Lungs & Diaphragm Flashcards

1
Q

What lines of separation does the right lung possess?

A

Oblique fissure and horizontal fissure

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2
Q

What is the location of the superior lobe of the right lung?

A

Above the horizontal fissure

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3
Q

What is the location of the middle lobe of the right lung?

A

Between the horizontal and oblique fissures

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4
Q

What is the location of the inferior lobe of the right lung?

A

Below the oblique fissure

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5
Q

Why are the grooves and impressions of the lungs not typically present in the living?

A

Due to the perfusion/inflation of the lungs

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6
Q

What are the grooves/impressions found in the right lung?

A

Grooves for the azygos vein, esophagus, superior vena cava, and right brachiocephalic vein, as well as the cardia impression (shallow)

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7
Q

What are the lines of separation found with the left lung?

A

Only the oblique fissure

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8
Q

What is the location of the superior lobe of the left lung?

A

Above the oblique fissure

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9
Q

What is the location of the inferior lobe of the left lung?

A

Below the oblique fissure

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10
Q

What are characteristic features of the left lung?

A

Lingula, grooves for the aorta and left subclavian artery, cardiac notch, and a deep cardiac impression

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11
Q

What is significant about the cardiac notch of the left lung?

A

Important for auscultation of the heart

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12
Q

Why does the esophagus typically not lie against the left lung?

A

It rests on the aorta

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13
Q

What are the functional units of the lung?

A

Bronchopulmonary segments

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14
Q

Each bronchopulmonary segment consists of what four things?

A

Segmental bronchus, branch of the pulmonary artery, segment of lung tissue, and surrounding septum

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15
Q

Why are bronchopulmonary segments clinically important?

A

Can be surgically removed without affecting the functioning of adjacent segments

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16
Q

What is the blood supply of the lungs?

A

Bronchial arteries and bronchial veins

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17
Q

From where do the bronchial arteries arise?

A

Thoracic aorta

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18
Q

Where do the bronchial veins drain?

A

Azygos and accessory hemiazygos veins

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19
Q

What is the primary tissue of the trachea, main bronchi, and lobar bronchi?

A

Cartilaginous rings

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20
Q

What is the primary tissue of segmental bronchi?

A

Smooth muscle

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21
Q

What is the primary tissue of bronchioles?

A

Smooth muscle

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22
Q

What is the primary tissue of alveoli?

A

Membrane

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23
Q

What is bronchitis?

A

Inflammation of the segmental bronchi

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24
Q

What is bronchiolitis?

A

Inflammation of the bronchioles

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25
Q

What is pneumonia?

A

Inflammation of the alveoli

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26
Q

What fibers form the anterior and posterior pulmonary plexuses?

A

Vagus and sympathetic trunk

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27
Q

The sympathetic trunk is made up from which cord levels?

A

T2-T5

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28
Q

What effect does sympathetic activation have on the lungs?

A

Bronchial dilation, vasoconstriction, and decreased glandular secretion

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29
Q

What effect does parasympathetic activation have on the lungs?

A

Bronchial constriction, vasodilation, and increased glandular secretion

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30
Q

What is asthma?

A

An obstructive airway disease characterized by coughing, wheezing, and difficulty breathing

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31
Q

What causes asthma?

A

Spasms of the smooth muscle which lies in the segmental bronchi and bronchioles

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32
Q

What also tends to accompany asthma?

A

Excessive secretion of mucus

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33
Q

What triggers extrinsic asthma?

A

Allergies

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34
Q

What triggers intrinsic asthma?

A

Stimuli such as stress, cold, or exercise

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35
Q

Subluxation of what area tend to accompany asthma?

A

Upper thoracic region

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36
Q

What part of the autonomic nervous system would dominate in asthma if there was a subluxation in the upper thoracics (T2-T5)?

A

Parasympathetics

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37
Q

What effect does the release of epinephrine have on the lungs that is released from the adrenal medulla that is supplied by the lower thoracics (T9-T11)?

A

Bronchodilation

38
Q

What is the pathway of lymph drainage in the lungs?

A

Lungs to pulmonary and bronchopulmonary nodes in hilum to tracheobronchial nodes

39
Q

Are the lungs rich or poor in lymphatics?

A

Rich

40
Q

Why do the lungs have so many lymphatics?

A

Breathing accumulates toxins and pathogens and the lungs are an interface with the external world

41
Q

What is a bronchogenic carcinoma?

A

Primary tumor of the bronchus

42
Q

What is a bronchogenic carcinoma directly related to?

A

Cigarette smoking and air pollution

43
Q

How does a bronchogenic carcinoma quickly spread to lymph nodes and the bloodstream?

A

By eroding a venue and traveling via the pulmonary veins to the heart and systemic circulation

44
Q

<p>A bronchogenic carcinoma often causes an enlargement of which type of lymph node?</p>

A

<p>Sentinel</p>

45
Q

How may a bronchogenic carcinoma result in paralysis of half of the diaphragm?

A

Damage to phrenic nerve

46
Q

How may a bronchogenic carcinoma result in paralysis of half of the larynx?

A

Damage to recurrent laryngeal nerve

47
Q

Where can referred pain be found with a bronchogenic carcinoma?

A

Upper or middle thoracic cord segments

48
Q

Which innervation of the lungs contain sensory fibers?

A

BOTH the vagal and sympathetic fibers

49
Q

What two things does the diaphragm separate?

A

Thorax from abdomen

50
Q

Why is the right dome of the diaphragm slightly higher than the left?

A

It overlies the liver

51
Q

What are the two parts of the diaphragm?

A

Muscular part and central tendon

52
Q

What is the origin of the sternal part of the diaphragm?

A

Xiphoid process

53
Q

What is the origin of the costal part of the diaphragm?

A

Lower 6 costal cartilages

54
Q

What is the origin of the lumbar part of the diaphragm?

A

Lumber vertebrae 1-3 and the medial and lateral arcuate ligaments

55
Q

At which vertebral level is the caval opening of the diaphragm located?

A

T8

56
Q

What does the caval opening of the diaphragm transmit?

A

Inferior vena cava and right phrenic nerve

57
Q

At which vertebral level is the esophageal hiatus of the diaphragm located?

A

T10

58
Q

What does the esophageal hiatus of the diaphragm transmit?

A

Esophagus and the anterior and posterior vagal trunks

59
Q

What is significant about the placement of the esophagus?

A

It is not firmly attached meaning it can slide

60
Q

At which vertebral level is the aortic hiatus of the diaphragm located?

A

T12

61
Q

What does the aortic hiatus of the diaphragm transmit?

A

Aorta, thoracic duct, and azygos vein

62
Q

What is the blood supply of the muscular part of the diaphragm?

A

Musculophrenic artery

63
Q

What is the blood supply of the central tendon of the diaphragm?

A

Pericardiacophrenic artery

64
Q

What is the blood supply of the upper surface of the diaphragm?

A

Superior phrenic artery

65
Q

What is the blood supply of the lower surfaces of the diaphragm?

A

Inferior phrenic artery

66
Q

From where do the superior and inferior phrenic arteries arise?

A

Aorta

67
Q

From where do the musculophrenic and pericardiacophrenic arteries arise?

A

Internal thoracic artery

68
Q

What nerve is motor to the diaphragm and sensory to its central part?

A

Phrenic nerve (C3-C5)

69
Q

What nerves are sensory to the peripheral part of the diaphragm?

A

Intercostal nerves

70
Q

Why does the inferior vena cava attach to the caval opening?

A

To facilitate greater venous return

71
Q

What is a hiatal hernia?

A

When the upper part of the stomach slides up into the thoracic cavity through the opening

72
Q

What is the cause of a hiatal hernia?

A

Weakness in the diaphragmatic wall around the esophageal hiatus

73
Q

A hiatal hernia typically occurs at what age?

A

After 50 years old

74
Q

What technique is specifically effective for a hiatal hernia?

A

S.O.T.

75
Q

Hiatal hernias are a major cause of what GI tract disease?

A

Gastroesophageal reflux

76
Q

What are the three movements of respiration that result in an increase in intrathoracic volume and a decrease in intrathoracic pressure?

A

Piston, bucket handle, and pump hande movements

77
Q

What is the piston movement of respiration?

A

Diaphragm contracts, pulling the domes inferiorly into the abdomen

78
Q

What is the bucket handle movement of respiration?

A

Elevation of the lower ribs (7th-10th) about an anteroposterior axis

79
Q

What is the pump handle movement of respiration?

A

Elevation of the upper ribs (2nd-6th) about a transverse axis

80
Q

The piston movement of respiration results in an increase in what diameter of the thorax?

A

Vertical

81
Q

The bucket handle movement of respiration results in an increase in what diameter of the thorax?

A

Transverse

82
Q

The pump handle movement of respiration results in an increase in what diameter of the thorax?

A

Antero-posterior

83
Q

Which movement of respiration is best seen from the side view as the chest rises?

A

Pump handle movement

84
Q

What muscles are responsible for both the bucket handle and pump handle movements of respiration?

A

External intercostal

85
Q

What is the second most important muscle of respiration?

A

External intercostal

86
Q

What muscles contract during forced expiration?

A

Internal intercostals, innermost intercostals, and the anterior abdominal wall muscles

87
Q

Which muscles are important for coughing, sneezing, and general clearing of the airway?

A

Internal intercostals

88
Q

During inspiration, what happens to the intrathoracic volume and pressure?

A

Increase, decrease

89
Q

During expiration, what happens to the intrathoracic volume and pressure?

A

Decrease, increase

90
Q

When abdominal volume is decreased, what happens to the intra-abdominal pressure?

A

Increased

91
Q

What are hiccups?

A

Results of spasmodic contractions of the diaphragm

92
Q

What are the distinguishing factors of serious hiccups that could be signs of pericarditis, pleuritic, or peritonitis?

A

Painful abdomen, fever, or hiccups lasting more than two days.