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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
Q

Difference in main bronchus between L and R lung

A

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

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26
Q

Names of 2 fissures in the right lung (from top to bottom)

A

Horizontal fissure

Oblique fissure

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27
Q

Horizontal fissure in R lung

A

Separates superior lobe from middle lobe

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28
Q

Oblique fissure in R lung

A

Separates inferior lobe from middle and superior lobe

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29
Q

Oblique fissure position in R lung

A

Posterior : T4
Lateral: 5th ICS
Anterior: rib 6

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30
Q

Horizontal fissure position in R lung

A

4th ICS from sternum until it meets oblique as it crosses rib 5

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31
Q

Oblique fissure in L lung

A

Slightly more oblique than in the R lung
Posterior : T3-4
Lateral: 5th ICS
Anterior: rib 6

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32
Q

Course of trachea

A

Extends from C6 to T4/5 where it bifurcates

33
Q

Composition of the posterior wall of the trachea

A

Mainly smooth muscle

34
Q

Bronchial tree

A 
Trachea
Main (primary) bronchus
Lobar (secondary) bronchi
Segmental (tertiary) bronchi --> supply bronchopulmonary segments
Bronchioles
35
Q

How do bronchioles differ from the rest of the structures in the biliary tree?

A

No cartilage or goblet cells

Clara cells present that secrete surfactant

36
Q

What is the carina?
Shape?
Where is it found?

A

Lowest tracheal ring
Hooked-shaped structure
Projects backwards in the midline between the origins of the two main bronchi

37
Q

What is a bronchopulmonary segment?

A

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
Q

Relationship between bronchopulmonary segments and veins?

A

Pass intersegmentally b/n + around the margins of the segments

39
Q

Bifurcation of pulmonary arteries in relation to bifurcation of trachea?

A

Bifurcation of pulmonary arteries, anteriorly and to the left of the bifurcation of the trachea

40
Q

Length of R vs L pulmonary artery

A

R > L

41
Q

Course of R pulmonary artery

Where does it branch?

A 
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
Q

Course of L pulmonary artery

Where does it branch?

A

Anterior to descending aorta
Posterior to superior pulmonary vein

Branches WITHIN the lung

43
Q

Where do R + L pulmonary veins drain?

A

L atrium

44
Q

Which are the pulmonary tissues (3) and where do they get their blood supply from?

A

Bronchial walls and glands
Walls of large vessels
Viscera pleura

Blood supply: bronchial arteries and veins

45
Q

Where do the bronchial arteries originate from?

A

Thoracic aorta or one of its branches

46
Q

R + L bronchial arteries - where do they arise from?

A

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
Q

Where do bronchial veins drain to? (2)

A

Pulmonary veins/L atrium
or
Azygos vein/hemiazygos vein/superior IC vein

48
Q

What supplies lungs and visceral pleura?

A

Visceral afferents (sensory neurones) and efferents (motor neurones)

49
Q

Where are the visceral efferents and afferents distributed?

A

Through anterior and posterior pulmonary plexus. Branches of these plexuses originate from sympathetic trunks and vagus nerves

50
Q

Where do these plexuses lie and what is their relative size?

A

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
Q

Effect of visceral efferents
PSNS
SNS

A

Vagus: Increases secretions, constrict bronchioles (contraction of smooth muscle)
Sympathetic trunks: Reduces secretions, dilate bronchioles (relaxes SM)

52
Q

In which nodes do the superficial, subpleural and deep lymphatics drain?

A

Tracheobronchal nodes

53
Q

Where are the tracheobronchal nodes located?

A

Extend from within the lung, through hilum and root into posterior mediastinum
Along roots of lobar and main bronchi
Along sides of trachea

54
Q

With which other nodes do the tracheobronchal nodes join to form which trunks?

A

Tracheobronchal + parasternal + brachiocephalic
to form:
R+L bronchomediastinal trunks

55
Q

Where do R+ L bronchomediastinal trunks drain?

A 
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
Q

Which nerve innervates the trachea?

A

The recurrent laryngeal nerve

57
Q

Where do inhaled foreign objects tend to lodge?

A

Right main bronchus

Wider and more vertical than the left

58
Q

Which bronchi supply the lobes of the lungs?

A

Secondary/Lobar

59
Q

Which bronchi supply the bronchopulmonary segments of the lungs?

A

Tetriary/Segmental

60
Q

List the structures involved in the conducting airways and state function of conducting airways

A 
Nose
Pharynx
Larynx
Trachea
Bronchi
Conducting and terminal bronchioles
Conduct air, no gas exchange
61
Q

List the structures involved in the respiratory airways and state function of conducting airways

A

Respiratory bronchioles
Alveolar ducts,
Alveoli

Gas exchange

62
Q 
Epithelium in
Bronchi
Bronchioles
Terminal bronchioles
Respiratory bronchioles
Alveolar sacs
A 
Pseudo-stratified ciliated columnar 
Simple columnar
Simple cuboidal
Simple cuboidal
Simple squamous (T1 and T2 pneumocytes)
63
Q

How does L lung differ from R lung

A

2 lobes instead of 3
Lingula
Cardiac notch

64
Q

Inferior border of lung

A

Sharp

Separates diaphragmatic surface from costal surface

65
Q

Anterior border of lung

A

Sharp

Separates costal surface from mediastinal surface

66
Q

Posterior border

A

Smooth, rounded

Separates costal surface from mediastinal surface

67
Q

Function of bronchial circulation

A

Part of systemic circulation

Provides lung with Oxygen

68
Q

Course of blood in bronchial circulation once it leaves LV until it returns to SVC

A 
LV
Descending aorta
Bronchial arteries
Capillaries
Bronchial veins
Azygos vein
SVC
69
Q

What is pleura?

A

A thin layer of flattened cells supported by connective tissue that lines each pleural cavity and covers the exterior of the lungs

70
Q

Innervation and vasculature of visceral pleura

A

Not sensitive to pain, temp, touch
Sensory fibres detect stretch
Bronchial arteries

71
Q

Innervation and vasculature of parietal pleura

A

Well localised pain, sensitive to temp and touch
Phrenic and intercostal nerves
Intercostal arteries

72
Q

Where do they pierce the diaphragm and which structures do they accompany?
Oseophagus
IVC
Aorta

A

T10 + CN10 (vagus)
T8 + R phrenic nerve
T12 + thoracic duct and azygos vein

73
Q

What pierces the tendinous part of the diaphragm and what the muscular? why?

A

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
Q

Living Anatomy - where is the cardiac notch located?

A

rib 4-6, left side

75
Q

Which is the first palpable spine?

A

C7

76
Q

How can you find T12?

A

Mid point between inferior angle of scapula and top of iliac bone along capular line

77
Q

Where can you find the lung hilum?

A

mid point of scapular and posterior median line opposite spines T4-T6

78
Q

Most likely location for foreign objects to dislodge

A

Right lower lobe

Anatomy - Charis (4 decks)

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