Lecture 3 RH Flashcards

1
Q

Where is the pectoralis minor muscle located?

A

pectoralis minor is deep to pec major and attaches to coracoid process and inserts onto the 3rd to 5th ribs

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2
Q

What is the function of the serratus anterior?

A

ribs 1 - 8 and attaches to medial border of the scapula and protracts it for extra reach.

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3
Q

How do superficial muscles influence the thoracic cavity?

A

Superficial muscles can add a pull onto the thoracic cage allowing it to expand.

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4
Q

What does seratus posterior do?

A

Serratus posterior have different groups of muscles with different attachments.

superior part attaches to spinous processes of C7 - T3 from the angle of the ribs 2 - 5 and act to elevate ribs.

Inferior part attaches to spinous processes of T11 - L2 from the angle of ribs 9 - 12. This part acts to depress the ribs.

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5
Q

How is smooth muscle arranged in the lungs?

A

Cartilaginous disk of bronchi is U-shaped and contains smooth muscle posteriorly. This muscle is called trachealis.

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6
Q

At what point do the main bronchi bifurcate?

A

T4/5

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7
Q

What is the plane of louie?

A

The point at which the manubrium meets the sternum. This occurs at the same point that the main bronchi bifurcate. (T4/5)

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8
Q

What are the main differences between the main bronchi?

A

The right main bronchus is shorter wider and more vertical than the left main bronchus.

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9
Q

What is the clinical significance of the arrangement of the main bronchi?

A

Obstruction tends to occur at the right main bronchus rather than the left.

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10
Q

How many lobar bronchi do people have?

A

3 lobar bronchi in the right lung.

2 lobar bronchi in the left lung.

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11
Q

Why are lobar bronchi called lobar bronchi?

A

Each one enters into a separate lobe.

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12
Q

Where do the main bronchi divide into lobar bronchi?

A

right main bronchus divides into lobar bronchi before reaching the hilum of the lungs.

Left main bronchus enters the hilum before bifurcating.

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13
Q

What is the stage of branching after the lobar bronchi?

A

segmental bronchi 9-10 segments approx.

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14
Q

What are bronchioles?

A

at a point the lungs lose cartilaginous support and at this point the airways change names from bronchi to bronchioles. Bronchioles connect to alveoli directly.

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15
Q

What happens during asthma?

A

athma is caused by spasm of smooth muscle in airways due to lack of cartilaginous support in the bronchioles. This is triggered by many factors.

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16
Q

Where is the cardiac notch located?

A

The cardiac notch is present on the left lung.

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17
Q

What does the left lung look like?

A

Left lung has 2 lobes a superior one and an inferior one separated by a horizontal fissure.

18
Q

Where are the lungs’ apexes located?

A

lung’s apex is located just above the 1st rib and is slightly exposed.

19
Q

What is the function of the pulmonary blood blood supply?

A

pulmonary blood supply is the system that is involved in gas exchange

20
Q

Where in the hilum are pulmonary arteries located?

A

Pulmonary arteries enter hilum of the lung at a superior and posterior position relative to the hilum.

21
Q

Where in the hilum are pulmonary veins located?

A

Pulmonary veins are located inferiorly and anteriorly relative to the hilum.

22
Q

What is the other system that supplies the lungs?

A

Bronchial supply for the lung parenchyma and the tissue of the lung (including bronchi and bronchioles and tissue between alveoli.

23
Q

How are the non-respiratory tissue drained by veins?

A

venous drainage of parenchyma or non-respiratory parts of the lung occurs via bronchial veins which drain into the hemiazygous veins which further drain into the azygous veins.

24
Q

What are bronchopulmonary segments?

A

broncho-pulmonary segments are segments of lungs that can function independently.

25
Q

What is the pulmonary ligament and what does it do?

A

The pulmonary ligament extends below the hilum and through it runs the inferior pulmonary vein.

26
Q

What structures are present in the hilum of the right lung?

A

Pulmonary artery

Pulmonary vein anteriorly

Pulmonary vein inferiorly

2 Lobar bronchi Posteriorly (bifurcation occurs before entering the lung)

Bronchial arteries

hilar/bronchopulmonary lymph nodes

27
Q

What nerve runs anteriorly to the hilum of the lung?

A

Phrenic nerve

28
Q

What structure runs posteriorly to the hilum of the lung?

A

Vagus nerve

29
Q

Where does the superior vena cava run relative to the right lung?

A

Anteriorly to the hilum

30
Q

What kind of impressions does the heart leave in the lungs?

A

Right lung has a shallow cardiac impression.

Left lung has a deeper cardiac impression.

31
Q

Where does the parasympathetic innervation of the lung come from?

A

Parasympathetic innervation of lung comes from vagus nerve.

32
Q

What is the path of the vagus nerve from the trachea to the lung?

A

Vagus nerve runs on the left running over the arch of the aorta behind the hilum (left main bronchus) and then gives off branches to the bronchi which gives signal to constrict the bronchi

33
Q

Where does the sympathetic innervation of the lungs come from?

A

Sympathetic origin at T1 - T4 and are synapses of pre and post ganglionic sympathetic neurons which run to the bifurcation of the main bronchi and into the lungs.

34
Q

What are the anterior and posterior pulmonary plexuses?

A

Anterior and Posterior pulmonary plexuses. Run behind and in front of bifurcation. These plexuses follow the bronchi into the lungs.

35
Q

Where is the lungs’ referred pain?

A

Visceral afferents from the lungs go to T1 - T4 cause referred pain at those dermatomes.

36
Q

How do lymphatics drain the lungs?

A

lymphatics that drain the parenchyma drain through the hilar lymph nodes into the bronchomediastinal trunks.

37
Q

What causes presence of black spots in lungs?

A

black spots on lungs are due to carbon deposits

38
Q

How is parietal pleura of the lung named?

A

Parietal pleura is named based on the structure it lines

39
Q

How are the parietal and visceral pleura connected?

A

At the hilum the parietal pleura is continuous with the visceral pleura and the sleeve formed is known as the pulmonary ligament.

40
Q

Why do viscera often have double membranes?

A

During embryonic development the membrane folds in to form viscera and this viscera grows within the other membrane to form a double membrane and a mesentery (or hilum)

41
Q

What nerves innervate pleura?

A

Parietal pleura are innervated from the somatic nerves located on adjacent tissue. Whereas visceral pleura get the nerve supply of the viscera.

42
Q

How are visceral and parietal pleura held together?

A

Surface tension holds the parietal and visceral pleura together. Any puncture between pleura can cause a lung collapse. This is known as pneumothorax.