Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anatomy MD3001 > Diaphragm > Flashcards

Diaphragm Flashcards

1
Q

What is the diaphragm?

A
  • Thin, musculotendinous
  • Muscular at its periphery, tendinous centrally
  • closes the inferior thoracic aperture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the shape of the diaphragm

A
  • Inverted J shape
  • Right hemidiaphragm is 1cm is higher than the left
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the position of the diaphragm in full expiration

A
  • R= 4th intercostal
  • L = 5th intercostal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the diaphragm attached to anteriorly?

A
  • Xiphoid process at vertebral level T8/T9
  • Deep surface of the last 6 ribs and costal cartilages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the diaphragm attached to posteriorly?

A

• Lumbar vertebrae and intervertebral discs between them

  • left crus = L1-L2
  • right crus = L1-L3

• Median arcuate ligament

  • forms the aortic hiatus
  • medial borders of the crura

• Medial arcuate ligament

  • body - transverse process of L1

• Lateral arcuate ligament

  • Transverse process of L1 - rib 12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the insertion of the diaphragm?

A

• Central tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What level is the central tendon?

A

Xiphosternal synchondrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a function of the central tendon

A
  • Fused to the pericardium
  • Halts the descent during forced inspiration
  • Further contraction of the diaphragmatic muscle pulls ribs 7-10 from the anchored central tendon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 openings of the diaphragm?

A
  • Caval opening
  • Oesophageal opening
  • Aortic hiatus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Caval opening

A
  • T8, through the central tendon
  • Inferior vena cava
  • Right phrenic nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oesophageal opening

A
  • T10 level, though the right crus (acts like a sphincter because of muscle fibres)
  • Oesophagus
  • Both vagus nerves
  • Left gastric vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Aortic hiatus

A
  • T12, behind the median arcuate ligament
  • Aorta • thoracic duct
  • Azygos
  • Hemiazygos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What passes through the crura

A
  • Branches of the left phrenic nerve
  • Splanchnic nerves
  • Azygos
  • Hemiazygos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What passes behind the medial arcuate ligament?

A

• Sympathetic trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the vascular supply to the superior surface of the diaphragm?

A
  • Superior phrenic artery (branch of the thoracic aorta)
  • Branches of musculophrenic arteries
  • Branches of pericardiacophrenic arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the vascular supply to the inferior surface of the diaphragm?

A

• Inferior phrenic artery - branch of the abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the motor supply to the diaphragm?

A
  • Phrenic nerve
  • C3, 4!, 5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the sensory supply to the diaphragm?

A
  • Phrenic: central tendon, parietal pleura and pericardium
  • Intercostal nerves: sensory from the periphery of the diaphragm (afferent)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where would you feel pain from the intercostal nerves?

A
  • Where it is on the side
  • Does not refer pain
20
Q

Describe the mechanism of inspiraiton

A
  • Contraction flattens the dome of the diaphragm
  • Dome descends
  • Vertical diameter increases
  • Volume of the thorax increases
  • Intrathoracic pressure decreases
  • Air is drawn into the lungs
21
Q

Describe the pump handle movement

A
  • Body of the rib passes obliquely downwards: the anterior end of the rib is usually lower than the posterior end
  • Contraction of the external intercostals raise the body of the rib to the one above
  • This also lifts the sternum and pushes it anteriorly
  • Increases sagittal diameter, increasing the volume of the thorax
22
Q

Describe the bucket handle movement

A
  • Only occurs in ribs 8-10 - flat costo transverse joints that allow gliding
  • Once the central diaphragm is anchored, further muscle contraction pulls on the ribs and causes them to evert like a bucket handle
23
Q

Accessory muscles

A
  • Pectoralis major and minor (inspiration)
  • Lastissimus dorsi (inspiration and expiration)
  • fixate and stabilise ribs

• Abdominal wall muscles (expiration)

24
Q

Which muscles help to fix the ribs?

A

Neck and back muscles:

  • Trapezius
  • Sternocleidomastoid
  • Scalene muscles
25
Q

Describe the boundaries of the pleura

A
  • Rises to the level of the 1st rib, 2cm above the clavicle
  • 2nd CC - lies adjacent to the midline
  • 4th CC - LEFT - cardiac notch
  • 6th CC deviates laterally
  • 8th rib - mid clavicular line
  • 10th rib: mid axillary line
  • T12: midline (just below 12th rib)
26
Q

Describe the boundaries of the lung

A

• Apex projects into the neck

  • curved line from the sternoclavicular joint to a point 2.5cm above the junction of the medial and intermediate thirds of the clavicle
  • 2nd CC: adjacent to the midline
  • 4th LCC: cardiac notch
  • 6th CC: deviates laterally
  • 6th rib: midclavicular line
  • 8th rib: mid axillary line
  • 10th rib: mid scapular line and mid line
27
Q

Pleural recesses

A
  • In quiet respiration, the lungs do not entirely fill the pleural cavities
  • This results in recesses which two layers of parietal pleura become opposed
  • Potential sites of accumulation of fluid from which they can be aspirated
28
Q

Why is the intapleural pressure more negative?

A
  • Surface tension between the parietal and visceral pleura pulls the visceral layer (and lung) with the movements of the thoracic wall
  • Elastic recoil of the lung tissue means the lungs are tending to deflate
  • This surface tension creates a slight negative pressure that maintains the lung in slight inflation even at the end of expiration
29
Q

What is the costodiaphragmatic recess?

A
  • Costophrenic recess
  • Narrow potential space between the periphery of the diaphragm and the ribs
30
Q

Surface anatomy of the oblique lung fissure

A
  • Curved line
  • Begins between spinous processes of T3 and T4
  • Crosses the mid axillary line at the 5th intercostal space
  • Then follows the contour of the 6th rib
31
Q

Surface anatomy of the horizontal lung fissure

A
  • Follows the 4th intercostal space from the sternum
  • Until it meets the oblique fissure as it crosses rib 5
32
Q

Where is the triangle of safety?

A
  • Anterior border of latissimus dorsi
  • Lateral border of pectoralis major muscle
  • Horizontal level of the nipple (5th intercostal space)
  • Apex below the axilla
  • Can be used for fluid or air just depends on if you put catheter up or down
33
Q

What is flail chest?

A
  • Trauma resulting in fracture of the ribs and the sternum would cause a segment to float freely
  • On inspiration, this segment would be sucked inwards instead of lifting upwards
  • Paradoxical respiration
34
Q

What is the black arrow?

A

Left Crus (L1-2)

35
Q

What is the blue

A

Median arcuate ligament (medial broders of the crura)

36
Q

What is the purple arrow?

A

Right Crus (L1-3)

37
Q

What is the green?

A

Medial arcuate ligament (from the body to the transverse process of L1)

38
Q

What is the red?

A

Lateral arcuate ligament

39
Q

What is the arrow pointing to?

A

Pericardium fused ot the central tendon

40
Q

What is the green arrow?

A

Caval opening (T8, throught the central tendon)

  • Inferior vena cava
  • Right phrenic nerve
41
Q

What is the red arrow

A

Oesophageal opening

  • At T10 level thorugh the right crus
  • Oesophagus
  • Both vagus nerves
  • Left gastric vessels
42
Q

What is the black arrow?

A

Aortic hiatus

  • Aorta
  • Thoracic duct
  • Azygos
  • hemiazygos
43
Q

What is the green arrow?

A

Inferior phrenic artery - branch of the abdominal aorta

44
Q

What is represented by the blue?

A

Phrenic nerve afferent supply

45
Q

What is represented by the red?

A

Phrenic nerve efferent supply

46
Q

What is the green?

A

Intercostal nerves - sensory

47
Q

What is the blue arrow

A

Costomediastinal recess

Anatomy MD3001 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions