lower resp tract Flashcards
بسم الله الرحمن الرحيم توكلنا عليك يا سميع الدعاء
مزايا الفقرات الصدرية ؟
costal facets
transvers process articular facets except 11 12
anterior surface of bodies are connected bt ?
anterior lonigtudinal ligament
The posterior surfaces are
connected by the posterior
longitudinal ligament.
Articular processes: are
articulated by
joints.
plane synovial
: are connected
by the ligamentum
flavum.
Laminae
Spines: are connected
by
and their tips by
interspinous ligaments
supraspinous ligaments.
are connected by
intertransverse ligaments.
Transverse processes:
The intervertebral discs (IVD) o They are ,,,,, cartilaginous joints and are designed for weight bearing and strength. o The discs provide
secondary
strong attachments between vertebral bodies but permit movements between vertebrae.
Each IVD consists of
an outer fibrous part (annulus fibrosus) and a gelatinous central part (nucleus pulposus).
Typical ribs from ?
3rd to 9th
the neck of 1st rib structers passes anteriot to it ?
The symphathtic chain with stallate ganglion
superior intercostal artery
Ventral ramus of first thoracic nerve
sclaneus anteriro related two to grooves explain “
The anterior subvlavian vein
the posterior
subclavain artery
lower trunkl of the the brachial pleux
The manubriosternal joint: o It is a ,,,, cartilaginous joint between the manubrium and the body of the sternum. o A small amount of angular movement is possible during respiration.
secondary
The xiphisternal joint: o It is a ,,,,,, cartilaginous joint between the xiphoid process and the body of the sternum. o The xiphoid process usually fuses with the body of the sternum during middle age.
secondary
▪ Costochondral joints (joints of the ribs and costal cartilages): o These joints are ,,,,joints. o No movement normally occurs at these joints.
cartilaginous
Sternocostal Joints o The first costal cartilages articulate with the manubrium, by ,,,,,,,,,,,,,,,,,,,,, cartilaginous joints that permit. No movement. o The 2nd to the 7th costal cartilages articulate with the lateral border of the sternum by ,,,,,,,,,,,,,,
primary
synovial
joints.
Interchondral joints o The 6 th , 7 th , 8 th , 9 th , and 10th costal cartilages articulate with one another along their borders by ??????????????
small synovial
joints.
Joints of the heads of the ribs o The head of each rib from the 2nd to the 9th ribs, articulates by means of a ,,,,,,,,,,,,, with the costal facet of the corresponding vertebral body and that of the vertebra above it (e.g. the head of the 6 th rib articulates with the superior part of the body of T6 , the inferior part of T5, and the intervertebral disc between these vertebrae).
synovial joint
The 1
st rib and the 10th
,
11th, and 12th ribs
have a
single synovial joint with
their corresponding
vertebral body.
There is a strong intraarticular ligament that
connects the head to the
intervertebral disc.
The tubercle of a rib articulates by means of a ,,,,,,,,,,,,,,,,, process of the corresponding vertebra. o This joint is absent on the 11th b and 12th ribs.
synovial joint with the
transverse
Costotransverse ligament:
passing from
the neck of the
rib to the transverse process.
Superior costotransverse
ligament: is a broad band that
joins
the crest of the neck of
the rib to the transverse
process superior to it.
Rotation movement occurs around a ..................that traverses the head and neck of the ........and this result in elevation and depression movements of the sternal ends of the ribs and the sternum causing the ............movement.
transverse axis
upper 6 ribs
pump-handle
............movement of the ......................... result in elevation and depression of the lateralmost portions of these ribs in the transverse plane causing the..............
Gliding
joints of the 7th-10th ribs
bucket-handle movement.
قسم لي عضلات الجدار الصدري ؟
عضلات رابطة للضلوع عضلات رابطة الضلوع بالقص transversus thoracics sternocostalis عضلات رابطة الضلوع الفقرات عضلات فاصلة التجويفين البطني والصدري
قسم لي عضلات الجدار الصدري ؟
عضلات رابطة للضلوع عضلات رابطة الضلوع بالقص transversus thoracics sternocostalis عضلات رابطة الضلوع الفقرات عضلات فاصلة التجويفين البطني والصدري
External intercostal muscles ?
From Tubercle of the rib to the costochondral junction
then replaced by anterior external membrane aponeurosis
down ward forward
Internal intercostal muscles
from the sternum to angle of rib
the replaced by posterior membran aponeurosis
from the floor of costal groove of one rib to the upper border of the next
downward backward
The innermost intercostals related
internally
externally
كذلك
subcostales
internally endothorcaic facia and parital plerua
externally to the intercostal vessels and nervce
subcostales muscles ?
muscles crossing 2 or 3 muscles below its attachment
directed downeard backward as internal and inner most
اللهم نعوذ بك من الهم والحزن والعجز والكسل والجبن والبخل وغلبة الدين وقهر الرجال
وشماتة الأعداء والمرض والحسد والسحر و الحياء وإلف النعمة
sternocostalis
sternum to 2-6 th costal carilage arise in internal thorax
upward and laterally
اسميها ؟ العضلة المجنحة
typical intercostal nerves ?
T3-T6
Forced Inspiration
The scapulae are fixed by the ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
which enable the ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, to pull up the ribs
trapezius,
levator scapulae and rhomboid muscles
serratus anterior and
pectoralis minor
Quadratus lumborum fixes the 12th rib so
that ?
the diaphragm can exert a more
powerful downward push on the abdominal
viscera.
Forced expiration:
It is an active process during
which the muscles of?
anterior abdominal wall and
latissimus dorsi contract
INTENAL INTERCOSTALS
Branches of the typical intercostal nerve ?
Rami communicantes white grey Musclar plerual sensory Lateral cutanuous branch anteroir cutanuous branch
T1 intercostal nerve divides into ?>
large branch > ascends across the neck of first rib to join brachial pleux
small branch > contiunes as the first intercostal nerve in 1st intercostal space ending as anterior intercostal nerve
T12 nerve is atypical ?
Its lateral cutanuous branch known as intercostobrachial nerve which supply
the floor of axilla
upper part of medial side of arm
anterior intercostal muscles ?
the upper 6 from the internal thoracic
the 789 from the musclophrenic
ends at the cosochondral junction by anastomsoing with the posterior intercosals and their collaterals
branches of the post intercostal arteries
Dorsal collateral muscular lateral cutanuous mammary right bronchial
Internal thoracic origin ? .
first part of subclavian art 1
Branches of internal thoracic artery ?
ANterior intercostals first 6 Musclophernic superior epigastric Pericaridphrenic perforating
posterior intercostal veins on the left side?
First in left brachicephalic
2,3 in the left superior intercostal vein into the left brachiocephalic
4th to 8th Accessory azygous T7
9-11 hemiazygous T8
POSTRIO INTERCOSTAL VEIN
right side ?
first in right brachiceohalic
2 3 in the right superior intercostal into the azygous
4-11 into the azygous
Major opeinig of diapharagm
VOICE OF ARAB
Vena cava openining T8
vena caca + right phrenic + lymph vessels
Oseophageal opening: T10
Osophgus
left gastric vessels branchess
gastric nerves
Aortic opeining>? T12 Aorta Aztgous Thoracic duct
Hemiazygos vein: pierces the ……….. of diaphragm to
enter the thoracic cavity.
left crus
- Behind the lateral arcuate ligament
Subcostal vessels and nerve.
Quadratus lumborum muscle
Behind the medial arcuate ligament:
- Sympathetic trunk
2. Psoas major muscle.
Nerve supply of The diaphragm:
- Motor supply:
right and left phrenic nerves (C 3, 4, 5 mainly C4). These nerves pierce the
diaphragm to supply it from its inferior surface. - Sensory supply:
branches from phrenic and lower intercostal nerves.
ARTERIAL SUPPLY OF DIAPHARAGM >?
Infreior phrenic
pericardiophernic
Muscolphrenic
posterio intercosta twigs
decnding thorcaci aorta twigs
ARTERIAL SUPPLY OF DIAPHARAGM >?
Infreior phrenic
pericardiophernic
Muscolphrenic
posterio intercosta twigs
decnding thorcaci aorta twigs
In forced inspiration:
• Scalenus anterior and medius elevate the first rib.
• Sternocleidomastoid acts directly through the manubrium
sterni and indirectly through the clavicle.
• The scapulae are fixed by the trapezius, levator scapulae and
rhomboid muscles which enable the serratus anterior and
pectoralis minor to pull up the ribs.
• Quadratus lumborum fixes the 12th rib so that the diaphragm
can exert a more powerful downward push on the abdominal
viscera.
Pleural Recesses ?
spaces where two layers of parietal plerua are oppossing each other
Costodiaphargmatic
Costomediastinal
clincal imp is plerual effusion
Nerve supply of the pleura ?
Parital sensitive to heat and pain are Phrenic, interrocstal nerves
aretrial > intercostal arterirs
visercal plerua “ senosry fibers not sensory to heat or pain but stretch
Autonimoc from Pulmonary pleux sympathatic and Vagus
Bronchial arteris from the desending thoracic aorta
lung and pleua
Mid clavicular
mid axillary
midscapular
lung 6 8 10 ribs
pleura 8 10 12 ribs
Crervical plerua
crossed anterioly by subclavian artery
posteriorly by the structure passing in front of the first rib
Stellate ganglion
Superior intercostal artery
Ventral ramus of first intercostal nerve
______________________________________
covered by supra pleral membrane or sibssons fascia
sibson’s fascia attacments
Laterally inner aspect of first rib
medially the trensverse process of 7th cervical rib
costal plerua separeted from muscle thoracic wall by ?
Endothoracic Fascia
nerve supply of parital pleura?
Costal and peripheral diapharagmatic > Intercostal nerves
Mediastinal and Central diapharagmatic> phrenic nerve
parital pleura aretrial supply ?
Intercostal
internal thoracic
Musclophrenic
الحب الحب في الله والكره الكره في الله ! !
لعن الله حبا أضل كثيرا من الناس
Relations of medial surface of the right lung
infront of hilum :
Pericardial impression
SVC Contiunuous with groove of the right brachiocephalic vein
IVC
behind the hilum
Osephagus
azygous
above the hilum
arch of the azygous
above the crossing of the arch of azygous and SVC right vagus and trachea and Osephagus
area for asending aorta and remenant of thymus and right phrenic nerve
تجنب طريقة العليم @@ ما دخلت المشاعر علي كلام إلا و أفهمته أصحاب الجنون
Relations of medial surface of the left lung
Infront of the hilum
Pericardial impressions for left ventricle and left auricle and Infindubulum of right ventricle.
beind the hiulm ?
osephagus
descending aorta contiuous with groove for arch of aorta
above the hilum
groove for the arch of aorta
with contiuation of 2 grooves above it
anterior for left common carotid
posterior for subclavian artery
above the groove of arch and behind the subclavian groove there is ?
Oseohpagus,thoracic duct , left reuccretn laryngeal nerve
infront of the aortic arch above the pericardial impression ?
Pulmnarry trunk and remenants of thymus
▪ Bronchus:
➢Lies in the ,,,,,,,,part of the hilum.
➢It can be identified by the presence of cartilagenous rings in its wall.
➢The,,,,,,,,,,,,,, bronchus divides before entering into the lung into upper
branch (eparterial bronchus) and lower branch (hyparterial
bronchus).
➢The bronchus divides after entering into the lung, so only a single
bronchus is present in the hilum.
posterior
right
left
▪ Bronchus:
➢Lies in the ,,,,,,,,part of the hilum.
➢It can be identified by the presence of cartilagenous rings in its wall.
➢The,,,,,,,,,,,,,, bronchus divides before entering into the lung into upper
branch (eparterial bronchus) and lower branch (hyparterial
bronchus).
➢The bronchus divides after entering into the lung, so only a single
bronchus is present in the hilum.
posterior
right
left
▪ Bronchus:
➢Lies in the ,,,,,,,,part of the hilum.
➢It can be identified by the presence of cartilagenous rings in its wall.
➢The,,,,,,,,,,,,,, bronchus divides before entering into the lung into upper
branch (eparterial bronchus) and lower branch (hyparterial
bronchus).
➢The bronchus divides after entering into the lung, so only a single
bronchus is present in the hilum.
posterior
right
left
▪ Bronchus:
➢Lies in the ,,,,,,,,part of the hilum.
➢It can be identified by the presence of cartilagenous rings in its wall.
➢The,,,,,,,,,,,,,, bronchus divides before entering into the lung into upper
branch (eparterial bronchus) and lower branch (hyparterial
bronchus).
➢The bronchus divides after entering into the lung, so only a single
bronchus is present in the hilum.
posterior
right
left
▪ Bronchus:
➢Lies in the ,,,,,,,,part of the hilum.
➢It can be identified by the presence of cartilagenous rings in its wall.
➢The,,,,,,,,,,,,,, bronchus divides before entering into the lung into upper
branch (eparterial bronchus) and lower branch (hyparterial
bronchus).
➢The bronchus divides after entering into the lung, so only a single
bronchus is present in the hilum.
posterior
right
left
▪ Bronchus:
➢Lies in the ,,,,,,,,part of the hilum.
➢It can be identified by the presence of cartilagenous rings in its wall.
➢The,,,,,,,,,,,,,, bronchus divides before entering into the lung into upper
branch (eparterial bronchus) and lower branch (hyparterial
bronchus).
➢The bronchus divides after entering into the lung, so only a single
bronchus is present in the hilum.
posterior
right
left
The…………………………………… is the most inferior structure in the
hilum.
inferior pulmonary vein
The ,,,,,,,,,,,,,,,,,,pulmonary vein is more anterior and at a lower
level than the bronchus and the pulmonary artery.
superior
Bronchial arteries?
2 in the left from the descending aorta
1 in the rigth from
_________________________________________________
1- the posterior intercostal artery of the right 3rd intercostal space
or
2-the left superior bronchial artery
__________________________________________________
Pulmnary autonmoic pleux ?
Anterior and posterior to the hilum
Symp (2nd-5th): sympathatic ganglia Para from : vagus bronchial tree lung substane visceral plerua
أوكلما اشتهيت اشتريت؟؟؟؟
Pulmnary autonmoic pleux ?
Anterior and posterior to the hilum
Symp (2nd-5th): sympathatic ganglia Para from : vagus bronchial tree lung substane visceral plerua
أوكلما اشتهيت اشتريت؟؟؟؟
Pulmnary autonmoic pleux ?
Anterior and posterior to the hilum
Symp (2nd-5th): sympathatic ganglia Para from : vagus bronchial tree lung substane visceral plerua
أوكلما اشتهيت اشتريت؟؟؟؟
Bronchi pulmonary segments?
Segmental bronchi
Segmental artery
Interaegmental veins
Anatomical functional and surgical unit of the lung
Oblique fissure and also horizintal
Oblique fissure
3rd thoracic spine laterally downward to the 6th costochondral junction
The horizontal below 4th costal cartilage horizontal laterally to join the oblique fissure
