Anatomy: Respiratory 🫁 + CNS Neuro Flashcards
L1 Basic overview of the resp tract
what anatomical strucs inspired air passes through to -> lungs
anatomy of bronchial tree + bronchopulmonary segments
What is posterior to the nasal and oral cavity?
pharynx:
combined tube of oesophagus (digestion) and larynx (respiration)
What does the larynx become?
the trachea
What special structure is located on the larynx and what does it do?
- epiglottis- valve
- closes when food is digested
- separates larynx from pharynx
What structure divides the nasal cavity into 2?
the nasal septum
What does air inhaled through the nasal cavity have to pass through?
- nasal conchae covered in mucosa
- olfactory epithelium (smell)
Name the 3 pharynxes and their anterior structures
what are they each posterior to?
1) nasopharynx - posterior to nasal cavity
2) oropharynx - posterior to oral cavity
3) laryngopharynx - posterior to larynx and epiglottis
What bone supports the larynx?
hyoid bone (superiorly)
What cartilages form the larynx? and where?
- epiglottis (superior)
- thyroid (superior)
- cricoid (inferior)
- arytenoid (inferior)
How does the trachea anatomically relate to the:
- oesophagus
- great vessels of heart
- anterior
- posterior
What parts of the arterial system are the trachea and bronchi intimately related to?
- arch of aorta
- pulmonary arties
How is the trachea anatomically related to the arch of the aorta?
posterior
How are the bronchi anatomically related to the left and right pulmonary arteries?
posterior
What nerves are intimately related to the trachea?
- left recurrent laryngeal nerve (on oesophagus)
- left vagus nerve (on arch of aorta)
At what vertebral level do the trachea bifurcate into the bronchi?
T4/5 (sternal angle)
What are the lobes of the right lung?
- superior
- middle
- inferior
What are the lobes of the left left?
- superior
- (lingula - smaller equivalent of middle lobe)
- inferior
What is the lingula?
tongue-shaped equivalent of middle lobe in left lung
What are the branches of the main right bronchi?
middle lobar bronchus
inferior lobar bronchus
What does the middle lobar bronchus go?
to the middle lobe
At what vertebral level are the inferior border of the hyoid bone/superior level of the thyroid cartilage?
C3/4
At what vertebral level are the inferior border of the cricoid cartilage/start of trachea?
C5/6
What composes the respiratory tract?
- nasal cavity
- naso/oro/laryngopharynx
- larynx
- trachea
- main bronchus
- superior/middle/inferior/lobar bronchi
What does the nasal cavity do?
warms and humidifies air
What is the arytenoid important for?
phonation
L2 Boundaries of the thorax
recall 3 main functions of thorax
describe boundaties
3 main functions of thorax?
- breathing (diaphragm)
- protection of organs + ribs
- conduit for other structures (subclavian and CC artery)
What structures form the borders of the thoracic skeleton?
- superior thoracic aperture
- inferior thoracic aperture
i. e. top and bottom of ribs
What is the sternum?
the anterior articulation of ribs 1-10
What structures form the superior thoracic aperture? 4
- vertebra T1 (posteriorly)
- rib 1 (laterally)
- 1st costal cartilage (anteriorly)
- manubrium (anteriorly)
What structures form the inferior thoracic aperture? at bottom of ribcage 5
- xiphoid process (anteriorly)
- costal margin
- top of rib 11 (laterally)
- inferior border of rib 12 (posteriorly)
- vertebra T12 (posteriorly)
What ribs form the costal margin?
6-10
What parts of the thoracic cage does the diaphragm connect to?
- xiphoid process
- inferior thoracic aperture
- costal margin of ribs 7-10
- rib 11
- rib 12
which point of inferior thoracic aperture foes diaphragm attach to sternum?
xiphoid process
L3 Lungs
anatomy of lungs + pulmonary circ
anatomy of bronchial tree + bronchopulmonary segments
What structures are within the lungs? 2
mediastinum and heart
Apart from the thoracic cavity, what other cavity does the lungs sit in?
the pleural cavity
What is the costal surface of the lungs?
covered by costal pleura and is along the sternum and ribs
What is the mediastinal surface of the lungs?
that which is in contact w the mediastinum of the heart
What structures are found within the right lung?
- lobes
- horizontal fissure
- oblique fissure
- hilum
- anterior/posterior/inferior border
what does right lung have that left doesnt?
middle lobe
still both have superior and lower lobes
What does the oblique fissure do?
separates the superior and inferior lobe
What does the horizontal fissure do?
separates the superior and middle lobe
What is the hilum?
the points at which the bronchus, vessels, nerves, lymphatics enter or leave the lungs
Why is the horizontal fissure only found in the right lung?
because it separates the middle and superior lobe, and the left lung doesn’t have a middle lobe
What is found within the hilum of the lungs?
- primary lobar bronchi
- pulmonary arteries
- pulmonary veins
What is the difference between pulmonary blood vessels and other blood vessels?
normal arteries will carry oxygenated blood away from heart, whereas pulmonary arteries carry deoxygenated blood away from heart
How do the pulmonary arteries relate to the pulmonary veins in the hilum?
superior to veins
What are the structures within the left lung?
- lobes (superior/inferior)
- oblique fissure
- hilum
- lingula
- cardiac notch
Why doesn’t the left lung have a middle lobe?
heart occupies the left of the thoracic cavity
How many bronchopulmonary segments are there per lung?
10- diff functions as all receive own tertiary bronchus
What structures form the bronchial tree?
- trachea
- carina
- bronchus
- left and right bronchus
- secondary bronchi
- tertiary bronchi
How does the right bronchus compare to the left?
- shorter
- wider
- more vertical
Where are aspirated foreign objects more likely to pass into: the left or right bronchus?
right bronchus (wider)
What do the secondary bronchi supply?
the lobes of each lung
3 on right
2 on left
What do the tertiary bronchi supply?
the bronchopulmonary segments
location of trachea
inferior and anterior to oesaphagus
posterior to aortic arch
where does bronchus divide left and right primary bronchi?
at level of sternal angle of Louis
What is the carina?
internal, keel-like cartilage at bifurcation of trachea
Which rib does the horizontal fissure extend along?
the 4th
impressions in lungs mad eby…
adjacent structures (bronchus, vessels, nerves, lymphatics) enter/ leave lungs
What is the cardiac notch?
an indentation for the heart in the left lung
Where does the oblique fissure extend from?
vertebra T2-T3 to 6th costal cartilage
Which blood vessels enter via the hilum?
pulmonary arteries
Which blood vessels leave via the hilum?
pulmonary veins
What are the main lymph nodes of the lung?
- pulmonary/intrapulmonary
- bronchopulmonary/hilar
- tracheobronchial
- paratracheal
- bronchomediastinal trunk
Where are the pulmonary/intrapulmonary and bronchopulmonary/hilar lymph nodes located?
within the lung
Where are the tracheobronchial lymph nodes located?
Where are the tracheobronchial lymph nodes located?
Where are the paratracheal lymph nodes located?
along the trachea
Where is the bronchomediastinal trunk located?
in the superior mediastinum
Where do the paratracheal lymph nodes drain into?
the bronchomediastinal trunk
Where does the bronchomediastinal trunk drain into?
the brachiocephalic veins
What does sympathetic innervation of pulmonary smooth muscle cause?
bronchodilation
vasoconstriction
What does parasympathetic innervation of pulmonary smooth muscle cause?
bronchoconstriction
vasodilation
Branches of what give the lungs their blood supply?
the thoracic aorta
What branches of the thoracic aorta supply the lung?
- bronchial branches
- posterior intercostal arteries
Where does blood leave the lungs?
- mostly: pulmonary veins
- some small bronchial veins: azygos, hemiazygos, accessory (superior) hemiazygos
Where do arteries to the lungs come from (after the thoracic aorta)?
the posterior intercostal arteries
Each lung has what features?
- base
- apex
- costal/mediastinal surface
- 3 borders (anterior/posterior/inferior)
- lobes
small vol of blood will drain where?
azygos system of veins
lungs surroud mediastinum and are surrounded by?
L and R pleural cavities
L4 anatomy of the pleura
lungs + pleura and neurovasc supply + lymphatic drainage
How many pleura are there?
- 2 pleura
- parietal (external)
- visceral (internal)
What is the pleural cavity?
- space between visceral and parietal pleura
- filled with thin layer of serous fluid to allow for lubrication required for the lung to slide during inspiration and expiration
What are the surfaces of the parietal pleura?
o Cervical
o Costal
o Diaphragmatic
o Mediastinal
What is the innervation for the different pleural surfaces?
- different innervation depending on their region
- BUT cervical and costal regions have the same innervation
What is the costomediastinal recess? role?
- potential space at the border of the mediastinal pleura and the costal pleura.
- It assists lung expansion during deep inspiration
What is the costodiaphragmatic recess?
- potential space around the lung inside the pleural cavity.
It assists lung expansion during deep inspiration
- assists more significantly than Costomediastinal recess due to its greater volume.
What is the nerve that supplies the costal and cervical pleua?
- intercostal nerve
- originates at the T1-11 vertebrae
What is the nerve that supplies the diaphragmatic and mediastinal pleua?
- phrenic nerve
- originates at C3-5 vertebrae
What is the visceral pleura innervated by?
- visceral afferent (autonomic) nerves via the pulmonary plexus.
vagus nerve
symp trunk
What is the midclavicular line?
parallel to the long axis of the body and passing through the midpoint of the clavicle on the ventral surface of the body.
What is the midaxillary line?
runs through an individual’s torso, separating the body into its anterior, or front, and posterior, or back, halves.
What is the paravertebral line?
corresponding to the tips of the transverse processes of the vertebrae.
What is the summary of the pleura and surface landmarks?
p56
lungs form anteriorly form what?
outgowth of the pharynx
as lungs push out what are they enveloped in?
dual fold of pleura…
parietal: innervated by somatic afferents in phrenic + intercostal nerves.. sense pain
visceeral: innervated by general afferent fibres accompanying bronchial vessels- cannot sense pain
what are recesses?
space between parietal/visceral pleura
inferior margin of what is at rib 6-8-10?
lung/visceral pleura
inferior margin of what is at rib 8-10-12?
parietal pleura
L4 muscles of respiration and the thoracic wall
boundaries of thorax + surface anatomy
muscles involved in vent + role of phrenic nerve
What are the main muscles involved in respiration? 2
- diaphragm
- intercostal muscles
What is the nerve supply to the diaphragm?
phrenic nerves (C3,4,5)
How many intercostal spaces are there?
11 each side
What is the posterior blood supply to the upper 2 intercostal spaces?
- posterior intercostal artery
- stems from the superior intercostal artery
What is the posterior blood supply to the lower 9 intercostal spaces?
- supplied by the posterior intercostal artery
- this is a DIRECT branch of the thoracic aorta
What is the anterior blood supply to the upper six intercostal spaces?
- supplied by the anterior intercostal arteries
- branch of the internal thoracic artery
What is the anterior blood supply to the 7-9th intercostal spaces?
supplied by the anterior intercostal arteries
- branch of the musculophrenic artery
What is the anterior blood supply to the bottom 2 intercostal spaces?
no ANTERIOR blood supply to these areas
What is the venous drainage of the thoracic wall?
- 11 posterior intercostal veins & 1 subcostal vein (on each side)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles? + roles
o External Intercostal muscle – inspiration
o Internal Intercostal muscle –expiration (forced)
o Innermost Intercostal muscle - expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What are the 3 main intercostal muscles?
o External Intercostal muscle – primary muscles of inspiration
o Internal Intercostal muscle – primary muscles of expiration (forced)
o Innermost Intercostal muscle - these are the primary muscle of expiration (forced)
What is the relationship between the intercostal muscles and the parietal muscles?
layers of muscle are very close to the parietal pleura – only separated by a thin layer of fascia
Where are the intercostal arteries/ veins located?
in the costal groove
mechanisms of the intercostal muscles?
o External – elevates rib below during inspiration – moving lung up and out
o Inner and Innermost - depresses rib above during expiration – moving lung down and in
What is the nerve innervation of the intercostal muscles?
· Innervated by Intercostal Nerves
- originate at the T1-11 vertebrae
order inside costal groove? VAN NAV
vein artery nerve .. ... .. nerve artery vein
What are accessory muscles?
any muscle that attaches to the rib cage is an accessory to respiration.
What are examples of accessory muscles?
o Serratus anterior – Elevate ribs (forced inspiration)
o Serratus posterior superior – Elevate ribs (forced inspiration)
o Serratus posterior inferior – Depress ribs (forced expiration)
o Pectoralis major/minor – Elevate ribs (forced inspiration)
o Anterior/ middle/ posterior scalene – Elevate ribs (forced inspiration)
o Abdominal wall muscles – Forced expiration
What is the mechanism of breathing In (INHALATION)
- Diaphragm contracts and flattens enlarging the chest cavity. (inc lung volume)
- Contraction creates a vacuum, which pulls air into the lungs. (dec in intrapulmonary pressure)
- Ribs and sternum undergo Pump handle and Bucket Movement
What is the mechanism of breathing Out (EXHALATION)
- diaphragm relaxes and returns to its dome-like shape, and air is forced out of the lungs.
What is the pump handle movement?
- Superior and anterior movement of chest cavity
- sternum moves up and forward
What is the bucket handle movement?
- Lateral expansion of chest cavity
- ribs move up and out
end qs… what is pleural cavity (serous fluid filled space) formed by?
cavity between parietal + visceral pleura
CNS NEUROANATOMY 1: review of CNS terminology
struc and divisions of brsin
grey and white matter
major grey and white matter strucs in brain
what is white matter grey matter, nuclei?
W: myelinated axons
G: cell bodies
N: collections of cell bodies
role of
corpus callosum?
caudate nucleus?
CC: connects 2 cerebral hemispheres
CN: part of basal ganglia
rostral =
caudal =
ventral =
dorsal =
rostral = nose caudal = tail ventral = belly dorsal = back
what do
somatic nerves supply?
visceral nerves?
S: to/from body wall: skin, skeletal, muscles
V: internal organs: liver, GI tract
what is ANS?
branch of visceral (internal) inenrvation
