Anatomy (Respiratory) Flashcards
What makes up the thoracic cage?
Sternum, 12 pairs of ribs, 12 thoracic vertebrae
Name A
Jugular notch of sternum
Name Joint B
Manubriosternal joint
Label C
Costal notches
Label Joint D
Xiphosternal joint of sternum
Where is the sternal angle
At the manubriosternal Joint on the sternum
What are the true ribs?
Ribs 1-7 are true ribs as their costal cartilages articulate directly with the sternum
What are false ribs?
Ribs 8-10 are false ribs as their costal cartilages do not directly articulate with the sternum
What are floating ribs?
Ribs 11-12 are floating as they do not connect to the sternum in any way
What is the costal angle?
The bending of ribs 3-9 are callled the constal angle
What are sternocostal joints?
1st-7th pairs of costal cartilages with sternum (synovial plane joints)
What are the interchondral joints?
Between costal cartilages 6-7,7-8 and 8-9 (synovial plane)
What type of joint is the sternoclavicular joint?
Synovial saddle joint
Where does the transversus thoracis attach?
The lower portion of the sternum to costal cartilages 2-6
Label A
Right common Carotid Artery
Label B
Vertebral Artery
Label C
Costocervical Trunk
Label D
Supreme intercostal Artery
Label E
Internal Thoracic Artery
Label F
11th Posterior intercostal Artery
What is the superior border of the mediastinum?
Superior thoracic aperture
What is the inferior border of the mediastinum
Diaphragm
What makes up the Anterior border of mediastinum
Sternum and costal cartilages
What makes up the Posterior border of mediastinum
Bodies of thoracic vertebrae
Label A?
Right Brachiocephalic Vein
Label B?
Azygos Vein
Label C?
Internal Thoraicic Vein
Label D?
Accessory Hemi-Azygos Vein
Label E?
Musculophrenic Vein
Label F?
Hemi-Azygos Vein
Label A?
Right Lymphatic Duct
Label B?
Right Venous Angle
Label C?
Thoracic Duct
Label D?
Left Venous Angle
Label A?
Sternal and Clavicular heads of the Sternocleidomastoid
Label B?
External Intercostal muscles
Label C?
Interchondral part of internal intercostal muscle
Label D?
Posterior to Anterior heads of the Scalene
Label A?
Right and Left internal Thoracic arteries
Label B?
Pericardicophrenic Artery and Vein
Label C?
Superior Phrenic Artery
Label D?
Musculophrenic Arteries and Veins
Label A?
Cental Tendon
Label B?
Median Arcuate Ligament
Label C?
Aortic Hiatus Opening
Label D?
Median Arcuate Ligament
Label E?
Lateral Arcuate Ligament
Label F?
Esophageal Hiatus
Label G?
Caval Opening
What is the potential pleural space inferior to where diaphragmatic and costal pleura meet called?
Costodiphragmatic recess
What is the potential pleural space anterior to the costal and mediastinal pleura meet?
Constimediastinal recess
What is diaphragmatic pleura innervated by?
Phrenic nerve centally and lower 6 intercostals peripherally
What is visceral pleural sensitive to?
Only sensitive to stretch
What is Parietal Pleura sensitive to?
Pain, Temperatire, Touch and Pressure
What is the Parietal Pleura supplied by?
Intercostal, Internal Thoracic and Musculophrenic Vessels
What is Visceral Pleura supplied by?
Bronchial Vessels
What is a Pleural Effusion?
An accumulation of fluid in the pleural cavity
What is a transudative pleural effusion and what’s the most common cause?
A pleural effusion due to fluid leaking into the pleural cavity, often due to heart failure
What is a exudative pleural effusion and what’s the most common cause?
Pleural effusion due to blockage of lymphatic draining system often due to tumours or inflammation
What is a pneumothorax?
When air enters the pleural caivty, may result in atelectasis
What is atelectasis?
Lung collapse
What is a tension pneumothorax?
When there is a mediastinal shift accompnaying a pneumothorax creating a one way valve where air enters the cavoty but cannot leave
What is Thoracocentisis?
Removal of fluid or air from pleural spaces
Function of nasal cavities?
Filtering, moistening and warming air
What is the functional significance of the shape of the conchae?
Large surface area to filter, moisten and warm air
What openings lead to the meatuses?
Paranasal air sinuses and nasolacrimal (tear) duct
What role does the nasolacrimal (tear) duct play in conditioning incoming air?
Moistens air
Internal Nares (choanae)
External Nares (Nostrils)
Pharynx
Nasal Cavity
Superior Concha
Middle concha
Inferior Concha
Label D
Superior Metaus
Label E?
Middle Meatus
Label F?
Inferior Meatus
Label B?
Nasolacrimal (Tear) Duct
Olfactory Region
What are the paranasal air sinuses lined with?
Ciliated columnar epithelium
A
Sphenoid Sinus
B
Ethmoidal Sinus
Label C?
Maxilllary Sinus
Label D?
Frontal Sinus
Name the three anatomical parts of the pharynx
- Nasopharynx
- Oropharynx
- Laryngopharynx
What is the main role of tonsils?
Trap pathogens to prevent lung/throat infections
They can produce an immune response
What type of mucosa lines the nasopharynx?
Pseudostratified columnar epithelium
What type of mucosa lines the osopharynx and laryngopharynx and why?
Stratified squamous epithelium
Since it’s part of digestive tract it acts as a protective function
Label A
Nasopharynx
Label B?
Oropharynx
Label C?
Laryngopharanx
Palatine Tonsils
What are the main cartilages in the larynx?
The thyroid, the cricoid, the two arytenoids and the epiglottis
Name the three portions of the larynx
Vestibule, ventricles. and infraglottic cavity
What is the function of arytenoids?
The change the tension in the vocal ligaments
What nerve innervates the the muscles that allow movements of the arytenoids ?
Vagus nerve
What is the function of the vocal folds?
Breathing and speech
How do the muscles in the larynx allow a person to breathe and speak?
They adduct the vocal folds for speech
They abduct the vocal folds to breathe
Label A?
Hyoid Bone
Label b?
Thyroid Cartilage
Label C
Epiglottis
Label E?
Cricoid Cartilage
What is the function of the trachealis muscle during coughing?
Constricts the trachea so air is expelled with more force therefore coughing is more forceful
What is the composition of the mucosa?
Respiratory epithelium supporting lamina propria
What epithelium lines the trachea?
Pseudostratified ciliated columnar epithelium
What is lamina propria?
Thin layer of dense irregular connective tissue
What is submucosa?
Layer of dense irregular connective tissue that supports the mucosa
What is found within the submucosa?
Sero-mucous glands
Carina
What is the clinical significance of bronchopulmonary segments
A surgeon may be able to remove a single diseased bronchopulmonary segment, without affecting the neighbouring segment
Facilitating postural drainage of fluid filled segments (infection or CF)
What is the shape of the bronchopulmonary segments?
Pyramidal shape with with their apices facing the lung root
Why is the right lung shorter and wider than the left lung?
Shorter because the right dome of diaphragm is higher to accommodate the liver
Wider because it compensates for the heart which bulges out to the left
What are the dark particles within lung tissue and lymph nodes?
Carbon ingested by macrophages
Label D?
Cardiac notch
Where do the bronchial arteries arise from?
Either the descending thoracic aorta or the posterior intercostal arteries
What are the thin walls called that separate the alveolar air spaces ?
Alveolar septa
Name a structure you would find in abundance in the alveolar septa?
Capillary
Are there sero-mucous glands found in the bronchiole wall?
No
Name all the components of the upper respiratory tract?
Nasal cavity, paranasal sinuses, pharynx and larynx
Name all the components of the lower respiratory tract?
Trachea, bronchi, bronchioles, and alveoli
What types of alveolar cells are there and what is their function?
Type I pneumocyte : Simple squamous for gas exchange
Type II pneumocyte : Secrete pulmonary surfactant to reduce surface tension
What are Clara cells and where are they found?
In bronchioles
Protect epithelium, secrete surfactant and involved in defence
What are pulmonary lobules separated by?
Interlobular septum
What is the respiratory unit or functional unit of the lung known as?
Pulmonary lobule
What is an acinus?
Where a bronchioles terminate, groups of alveoli
What does a pulmonary lobule consist of?
Many acini
In a pulmonary lobule describe the distribution of arterioles ?
Arterioles follow the respiratory pathways and branch to form capillary network to supply the alveoli
In a pulmonary lobule describe the distribution of venules?
Venules branch off the capillaries and are travel in the interlobular septum to supply the heart
Name the three layers of the blood-air barrier
- Pneumocyte type 1 cell
- Basal lamina
- Endothelial cell
What innervates the diaphragm?
Two phrenic nerves
What spinal nerves do the phrenic nerves originate from?
From the ventral rami of the C3-C5 spinal nerves
What is the pleura called that lines the thoracic wall and what is the pleura called that lines the lung?
Parietal pleura lines thoracic wall
Visceral pleura lines the lungs
Explain why referred pain from parietal pleura covering the diaphragm is felt over the shoulder tip
The supraclavicular nerves have the same cervical nerves origin as the phrenic nerve (C3,C4)
What is pneumonia?
Infection of the lung parenchyma (tissue)
What are the two types of bacterial pneumonia which are differentiated by distribution?
Lobular bronchopneumonia : patchy consolidation of the lung
Lobar pneumonia : consolidation of a large part of a lobe
What is the difference between secondary cartilaginous joints (symphysis) and primary cartilaginous joints (synchondroses”)?
Primary : connected by hyaline cartilage
Secondary : connected by hyaline cartilage and fibrocartilaginous disc
Give some examples of secondary cartilaginous joints (symphysis) and primary cartilaginous joints (synchondroses”)?
Primary : growth plates and joint between first rib and sternum
Secondary : Manubriosternal joint, pubic symphysis and intervertebral disc
In early life, the sternum’s body is divided into four segments, not three, what are these segments called?
Sternebrae
How many ribs do you have
24 (12 pairs)
What articulates with the two demifacets on the head of the rib?
Superior and inferior costal facet of vertebral column
On the rib, what articulates with the articular surface of the tubercle?
Transverse costal facet of vertebral column
What is the function of the costal groove?
It protects and accommodates the intercostal nerves and blood vessels
What type of joints are the costotransverse and costovertebral joint?
Plane synovial
How many true ribs, false ribs and floating ribs are there
7 pairs of true ribs
3 pairs of false ribs
2 pairs of floating ribs
In a clinical setting what is the superior thoracic aperture sometimes referred to as?
Thoracic outlet
What ribs make up the costal margin?
The false ribs and one true rib, from the 7th- 10th rib
Where do the first two posterior intercostal arteries arise from?
A branch of the subclavian artery
Where do the 3rd-11th posterior intercostal arteries arise from?
Branches of the descending thoracic aorta
Describe the relationship between the anterior and posterior intercostal arteries
Anastomose
Where do the anterior intercostal veins drain into
Musculophrenic and internal thoracic veins
Where do the posterior intercostal veins drain into
First vein drains into brachiocephalic vein
rest of veins drain into azygos system of veins
What does the musculophrenic artery supply?
Lower intercostal muscles, diaphragm and some of the anterior abdominal wall
What spinal nerves do the intercostal nerves arise from?
The ventral rami of the T2 to T11 spinal nerves
What spinal nerve does the subcostal nerve arise from?
The ventral ramus of T12
In each intercostal space, where does the intercostal nerve run in relation to the intercostal vein and artery?
Intercostal vein and artery lie superior to intercostal nerve
What is the mediastinum
The region in the thorax between the two pleural cavities
Shift of the mediastinum may produce sufficient deflection of the trachea, how does this occur?
The relative pressures in the two pleural cavities is unequal
Shift of the mediastinum may produce sufficient deflection of the trachea, how can this be recognised?
Palpation above the jugular notch
What is contained within the anterior mediastinum?
Remnants of thymus, a few lymph nodes and internal thoracic vessels
What is contained within the middle mediastinum?
Heart, parts of great vessels and lung roots
What is contained within the posterior mediastinum?
Descending thoracic aorta, oesophagus, thoracic duct, azygos and hemiazygos veins
What is contained within the superior mediastinum?
Part of oesophagus, trachea, great vessels, nerves and remnants of thymus
What nerves are found in the superior mediastinum?
Phrenic and vagus nerves
What is shown here?
Phrenic Nerve
What is shown here?
Vagus Nerve
Describe the route of the thoracic duct
Arises in the abdomen just below the diaphragm from the cisterna chyli
Enters the thorax through the aortic opening of diaphragm
Goes to roof of neck
What veins does the azygos vein receive and what does the azygos vein drain into?
Azygos vein receives the posterior intercostal veins on the right and arches over the right lung root to empty into the superior vena cava
What veins does the hemiazygos vein receive and what does the azygos vein drain into?
Hemiazygos vein receives the posterior intercostal veins on the left and then drains into the azygos vein at the midline
Thoracic Duct
Cisterna Chyli
Azygos Vain
Hemiazygos Vein
What nerve is the vagus nerve?
The vagus nerve is the tenth cranial nerve
What kind of nerve fibres does the vagus nerve bring to the thorax? What do they innervate in thorax and abdomen, generally speaking?
Parasympathetic nerves
Viscera
In the thorax what plexuses come off the vagus nerve and what do they innervate?
Cardiac, pulmonary and oesophageal plexuses
Control of the heart, lungs, trachea, bronchi and oesophagus
In lungs : supply smooth muscles, glands and epithelium of bronchi and the wall of blood vessels
What nerves carry the afferent nerve fibres of the lung
Carried in vagus nerve
Describe parasympathetic innervation of the lung?
Constrict bronchioles and causes secretion of glands
Lung tissue receives oxygen and nutrients from bronchial arteries, where do these arise from?
Descending thoracic aorta and posterior intercostal arteries
Describe route of left vagus nerve
Enters thorax between left common carotid artery and left subclavian artery
Describe route of left recurrent nerve which is a branch off the vagus nerve
Loops under the aortic arch and up to the neck
Describe route of right recurrent nerve which is a branch off the vagus nerve
Loops under right subclavian artery
Why does compression of vagus nerve cause hoarse voice?
Recurrent laryngeal nerve innervates vocal cords
Label G?
Thoracic Duct
Label Q?
Cisterna Chyli
Label N?
Parasternal Nodes
Label F?
Posterior Intercostal nodes
