Lecture 11: Thoracic Wall & Lungs Flashcards

1
Q

Superficial to deep layers of the thorax

A
  1. Skin
  2. Superficial Fasica
  3. Muscles of upper limb
  4. Intercostal muscles
  5. Endothoracic Fasica
  6. Parietal pleura
  7. Thoracic cavity
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2
Q

Describe the transversus thoracic

A

Same “depth” as the innermost intercostals BUT is found on the anterior thoracic wall

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3
Q

Where do you find the transversus thoracis (I/O)

A

Sternum to 2nd-6th costal cartilages

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4
Q

What is the innervation of the thoracic wall?

A

Anterior rami of T1-T11 intercostal nerves

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5
Q

What is another name for the subcostal nerve?

A

T12

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6
Q

T/F: T12 innervates the thoracic wall

A

False - This is the subcostal nerve and it innervated the abdominal wall

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7
Q

What do you find in the intercostal space?

A

Intercostal VAN

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8
Q

The _______ branches of the intercostal vessels run in the costal groove, while the ________ branches run superior to the rib.

A

Main; collateral

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9
Q

Intercostal vessels supply blood to the…

A

thoracic wall

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10
Q

There are _____ anterior intercostal vessels

A

9

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11
Q

There are ____ posterior intercostal vessels

A

11

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12
Q

The anterior and posterior intercostal vessels do what?

A

Anastomose - form a vessel ‘arc’

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13
Q

Where do anterior and posterior intercostal vessels originate?

A

Aorta - descending aorta

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14
Q

Internal thoracic arteries are branches of ____________

A

subclavian artery

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15
Q

Where do you find internal thoracic arteries?

A

Along lateral side of sternum

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16
Q

What are the branches of the internal thoracic artery?

A

Anterior intercostal arteries (1st 6)
Musculophrenic artery (7th-9th anterior intercostal)
Superior epigastric artery (continuation of internal thoracic)

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17
Q

Superior epigastric artery anastomoses with…

A

Inferior epigastric artery

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18
Q

Posterior intercostal arteries

A

1 and 2 from supreme intercostal artery

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19
Q

Where do the branches of posterior intercostal arteries 3-11 come from?

A

Descending thoracic aorta

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20
Q

What are the veins of the thoracic wall?

A

Anterior intercostal veins –> internal thoracic vein

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21
Q

Posterior intercostal veins - describe them

A

Right: Azygos
Left: Hemiazygos

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22
Q

What are the boundaries of the thorax?

A

Superior thoracic aperture
diaphragm
sternum/costal cartilages
Thoracic vertebral bodies

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23
Q

What is the thorax divided into?

A

Central mediastinum and lateral pleural cavities

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24
Q

T/F: The lungs are in the mediastinum

A

False

25
Q

The thoracic diaphragm is the boundary between…

A

Thorax and abodmen

26
Q

T/F The diaphragm is only tendionus

A

F: Muscular and tendinous components

27
Q

What is the primary muscle of respiration

A

Diaphragm

28
Q

Label each of the following

A
  1. Central Tendon
  2. Aortic Opening (T12)
  3. Esophageal opening
  4. Caval opening (T8)

“I8 10 Eggs @ 12”

29
Q

What is the innervation of the thoracic diaphragm?

A

L/R Phrenic Nerves (C3-5)

30
Q

What is happening during inspiration?

A

Thoracic cavity is expanding
Vertical dimensions: diaphragm
Lateral dimensions: ribs
Anterior to posterior: sternum

31
Q

What is happening during expiration?

A

Thoracic cavity is compressing
Vertical dimensions: diaphragm
Lateral dimensions: ribs
Anterior to posterior: sternum

32
Q

__________ is a serous “sac” with 2 continuous membranes

A

Pleura

33
Q

Describe the parietal pleura

A

Lines the thoracic wall

34
Q

Describe the visceral pleura

A

Covers the lung

35
Q

What is the space between the parietal and visceral pleura

A

Pleural cavity

36
Q

Why is there serous fluid in the pleural cavity?

A

Lubrication and friction reduction

37
Q

Describe a pleural effusion

A

When there is too much fluid in the lung and it makes it hard to breathe

38
Q

If you have to remove fluid or pus from the thoracic cavity, where would you stick the needle – just superior to the rib or just inferior? Why?

A

Superior rib - it is better to hit collateral rather than main intercostal NAV
“Collateral damage”

39
Q

Describe a Thoracocentesis

A

Draining fluid from pleural cavity (the space)

40
Q

What is the blood supply to the parietal pleura

A

Same as thoracic wall

41
Q

What is the innervation to the parietal pleura

A

Thoracic wall

42
Q

What is the blood supply to the visceral pleura

A

Same as lungs [pulmonary and bronchial vessels]

43
Q

What is the innervation to the visceral pleura

A

Same as lungs [ANS]

44
Q

Describe the right lung

A

3 lobes (S, M, I)
2 Fissures (Horizontal, Oblique)

45
Q

Describe the left lung

A

2 Lobes (S, I)
1 Fissrue (Oblique)

46
Q

What is the lingula?

A

A structure in the L lung that is homologous to middle lobe of R lung

47
Q

What are the surfaces of the lungs?

A

Costal
Diaphragmatic
Mediastinal
Costodiaphragmatic Recess
Costomediastinal Recess

48
Q

Where does fluid start to collect in the lungs?

A

Costodiaphragmatic recess
Costomediastinal recess

49
Q

What is the conducting portion of respiratory system made up of?

A

Larger tubes + passageways
Transports respiratory gases
NO GAS EXCHANGE HERE

50
Q

Describe the respiratory portion of the respiratory system

A

Where gas exchange happens
Smallest tubes and air sacs (alveoli)

51
Q

What is the order of teh conducting portion of the respiratory system

A

Trachea
L/R Main Bronchi
Lobar Bronchi
Segmental Bronchi
Bronchi
Bronchioles
Terminal Bronchioles

52
Q

Describe the trachea

A

Connects to Larynx superiorly
Travels from the neck to the thorax
Splits into L/R primary bronchi

53
Q

What cartilage is found in the trachea

A

C-shaped hyaline cartilage

54
Q

Where do you find irregular plates of cartilage in the respiratory system?

A

L/R Primary Bronchi

55
Q

If you accidentally inhale something, which primary bronchus would you expect it to go in to?

A

Right is more likely (3 lobes, increased diameter, straight down)

56
Q

Where do you find cartilage plates in the conducting portion of the respiratory system?

A

Secondary (lobar) bronchi

57
Q

What supplies one bronchopulmonary segment of the lung

A

Tertiary (segmental) bronchi

58
Q

What are Bronchopulmonary segments

A

Supplied by a single tertiary bronchus, artery and vein, lymphatic vessels and nerves
Each is surrounded by CT and is a division of a lung lobe

59
Q

Why are bronchopulmonary segments important?

A

Each segment has its own “thing”, i.e. segments can be removed due to pathology.