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Anatomy > Diaphragm and Pleurae > Flashcards

Diaphragm and Pleurae Flashcards

1
Q

what is the thoracic cavity divided into

A

the mediastinum and left and right pleural cavities

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2
Q

what is the mediastinum

A

a movable median partition of the thoracic cavity that extends superiorly to the thoracic outlet/root of the neck and inferiorly to the diaphragm. extends anteriorly to the sternum and posteriorly to the vertebral bodies

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3
Q

what is the diaphragm

A

skeletal muscle lined by pleura superiorly and peritoneum inferiorly that separates the thoracic and abdominal viscera

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4
Q

where is the superior mediastinum

A

bounded anteriorly by the manubrium and posteriorly by vertebral bodies of T1-T4

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5
Q

where is the inferior mediastinum

A

bounded anteriorly by the body of the sternum and posteriorly by the vertebral bodies of the lower 8 thoracic vertebrae

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6
Q

what makes up the inferior mediastinum

A

anterior, middle, and posterior mediastinum

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7
Q

what divides the superior mediastinum and the inferior mediastinum

A

an imaginary planed that runs from the sternal angle to the T4 vertebrae

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8
Q

what is the anterior mediastinum

A

space between the pericardium and the sternum

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9
Q

what is in the middle mediastinum

A

pericardium and the heart

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10
Q

where is the posterior mediastinum

A

between the pericardium and the vertebral column

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11
Q

what runs through the diaphragm

A

IVC, esophagus, and aorta

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12
Q

describe the shape of the diaphragm

A

dome shaped (convex superiorly) and consists of a peripheral muscular part which arises from the lateral walls of the thorax and a centrally placed tendon

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13
Q

what is the most important muscle in respiration

A

the diaphragm

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14
Q

what are crura

A

musculotendinous bands of the diaphragm that arise from the anterior surface of L1-L3 and the anterior longitudinal ligament

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15
Q

describe the differences between the right and left crus

A

the right crus is larger and longer and is from L1-L3/L4
the left crus is from L1-L2/L3

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16
Q

what does the median arcuate ligament do

A

unites the crura and forms the aortic hiatus

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17
Q

what is the medial arcuate ligament

A

thickening of fascia (psoas major)

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18
Q

what is the lateral arcuate ligament

A

thickening of fascia (quadratus lumborum)

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19
Q

where are the diaphragmatic apertures

A
  • IVC @ T8
  • Esophogeal hiatus @ T10
  • Aortic hiatus @ T12
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20
Q

what is the nemonic to remember the diaphragmatic apertures

A

i ate ten eggs at noon

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21
Q

what are small openings in the diaphragm for

A

sympathetic splanchnic nerves, sympathetic trunk and superior epigastric vessels

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22
Q

what is the diaphragm innervated by and where

A

mainly the phrenic nerve (C3-5). peripheral parts of diaphragm receive some sensory innervation from lower intercostal nerves

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23
Q

what is the innervation type of the phrenic nerve in the diaphragm

A
  • somatic motor (C3-5)
  • sensory (pain and proprioception)
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24
Q

what happens to the diaphragm during inhalation

A

it flattens and contracts and moves down

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25
Q

what happens to the diaphragm during exhalation

A

diaphragm relaxes and moves up

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26
Q

what is the arterial supply to the diaphragm’s superior surface

A

musculophrenic and pericardiacophrenic and superior phrenic

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27
Q

what part of the diaphragm does the pericardiacophrenic supply and what does it branch from

A

supplies the middle of the diaphragm and branches from the internal thoracic artery

28
Q

what is the arterial supply to the diaphragm’s inferior surface

A

inferior phrenic

29
Q

where does the superior phrenic branch from

A

thoracic aorta

30
Q

what is the venous drainage of the diaphragm’s superior surface

A

musculophrenic and pericardiacophrenic and right superior phrenic

31
Q

what do musculophrenic and pericardiacophrenic veins drain into

A

the internal thoracic vein

32
Q

what does the right superior phrenic vein drain into

A

inferior vena cava

33
Q

where do veins from the posterior curvature of the diaphragm drain into

A

azygous and hemiazygous veins

34
Q

what is the venous drainage of the diaphragm’s inferior surface

A

right inferior phrenic and left inferior phrenic

35
Q

what are pleura or pleural membranes

A

serous membranes forming closed sacs in the lining of the thoracic cavity

36
Q

what are the two layers of the pleura

A

visceral pleura and parietal pleura

37
Q

where is the visceral pleura

A

adheres to lung, continuous with parietal pleura at root of lung

38
Q

where is the parietal pleura

A

lines the thoracic cavity

39
Q

what is the cupula of the lung

A

the apex of the lung that extends out above 1st rib

40
Q

what does the pleural cavity contain and what is its function

A

a small amount of serous pleural fluid that lubricated pleural surfaces and allows layers to slide smoothly over one another during respiration

41
Q

what is a pleural reflection

A

transitional part when moving from one type of parietal pleura to another type

42
Q

what are pleural recesses

A

places where parietal pleurae appose each other because the lungs do not completely fill the pleural cavity

43
Q

what are the types of pleural recesses

A

-costodiaphragmatic
- costomediastinal

44
Q

what is the costodiaphragmatic pleural recess

A

slit like space between costal and diaphragmatic pleurae along the inferior border of the lung which enters through it in deep inspiration

45
Q

what is the costomediastinal pleural recess

A

slit like space between costal and mediastinal pleurae along the anterior border of the lung which enters into it in deep inspiration

46
Q

what is a thoracentesis

A

a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall

47
Q

what is the purpose of a thoracentesis

A

to remove excess fluid, known as pleural effusion from the pleural space to help you breathe easier

48
Q

where is a thoracentesis done and why

A

between rib 8 and 9 but most commonly above rib 8 because the costodiaphragmatic pleural recess is there and you will avoid vessels and nerves above the rib

49
Q

what is empyema

A

pus in the pleural space

50
Q

what is hemothorax

A

blood in the pleural space

51
Q

what is a pneumothorax

A

air in the pleural space

52
Q

what can a pneumothorax be caused by

A

blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease, or occur for no reason,
- punctured or collapsed lung

53
Q

what are the symptoms of a pneumothorax

A

sudden chest pain and shortness of breath

54
Q

what is the treatment for a pneumothorax

A

inserting a flexible tube or needle between the ribs to remove excess air, small ones may heal on their own

55
Q

what is the arterial blood supply to the visceral pleura

A

from the branches of the bronchial and pulmonary arterial systems

56
Q

where do bronchial arteries branch off

A

thoracic/descending aorta

57
Q

where do the veins of the visceral pleura drain into

A

azygous/hemiazygous veins and some to the pulmonary vein

58
Q

how many bronchial arteries supply each lung

A

1-2

59
Q

where do bronchial arteries supply blood and what kind of blood

A

supply oxygenated blood to the nonrespiratory tissues of the lung and visceral pleura

60
Q

where do bronchial arteries anastomose

A

between the capillaries of the bronchial and pulmonary systems

61
Q

where do bronchial veins drain into

A

azygos or hemiazygos depending on side

62
Q

what is the arterial supply to the sections of the parietal pleura

A

-cervical pleura: intercostal vessels
- costal pleura: intercostal vessels
- diaphragmatic pleura: intercostal vessels (periphery) and pericardiacophrenic vessels (central tendon)
- mediastinal pleura: pericardiacophrenic vessels

63
Q

describe the venous drainage of the parietal pleura

A

venous drainage would be the companion veins of the arterial supply

64
Q

what is the nerve supply in the visceral pleura

A

no nerve supply

65
Q

what is the nerve supply to the sections of the parietal pleura

A

identical to vascular supply
-cervical pleura: intercostal nerves
- costal pleura: intercostal nerves
- diaphragmatic pleura: intercostal nerves (around edges) and phrenic nerves (central tendon)
- mediastinal pleura: phrenic nerves

Anatomy (27 decks)

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