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Medicine year 1 semester 2 > Case 6- lung anatomy > Flashcards

Case 6- lung anatomy Flashcards

1
Q

What is in the thoracic cage

A

Thoracic vertebra, sternum, ribs and costal cartilage

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2
Q

What is the thoracic wall

A

Contains the bone structures of the thoracic cage as well as muscle, connective tissue and neurovascular structures.

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3
Q

Sternum

A

Split into the Manubrium, sternal body and xiphoid process (T9/T10).

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4
Q

Location of suprasternal (jugular) notch

A

T2

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5
Q

Location of sternal angle

A

T4/T5 also where the second rib is

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6
Q

Location of ribs

A

The thoracic vertebra are between T1-T12
True ribs T1-7
False ribs T8-10
The floating ribs are T11-12

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7
Q

Difference between true and false ribs

A

The true ribs have cartilage which directly attaches to the sternum. The false ribs attach to the sternum via the costal cartilage of the rib above

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8
Q

Costal cartilage

A

Connects the ribs to the sternum anteriorly

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9
Q

How the thoracic vertebra are split from top to bottom

A
  • 7 cervical vertebra- neck
  • 12 thoracic vertebra- thorax
  • 5 Lumbar vertebra- abdomen
  • The Sacrum and then the Coccyx- around the pelvis and hip bone
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10
Q

Body of vertebra

A

Bares the weight, is where the vertebra articulate, have the interverbal disk above and below it

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11
Q

Vertebra- neural arch

A

The vertebra is split into the body and the neural arch. The neural arch contains the pedicle, the Lamina, the spinous process and the transverse process.

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12
Q

Vertebra- vertebral foramen

A

Between the body and the neural arch, transports the spinal cord

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13
Q

Vertebra- superior and inferior articular processes

A

Facet articulates with adjacent superior and inferior vertebra. How the different vertebra connect with each other

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14
Q

Superior and inferior demifacet

A

Where the vertebra articulates with the superior and inferior facet on the head of the rib

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15
Q

Atypical ribs

A

Ribs 1, 2, 10, 11 and 12. Atypical shape and articulates with its own vertebra only

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16
Q

Typical rib

A

Curved shaft with both anterior and posterior parts. They will have a head, neck and tubercle. It articulates with their own vertebra and the one above, so rib 4 would articulate with T4 and T3.

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17
Q

Anatomy of typical rib

A
  • Head- articular facets which connect with the vertebra bodies. Contains both the superior and inferior facets, the inferior connects with its own vertebrae and the superior connects to the rib above.
  • Neck- contains the tubercle facet which articulates with the transverse process
  • Angle- where the rib curves.
  • Costal groove- a depression in the rib which transports the neurovascular bundle.
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18
Q

Costovertebral joint

A

Head of a typical rib articulates between its own thoracic vertebra and the one above

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19
Q

Costotransverse joint

A

Head of typical rib articulates between its own thoracic vertebra and the one above. The inferior facet of the head of the rib articulated with the superior demi-facet of the body of the same vertebra. The superior facet of the head of the rib articulates with the inferior facet of the above vertebra.

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20
Q

Costotransverse joint

A

Articulation of rib tubercle with the costal facet on the transverse process of the corresponding vertebra

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21
Q

Manubiosternal joint

A

Between the manubrium and the sternal body. It is a symphysis joint.

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22
Q

Xiphisternal joint

A

Between the sternal body and the Xiphoid process. It is a synchondrosis joint

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23
Q

Sternocostal joints

A

Between the costal cartilage and the sternum.

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24
Q

The Costochondrial joint

A

Between the ribs and the cartilage

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25
Q

The interchondrial joints

A

Between the different joints of the cartilage

26
Q

How do the joints help in respiration

A

Allow changes in thoracic volume so are useful in inspiration and expiration. They allow for the bucket handle and pump handle movement

27
Q

Cartilaginous joints

A

When structures are attached by cartilage. The two types:
• Primary cartilaginous joints (synchondrosis) – Connected by hyaline cartilage.
• Secondary cartilaginous joints (symphysis) – Connected by fibrocartilage.

28
Q

Synovial joints

A

Between structures that aren’t directly joined but are surrounded by a joint capsule that contains synovial fluid

29
Q

Openings in the thoracic wall

A

There are two openings of the thoracic wall: the superior and inferior thoracic apertures

30
Q

Muscle in the intercostal space

A

The intercostal space is the space between the ribs, there are 11 intercostal spaces. The muscles in the interoctsal space are the external, internal and innermost intercostal muscle. The intercostal muscles keep the intercostal space (ICS) rigid and prevent the spaces being blown out during expiration or in during inspiration. They provide structure to the thoracic wall and have a role in respiration.

31
Q

The neurovascular bundle in the intercostal space

A

The neurovascular bundle is between the inner intercostal muscle and the innermost intercostal muscle. The main part of the vein, artery and nerve travels in the costal groove, the collateral branch sits inferiorly in the intercostal space. Superiorly to inferiorly it goes vein, artery and nerve.

32
Q

Spinal nerve

A

The nerve supply to the thoracic wall and parietal pleura is from the anterior division of the spinal nerves T1-T11. Each spinal nerve gives rise to a intercostal nerve and collateral branch.

33
Q

Intercostal nerve

A

It is an extension of the ventral rami of segmental nerves leaving the spinal cord at the thoracic vertebral levels. Between the inner and innnermost intercostal muscle. The collateral parts travel across the inferior parts of the intercostal space. The lateral and anterior cutaneous branch provides sensation to the skin of the thoracic wall and the parietal pleura and the muscles of the thoracic wall.

34
Q

Blood supply of the thoracic wall

A

Through intercostal arteries which are in the neurovascular bundle. The posterior intercostal artery comes of the thoracic aorta, the anterior intercostal artery comes of the internal thoracic artery. These arteries anastome, meaning they fuse together and form a continuous blood supply around the thoracic wall. Though the blood supply looks continuous they are two separate vessels

35
Q

Blood supply to the first and second posterior intercostal space

A

The subclavian artery gives of the costocervical trunk which then gives off the posterior intercostal artery.

36
Q

Blood supply to the majority of the posterior intercostal space

A

Branches of the thoracic aorta (3-11)

37
Q

Blood supply to the anterior intercostal arteries

A

Internal thoracic artery (1-6) which is a branch of the subclavian artery. The musculophrenic artery (7-9) is a branch of the internal thoracic which runs around the costal margin. Ribs 11-12 are floating ribs so dont have anterior arteries

38
Q

Azygos vein- intercostal space

A

Comes from the ascending lumbar veins which have drained the posterior abdominal wall. The 4-11th right posterior intercostal veins drain into here

39
Q

Accessory hemiazygos vein

A

Drains into the Azygos vein. The 4th-7th left posterior intercostal veins drain into the accessory hemiazygos.

40
Q

Hemiazygos vein

A

Comes from the ascending lumbar veins then drains into the Azygos vein. The 8-11th left posterior intercostal veins drain into the Hemiazygos vein

41
Q

What drains the first intercostal space

A

The supreme intercostal vein which drains into the vertebral or brachiocephalic vein

42
Q

What drains the 2nd and 3rd intercostal space

A

Drains into the intercostal veins, on the right it drains into the Azygos vein and on the left it drains into the Brachiocephalic

43
Q

Where do the anterior intercostal veins drain into

A

The internal thoracic and musculophrenic vein following the arterial supply

44
Q

The diaphragm

A

Separates the thorax from the abdomen and allows for structures to move between them. It increases intrabdominal pressure to expel vomit, faeces and urine

45
Q

What’s the diaphragm made of

A

It is made of skeletal muscle, 60% of which is slow-twitch fibres which have are resistant to fatigue and has a lot of endurance. The skeletal muscle has a higher oxidative capacity and larger blood-flow than limb muscles so it can work continuously.

46
Q

Diaphragm- central tendon

A

Where the fibrous pericardium attaches to the diaphragm

47
Q

Diaphragm attachments

A

The inferior attachments of the diaphragm are: the costal margin, posterior abdominal wall and lumbar vertebra. It attaches to the xiphoid process of the sternum, the costal cartilages of ribs 7-10, ribs 11 and 12, and the lumbar vertebrae. The attachments are the right crus (L1-3) and the left crus (L1-2) and the 4 arcuate ligaments: Median (travels over the aorta), Medial (passes over the psoas major) and Lateral (travels over the quadratus lumborum muscle of the posterior abdominal wall). The left and right crus are the posterior attachments

48
Q

The caval hiatus

A

At T8 where the inferior vena cava and the terminal bronchus of the right phrenic nerve travel from the abdomen into the thorax

49
Q

Oesophageal hiatus

A

At T10, the oesophagus and right and left vagus nerve travel through this hiatus to the abdomen

50
Q

Aortic hiatus

A

At T12. Where the descending aorta travels into the abdomen becoming the abdominal aorta. The thoracic duct and the azygos vein travel from the abdomen to the thorax through the aortic hiatus also.

51
Q

Diaphragm nerve supply

A

The phrenic nerves supply the diaphragm and are from the spinal routes C3, C4 and C5

52
Q

The intercostal muscles

A

Within the intercostal space. The muscles run in different directions, the external muscles run medially and down, the internal and innermost intercostal muscles run medially and up.

53
Q

Subcostalis muscle

A

Attach to the posterior ribs

54
Q

Transversus thoracic muscle

A

Attach to the anterior ribs

55
Q

The innermost muscle layer

A

Consists of the innermost intercostal muscles, the subcostalis muscle and the transversus thoracis. They are the accessory muscles of expiration. They are primarily responsible for changing the volume of the thoracic cavity during respiration along with the diaphragm.

56
Q

What is different about interchondrial muscles

A

The interchondrial part of the internal intercostal muscles have the same role as the external intercostal muscles.

57
Q

The abdominal wall muscles

A

• External oblique muscle
• Internal oblique
• Transverse abdominus
• Rectus abdominus- the only layer posteriorly
The muscles are from the outside in. They are accessory muscles which may be used in recovery from strenuous exercise or in individuals with respiratory disorders

58
Q

Sternocleidomastoid muscle

A

Attaches to the sternum and the clavicle, when it contracts it elevates them increasing the thoracic volume

59
Q

Scalene muscles

A

In the back of the neck attached to ribs 1 and 2. They contract to elevate the ribs and increase the thoracic volume

60
Q

Pectoralis minor and major

A

Attach to the superior ribs, contract to elevate them

61
Q

Serratus anterior

A

On each side of the ribs, elevate them

62
Q

Quadratus lumborum

A

A muscle of expiration and inspiration, it attaches to the lower ribs and depresses them when they contract. It stabilises the diaphragm so it has more force on inspiration

Medicine year 1 semester 2 (61 decks)

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