lungs and diaphragm exam 3 anatomy Flashcards
pleura
serous sacs surrounding lungs
visceral vs parietal pleura
visceral- lines surface of lungs
parietal-lines walls of thoracic cavity
visceral pleura innervation
visceral sensory= stretch and ischemia
somatic sensory= none *no pain, temp, touch
parietal pleura innervation
somatic sensory
intercostal and phrenic nerves
why does pleuritis hurt?
there is somatic sensory innervation on the parietal pleura
what are the pleural cavities?
-potential space between visceral and parietal pleura
-contains serous fluid
what is the function of serous fluid?
keeps membranes from sticking to one another during inspiration and expiration
atelectasis
-lung collapse
-there is a mediastinal shift that makes trachea move toward unaffected side
what do you hear during ausculation in a pt w a spontaneous pneumothorax?
nothing
how do you tell what substance is accumulating in pleural cavity?
why they came in and you can do a thoracentesis
pneumothorax
air in pleural cavity
hydrothorax
liquid in pleural cavity
hemothorax
blood in pleural cavity
what is the significance of the costodiaphragmatic recesses?
-fluid likes to accumulate here *where fluid comes from in thoracentesis
-they decrease in area during inspiration
thoracentesis (what is it, where)
-removes accumulated fluid in pleural cavity
-intercostal nerve block first
-typically 7-9th intercostal spaces
-enters costodiaphragmatic recess
what part of lung do things enter?
the root
right lung
-3 lobes
-superior, middle, inferior
-horizontal fissure and oblique fissure
left lung
-2 lobes
-superior and inferior
-oblique fissure
-cardiac notch
where is the trachea palpable?
jugular notch
where does the trachea bifurcate?
the sternal angle T4-5
carina
-bifurcation of trachea happens here
-very sensitive mucosa here and illicits strong cough
what composes trachea?
cartilage supported airway with c shaped hyaline rings
what is the difference between the R and L main bronchi?
the right is wider, shorter, and more vertical. Aspiration is more likely to happen here
bronchial tree
-lobar bronchi (3 right 2 left)
-segmental bronchi
what does each bronchopulmonary segment contain?
segmental bronchus, segmental branch pulmonary artery
*each segment is functionally independent
where does gas exchange in lungs occur?
alveoli
pulmonary arteries/veins
arteries-oxygen poor blood from heart
veins-oxygen rich blood to heart
bronchial arteries/veins
arteries- supply bronchi
veins-drain bronchi
*within connective tissues of lungs
blood flow of pulomary arteries
oxygen poor blood comes from right ventricle
then goes to pulm trunk
then to R/L pulmonary arteries
then to lobar arteries
then to segmental arteries
drainage of pulmonary veins
oxygen rich blood from lungs
goes to 2 pulm veins each side
blood goes to left atrium
blood flow of bronchial arteries
oxygen rich blood to lung tissues
drainage of bronchial veins
returns oxygen poor blood from lungs to azygos system/intercostal veins
parasympathetic function of lungs
bronchoconstriction of smooth muscle of bronchial tree
parasympathetic innervation of lungs (nerve, pre and post cb and pregang fibers
CN X
-pregang CB= brain
-pregang fibers=vagus nerves
postgang CB and fibers= in walls of lungs
sympathetic function of lungs
-bronchodilation of smooth muscle of bronchial tree
sympathetic innervation of lungs
-pregang CB= lateral horn of thoracic spinal chord
-pregang fibers= ventral ramus > white ramus > sympathetic trunk
-postgang CB= thoracic paravertebral ganglia
-postgang fibers= pulmonary nerves
diaphragm
-seperates thoracic and abdominal cavities
-skeletal muscle surrounding central tendon
why is the right dome of the diaphragm superior to the left?
the liver makes the right sit superior to the left dome
what is sensory innervation of the diaphragm?
medial portion=phrenic nerve
peripheral area= intercostal nerve innervation
diaphragm attachments
-xiphoid process
-costal margin
-ribs 11-12
-lumbar vertebrae via crus
what are the diaphragm openings and what goes through them
caval opening
-t8
-IVC
esophageal hiatus
-t10
-esophagus
-vagus nerve
aortic hiatus
-t12
-aorta
-thoracic duct
-azygos vein
what is the motor innervation of the diaphragm?
-phrenic nerves
-c3,c4,c5
blood vessels on the superior surface of the diaphragm
-internal thoracic
*pericardiophrenic
*musculophrenic
-thoracic aorta
*superior phrenic artery
blood vessels on the inferior surface of the diaphragm
abdominal aorta
*inferior phrenic
thorax movements during inspiration
-thoracic pressure less than atmospheric
-forceful- pectoralis major
thorax movements during expiration
-thoracic pressure greater than atmospheric
-diaphragm relaxation
-forceful= obliques and rectus abdominis
what happens when the costal margins come together and the diaphragm moves down?
forces expiration
