bronchial tree Flashcards
which lung is larger, & why
right
bc of heart on left
name of pleura that adheres to thoracic wall / mediastinum / diaphragm
parietal pleura
name of pleura that adheres to lungs
visceral pleura
name of area of continuity between parietal & visceral pleura
pleural sleeve
apex of lung goes _____ clavicle
above
which rib aligns with horizontal fissure
rib 4
oblique fissure spatial relationship with ribs
starts laterally at rib 4 -> descends to meet rib 6 at midclavicular line
anterior midclavicular base of b/l lungs is at what rib level
rib 6
anterior midclavicular pleural cavity b/l ends at what rib level
rib 8
what costal cartilage # does cardiac notch start at
costal cartilage 4
pleural cavity spaces are filled with _____
fluid
outer pleural cavity is composed of _____; inner pleural cavity is composed of _____
outer- parietal pleura
inner- visceral pleura
the 2 pleura that line inner & outer of pleural cavity are _____, & join to form _____
continuous
join to form each hilum
where is the costomediastinal recess
left side of thorax-
medial to lung (space for heart & mediastinum)
location of costodiaphragmatic recess
space between lung & diaphragm
the lungs _____ expand; _____ within the lungs draws air in
passively expand
negative pressure
pleural cavities expand by _____
action of the diaphragm & thoracic wall muscles
thorax is a _____ machine
negative pressure
what is a pneumothorax, & what can cause it
air inside pleural cavities but outside lungs
caused by perforation of lung or chest wall
what is a pleural effusion
fluid pooling in pleural cavities
what is a hemothorax
blood in pleural cavities
what is a chylothorax, & what causes it
lymph in pleural cavities
caused by torn thoracic duct
how much lymph does thoracic duct pass every 24 hrs
1 gallon lymph
what is a hydrothorax
serous fluid in pleural cavities
what is a pyothorax / empyema
pus in pleural cavities
what is primary procedure called to drain pleural cavities; & where is it done
thoracentesis
posterior 8, 9, 10 intercostal spaces
what is procedure called to drain pleural cavities when there’s TONS of fluid; & where is it done
tube thoracostomy
beneath axilla, 5 intercostal space
when doing either procedure to drain pleural cavities, where is best to enter in relation to ribs
ABOVE ribs to avoid intercostal V, A, N
contents of hilum listed in order of wall thickness
(thickest)
pulmonary bronchi
pulmonary a.
pulmonary v.
(thinnest)
what does RALS mean
RIGHT lung- pulmonary a. is ANTERIOR to bronchus
LEFT lung- pulmonary a. is SUPERIOR to bronchus
_____ is the inferior extension of the hilum
pulmonary ligament
tricuspid valve also called _____
right atrioventricular valve
aortic valve also called _____
aortic / left semilunar valve
pulmonary valve also called _____
pulmonary / right semilunar valve
mitral valve also called _____
bicuspid valve
left atrioventricular valve
foreign object inhaled will most likely follow what path
trachea
->
right main bronchus
->
bronchus intermedius
->
inferior lobar bronchus
->
inferior lobe of right lung
bronchial aa. branch from _____ on the left; from _____ on the right
thoracic aorta on the LEFT
3rd posterior intercostal a. on the RIGHT
right bronchial vv. drain to _____ -> then _____
right bronchial vv.
->
azygos v.
->
SVC
left bronchial vv. drain to _____ -> then _____ -> then _____
left bronchial vv.
->
hemi-azygous vv.
->
azygos v.
->
SVC
% of blood from bronchial aa. drained by bronchial vv.
13%
% of blood from bronchial aa. drained by pulmonary vv.
87%
peripheral diaphragmatic & costal parietal pleura are innervated by _____
intercostal nn.
central diaphragmatic & mediastinal parietal pleura are innervated by _____
phrenic n.
parietal pleura are _____ to painful stimuli
very sensitive
visceral pleura (& lungs) are _____ to painful stimuli
insensitive
visceral pleura & lungs are innervated by _____
visceral afferents from autonomic fibers
mediastinum boundaries
anterior- sternum
laterally- lungs
posterior- vertebral column
contents of superior mediastinum (anterior to posterior)
(That Bitch Carla ATE, she was superior)
(anterior)
-thymus
-brachiocephalic veins leading to SVC
-cardiac plexus & phrenic n.
-aortic arch
-trachea
-esophagus
(posterior)
contents & location of anterior mediastinum
between pericardium & sternum
-fatty tissue
-lymph nodes
-internal thoracic a. & v.
contents of middle mediastinum
-pericardial sac
-pericardium
-heart
-ascending aorta
-pulmonary trunk
location & contents of posterior mediastinum
posterior to tracheal bifurcation & pericardial sac
-descending thoracic aorta
-esophagus
-thoracic duct
-azygos vv.
where do the intercostal aa. in the 1st & 2nd intercostal spaces originate from
costo-cervical trunk
where do the intercostal aa. in the 3rd - 11th intercostal spaces originate from
aorta
movement of aorta as it descends through thorax
starts anterior, then wraps around on the left
-> ends up behind esophagus as they pass through diaphragm
how does the position of aorta & esophagus change as they go from thorax to abdomen
thorax: aorta on LEFT, esophagus on RIGHT
abdomen: aorta on RIGHT, esophagus on LEFT
azygos v. drains the _____
right thoracic wall
location of azygos v. in relation to esophagus
azygos v. is posterior to (behind) esophagus
hemiazygous vv. cross _____ to drain into _____
cross midline to drain into azygous v.
left thoracic wall is drained by _____ at what spinal level
the hemiazygous vv. system
T8
left superior intercostal v. spinal level
above T4
accessory hemiazygous v. spinal level
T4 - T8
hemiazygous v. spinal level
below T8
aortic hiatus spinal level
T12
what passes through aortic hiatus
aorta
azygos v.
thoracic duct
aortic hiatus is made out of what
lateral sides: right crus & left crus (diaphragmatic crura)
anterior: median arcuate ligament
Superior mediastinum location
Above sternal angle / T4
Inferior mediastinum location
Below sternal angle / T4
2 categories of mediastinum
Superior
Inferior
The categories of the inferior mediastinum
Anterior
Middle
Posterior
