Diaphragm and Pleurae Flashcards

1
Q

What is the mediastinum?

A

Moveable median partition of the thoracic cavity that extends superiorly to thoracic outlet of the neck and inferiorly to the diaphragm

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2
Q

What are the borders of the diaphragm?

A

Skeletal muscles lined by pleura superiorly and peritoneum inferiorly

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3
Q

Borders of superior mediastinum

A

anterior by manubrium and posterior by vertebral bodies T1-T4

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4
Q

Borders of inferior mediastinum

A

anterior by body of sternum and posterior of vertebral bodies of lower 8 thoracic vertebrae

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5
Q

divisions of inferior mediastinum

A

anterior mediastinum- space between pericardium and sternum
middle mediastinum- pericardium and heart
posterior mediastinum- between pericardium and vertebral column

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6
Q

most important muscle for breathing

A

diaphragm

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7
Q

Right crus length

A

L1-L3/4

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8
Q

Left crus length

A

L1-L2/3

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9
Q

median acruate ligament

A

unite the crura and forms the aortic hiatus

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10
Q

Lateral acruate ligament

A

thickening of fascia (quadratus lumborum)

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11
Q

medial acruate ligament

A

thickening of fascia (psoas major)

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12
Q

Inferior caval hiatus level

A

T8

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13
Q

Esophageal hiatus level

A

T10

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14
Q

Aortic hiatus level

A

T12

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15
Q

innervation of diaphragm

A

phrenic nerve
-somatic motor
-sensory (pain and proprioception)
peripheral parts
-lower intercostal nerves (peripheral sides)

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16
Q

Where does diaphragm move during inhalation?

A

down

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17
Q

where does diaphragm move during exhalation?

A

up

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18
Q

Arterial supply of diaphragm

A

superior surface
-musculophrenic
-pericardiacophrenic (br ITA)
-superior phrenic (br thoracic aorta)

inferior surface
-inferior phrenic (br abdominal aorta)

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19
Q

Venous drainage of diaphragm

A

Superior surface
-musculophrenic
-pericardiacophrenic (drain into ITV)
-Right superior phrenic (IVC)
-some veins from posterior curvature drain into azygos and hemiazygos veins

inferior surface
-right inferior phrenic (IVC)
left inferior phrenic (IVC of left suprarenal vein)

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20
Q

Pleura of thoracic cavity

A

visceral pleura
-adhere to lung

parietal pleura
-line thoracic cavity

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21
Q

What is the pleural cavity?

A

potential space between the visceral and parietal pleura
-fluid between to decrease surface area
-allow the layers to slide over one another during respiration

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22
Q

Why do the lungs not fill up the entire pleural cavity?

A

-allow for some swelling to occur
-do not put too much pressure on the heart
-allow for fluid extraction without hitting the lungs

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23
Q

costodiaphragmatic recess

A

slit-like space between costal and diaphragmatic pleurae, along the inferior border of the lungs
*entered into during deep inspiration

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24
Q

costomediastinal recess

A

slit-like space between costal and mediastinal pleurae, along the anterior border of the lung
*entered into during deep inspiration

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25
Q

Thoracentesis

A

procedure to try and remove fluid from the pleural cavity
needle inserted into the pleural space b/w lungs and chest wall

26
Q

pleural effusion

A

presence of fluid in the pleural space

27
Q

Empyema

A

pus in the pleural space

28
Q

hemothorax

A

blood in the pleural space

29
Q

Pneumothorax

A

damage of the lung that causes air to enter the pleural cavity
-causes pressure to decrease in the lung and cause collapse
-treatment is a chest tube

30
Q

Blood supply to visceral pleura

A

Arterial supply
-branches of bronchial and pulmonary arterial systems

Venous drainage
-azygos/hemiazygos veins and some pulmonary veins

31
Q

Characteristics of bronchial arteries

A

-arise in thoracic arota
-1-2 for each lung
-supply oxygenated blood to nonrespiratory tissue of the lung and visceral pleura
-anastomoses occur between the capillaries of bronchial and pulmonary system

32
Q

Bronchial veins

A

-carry about 13% of bronchial venous blood to systemic venous circuit
-the 87% left drains to pulmonary venous circuit desaturating from 100 to 99%

33
Q

Blood supply of cervical pleura

A

intercostal vessels

34
Q

Blood supply of costal pleura

A

intercostal vessels

35
Q

Blood supply of diaphragmatic pleura

A

intercostal vessels (periphery) and pericardiacophrenic vessels (central tendon)

36
Q

Blood supply of mediastinal pleura

A

pericardiacophrenic vessels

37
Q

venous drainage of parietal pleura

A

to the companion veins of the arterial supply

38
Q

nerve supply to visceral pleura

A

autonomic pulmonary plexus

39
Q

nerve supply to cervical pleura

A

intercostal nerves

40
Q

nerve supply to costal pleura

A

intercostal nerves

41
Q

nerve supply to diaphragmatic pleura

A

intercostal nerves and phrenic nerves (central tendon)

42
Q

nerve supply to mediastinal pleura

A

phrenic nerves

43
Q

If there is a mass in the lungs, what do thoracic surgeons biopsy?

A

lymph nodes

44
Q

what is inside the anterior mediastinum?

A

space between the pericardium and the sternum

45
Q

What is included in the middle mediastinum?

A

pericardium and the heart

46
Q

What is included in the posterior mediastinum?

A

between the pericardium and the vertebral column

47
Q

When the diaphragm contracts it moves…

A

inferiorly

48
Q

When the diaphragm relaxes it moves…

A

superiorly

49
Q

When the diaphragm moves inferiorly, what happens?

A

the pressure in the thoracic cavity drops and allows for the lungs to fill with air

50
Q

Where does the aorta run in the thoracic cavity? (compared to vertebral column)

A

right in front of the vertebral column

51
Q

Referred pain from the diaphragm can be felt in…

A

the shoulder/trapezius area

52
Q

Where does the pericardiacophrenic artery branch from? (supply the superior surface of diaphragm)

A

internal thoracic artery

53
Q

Where does the inferior phrenic artery branch from? (supply the inferior surface of diaphragm)

A

abdominal aorta

54
Q

What do serous membrane secrete?

A

fluid

55
Q

What does the fluid in the pleural cavity allow?

A

sliding of the lung tissue
-also creates surface tension so the lungs stay open

56
Q

What allows the lung to expand out during inhalation?

A

the surface tension between the pleura and the lung

57
Q

what is the green section?

A

superior mediastinum

58
Q

what is the yellow section?

A

middle mediastinum

59
Q

what is the blue section?

A

posterior mediastinum

60
Q

what is the purple section?

A

anterior mediastinum

61
Q

which crus of the diaphragm is larger and longer?

A

right crus

62
Q

“I ate 10 eggs at noon”

A

I- IVC
ate- T8
10- T10
eggs- esophagus
at- aortic hiatus
noon- T12