Brainscape's Knowledge GenomeTM

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


See full index

Y2S1 RESP. > Diaphragm, mechanism of breathing and surface anatomy > Flashcards

Diaphragm, mechanism of breathing and surface anatomy Flashcards

1
Q

what is the diaphragm

A

Musculotendinous dome that separates the thoracic cavity from the abdominal cavity
Pale blue position centrally which represents the tendinous part
Muscular fibres peripherally

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

what are the anterior attachments of the diaphragm

A

Anteriorly attachment to the xiphisternum and costal cartilages of ribs

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

why is the right hemidiaphragm higher than the left

A

due to the position of the liver

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

wha lies between the two crura

A

Median arcuate ligament which attaches to L1

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

what are crura and where are they

A

Posteriorly two crura which are musculotendinous slips arise from the diaphragm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where is the right crus

A

attach to bodies and intervertebral disks of L1-L3

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

where is the left crus

A

attach to bodies and

intervertebral disks of L1-2

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

Lateral accurate ligament

A

attaches to rib 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Caval opening

A

at level of T8

allows the passage of the IVC and the right phrenic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aortic Hiatus

A

at the level of T12

allows the passage of the descending aorta, the thoracic duct and the azygous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oesophageal opening

A

at the level of T10

allows the passage of the oesophagus and the posterior and anterior vagal trunks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The IVC

A

pierces the tendinous part of the diaphragm. As the diaphragm moves it helps ‘push’ blood to return to the heart.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The oesophagus

A

The oesophagus passes through a muscular slip in the diaphragm. (this does not form a true sphincter hence the risk of reflux of gastric acid from the stomach causing ‘heartburn’)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

the aorta

A

lies behind the diaphragm with the right and left crus either side (the thoracic duct is also visible passing through at T12 )

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

The phrenic nerves

A

C3,4,5) provide motor and sensory innervation to the central portion of diaphragm (also sensation to fibrous and parietal pericardium and mediastinal pleura)

pass between the venous and arterial planes in the superior mediastinum then descend ANTERIOR to the lung root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Right phrenic nerve

A

passes through the diaphragm with the IVC

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

The left phrenic nerve

A

pierces the diaphragm but does not pass through it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Peripherally the diaphragm has sensory innervation from the

A

intercostal and subcostal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

the internal thoracic arteries

A

run in the thoracic cavity on either side of the sternum. The internal thoracic arteries are branches of the 2nd part of the subclavian arteries.

20
Q

Two inferior phrenic arteries

A

are direct branches of the abdominal aorta and supply the diaphragm inferiorly

21
Q

The thoracic aorta

A

gives off superior phrenic arteries

22
Q

The internal thoracic arteries

A

give off a pericardiophrenic artery which supplies the diaphragm.
They also give off
musculophrenic arteries

23
Q

Referred pain

A

Inflammation of the gallbladder (cholecystitis) may irritate the central tendon of the diaphragm. This area has sensory innervation from the phrenic nerve (C3,4,5) so visceral pain can be referred to the right shoulder which is the dermatome of C4

24
Q

During expiration the diaphragm

A

is raised therefore reducing the volume of the thoracic cavity

25
Q

During inspiration the diaphragm

A

flattens. This increases the volume in the thoracic cavity

26
Q

Boyle’s law states

A

that the pressure exerted by a gas is inversely proportional to the volume it occupies. By increasing volume in the thoracic cavity the pressure is reduced relative to atmospheric pressure so air flows into the lungs

27
Q

Damage to the phrenic

A

As the volume of the thoracic cavity increases during inspiration the pressure in the abdominal cavity increases and causes the right hemidiaphragm to elevate.

Damage may occur following cardiac surgery or due to invasion of the phrenic nerve by a lung tumour

therefore the right hemi diaphragm is raised

28
Q

external intercostal muscles

A

pass infero-medially in the intercostal space (replaced by aponeurosis anteriorly)
ibres of the external intercostal muscles passing infero-medially. When these fibres contract both the ribs and sternum will be elevated.

raise the ribs and sternum. This increases the antero- posterior diameter if the
thoracic cavity. (the movement of the sternum is referred to as pump handle movement

Contraction of external intercostal muscles raise the ribs and increase the lateral diameter of the thoracic cavity. (the movement of the ribs is likened to the
movement up and down of a bucket handle)

29
Q

What muscles are involved in quiet respiration?

A

inspiration:
Diaphragm – main muscle of respiration. Descends and flattens
External intercostal muscles – elevate ribs

expiration:
Relaxation of diaphragm and external intercostals provide elastic recoil.

30
Q

What muscles are involved in forced respiration?

A

inspiration:
Diaphragm – can descend up to 10cm
External intercostal muscles
Accessory muscles of respiration i.e.
trapezius, scalenes and sternocleidomastoid help elevate the upper portion of the rib cage
Nasalis – flares the nostrils to increase volume of inspired air

expiration:
Relaxation of diaphragm and external intercostal muscles.
Internal intercostal muscles – contract to help reduce intra-thoracic volume
Muscles of abdominal wall – contraction increases intraabdominal pressure and therefore intrathoracic pressure

31
Q

Accessory muscles of respiration

A

Trapezius, scalenus anterior and sternocleidomastoid

32
Q

Visceral pleura

A

lines the lungs

33
Q

Parietal pleura

A

lines the rib cage

34
Q

Role of the pleura

A

1) Reduce friction to
allow movement of lungs
2) Intrapleural pressure - negative relative to atmospheric pressure to prevent collapse of lungs

35
Q

the costodiaphragmatic

A

recess (also called the costophrenic recess) two layers of parietal pleura oppose each other creating a potential space

36
Q

Horizontal fissure

A

starting at the costal cartilage of rib 4 anteriorly and ending by meeting the oblique fissure.

37
Q

Oblique fissures

A

can be drawn from T4 vertebrae posteriorly to rib 6 anteriorly

38
Q

Pneumothorax definition and risk factors

A 
air in the thorax
Between the visceral and parietal layers of pleura causing compression of the lung tissue 
- tall 
- male 
- smoker 
- underlying lung disease COPD/asthma

Dyspnoea
Pleuritic chest pain

39
Q

Haemothorax

A

blood between the visceral and parietal layers of pleura

40
Q

Chylothorax

A

chyle (lymph) between the visceral and parietal layers of pleura

41
Q

what is a tension pneumothorax

A

MEDICAL EMERGENCY
Air gets trapped between the parietal and visceral pleura however due to a valve like effect air can enter the pleural space but can not leave! There is increasingly positive intrapleural pressure
- Trachea and mediastinum is shifted away from the side of the pneumothorax due to increasingly positive intrapleural pressure
- Due to this increased intrapleural pressure venous return to the heart is impaired and hypotension can develop. This can lead to cardiac arrest

42
Q

how do you decompress a tension pneumothorax

A

Insert a cannula on the side of the pneumothorax, 2nd intercostal space midclavicular line.

43
Q

chest drain

A 
• Large pneumothorax
• Tension pneumothorax
• Haemothorax – often traumatic 
• Large pleural effusion
Aims to enable removal of fluid/air from intrapleural space.
44
Q

what makes up the safe triangle

A
  • base of the axilla
  • lateral edge of lat dorsi
  • lateral edge of pec major
  • 5th intercostal space
45
Q

why is the safe triangle not exactly safe

A
  • False passage
  • Damage to long thoracic nerve
  • Haemothorax due to damage to intercostal arteries • Liver/spleen injury

Y2S1 RESP. (38 decks)

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