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Anatomy - Charis > Bronchi, Lungs, pleura, Diaphragm > Flashcards

Bronchi, Lungs, pleura, Diaphragm Flashcards

1
Q

Where is visceral pleura continuous with parietal pelura?

A

At the hilum of the lung where visceral pleura reflects off the lung to become parietal pleura

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2
Q

How many bronchopulmonary segments does each lung have?

A

10 - some of them fuse in the L lung

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3
Q

Where does the diaphragm attach to peripherally? (6)

A 
End of costal margin
Xiphoid process
Costal catilages of ribs 7-10
Ribs 11 + 12
Lumbar vertebrae
Ligaments that span across structures of the posterior abdominal wall (cruri and arcuate ligaments)
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4
Q

Where is the pericardium attached in relation so the diaphragm?

A

Middle part of the central tendon

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5
Q

Innervation of the diaphragm

A

C3, C4, C5

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6
Q

Arterial supply to the diaphragm superiorly (and where does each artery arise from) (4)

A

Pericardiacophrenic (branch of internal thoracic aorta)
Musculophrenic (branch of internal thoracic aorta)
Branches of intercostals
Superior phrenic arteries (directly from lower parts of thoracic aorta)

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7
Q

Arterial supply to the diaphragm inferiorly (and where does each artery arise from)

A

Inferior phrenic arteries (directly from abdominal aorta)

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8
Q

Venous drainage of diaphragm (3)

A

Brachiocephalic veins in neck
Azygos system of veins
Abdominal veins (left suprarenal + IVC)

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9
Q

How can the ribs undergo the pump handle movement?

A

Anterior end of the ribs is lower than posterior end

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10
Q

How can the ribs undergo the bucket handle movement?

A

Middles of shafts are lower than the two ends

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11
Q

What is in the pleural cavity? Function?

A

Thin layer of serous fluid. Reduces friction during respiration

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12
Q

Is the pleural cavity a real or a potential space?

A

Potential

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13
Q

What is the function of the suprapleural membrane and where is it found?

A

Provides apical support for the pleural cavity in the root of the neck.

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14
Q

Where does the suprapleural membrane attach and what is it made of?

A

Attached laterally to the medial margin of rib 1 to the transverse process of vertebra C7.

Connective tissue membrane that recieves skeletal muscle fibre from scalene muscles to keep it taught

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15
Q

The parietal pleura can be divided into: (4)

A

Cervical pleura
Costal pleura
Mediastinal pleura
Diaphragmatic pleura

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16
Q 
Innervation of
Parietal pleura
Costal pleura
Mediastinal pleura
Diaphragmatic pleura
Visceral pleura
A

parietal - somatic afferent fibres
costal - intercostal fibres
diaphragmatic + mediastinal - phrenic nerves
visceral - visceral afferent nerves that accompany bronchial vessels (pain not elicited from this tissue)

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17
Q

Dermatomes of C3,C4,C5

A

Lateral neck

Supraclavicular region of shoulder

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18
Q

Pleural boundaries

A 
Apex: Just above the medial third of clavicle
Anterior;
 rib 6 (xiphoid process
Inferior:
rib 8
rib 10
vertebra 12
Posterior:
L1
T1
Scapular line
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19
Q

Lung noundaries

A

rib 6
rib 8
vertebra 10 (scapular line)

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20
Q

What is the costodiaphragmatic recess?

A

Region between inferior margin of lung and pleural cavities. This is where fluid (pleural effusion) first accumulates and is seen on CXR

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21
Q

When is the costodiaphragmatic recess
Deepest
Swallowest

A

Forced expiration

Forced inspiration

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22
Q

Functions of pulmonary ligament (2)

A

Stablizes the postion of the inferior lobe

Accomodates for the down-and-up translocation of structures in the root during breathing

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23
Q

Vagus and phrenic nerves in relation to the lungs

A

Vagus nerves pass immediately posterior to the root of the lungs
Phrenic nerves pass immediately anterior to the roots

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24
Q

Within each root and located in the hilum of the lung are (6)

A 
1 pulmonary artery (superior to veins)
1 main bronchus (near the straight line of the lung)
2 pulmonary veins
Lymphatics
Nerves
Bronchial vessels
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25
Difference in main bronchus between L and R lung
R lung: Bronchus divides into 2 in the root of the lung, next to the pulmonary artery. Further divides into 2 within the lung to supply the superior lobe L lung: Bronchus divides into 2 within the lung, inferior to pulmonary artery
26
Names of 2 fissures in the right lung (from top to bottom)
Horizontal fissure | Oblique fissure
27
Horizontal fissure in R lung
Separates superior lobe from middle lobe
28
Oblique fissure in R lung
Separates inferior lobe from middle and superior lobe
29
Oblique fissure position in R lung
Posterior : T4 Lateral: 5th ICS Anterior: rib 6
30
Horizontal fissure position in R lung
4th ICS from sternum until it meets oblique as it crosses rib 5
31
Oblique fissure in L lung
Slightly more oblique than in the R lung Posterior : T3-4 Lateral: 5th ICS Anterior: rib 6
32
Course of trachea
Extends from C6 to T4/5 where it bifurcates
33
Composition of the posterior wall of the trachea
Mainly smooth muscle
34
Bronchial tree
``` Trachea Main (primary) bronchus Lobar (secondary) bronchi Segmental (tertiary) bronchi --> supply bronchopulmonary segments Bronchioles ```
35
How do bronchioles differ from the rest of the structures in the biliary tree?
No cartilage or goblet cells | Clara cells present that secrete surfactant
36
What is the carina? Shape? Where is it found?
Lowest tracheal ring Hooked-shaped structure Projects backwards in the midline between the origins of the two main bronchi
37
What is a bronchopulmonary segment?
Area of lung supplied by segmental bronchus and its accompanying pulmonary artery branch Smallest, functionally independent region of lung and smallest area of lung that can be removed without affecting adjacent regions Irregular cone
38
Relationship between bronchopulmonary segments and veins?
Pass intersegmentally b/n + around the margins of the segments
39
Bifurcation of pulmonary arteries in relation to bifurcation of trachea?
Bifurcation of pulmonary arteries, anteriorly and to the left of the bifurcation of the trachea
40
Length of R vs L pulmonary artery
R > L
41
Course of R pulmonary artery Where does it branch?
``` Across mediastinum Anteroinferiorly of tracheal bifurcation Anteriorly to R main bronchus Posteriorly to ascending aorta IVC upper R pulmonary vein ``` Branches AT THE ROOT of the lung
42
Course of L pulmonary artery Where does it branch?
Anterior to descending aorta Posterior to superior pulmonary vein Branches WITHIN the lung
43
Where do R + L pulmonary veins drain?
L atrium
44
Which are the pulmonary tissues (3) and where do they get their blood supply from?
Bronchial walls and glands Walls of large vessels Viscera pleura Blood supply: bronchial arteries and veins
45
Where do the bronchial arteries originate from?
Thoracic aorta or one of its branches
46
R + L bronchial arteries - where do they arise from?
1 R bronchial artery: Either from: 3rd posterior IC artery or upper left bronchial artery 2 L bronchial arteries: Directly from the anterior surface of the thoracic aorta superior and inferior left bronchial arteries
47
Where do bronchial veins drain to? (2)
Pulmonary veins/L atrium or Azygos vein/hemiazygos vein/superior IC vein
48
What supplies lungs and visceral pleura?
Visceral afferents (sensory neurones) and efferents (motor neurones)
49
Where are the visceral efferents and afferents distributed?
Through anterior and posterior pulmonary plexus. Branches of these plexuses originate from sympathetic trunks and vagus nerves
50
Where do these plexuses lie and what is their relative size?
Lie anteriorly and posteriorly to the bifurcation of the trachea and the main bronchi, distributed along branches of the airway and vessels posterior plexus > anterior plexus
51
Effect of visceral efferents PSNS SNS
Vagus: Increases secretions, constrict bronchioles (contraction of smooth muscle) Sympathetic trunks: Reduces secretions, dilate bronchioles (relaxes SM)
52
In which nodes do the superficial, subpleural and deep lymphatics drain?
Tracheobronchal nodes
53
Where are the tracheobronchal nodes located?
Extend from within the lung, through hilum and root into posterior mediastinum Along roots of lobar and main bronchi Along sides of trachea
54
With which other nodes do the tracheobronchal nodes join to form which trunks?
Tracheobronchal + parasternal + brachiocephalic to form: R+L bronchomediastinal trunks
55
Where do R+ L bronchomediastinal trunks drain?
``` Directly in deep veins at the base of the neck or May drain into the R lymphatic trunk or May drain into the thoracic duct ```
56
Which nerve innervates the trachea?
The recurrent laryngeal nerve
57
Where do inhaled foreign objects tend to lodge?
Right main bronchus | Wider and more vertical than the left
58
Which bronchi supply the lobes of the lungs?
Secondary/Lobar
59
Which bronchi supply the bronchopulmonary segments of the lungs?
Tetriary/Segmental
60
List the structures involved in the conducting airways and state function of conducting airways
``` Nose Pharynx Larynx Trachea Bronchi Conducting and terminal bronchioles Conduct air, no gas exchange ```
61
List the structures involved in the respiratory airways and state function of conducting airways
Respiratory bronchioles Alveolar ducts, Alveoli Gas exchange
62
``` Epithelium in Bronchi Bronchioles Terminal bronchioles Respiratory bronchioles Alveolar sacs ```
``` Pseudo-stratified ciliated columnar Simple columnar Simple cuboidal Simple cuboidal Simple squamous (T1 and T2 pneumocytes) ```
63
How does L lung differ from R lung
2 lobes instead of 3 Lingula Cardiac notch
64
Inferior border of lung
Sharp | Separates diaphragmatic surface from costal surface
65
Anterior border of lung
Sharp | Separates costal surface from mediastinal surface
66
Posterior border
Smooth, rounded | Separates costal surface from mediastinal surface
67
Function of bronchial circulation
Part of systemic circulation | Provides lung with Oxygen
68
Course of blood in bronchial circulation once it leaves LV until it returns to SVC
``` LV Descending aorta Bronchial arteries Capillaries Bronchial veins Azygos vein SVC ```
69
What is pleura?
A thin layer of flattened cells supported by connective tissue that lines each pleural cavity and covers the exterior of the lungs
70
Innervation and vasculature of visceral pleura
Not sensitive to pain, temp, touch Sensory fibres detect stretch Bronchial arteries
71
Innervation and vasculature of parietal pleura
Well localised pain, sensitive to temp and touch Phrenic and intercostal nerves Intercostal arteries
72
Where do they pierce the diaphragm and which structures do they accompany? Oseophagus IVC Aorta
T10 + CN10 (vagus) T8 + R phrenic nerve T12 + thoracic duct and azygos vein
73
What pierces the tendinous part of the diaphragm and what the muscular? why?
Tendinous: IVC --> It is compressible so pierces tendon so that it doesnt collapse Oesophagus --> muscle Aorta --> thicker therefore they can pierce the muscular part of the diaphragm
74
Living Anatomy - where is the cardiac notch located?
rib 4-6, left side
75
Which is the first palpable spine?
C7
76
How can you find T12?
Mid point between inferior angle of scapula and top of iliac bone along capular line
77
Where can you find the lung hilum?
mid point of scapular and posterior median line opposite spines T4-T6
78
Most likely location for foreign objects to dislodge
Right lower lobe

Anatomy - Charis (4 decks)

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