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12. Respiratory > Anatomy of the Respiratory System > Flashcards

Anatomy of the Respiratory System Flashcards

1
Q

What makes up the bony thorax?

A

Posteriorly - the ribs and intercostal spaces.
Medially - the sternum.
Anteriorly - the costal cartilages.

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2
Q

What happens above the bony thorax?

A

It is continuous with the neck at the thoracic inlet.

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3
Q

What happens below the bony thorax?

A

It is separated from the abdominal cavity by the diaphragm.

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4
Q

What do the twelfth ribs articulate with posteriorly?

A

The vertebral column via the costovertebral joints.

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5
Q

What do ribs 1-7 articulate with anteriorly?

A

The sternum via costal cartilages.

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6
Q

What do ribs 8-10 articulate with anteriorly?

A

The costal cartilages.

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7
Q

What do ribs 11-12 articular with anteriorly?

A

Nothing, ribs end free in abdominal muscles - floating ribs.

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8
Q

What are the parts of a typical rib?

A

Head, neck, tubercle, and shaft.

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9
Q

Which ribs are typical?

A

3rd-9th.

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10
Q

What are the features of the head of typical ribs?

A

Two articular facets for articulation with the body of the corresponding vertebra and the vertebra above.

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11
Q

What are the features of the neck of typical ribs?

A

Connect the head of the rib with the body at the level of the tubercle.

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12
Q

What are the features of the tubercle of typical ribs?

A

One articular facet for articulation with the transverse process of the corresponding thoracic vertebra.

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13
Q

What are the features of the shaft of the typical ribs?

A

Thin, flat, and curved. At the angle, the shaft twists forward in the characteristic curve of ribs. It has a costal groove close to its lower border, which protects the intercostal vessels and nerves.

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14
Q

How are the intercostal vessels and nerves protected by the ribs?

A

The shaft of typical ribs has a costal groove close to its lower border to protect them.

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15
Q

What makes most thoracic vertebra typical?

A

They are independent, have bodies, vertebral arches, and seven processes for muscular and articular connection.

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16
Q

What are the three main features of thoracic vertebrae?

A

Bilateral costal facets, costal facets, spinous processes.

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17
Q

Where are the bilateral costal facets of thoracic vertebrae?

A

On the vertebral bodies, in inferior and superior pairs.

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18
Q

What do the bilateral costal facets of thoracic vertebrae articulate with?

A

Heads of ribs.

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19
Q

What do costal facets of thoracic vertebrae articulate with?

A

The tubercles of ribs.

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20
Q

What do costovertebral joints connect?

A

The ribs with the thoracic vertebrae.

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21
Q

Where do movements of respiration take place?

A

At the joints of the ribs and thoracic vertebrae. Joint at the rib head an costotransverse joint.

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22
Q

What is the joint of the rib head?

A

Head of the rib articulating with the corresponding vertebra and the vertebra above.

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23
Q

What is the costotransverse joint?

A

Articular facet on the tubercle of the rib articulates with the transverse process of the corresponding vertebra.

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24
Q

What are the atypical ribs?

A

Ribs 1, 2, 10, 11, and 12.

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25
Q

How is the first rib atypical?

A

It is the broadest, shortest, and most sharply curved rib. It only has a single articular facet for articulation with T1 vertebra. It has two transversely directed grooves crossing its superior surface for the subclavian vessels, separated by a scalene tubercle.

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26
Q

How is the second rib atypical?

A

It has two articular facets for articulation with the bodies of T1 and T2 vertebrae. It has a tuberosity for the serratus anterior - roughened area on upper surface.

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27
Q

How are ribs 10-12 atypical?

A

Single articular facet for articulation with a single vertebra. Ribs 11 and 12 are short with no neck or tubercle.

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28
Q

What are the three muscles of each intercostal space?

A

External intercostals, internal intercostals, innermost intercostals.

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29
Q

When are each of the three muscles of the intercostal spaces used?

A

External intercostals in inspiration, internal intercostals in forced expiration, and innermost intercostals in forced expiration.

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30
Q

Where do the fibres of external intercostals run?

A

Downwards and anteriorly from above the rib to the one below.

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31
Q

What is the action of external intercostals?

A

Elevate the ribs in a bucket-handle motion to increase the anteroposterior and transverse diameters of the chest.

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32
Q

What is responsible for 30% of chest expansion during quiet respiration?

A

External intercostal muscles.

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33
Q

Where do the fibres of the internal intercostals run?

A

Downwards and posteriorly from above rib to one below.

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34
Q

What is the action of internal intercostals?

A

Pulls the ribs down from the position of chest expansion.

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35
Q

How do the innermost intercostal muscles differ from the internal intercostals?

A

They are similar but less well developed.

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36
Q

What is the nerve supply to the intercostal muscles?

A

The intercostal nerves.

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37
Q

What is the main muscle of inspiration?

A

The diaphragm.

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38
Q

What does contraction of the diaphragm cause?

A

Descent on the diaphragm so expansion of the chest.

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39
Q

What is responsible for 70% of chest expansion during quiet respiration?

A

The diaphragm.

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40
Q

What are the openings of the diaphragm?

A

T8 - vena cava.
T10 - oesophagus.
T12 - aorta (aortic hiatus).

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41
Q

What are the three parts of the diaphragm?

A

Vertebral part, costal part, sternal part.

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42
Q

What does the vertebral part of the diaphragm arise from?

A

The crura and arcuate ligaments.

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43
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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44
Q

What does the sternal part of the diaphragm arise from?

A

Deep surface of the xiphisternum.

45
Q

What is the nerve supply of the diaphragm?

A

The phrenic nerve (C3,4,5).

46
Q

What are the important structures lying in the intercostal groove of the rib between the internal and innermost intercostal muscles?

A

Intercostal vein, artery, and nerve (VAN).

47
Q

Where should the needle of a chest drain or aspiration be inserted and why?

A

At the upper border of the rib to avoid injury to the intercostal vein, artery, and nerve that lie in the intercostal groove of the rib.

48
Q

What do the intercostal nerves supply?

A

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

49
Q

What are the arteries of the intercostal spaces?

A

Anterior intercostal artery (all but last two spaces) that anastomoses with a posterior intercostal artery.

50
Q

What is the root of the anterior intercostal artery?

A

Brachiocephalic branch of aortic arch -> subclavian -> internal thoracic/ musculophrenic -> anterior intercostal.

51
Q

What is the root of the posterior intercostal artery?

A

Brachiocephalic branch of the aortic arch -> subclavian -> costocervical trunk -> superior intercostal -> first two posterior intercostals.
Thoracic aorta -> posterior intercostal of other spaces.

52
Q

What are the veins of the intercostal spaces?

A

Two anterior and one posterior vein.

53
Q

Where do the anterior intercostal veins drain?

A

Into the internal thoracic vein into the subclavian vein.

54
Q

Where do the posterior intercostal veins drain?

A

Via the azygous vein on the right and hemiaxygous on the left into the superior vena cava.

55
Q

What is the pleura?

A

A serous membrane consisting of a single layer of mesothelial cells with a think layer of underlying connective tissue.

56
Q

What does the parietal pleura line?

A

The insides of each hemi thorax and become continuous with the visceral pleura at the hilum of the lung.

57
Q

What does the visceral pleura line?

A

The outside of the lung, extending between lobes of lung and into depths of oblique and horizontal fissures.

58
Q

What is the blood supply of the pleura?

A

Intercostal and internal thoracic arteries and veins.

59
Q

What is the parietal pleura innervated by?

A

Somatic innervation by intercostal and phrenic nerves, and autonomic innervation.

60
Q

What is the visceral pleura innervated by?

A

No somatic innervation, only autonomic innervation.

61
Q

What is the pleural cavity?

A

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

62
Q

What is the purpose of pleural fluid?

A

It allows the two layers to slide over one another, so allows movement of the lung against the chest wall while breathing.

63
Q

What keep that lung surface in contact with the thoracic wall?

A

Surface tension of the pleural fluid provides cohesion.

64
Q

What are the lines of pleural reflection?

A

Relatively abrupt lines along which the parietal pleura changes direction as it passes from one wall of the pleural cavity to another.

65
Q

What are the lines of pleural reflection?

A

Sternal, costal, diaphragmatic.

66
Q

Where is the apex of the lung?

A

It extends above the level of the first rib into the neck.

67
Q

What is the base of the lungs?

A

The concave inferior surface that rests on the diaphragm.

68
Q

How many lung lobes are there?

A

5 - 2 of the left lung, 3 of the right lung.

69
Q

What creates the lobes of the lung?

A

Fissures - one on the left side, two on the right side.

70
Q

What are the three surfaces of the lung?

A

Costal, mediastinal, diaphragmatic.

71
Q

What are the three borders of the lung?

A

Anterior, inferior, posterior.

72
Q

What are the fissures of the right lung?

A

The right oblique and horizontal fissures.

73
Q

What is the fissure of the left lung?

A

The left oblique.

74
Q

What is the hilum of the lung?

A

A wedge-shaped area on the mediastinal surface of each lung through which the structures forming the roots of the lung pass to enter or exit.

75
Q

What are the roots of the lungs?

A

Bronchi, pulmonary arteries, superior and inferior pulmonary vein, pulmonary plexus of nerves and lymphatics.

76
Q

Where does the trachea run from and to?

A

Begins at the lower border of the cricoid cartilage in the neck and terminated by dividing into the right and left main bronchi at the level of the sternal angle.

77
Q

What holds open the trachea?

A

C-shaped cartilage rings, supported posteriorly by trachealis muscle.

78
Q

What epithelium lines the trachea?

A

Pseudostratified ciliated epithelia.

79
Q

What is the carina?

A

The angle between the right and left main bronchi.

80
Q

How do the left and right bronchi differ?

A

Right main bronchus is shorter, wider, and more vertical than the left.

81
Q

Which bronchi are inspired objects more likely to fall into?

A

The right as it is more vertical.

82
Q

What are the lengths of the left and right bronchi?

A

Left - 5cm, right - 2.5cm.

83
Q

What is the path of the right main bronchus?

A

It is 2.5cm and travels to the hilum of the lungs, giving off the upper lobar branch.

84
Q

What is the path of the left main bronchus?

A

It is 5cm and passes below the arch of the aorta, anterior to the descending aorta and oesophagus.

85
Q

What do the left and right main bronchi divide into?

A

Lober bronchi - one to each lobe.

86
Q

What do the lobar bronchi divide into?

A

Segmental bronchi.

87
Q

What is the blood supply to the lungs?

A

Pulmonary artery and two pulmonary veins to each lung.

88
Q

Where do the pulmonary arteries arise?

A

From the pulmonary trunk at the level of the sternal angle.

89
Q

What happens to the pulmonary arteries as they enter the lung?

A

They split into lobar arteries and then segmental arteries.

90
Q

What type of blood do the pulmonary artery and veins carry?

A

Artery - low-oxygen blood to the lungs for oxygenation. Veins - oxygen-rich blood back to the head.

91
Q

What is the middle lobe vein?

A

A tributary of the right superior pulmonary vein in the right lung.

92
Q

How are the pulmonary arteries, veins, and bronchi linked in course?

A

Pulmonary arteries and bronchi are paired in the lung, but pulmonary veins run independently.

93
Q

What is the purpose of bronchial arteries?

A

Supply blood for nutrition of the structured making up the root of the lungs, the supporting tissues, of the lungs and visceral pleura.

94
Q

What is the general route of bronchial arteries?

A

Typically pass along the posterior aspects of the main bronchi.

95
Q

Where do the bronchial arteries arise from?

A

Thoracic aorta -> 2x left bronchial arteries and 3rd intercostal artery -> 1x right bronchial.

96
Q

Where do the superficial bronchial veins drain?

A

Drain visceral pleural and bronchi in the hilar region to the azygous vein on the right, and the accessory hemiaxygous on the left.

97
Q

Where do the deep bronchial veins drain?

A

Drain the rest of the bronchi into the main pulmonary vein or directly into the left atrium.

98
Q

What is the mediastinum?

A

The central compartment of the thoracic cavity.

99
Q

What is the mediastinum covered by?

A

Mediastinal pleura.

100
Q

What does the mediastinum contain?

A

All thoracic viscera and structures, except the lungs.

101
Q

What does the mediastinum consist of in living people?

A

Primarily hollow, visceral structures unites by loose connective tissue and often infiltrated by fat.

102
Q

Where does the mediastinum extend from and to?

A

Superior thoracic aperture to the diaphragm and from the sternum and costal anteriorly to the bodies of the thoracic vertebrae posteriorly.

103
Q

Where does the superior mediastinum extend from and to?

A

Inferiorly from the superior thoracic aperture to the transverse thoracic plane.

104
Q

What is the transverse thoracic plane?

A

A horizontal plane that includes the sternal angle anteriorly and passes around through the junction of T4 and T5 posteriorly.

105
Q

Where does the inferior mediastinum extend from and to?

A

Inferiorly from the transverse thoracic plane to the diaphragm.

106
Q

What is the inferior mediastinum separated by and into what?

A

By the pericardium into anterior, middle, and posterior.

107
Q

What is in the middle inferior mediastinum?

A

Heart, and roots of its great vessels.

108
Q

Give an example of a structure that lies in more than one compartment of the mediastinum.

A

The oesophagus as it runs vertically down.

109
Q

How can the pulmonary circulation work with low resistance?

A

Short, wide vessels and lots of capillaries connected in parallel and arterioles with relatively little smooth muscle so low resistance.

12. Respiratory (10 decks)

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