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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
Q

What are the 7 processes of the thoracic vertebrae for?

A

Muscular and articular connections

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26
Q

What are the characteristic features of thoracic vertebrae?

A
  • Bilateral costal facets (demifacets)
  • Costal facets
  • Spinous processes
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27
Q

Where do the demifacets of thoracic vertebrae occur?

A

On the vertebral bodies, usually occuring in inferior and superior pairs

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28
Q

What is the purpose of the vertebral body demifacets?

A

Articulation with the heads of ribs

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29
Q

Where are the costal facets of thoracic vertebrae found?

A

On the transverse processes

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30
Q

What is the purpose of the costal facets of thoracic vertebrae?

A

Articulation with the tubercles of the ribs

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31
Q

Which ribs are atypical?

With respect to costal facets

A

The inferior two or three, as they do not articulate with costal facets

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32
Q

Describe the spinous process of thoracic vertebrae?

A

Long, inferiorly slanting

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33
Q

What connects ribs with thoracic vertebae?

A

Costovertebral joints

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34
Q

What kind of joints are costovertebral?

A

Synovial

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35
Q

When does movement take place at the costovertebral joints?

A

Movement of the ribs during respiration

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36
Q

What does the costovertebral joint consist of?

A
  • Joint of the rib head
  • Costotransverse joint
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37
Q

What articulates at the joint of the rib head?

A

The head of the rib articulates with the corresponding vertebrae, and the vertebrae above

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38
Q

What articulates at the costotransverse joint?

A

The articular facet of the tubercle of the rib and the transverse process of the corresponding vertebrae

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39
Q

Which ribs are atypical?

A

1, 2 and 10

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40
Q

Describe the shape of the first rib

A

Broadest, shortest, and most sharply curved rib

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41
Q

Describe the features of the first rib

A
  • 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
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42
Q

Label this diagram of the first rib

A
  • A - Single facet on head
  • B - Tubercle
  • C - Scalene tubercle
  • D - Grooves for…
    • di - Subclavian vein
    • dii - Subclavian artery
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43
Q

Describe the features of the second rib

A
  • Two articular facets for articulation with the bodies of T1 and T2 vertebrae
  • Rough area on its upper surface, the tuberosity for serratus anterior
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44
Q

Label this diagram of the second rib

A
  • A - Head
  • B - Neck
  • C - Tubercle
  • D - Tuberosity for serratus anterior
  • E - Body
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45
Q

Describe the features of the 10th-12th ribs

A

Single articular facet (like 1st rib) for articulation with a single vertebrae

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46
Q

Describe the features of the 11th and 12th rib?

A

Short, with no neck or tubercle

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47
Q

What does each intercostal space contain?

Regarding muscles

A

3 muscles

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48
Q

What are the 3 muscles of the intercostal spaces?

A
  1. External intercostals
  2. Internal intercostals
  3. Innermost intercostals
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49
Q

When are external intercostals used?

During breathing

A

Inspiration

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50
Q

In which direction do the fibres of the external intercostal muscles run?

A

Downwards and anteriorly from above rib, to the one below

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51
Q

What is the action of the external intercostal muscles?

A

Elevate the ribs in a ‘bucket handle’ type movement, to increase anteroposterior and transverse diameters of the chest

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52
Q

What are the external intercostal muscles responsible for during quiet respiration?

A

30% of chest expansion

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53
Q

When are the internal intercostal muscles used?

During breathing

A

During forced expiration

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54
Q

In which direction do the fibres of the internal intercostal muscles run?

A

Downwards and posteriorly, from above rib to the one below

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55
Q

What is the action of the internal intercostal muscles?

A

Pulls rib down from the position of chest expansion

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56
Q

When are the innermost intercostals used?

A

During forced expiration

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57
Q

What are the innermost intercostal muscles similar to?

A

Internal intercostals, but less well developed

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58
Q

What is the nerve supply of the intercostal muscles?

A

Intercostal nerves

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59
Q

Label this diagram

A
  • 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
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60
Q

What is the main muscle of inspiration?

A

The diaphragm

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61
Q

What is the result of contraction of the diaphragm?

A

Descent

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62
Q

What does the diaphragm contraction account for during quiet respiration?

A

70% of chest expansion

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63
Q

Where are the openings in the diaphragm?

A
  • T8 - Vena Cava
  • T10 - Oesophagus
  • T12 - Aorta (Aortic hiatus)
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64
Q

What is the diaphragm made up of?

A
  1. Vertebral part
  2. Costal part
  3. Sternal part
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65
Q

What does the vertebral part of the diaphragm arise form?

A

The crura and the Arcuate ligaments

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66
Q

What does the costal part of the diaphragm arise from?

A

The inner aspects of the 7-12 costal cartilages

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67
Q

What does the sternal part of the diaphragm arise from?

A

The deep surface of the xiphisternum

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68
Q

What is the nervous supply of the diaphragm?

A

From the phrenic nerve, C3, 4, 5.

Remember, C3, 4, 5, keeps you alive

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69
Q

What is the motor function of the phrenic nerve?

A

Supplies the diaphragm

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70
Q

What is the sensory function of the phrenic nerve?

A

Supplies both sides of the diaphragm, and the mediastinal/diaphragmatic part of the parietal pleura

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71
Q

What lies in the intercostal groove of the rib?

A

The intercostal vein, artery and nerve

In that order- remember VAN

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72
Q

Where do the intercostal vein, artery, and vein?

Which part of the rib

A

Along the lower border

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73
Q

What is the clinical importance of the intercostal vein, artery and nerve running along the lower border of the rib?

A

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

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74
Q

Label this diagram

A
  • 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
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75
Q

How many intercostal nerves are there?

A

12

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76
Q

Where do the intercostal nerves originate from?

A

The anterior rami of the thoracic spinal nerves T1 - T12

77
Q

What do the intercostal nerves supply?

A

The intercostal muscles in the corresponding space, the parietal pleura, and the overlying skin

78
Q

What does each intercostal space contain?

Regarding arteries

A

An anterior intercostal artery (except the last two)

79
Q

What do the anterior intercostal arteries anastomose with?

A

A posterior intercostal artery

80
Q

What do the intercostal arteries supply?

A

The intercostal muscles, parietal pleura, and overlying skin

81
Q

How do the anterior intercostal arteries arise?

A

Brachiocephalic/aortic arch → Subclavian → Internal thoracic/musculophrenic → anterior intercostal

82
Q

What do the posterior intercostal arteries arise from?

A
  • 1st- 2nd spaces; Brachiocephalic/aortic arch → Subclavian → Costocervical trunk → Superior intercostal → Posterior intercostal
  • Other spaces; Thoracic aorta → Posterior intercostal
83
Q

What does each intercostal space contain?

Regarding nerves

A

Two anterior and one posterior vein accompanying the arteries

84
Q

How do the anterior intercostal veins drain?

A

Via the Internal Thoracic Vein, into the right subclavian vein

85
Q

How do most posterior intercostal veins drain?

A

Via the Azygous vein on the right, and the Hemiazygous on the left, into the superior vena cava

86
Q

Label the veins on this diagram

A
  • 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
Q

What is the pleura?

A

A serous membrane

88
Q

What does the pleura consist of?

A

A single layer of mesothelial cells, with a thin layer of underlying connective tissue

89
Q

What does the parietal plerua line?

A

The inside of each hemithorax

90
Q

What does the hemithorac consist of?

A

The bony thoracic cage, diaphragm, and mediastinal surface

91
Q

What does the perietal pleura become continuous with?

A

The visceral pleura

92
Q

Where does the parietal pleura become continuous with the visceral plerua?

A

At the hilum of the lung

93
Q

What does the visceral pleura line?

A

The outside of the lung

94
Q

Where does the visceral pleura extend?

A

Between the lobes of the lung, into the depth of the oblique and horizontal fissures

95
Q

What is the blood supply of the pleura?

A

Via the intercostal and internal thoracic arteries and veins

96
Q

What is the innervation of the perietal pleura?

A

Both somatic (Intercostal and Phrenic nerves) and autonomic

97
Q

What is innervation of the visceral pleura?

A

Autonomic

No somatic innervation

98
Q

What is the pleural cavity (or space)?

A

A potential space between the two layers of pleura that are continuous at the hilum

99
Q

What are both layers of pleura covered with?

A

A common film of fluid

100
Q

What is the fluid covering the layers of pleura produced from?

A

The parietal surface

101
Q

What is the fluid covering the layers of pleura absorbed by?

A

The parietal lymphatic vessels

102
Q

What does the pleural fluid allow?

A

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
Q

What does the surface tension of the pleural fluid provide?

A

The cohesion that keeps the lung surface in contact with the thoracic wall

104
Q

What is the result of the surface tension of the pleural fluid keeping the lung surface in contact with the thoracic wall?

A

When the thorax expands in inspiration, the lung expands along with it and fills with air

105
Q

Do the lungs occupy all the available space in the pleural cavity?

A

No, even in deep inspiration

106
Q

Label this diagram

A
  • 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
Q

What are the lines of pleural reflection?

A

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
Q

How many lines of pleural reflection are there?

A

3 on each side

109
Q

Name the lines of pleural reflection

A
  1. Sternal
  2. Costal
  3. Diaphragmatic
110
Q

Label this diagram

A
  • 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
Q

What does each lung have?

A
  • An apex
  • A base
  • Lobes
  • Three surfaces
  • Three borders
112
Q

Where does the apex of each lung extend?

A

Above the level of the 1st rib into the neck

113
Q

What is the base of the lung?

A

A concave, inferior surface

114
Q

Where is the base of the lung?

A

Resting on the diaphragm

115
Q

How many lobes does the lung have?

A
  • Left has two
  • Right has three
116
Q

What are the lobes of the lungs created by?

A

One (left) or two (right) fissures

117
Q

What are the surfaces of the lungs?

A
  1. Costal
  2. Mediastinal
  3. Diaphragmatic
118
Q

What are the borders of the lungs?

A
  • Anterior
  • Inferior
  • Posterior
119
Q

What divides the right lung into it’s three lobes?

A

A right oblique and horzontal fissure

120
Q

What divides the left lung into its two lobes?

A

A single left oblique fissure

121
Q

What are the lobes of the right lung named?

A
  1. Superior
  2. Middle
  3. Inferior
122
Q

What are the lobes of the left lung named?

A
  1. Superior
  2. Inferior
123
Q

What is the hilum of the lung?

A

A wedge-shaped area on the mediastinal surface of each lung

124
Q

What is the function of the hilum of the lung?

A

It is a passageway through which structures forming the roots of the lung enter or exit

125
Q

What do the roots of the lung consist of?

A
  • Bronchi
  • Pulmonary arteries
  • Superior and inferior pulmonary veins
  • Pulmonary plexus of nerves and lymphatics
126
Q

Label this diagram

A
  • 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
Q

Where does the trachea begin?

A

At the lower border of the cricoid cartilage in the neck

128
Q

How does the trachea terminate?

A

By dividing into the right and left main bronchi at the level of sternal angle

129
Q

What holds the trachea open?

A

By C-shaped cartilage rings, supported posteriorly by the trachealis muscle

130
Q

What is the trachea lined with?

A

Pseudostratified ciliated epithelia

131
Q

What is the carina?

A

The angle between the right and left main bronchi

132
Q

How does the right main bronchus differ from the left?

A

It is shorter, wider and more vertical

133
Q

What is the consequence of the differences between left and right bronchi?

A

Any inspired objects are more likely to fall into the right main bronchus

134
Q

How long is the right main bronchus?

A

2.5cm

135
Q

What happens to the right main bronchus before reaching the hilum of the lung?

A

It gives off its upper lobar branch

136
Q

How long is the left main bronchus?

A

5cm

137
Q

Where does the left main bronchus pass?

A

Below the arch of the aorta, anterior to the descending aorta and oesophagus

138
Q

What do the left and right main bronchi divide into?

A

Lobar bronchi, one for each lobe

139
Q

What do the lobar bronchi divide into?

A

Segmental bronchi

140
Q

What do the segmental bronchi branch into?

A

Sub-segmental bronchi

141
Q

What do the sub-segmental bronchi divide into?

A

Bronchioles

142
Q

What do the bronchioles divide into?

A

Terminal bronchioles

143
Q

What do the terminal bronchioles divide into?

A

Alveolar ducts

144
Q

What do the alveolar ducts divide into?

A

Alveoli

145
Q

What blood vessels service the lung?

A

Each lung has a pulmonary artery supplying blood to it, and two pulmonary veins draining blood from it

146
Q

What do the pulmonary arteries arise from?

A

The pulmonary trunk

147
Q

Where do the pulmonary arteries arise from the pulmonary trunk?

A

At the level of the sternal angle

148
Q

What do the pulmonary arteries carry?

A

Low-oxygen blood to the lungs

149
Q

What is the purpose of the pulmonary arteries carrying low-oxygen blood to the lungs?

A

For oxygenation

150
Q

What course do the pulmonary arteries take?

A

They become part of the root of each lung before splitting into lobar arteries, and subsequently segmental arteries

151
Q

How are the arterie and bronchi related in each lung?

A

They are paired, branching simulataneously and running parallel courses

152
Q

Name the pulmonary veins

A
  • Superior
  • Inferior
153
Q

What do the pulmonary veins do?

A

Carry oxygen-rich blood back to the heart

154
Q

Where is the middle lobe vein found?

A

In the right lung

155
Q

What is the middle lobe vein a tributary of?

A

The right superior pulmonary vein

156
Q

How are the pulmonary veins related to the pulmonary arteries and bronchi?

A

They are not- they are independant

157
Q

What do the bronchial arteries supply blood too?

A
  • The structures making up the root of the lungs
  • Suppoting tissues of lungs
  • Visceral pleura
158
Q

Where do the bronchial arteries pass?

A

Typically, along the posterior aspects of the main bronchi

159
Q

How many left bronchial arteries are there?

A

2

160
Q

Where do the left bronchial arteries arise from?

A

Directly from the thoracic artery

161
Q

How many right bronchial arteries are there?

A

1

162
Q

Where does the right bronchial artery arise from?

A

The 3rd intercostal artery, arising from the thoracic aorta

163
Q

What are the groups of the bronchial veins?

A
  • Superficial
  • Deep
164
Q

What do the superficial group of the bronchial veins do?

A

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
Q

What do the deep group of the bronchial veins do?

A

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
Q

How is most of the blood supplied by the bronchial arteries returned?

A

Via the pulmonary veins, rather than the bronchial ones

167
Q

Label this diagram

A
  • 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
Q

What is the mediastinum?

A

The central compartment of the thoracic cavity

169
Q

What covers the mediastinum on each side?

A

The mediastinal pleura

170
Q

What does the mediastinum contain?

A

All of the thoracic visceea and structures, except the lungs

171
Q

What is true of the mediastinum in living people?

A

It is highly mobile

172
Q

Why is the mediastinum highly mobile in living people?

A

As it consists primarily of hollow, visceral structures, united only by loose connective tissue, often infiltrated by fat

173
Q

Where does the mediastinum extend?

A
  • From the superior thoracic aperture to the diaphragm
  • From the sternum and costal cartilages anteriorly to the bodies of the thoracic vertebrae posteriorly
174
Q

What is the mediastinum divided into?

A

Superior and inferior parts

175
Q

Label this diagram

A
  • 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
Q

Where does the superior mediastinum extend?

A

Inferiorly from the superior thoracic aperture to the transverse thoracic plane

177
Q

What is the transverse thoracic plane?

A

A horizontal plane

178
Q

What does the transverse thoracic plane include anteriorly?

A

The sternal angle

179
Q

Where does the transverse thoracic plane pass posteriorly?

A

Approximately through the junction of the T4 and T5, through the intervertebral disk

180
Q

Where does the inferior mediastinum extend?

A

Inferiorly from the transverse thoracic plane to the diaphragm

181
Q

What further subdivides the inferior mediastinum?

A

The pericardium

182
Q

What is the inferior mediastinum further subdivided into?

A
  • Anterior
  • Middle
  • Posterior
183
Q

What does the middle inferior mediastinum contain?

A

The heart, and roots of its great vessels

184
Q

How can some structures lie in more than one mediastinal compartment?

A

They pass vertically through the mediastinum, for example the oesophagus

185
Q

How much of the cardiac output must the pulmonary circulation accept?

A

All of it

186
Q

At what resistance does the pulmonary circulation operate?

A

Low

187
Q

What allows the pulmonary circulation to work at low resistance?

A
  • Short, wide vessels
  • Lots of capillaries connected in parallel
  • Arterioles with relatively little smooth muscle
188
Q

What is the result of the low resistance of the pulmonary circulation?

A

It operates at a lower pressure

189
Q
A

ESA 3 - Respiratory System (14 decks)

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