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anatomy of the thorax > Bronchi, pleura, lungs and diaphragm > Flashcards

Bronchi, pleura, lungs and diaphragm Flashcards

1
Q

what are the 4 components of the bronchial tree

A

trachea
primary bronchi - R and L
Lobar (secondary) bronchi
segmental (tertiary) bronchi

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2
Q

describe the trachea

A

central
from C6 to T4/5 manubriosternal joint
C shaped rings of cartilage (so oesophagus can expand)
lowest ring has hook called carina - hooks under bifurcation of the trachea

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3
Q

what does the sternal notch relate to anatomically

A

2nd costal cartilage

T4/5 posteriorally

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4
Q

what can change the appearance of the subcarinal angle

A

flow to the subcarinal lymph nodes

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5
Q

describe the primary bronchi

A

formed at T4/5

right is wider and more vertical than left

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6
Q

significance of R primary bronchi being thicker

A

solid objects are more likely to move down the right when swallowed

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7
Q

describe the lobar bronchi

A

formed in the lung s

supply the lobes of the lungs

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8
Q

describe the arrangement of lobes in the lung

A

3 in R (more lobar bronchi)

2 in L

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9
Q

what do the segmental bronchi do

A

supply individual bronchopulmonary segments - self contained independent units of lung tissue

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10
Q

what is the thyroid cartilage seen as

A

Adam’s apple

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11
Q

what is a cricothyroidotomy

A

make an incision in cricothyroid membrane to open airways in trauma

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12
Q

what joins the cricoid cartilage and thyroid cartilage

A

median cricothyroid ligament

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13
Q

at what point is a tracheostomy done

A

in hospital

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14
Q

number of bronchiopulmonary segments in each lung

A

10

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15
Q

what is the term for the branches coming off another branch

A

airway tree - supply a specific segment of the lungs

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16
Q

are the bronchopulmonary segments related

A

no - functionally different

can remove 1 without moving any of the others - have own nerve and blood supply and own airways

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17
Q

what are the lungs

A

essential organs for respiration

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18
Q

where are the lungs

A

thorax
separated from each other by mediastinum
lie in pleural cavity freely - except from attachment to heart (via pul vessels and trachea at the lung root/hilum . therefore has mobility in pleural cavity

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19
Q

which way does blood flow on the pulmonary circulation

A

from heart to the lung

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20
Q

which way does deoxygenated blood flow in bronchial circulation

A

away from the lungs (oxygen used by the lungs to function)

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21
Q

describe the structure of the lungs

A

conical
apex - thoracic inlet oblique, rises 3- 4cm above 1st costal cartilage
base is concave because diaphragm rises up and it rests on the convex wall
the 3 edges - anterior, posterior, interior
3 surfaces - costal, medial, inferior

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22
Q

what does the diaphragm separate

A

R lung from R lobe of liver

L lung from l lobe of liver, stomach and spleen

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23
Q

where is the liver

A

under the rib cage because the diaphragm is curved superiorly

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24
Q

what is the function of the pleural cavity

A

has fluid
provides surface tension - allow sliding of tissue
if surface tension breaks inner layer doesn’t move with outer layer

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25
Q

3 features of the mediastinal surface of the lung

A

posterior
anterior
above and behind the cardiac impression - hilum of the lung

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26
Q

describe the posterior part of lung

A

contact with the vertebrae

thick

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27
Q

describe the anterior part of the lung

A

deeply concave - where heart is, bigger on L

28
Q

describe the hilum of the lung

A

where vessels, bronchi and nerves leave and enter the mediastinum

29
Q

what is the pleural reflection

A

change from parietal pleura to visceral pleura
this is the lung hilum
(the root is the structures in this)

30
Q

describe the medial/mediastinal aspect of the heart

A

indentation for major muscles
tubes point towards the middle
small vein that brings blood back to other veins
left lung has lingula - ‘hand’ in front of the heart

31
Q

describe the L lung

A

2 lobes - superior and inferior
separated by oblique fissure - similar direction to ribs
superior lobe lies above the fissure - has the apex and most anterior part of the heart

32
Q

mediastinal aspect of R lung

A

grooves for the arteries
and superior vena cava
and oesophagus

33
Q

features of the R lobe

A

superior, middle, inferior lobes
oblique fissure - separates inferior lobe from others
horizontal fissure - separate superior from the middle lobe
R larger than L

34
Q

what does the lung hilum do

A

connect mediastinal surface to the heart and trachea

35
Q

what structures are in the hilum

A

principle bronchus
pul artery - deoxygenated blood from RV
2 pul veins - ox blood to LA
bronchial arteries (ox blood from descending aorta) and veins
pulmonary plexus of nerves - autonomic - change calibre of airways
lymph vessels and nodes - pathology

this is all in the pleura

36
Q

what is in the hilum of the L lung

A 
pul artery 
pul vein (upper lobe) 
primary bronchus 
bronchial artery
lymph node 
pul ligament - inferior fold of pleura (thickening of tissue) -  expands when you take in breath
37
Q

why cant you see the LA on x ray

A

it is at the back of the heart

38
Q

where is the most oxygenated blood

A

coronary arteries

39
Q

what is the pleura

A

thin layer flattened cells
supported by connective tissue
lines each pleural cavity
covers the exterior of the lung

40
Q

visceral pleura

A

covers surface lungs and lines fissures

41
Q

parietal pleura

A

lines inner surface of the chest walls

42
Q

how are visceral and parietal pleura related

A

continuous with each other around the root of the lung

this is the hilum

43
Q

what is the pleura like in health

A

pleural cavity is collapsed

moist surfaces allow lungs to glide as they expand and collapse = mobility

44
Q

describe the pleural origin

A

pleural cavities in chest wall
lined by parietal pleura
lung buds grow into them
within the covering of visceral pleura

45
Q

where is the heart

A

central but projects to the left

46
Q

what is the area under the lungs in the pleural cavity

A

costodiaphragmatic recess
blood and pus can accumulate here
ung is here in maximal inspiration

47
Q

oblique fissure runs along…

A

the 6th rib

48
Q

horizontal fissure runs

A

from 4th costal cartilage and rib

laterally until 6th rib where it meets the oblique fissure

49
Q

how does breathing occur

A

controlled by nervous system and produced by skeletal muscle - automatic
inhalation and exhalation of air out of the lungs to ventilate alveolar sacs

50
Q

how can you increase the capacity of the thoracic cavity

A

movements of the diaphragm and ribs

51
Q

describe the mechanism of breathing

A

pleural cavity expanded by muscle in walls
elastic lungs expand with the pleural cavity
air bought down trachea and bronchi into lungs

52
Q

what happens when the diaphragm contract

A

increase vertical dimension of thoracic cavity
presses on abdominal viscera which descend because of relaxation of the abdominal wall
diaphragm stopped by abdominal viscera so costal margin raised
combined with rib movement - reduced intrapleural pressure - entry of air anmd expansion of respiratory passages

53
Q

describe the thoracic surface of the diaphragm

A

skeletal muscle from the costal margin
sheet like central tendon
pericardial sac
a lot of the diaphragm is tendon because it is a muscle - bit from costal margin to tendon that contracts

54
Q

what is the costal margin

A

lower border of the rib cage

55
Q

what is the margin of the diaphragm attached to

A

costal margin
xiphoid process
ends of ribs 11 and 12
lumber vertebrae in back

56
Q

where does the dome of the diaphragm go

A

bulges high into the rib cage

liver are covered by diaphragm pleura and lungs

57
Q

describe the ribs in breathing

A

ribs elevated - anterior forward and up
increase anterio-posterior dimension of thoracic cavity
also everted increase transverse diameter of thoracic cavity
intercostal muscle pull rib up and out because they stiffen the rib cage to increase efficiency of diaphragm

58
Q

effect of rising the costal margin

A

widens the pleural cavity by raising drooping lateral parts of the ribs
this tilts the sternum upwards = increase in antero-posterior diameter of pleural cavities (pump handle action)

59
Q

describe breathing out

A

quiet expiration is a passive activity not requiring muscles - recoil - diaphragm moves up and ribs down
recoil is from the elastic tissue in lungs and rib cage
deep expiration - assisted by muscles of abdominal walls that squeeze the abdominal organs against the diaphragm and pull lower ribs downward

60
Q

where do you listen to the aorta

A

top right

61
Q

where do you listen to the atrioventricular valves

A

bottom left

62
Q

why do ribs point posteriorly before anteriorly

A

allow some of the stuff in the chest posterior to vertebral column
a lot of the lungs are in the paravertebral gutter

63
Q

what is the pul trunk

A

vessel from RV then divide into R and L pul artery
1st vertical orientated bv from RV
goes posteriorly and then bifurcates

64
Q

where is aorta in relation to pul trunk

A

posterior

65
Q

where does superior vena cava bifurcate

A

right of sternoclavicular joint b

66
Q

path of aorta

A

over L primary bronchus
through diaphragm
into abdomen

anatomy of the thorax (14 decks)

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