Lecture 3 RH

Question 1

Where is the pectoralis minor muscle located?

Answer 1

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

Question 2

What is the function of the serratus anterior?

Answer 2

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

Question 3

How do superficial muscles influence the thoracic cavity?

Answer 3

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

Question 4

What does seratus posterior do?

Answer 4

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.

Question 5

How is smooth muscle arranged in the lungs?

Answer 5

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

Question 6

At what point do the main bronchi bifurcate?

Answer 6

T4/5

Question 7

What is the plane of louie?

Answer 7

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

Question 8

What are the main differences between the main bronchi?

Answer 8

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

Question 9

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

Answer 9

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

Question 10

How many lobar bronchi do people have?

Answer 10

3 lobar bronchi in the right lung.

2 lobar bronchi in the left lung.

Question 11

Why are lobar bronchi called lobar bronchi?

Answer 11

Each one enters into a separate lobe.

Question 12

Where do the main bronchi divide into lobar bronchi?

Answer 12

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

Left main bronchus enters the hilum before bifurcating.

Question 13

What is the stage of branching after the lobar bronchi?

Answer 13

segmental bronchi 9-10 segments approx.

Question 14

What are bronchioles?

Answer 14

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.

Question 15

What happens during asthma?

Answer 15

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.

Question 16

Where is the cardiac notch located?

Answer 16

The cardiac notch is present on the left lung.

Question 17

What does the left lung look like?

Answer 17

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

Question 18

Where are the lungs’ apexes located?

Answer 18

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

Question 19

What is the function of the pulmonary blood blood supply?

Answer 19

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

Question 20

Where in the hilum are pulmonary arteries located?

Answer 20

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

Question 21

Where in the hilum are pulmonary veins located?

Answer 21

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

Question 22

What is the other system that supplies the lungs?

Answer 22

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

Question 23

How are the non-respiratory tissue drained by veins?

Answer 23

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.

Question 24

What are bronchopulmonary segments?

Answer 24

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

Question 25

What is the pulmonary ligament and what does it do?

Answer 25

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

Question 26

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

Answer 26

Pulmonary artery

Pulmonary vein anteriorly

Pulmonary vein inferiorly

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

Bronchial arteries

hilar/bronchopulmonary lymph nodes

Question 27

What nerve runs anteriorly to the hilum of the lung?

Answer 27

Phrenic nerve

Question 28

What structure runs posteriorly to the hilum of the lung?

Answer 28

Vagus nerve

Question 29

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

Answer 29

Anteriorly to the hilum

Question 30

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

Answer 30

Right lung has a shallow cardiac impression.

Left lung has a deeper cardiac impression.

Question 31

Where does the parasympathetic innervation of the lung come from?

Answer 31

Parasympathetic innervation of lung comes from vagus nerve.

Question 32

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

Answer 32

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

Question 33

Where does the sympathetic innervation of the lungs come from?

Answer 33

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.

Question 34

What are the anterior and posterior pulmonary plexuses?

Answer 34

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

Question 35

Where is the lungs’ referred pain?

Answer 35

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

Question 36

How do lymphatics drain the lungs?

Answer 36

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

Question 37

What causes presence of black spots in lungs?

Answer 37

black spots on lungs are due to carbon deposits

Question 38

How is parietal pleura of the lung named?

Answer 38

Parietal pleura is named based on the structure it lines

Question 39

How are the parietal and visceral pleura connected?

Answer 39

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

Question 40

Why do viscera often have double membranes?

Answer 40

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)

Question 41

What nerves innervate pleura?

Answer 41

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

Question 42

How are visceral and parietal pleura held together?

Answer 42

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