Anatomy - Pre practical on Respiratory

Question 1

What is the superior thoracic aperture referred to as?

Answer 1

Thoracic inlet (anatomically)
Thoracic outlet (clinically)

Question 2

What makes up the superior thoracic aperture?

Answer 2

1st thoracic vertebra (T1) posteriorly
1st pair of ribs laterally
Costal cartilage of the first rib
Superior border of the manubrium anteriorly

Question 3

What vessels are found in the anterior groove of the 1st rib?

Answer 3

Subclavian vein

Question 4

What vessels are found in the posterior groove of the 1st rib?

Answer 4

Subclavian artery
Brachial plexus (lowest trunk)

Question 5

What separates the anterior and posterior groove of the 1st rib?

Answer 5

Scalene tubercle (site of attachment of anterior scalene muscles)

Question 6

What does the head of a rib articulate with?

Answer 6

The head of the rib articulates with the body of the thoracic vertebra of the same number as well as the body of the vertebra above

Question 7

What joint is found between the head of a rib and the body of a vertebrae?

Answer 7

costovertebral joints = synovial plane joints

Question 8

What does the tubercle of a rib articulate with?

Answer 8

The tubercle of the rib articulates with the with the transverse process of the thoracic vertebra of the same number

Question 9

What joint is found between the tubercle of a rib and the transverse process of a vertebrae?

Answer 9

costotransverse joint = synovial plane joint

Question 10

What makes up the inferior thoracic aperture?

Answer 10

12th thoracic vertebra posteriorly
11th and 12th pairs of ribs laterally
Costal cartilages of ribs 7 through 10 Xiphisternal joint anteriorly

Question 11

What drains into the thoracic duct?

Answer 11

Left side of chest wall through left brachiocephalic/subclavian v.

Question 12

What drains into the right lymphatic duct?

Answer 12

Right side of the chest wall into the right brachiocephalic/subclavian v.

Question 13

What vertebral level is the cisterns chyli found?

Answer 13

It is located posterior to the abdominal aorta on the anterior aspect of the bodies of the first and second lumbar vertebrae (L1 and L2)

Question 14

What are the three peripheral attachments of the diaphragm?

Answer 14

Lumbar vertebrae and arcuate ligaments.
Costal cartilages of ribs 7-12.
Xiphoid process of the sternum

Question 15

From which vertebrae does the right crus of the diaphragm arise from?

Answer 15

L1-3

Question 16

From which vertebrae does the left crus of the diaphragm arise from?

Answer 16

L1-2

Question 17

What 3 vessels travel through the diaphragm?

Answer 17

Vena cava, oesophagus and aorta

Question 18

Describe the nerve roots of the phrenic nerve

Answer 18

Anterior rami of C3, C4 (mainly) and C5. It is both motor and sensory.

Question 19

Which nerves innervate the diaphragm?

Answer 19

Phrenic nerve supplies central diaphragm The peripheral diaphragm is innervated by sensory fibres of intercostal nerves, T7-T12

Question 20

Why can inflammation of the gallbladder cause pain in the shoulder?

Answer 20

The gall bladder lies just beneath the diaphragm. If this organ becomes inflamed it can irritate the diaphragm which prompts a “pain” impulse to be sent up the phrenic nerve into the spinal cord at C3, C4 and C5. Sensation from the shoulder is also perceived by the spinal cord, at C3 and C4.

Question 21

At what vertebral level is the caval hiatus of the diaphragm, and what passes through it?

Answer 21

T8: The caval opening passes through the central tendon of the diaphragm. It transmits the inferior vena cava and the right phrenic nerve

Question 22

At what vertebral level is the oesophageal hiatus of the diaphragm, and what passes through it?

Answer 22

T10: The oesophageal hiatus is located through the muscular sling of the right crus. It transmits the oesophagus and both vagus nn. Hiatus hernia, heartburn, indigestion

Question 23

At what vertebral level is the aortic hiatus of the diaphragm, and what passes through it?

Answer 23

T12: The aortic hiatus is between the left and right crus. It transmits the aorta, the azygos vein, the hemiazygos vein, and the thoracic duct.

Question 24

What makes up the upper respiratory tract?

Answer 24

Nasal cavity
Pharynx
Larynx

Question 25

What makes up the lower respiratory tract?

Answer 25

Trachea Bronchi Bronchioles Alveoli

Question 26

Where is the larynx found?

Answer 26

Found in the anterior neck between C3-C6. (Trachea ant. to oesophagus) Extends from the tip of the epiglottis to the inferior border of the cricoid cartilage.

Question 27

What innervates the larynx?

Answer 27

Branches of the vagus nerve

Question 28

What is the hyoid bone and where is it?

Answer 28

Suspends the larynx, found at C2/C3

Question 29

At what vertebral level is the laryngeal prominence?

Answer 29

C5

Question 30

At what vertebral level does the trachea start?

Answer 30

C6 (start of cricoid cartilage)

Question 31

Which lung has 3 lobes?

Answer 31

Right

Question 32

Which lung has a lingula?

Answer 32

Left (created by cardiac notch above it)

Question 33

Describe the location of the two pleura of the lung

Answer 33

Visceral pleura lines the organ | Parietal pleura lines the body cavity

Question 34

Describe the nerve supply of the parietal pleura

Answer 34

``` Somatic nerves (IC and phrenic nerves) Pain sensitive ```

Question 35

Describe the nerve supply of the visceral pleura

Answer 35

``` Autonomic nerves (T2-T5) Pain insensitive ```

Question 36

What is a pleural reflection?

Answer 36

Pleural reflection: Place at which pleura changes its direction of travel.

Question 37

What is a pleural recess?

Answer 37

Pleural recess: The increased space between the layers of pleura occurring at the pleural reflections.

Question 38

Describe the surface anatomy of the horizontal fissure of the right lung?

Answer 38

Follows line of 4th rib anteriorly.

Question 39

Describe the surface anatomy of the oblique fissure of the lungs?

Answer 39

Begins at spine of T3 and follows the line of the 6th rib anteriorly.

Question 40

How does lymph drain back into the systemic circulation?

Answer 40

Cisterna chyli forms the beginning of the primary lymph vessel, the thoracic duct, which transports lymph and chyle from the abdomen via the aortic opening of the diaphragm up to the junction of the left subclavian vein and internal jugular veins

Question 41

Which if the vessels in the lung hilum is most superior?

Answer 41

Pulmonary artery

Question 42

Which of the vessels in the lung hilum us most inferior?

Answer 42

Inferior pulmonary vein

Question 43

Which of the vessels in the lung hilum is the most anterior?

Answer 43

Superior pulmonary artery

Question 44

Which of the vessels in the lung hilum is the most posterior?

Answer 44

Bronchi

Question 45

Where can an additional bronchi be found, and what is it called?

Answer 45

``` In right lung Eparterial bronchus (found above artery) ```

Question 46

What is the name of the main right bronchus?

Answer 46

Hyparterial bronchus

Question 47

Describe the vertebral levels of the inferior margin of the lung

Answer 47

Midclavicular line - rib 6 Midaxillary line - rib 8 Midscapular line - rib 10

Question 48

Describe the vertebral levels of the inferior margins of the parietal pleura

Answer 48

Midclavicular line - rib 8 Midaxillary line - rib 10 Midscapular line - rib 12

Question 49

The horizontal fissure runs along the line of what rib?

Answer 49

Rib 4 anteriorly

Question 50

The oblique fissure runs along the line of what rib?

Answer 50

Begins at spine of T3 and follows line of 6th rib anteriorly

Question 51

How can we tell histologically that we are looking at a bronchiole and not a bronchi?

Answer 51

``` No goblet cells No cartilage No glands Epithelium is columnar/cuboidal Diameter of <1mm ```