lungs and diaphragm exam 3 anatomy

Question 1

pleura

Answer 1

serous sacs surrounding lungs

Question 2

visceral vs parietal pleura

Answer 2

visceral- lines surface of lungs
parietal-lines walls of thoracic cavity

Question 3

visceral pleura innervation

Answer 3

visceral sensory= stretch and ischemia

somatic sensory= none *no pain, temp, touch

Question 4

parietal pleura innervation

Answer 4

somatic sensory

intercostal and phrenic nerves

Question 5

why does pleuritis hurt?

Answer 5

there is somatic sensory innervation on the parietal pleura

Question 6

what are the pleural cavities?

Answer 6

-potential space between visceral and parietal pleura
-contains serous fluid

Question 7

what is the function of serous fluid?

Answer 7

keeps membranes from sticking to one another during inspiration and expiration

Question 8

atelectasis

Answer 8

-lung collapse
-there is a mediastinal shift that makes trachea move toward unaffected side

Question 9

what do you hear during ausculation in a pt w a spontaneous pneumothorax?

Answer 9

nothing

Question 10

how do you tell what substance is accumulating in pleural cavity?

Answer 10

why they came in and you can do a thoracentesis

Question 11

pneumothorax

Answer 11

air in pleural cavity

Question 12

hydrothorax

Answer 12

liquid in pleural cavity

Question 13

hemothorax

Answer 13

blood in pleural cavity

Question 14

what is the significance of the costodiaphragmatic recesses?

Answer 14

-fluid likes to accumulate here *where fluid comes from in thoracentesis
-they decrease in area during inspiration

Question 15

thoracentesis (what is it, where)

Answer 15

-removes accumulated fluid in pleural cavity
-intercostal nerve block first
-typically 7-9th intercostal spaces
-enters costodiaphragmatic recess

Question 16

what part of lung do things enter?

Answer 16

the root

Question 17

right lung

Answer 17

-3 lobes
-superior, middle, inferior
-horizontal fissure and oblique fissure

Question 18

left lung

Answer 18

-2 lobes
-superior and inferior
-oblique fissure
-cardiac notch

Question 19

where is the trachea palpable?

Answer 19

jugular notch

Question 20

where does the trachea bifurcate?

Answer 20

the sternal angle T4-5

Question 21

carina

Answer 21

-bifurcation of trachea happens here
-very sensitive mucosa here and illicits strong cough

Question 22

what composes trachea?

Answer 22

cartilage supported airway with c shaped hyaline rings

Question 23

what is the difference between the R and L main bronchi?

Answer 23

the right is wider, shorter, and more vertical. Aspiration is more likely to happen here

Question 24

bronchial tree

Answer 24

-lobar bronchi (3 right 2 left)
-segmental bronchi

Question 25

what does each bronchopulmonary segment contain?

Answer 25

segmental bronchus, segmental branch pulmonary artery

*each segment is functionally independent

Question 26

where does gas exchange in lungs occur?

Answer 26

alveoli

Question 27

pulmonary arteries/veins

Answer 27

arteries-oxygen poor blood from heart
veins-oxygen rich blood to heart

Question 28

bronchial arteries/veins

Answer 28

arteries- supply bronchi
veins-drain bronchi

*within connective tissues of lungs

Question 29

blood flow of pulomary arteries

Answer 29

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

Question 30

drainage of pulmonary veins

Answer 30

oxygen rich blood from lungs

goes to 2 pulm veins each side

blood goes to left atrium

Question 31

blood flow of bronchial arteries

Answer 31

oxygen rich blood to lung tissues

Question 32

drainage of bronchial veins

Answer 32

returns oxygen poor blood from lungs to azygos system/intercostal veins

Question 33

parasympathetic function of lungs

Answer 33

bronchoconstriction of smooth muscle of bronchial tree

Question 34

parasympathetic innervation of lungs (nerve, pre and post cb and pregang fibers

Answer 34

CN X
-pregang CB= brain
-pregang fibers=vagus nerves
postgang CB and fibers= in walls of lungs

Question 35

sympathetic function of lungs

Answer 35

-bronchodilation of smooth muscle of bronchial tree

Question 36

sympathetic innervation of lungs

Answer 36

-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

Question 37

diaphragm

Answer 37

-seperates thoracic and abdominal cavities
-skeletal muscle surrounding central tendon

Question 38

why is the right dome of the diaphragm superior to the left?

Answer 38

the liver makes the right sit superior to the left dome

Question 39

what is sensory innervation of the diaphragm?

Answer 39

medial portion=phrenic nerve
peripheral area= intercostal nerve innervation

Question 40

diaphragm attachments

Answer 40

-xiphoid process
-costal margin
-ribs 11-12
-lumbar vertebrae via crus

Question 41

what are the diaphragm openings and what goes through them

Answer 41

caval opening
-t8
-IVC

esophageal hiatus
-t10
-esophagus
-vagus nerve

aortic hiatus
-t12
-aorta
-thoracic duct
-azygos vein

Question 42

what is the motor innervation of the diaphragm?

Answer 42

-phrenic nerves
-c3,c4,c5

Question 43

blood vessels on the superior surface of the diaphragm

Answer 43

-internal thoracic
*pericardiophrenic
*musculophrenic
-thoracic aorta
*superior phrenic artery

Question 44

blood vessels on the inferior surface of the diaphragm

Answer 44

abdominal aorta
*inferior phrenic

Question 45

thorax movements during inspiration

Answer 45

-thoracic pressure less than atmospheric
-forceful- pectoralis major

Question 46

thorax movements during expiration

Answer 46

-thoracic pressure greater than atmospheric
-diaphragm relaxation
-forceful= obliques and rectus abdominis

Question 47

what happens when the costal margins come together and the diaphragm moves down?

Answer 47

forces expiration