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Anatomy Exam 1 > Lungs and Diaphragm > Flashcards

Lungs and Diaphragm Flashcards

1
Q

Thoracic cavity

A

Region enclosed by the thoracic wall

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2
Q

Pleurae

A

Serous sacs surround the lungs

Visceral pleura lines lung

Parietal pleura lines walls of thoracic cavity

Visceral and parietal pleurae are continuous with each other

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3
Q

Visceral pleura

A

Lines surface of the lung

Closely adherent to the lungs and extends into lung fissures

Has visceral sensory innervation

Does NOT have somatic sensory (pain, temperature, touch) innervation

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4
Q

Parietal pleura

A

Lines walls of the thoracic cavity

Does HAVE somatic sensory (pain, temperature, touch) innervation by intercostal nerves and phrenic nerves

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5
Q

Pleuritis

A

Inflammation of the pleura

Can lead to adhesion of visceral and parietal layers, resulting in acute pain association with elevated activity

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6
Q

Pleural cavity

A

Potential space between the visceral and parietal pleurae

Normally contains only a thin layer of serous fluid, which acts as a lubricant, facilitating movement of lungs during respiration

Right and left pleural cavities are independent

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7
Q

Hydrothroax

A

Accumulation of fluid in pleural cavity

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8
Q

Pneumothorax

A

Accumulation of air in pleural cavity

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9
Q

Hemothorax

A

Accumulation of blood in pleural cavity

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10
Q

Costodiaphragmatic recess

A

With inspiration, lungs expand and recess decreases in area

With expiration, recesses enlarge again

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11
Q

Thoracentesis

A

Procedure to drain excess fluid or blood from pleural cavity

Following an intercostal nerve block, a needle is inserted into an intercostal space (avoiding the inferior border of the rib above and superior border of the rib below)

Good place to perform thoracentesis is the posterior aspect of 7-9 intercostal space. Needle will enter costodiaphragmatic recess, avoiding injury to lungs and abdominal organs

However, other locations can be targeted depending on the effusion

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12
Q

Lungs

A

Organ of respiration - function is to oxygenate blood

Pink color darkens over time with exposure to particulates in air

Due to elasticity, if thoracic wall is breached (knife, GSW, etc), the lung will shrink to 1/3 of its normal size (as result of a pneumothorax)

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13
Q

Anatomy of lung

A

Root - collection of structures entering and exiting the lung (pulmonary vessels and bronchi)

Apex - superior portion extending into the neck

Base - concave inferior portion adjacent to diaphragm

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14
Q

Right lung

A

3 lobes - superior, inferior, and middle

Horizontal fissure separates superior and middle

Oblique fissure separates inferior

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15
Q

Left lung

A

2 lobes - superior and inferior

Oblique fissure separates

Superior lobe has cardiac notch on anterior margin

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16
Q

Organization of trachea and bronchi

A

Trachea
Right and left main bronchi
Lobar bronchi
Segmental bronchi

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17
Q

Trachea

A

Inferior to larynx

Palpable at jugular notch due to cartilaginous rings

C shaped hyaline cartilages (open posteriorly because esophagus is there and will expand when eating)

Bifurcates at sternal angle (T4 / T5 level)

Carina - ridge of cartilage at the bifurcation

18
Q

Right and left main bronchi

A

Extrapulmonary (outside the lungs)

Also supported by C shaped rings of cartilage

Right main bronchus is wider, shorter, and more vertical than left

Therefore, aspirated foreign objects are more likely to lodge in the right bronchus

19
Q

Lobar bronchi

A

Each main bronchus divides into lobar bronchi

Intrapulmonary (within the lungs)

Right lung has 3 lobar bronchi

Left lung as 2 lobar bronchi

20
Q

Segmental bronchi

A

Each lobar bronchi divides into segmental bronchi, which each correspond to specific bronchopulmonary segment

21
Q

Bronchopulmonary segment

A

10 segments per lung

An area of the lung supplied by a segmental bronchus and a segmental branch of the pulmonary artery

Segments are separated by connective tissue, therefore a segment can be surgically resected if needed

Pulmonary veins are intersegmental - run within the connective tissue that separates the segments

22
Q

Pulmonary vessels

A

Pulmonary trunk
Pulmonary arteries
Pulmonary veins

23
Q

Pulmonary trunk

A

Exits right ventricle of heart and divides into right and left pulmonary arteries, when then enter lungs

24
Q

Pulmonary arteries

A

Carry O2 poor blood from heart to lungs for oxygenation

Each pulmonary artery divides into lobar and segmental arteries, running parallel with the bronchi

25
Q

Pulmonary veins

A

Carry O2 rich blood from the lungs to left atrium of the heart

2 pulmonary veins bilaterally (vs. 1 artery bilaterally)

Lie in intersegmental connective tissue separating the bronchopulmonary segments and do NOT course with arteries and bronchi

26
Q

Bronchial arteries

A

Carry O2 rich blood to the tissues of the lung itself

Most are branches off the thoracic aorta

27
Q

Bronchial veins

A

Return O2 poor blood from the tissues of the lung to the azygos system or intercostal veins

28
Q

Innervation of the lungs

A

Innervation of the lungs is via pulmonary plexus with contributions from vagus nerve (CN X) and pulmonary nerves

All organs are innervated by the AUTONOMIC NS

Remember: autonomic NS includes sympathetic (fight or flight) and parasympathic (rest and digest)

Parasympathetic - bronchoconstriction

Sympathetic - bronchodilation

29
Q

Parasympathetic innervation of lungs via vagus nerve (CN X)

A

Achieves bronchoconstriction of smooth muscle of bronchial tree

Parasympathetic:

Preganglionic cell bodies - brain

Preganglionic fibers - vagus nerve

Postganglionic cell bodies - wall of target organ (lung)

Postganglionic fibers - wall of target organ (lung) and are very short in length

30
Q

Sympathetic innervation of lungs

A

Achieves bronchodilation of smooth muscle of bronchial tree

Sympathetic:

Preganglionic cell bodies - lateral horn of thoracic spinal cord

Preganglionic fibers - ventral root, spinal nerve, ventral ramus, white ramus communicans, sympathetic trunk

Postganglionic cell bodies - upper thoracic paravertebral ganglia

Postganglionic fibers - pulmonary nerves

31
Q

Diaphragm

A

Separates the thoracic and abdominal cavities

Composted of skeletal muscle surrounding C shaped central tendon

Pericardium surrounding heart is attached to central tendon

2 domes - right sits higher than left due to liver

32
Q

Attachments to the diaphragm

A

All are peripheral -

Xiphoid process
Costal margin
Ribs 11-12
Lumbar vertebrae (via right and left crura)

33
Q

Openings in the diaphragm

A

I ate 10 eggs at 12

Inferior vena cava (caval opening) at T8 - goes through central tendon

Esophagael hiatus at T10 - for esophagus and vagus nerve (CN X)

Aortic hiatus at T12 - for aorta, thoracic duct, and azygos vein

34
Q

Sensory innervation for diaphragm

A

Primary phrenic nerves

Peripherally, via intercostal nerves

35
Q

Motor innervation for diaphragm

A

Phrenic nerves - ventral rami C3, 4, and 5 keep the diaphragm alive

Primary muscle of inspiration

36
Q

Phrenic nerves

A

Phrenic nerves course along lateral mediastinum and anterior to roots of lungs

Phrenic nerves independently innervate left and right domes

37
Q

Lesion of a phrenic nerve

A

This paralyzes the corresponding side of the diaphragm

X-ray during inspiration will show a depressed (active side) and raised (paralyzed side) of the diaphragm

38
Q

Diaphragm is primary muscle of inspiration

A

When diaphragm contracts, the domes descend and flatten, increasing vertical dimension of thoracic cavity. This also decreases volume of abdominal cavity, which increases abdominal pressure.

Diaphragm relaxes during expiration, allowing domes to rise.

39
Q

Basic principles of respiration

A

Inspiration

  • To draw air into lungs, thoracic pressure must be less than atmospheric pressure
  • An increase in the volume of the thoracic cavity will decrease the thoracic pressure

Expiration

  • To expel air from the lungs, thoracic pressure must be higher than atmospheric pressure
  • A decrease in the volume of the thoracic cavity will increase the thoracic pressure
40
Q

Movements of thorax during inspiration

A

Contraction (flattening) of the diaphragm causes the abdominal contents to be forced down, thereby increasing the vertical dimension of the thorax

Contraction of muscles that elevate the ribs (external intercostals) expands the thoracic cavity transversely (laterally) as a “bucket handle” movement and anteroposteriorly as a “pump handle” movement

During forceful inspiration, may also use pectoral muscles

41
Q

Movements of thorax during expiration

A

Thoracic cavity reduces in size primarily due to relaxation of the diaphragm and elastic recoil of lungs

During forceful expiration, abdominal muscles are recruited to compress abdominal viscera upward, expelling air from lungs

Anatomy Exam 1 (8 decks)

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