Lecture 35 - Diaphragm and accessory muscles/pleurae/lungs Flashcards
3 portions of the diaphragm
costal portion, sternal portion, vertebral portion
the main vertebral attachments are formed by the
left and right diaphragmatic crus
the right crus is __ and arises from __
long, L4
the left crus is __ and arises from __
short, L3
attachments from vertebral body of L2 and transverse process of L1
medial arcuate ligaments (psoas major)
attachments from transverse process of L1 to the 12th rib
lateral arcuate ligaments (quadrates lumborum)
the right hemidiaphragm reaches as high as the
4th interspace
the left hemidiaphragm reaches as high as the
5th rib
3 openings that pierce the diaphragm
aortic hiatus, esophageal hiatus, caval hiatus
opening formed by the right crus as it arches to meet the left crus (at 12th thoracic vertebral level)
aortic hiatus
opening formed by the muscle fibers of the right crus as they recur around the esophagus (10th thoracic vertebral level)
esophageal hiatus
perforation through the diaphragm lying in the right portion of the central tendon (between 8th and 9th thoracic vertebral levels)
caval hiatus
occurs through the esophageal hiatus
hiatal hernia
the diaphragm is innervated bilaterally by the
phrenic nerves (C3-5)
the phrenic nerve lies
on the belly of the anterior scalene
inspiration is an ___ process and requires ___ of muscles
active, contraction
quiet expiration is a ___ process and requires ___ of muscles along with ___ of lung tissue
passive, relaxation, recoil
created by the mucous membranes of the airways in the lungs, plays an important role in expiration, causes a partial collapse
surface tension
shiny serous layer, which tightly adheres to the lungs
visceral pleura
fibrous connective tissue layer that is attached to the bony thorax and diaphragm, and lies next to the fibrous layer of the pericardium
parietal pleura
4 parts of the parietal pleura
costal pleura (contact w/ thoracic wall), diaphragmatic pleura (contact w/ diaphragm), cervical pleura (apex of lungs), mediastinal pleura (inside lungs where heart lies)
the area between the visceral and parietal pleural layers that is formed by the pleural membrane as they reflect upon themselves
pleural space
the extension of the pleural space into the area formed between the posterior body wall and the posterior dome of the diaphragm
costodiaphragmatic recess
the fluid that accumulates in the pleural space and settles into the costodiaphragmatic recess
pleural effusion
the superior aspect of each lung is called the
apex
the inferior aspect of each lung is called the
base
part of the lung where vessels and airways enter
hilum (root)
the left lung has __ lobes and a ___
2, lingula
the right lung has __ bronchopulmonary segments and the left lung has __
10, 8
represent subdivisions of the pulmonary lobes
bronchopulmonary segments
the right bronchial artery arises from the
right 3rd posterior intercostal artery
the superior left bronchial artery arises from the
aortic arch
the inferior left bronchial artery arises from the
thoracic aorta
what lies in the pleural space
nothing! it’s a potential space
boundaries of parietal pleura
2 rib spaces below the lung base (midclavicular line, lung base ends at 6th rib so parietal pleura ends at 8th rib) *different ribs at the different lines
which hilum is hypoarterial (below pulmonary a)
left
which hilum is epiarterial (above and around pulmonary a)
right
“keel-like” projection of the last trachial ring up to the lumen of the trachea
carina
used as a landmark for visualizing the branching from the trachea of the two mainstem bronchi during fiber optic bronchoscopy
carina
characteristics of mainstream bronchi
the bifurcation creates a 62 degree angle, the left is longer/horizontal/smaller diameter; right is shorter/vertical/larger diameter
bronchial veins empty into
superior vena cava
they run with bronchial arteries
the right mainstream bronchi has ___ lobar bronchi and the left has ___ lobar bronchi
3, 2
the lobar bronchi divide into the
segmental bronchi
the right lung has __ segmental bronchi and __ on the left
10, 8 (one for each bronchopulmonary segment)
the segmental bronchi subdivide into __
20-25 subsegmental bronchi
the last sub segmental bronchus divides into the
bronchioles
the bronchioles have no
cartilage
bronchioles terminate in the
alveoli
the alveoli are surrounded by ______, thus creating an _______
pulmonary capillaries, alveolar-capillary membrane
what occurs at the alveoli
exchange of respiratory gasses (O2 and CO2)
derived from 3rd posterior intercostal artery, follows the right mainstream bronchis and its branches to the lung
the right bronchial artery
comes from descending portion of aortic arch; follow left mainstream bronchus and its branches to the left lung
the 2 left bronchial arteries
venous blood is returned via the
right/left bronchial veins to the azygous vein and accessory hemiazygous vein
left lung upper lobe bronchopulmonary segment names
anterior, apico-posterior
left lung lingula bronchopulmonary segment names
superior, inferior
left lung lower lobe bronchopulmonary segment names
superior, posterior basal, lateral basal, antero-medial basal
right lung upper lobe bronchopulmonary segment names
apical, anterior, posterior
right lung middle lobe bronchopulmonary segment names
medial, lateral
right lung lower lobe bronchopulmonary segment names
superior, medial & lateral basal, anterior & posterior basal