteries and bronchi?
They are not- *they are independant*
157
What do the bronchial arteries supply blood too?
* The structures making up the root of the lungs * Suppoting tissues of lungs * Visceral pleura
158
Where do the bronchial arteries pass?
*Typically*, along the posterior aspects of the main bronchi
159
How many left bronchial arteries are there?
2
160
Where do the left bronchial arteries arise from?
Directly from the thoracic artery
161
How many right bronchial arteries are there?
1
162
Where does the right bronchial artery arise from?
The 3rd intercostal artery, *arising from the thoracic aorta*
163
What are the groups of the bronchial veins?
* Superficial * Deep
164
What do the superficial group of the bronchial veins do?
Drain **visceral pleura** and the **bronchi** in the hilar region to the **Azygous vein** on the right, and the **accessory Hemiazygous** on the left
165
What do the deep group of the bronchial veins do?
Drain the **rest of the bronchi** *(deep in the lung, not in the hilar region)* into the **main pulmonary vein**, or directly into the **left atrium**
166
How is most of the blood supplied by the bronchial arteries returned?
Via the pulmonary veins, *rather than the bronchial ones*
167
Label this diagram
* A - Right superior posterior intercostal artery * B - Run on posterior aspect of main bronchi * C - Arch of aorta * D - Left superior intercostal artery * E - Bronchial arteries * F - Esophageal artery * G - Thoracic aorta
168
What is the mediastinum?
The central compartment of the thoracic cavity
169
What covers the mediastinum on each side?
The mediastinal pleura
170
What does the mediastinum contain?
All of the thoracic visceea and structures, *except the lungs*
171
What is true of the mediastinum in living people?
It is highly mobile
172
Why is the mediastinum highly mobile in living people?
As it consists primarily of hollow, visceral structures, united only by loose connective tissue, often infiltrated by fat
173
Where does the mediastinum extend?
* From the superior thoracic aperture to the diaphragm * From the sternum and costal cartilages anteriorly to the bodies of the thoracic vertebrae posteriorly
174
What is the mediastinum divided into?
Superior and inferior parts
175
Label this diagram
* A - Cervical pleura * B - Apex of lung * C - Manubrium * D - Sternal angle * E - Sternum (body) * F - Xiphoid process * **G - Superior mediastinum** * **H - Inferior mediastinum** * I - Superior thoracic aperture * J - Superior mediastinum * K - Sternum * ki - Manubrium * kii - Angle * kiii - Body * L - Inferior mediastinum * li - Anterior mediastinum * lii - Middle mediastinum * liii - Posterior mediastinum * M - Xiphoid process * N - Diaphragm * O - Transverse thoracic plane
176
Where does the superior mediastinum extend?
Inferiorly from the superior thoracic aperture to the transverse thoracic plane
177
What is the transverse thoracic plane?
A horizontal plane
178
What does the transverse thoracic plane include anteriorly?
The sternal angle
179
Where does the transverse thoracic plane pass posteriorly?
Approximately through the junction of the T4 and T5, *through the intervertebral disk*
180
Where does the inferior mediastinum extend?
Inferiorly from the transverse thoracic plane to the diaphragm
181
What further subdivides the inferior mediastinum?
The pericardium
182
What is the inferior mediastinum further subdivided into?
* Anterior * Middle * Posterior
183
What does the middle inferior mediastinum contain?
The heart, and roots of its great vessels
184
How can some structures lie in more than one mediastinal compartment?
They pass vertically through the mediastinum, *for example the oesophagus*
185
How much of the cardiac output must the pulmonary circulation accept?
All of it
186
At what resistance does the pulmonary circulation operate?
Low
187
What allows the pulmonary circulation to work at low resistance?
* Short, wide vessels * Lots of capillaries connected in parallel * Arterioles with relatively little smooth muscle
188
What is the result of the low resistance of the pulmonary circulation?
It operates at a lower pressure
189

ESA 3 - Respiratory System (14 decks)

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