Lungs, Pleura, and Thoracic Wall Flashcards
Do any ribs articulate with the sternum directly?
No, they have a cartilage joining them.
In between which two vertebra is the top of the manubrium in line with?
T2-T3
Between which two vertebra is the manubriosternal joint in line with?
T4-T5
Which vertebra is the inferior portion of the body of the sternum inline with?
T9
Which ribs are atypical?
1, 2, 11, and 12
Which ribs are “true” (vertebrocostal) ribs?
1-7
Which ribs are “false” (vertebrochondral) ribs?
8-10
Which ribs are “floating” ribs?
11 and 12
What articulates with only the manubrium of the sternum?
clavicle and 1st rib
Which rib articulates with the manubrium and the body of the sternum?
2nd rib
Which rib articulates with the body and the xiphoid process?
7th rib
Which rib has grooves for the subclavian vein and artery?
1st rib
Which rib has a tuberosity for the serratus anterior?
2nd rib
What is found on the vertebral end of ribs?
- head
- neck
- tubercle
- angle
What is the middle of the rib called?
Body
What does the sternal end of true ribs articulate with?
- sternum
- costal cartilage
True or False:
The head of the rib articulates with the inferior demifacet of the superior vertebra and the superior demifacet of the inferior vertebra, and the intervertebral disc.
True
Which portion of the vertebre, superior or inferior, does the numbered rib and same numbered vertebre articulate?
superior demifacet
Which part of the rib articulates with the transvers process of vertebra of same number as rib, making up the costotransverse joint?
tubercle of rib
Which ligament is found covering the costal cartilage between the rib and manubrium?
Radiate sternocostal ligament
Which ligament helps keep the sternal end of the rib in place at either the manubrium or body of the sternum?
intra-articular sternocostal ligament
Which ligament is found at the costotransverse joint?
Lateral costotransverse ligament.
What is the name of the joint between the head of the rib and the vertebra?
costovertebral join of head of rib
Which ligament covers the costovertebral joint of head of rib?
Radiate ligament of head of rib
What makes up the intervertebral disc?
- anulus fibrosus
- nucleus pulposus
What is the name of the joint between the rib and the costal cartilage?
costochondral joint (cartilaginous joint)
Which muscles elevate the ribcage?
- external intercostal muscles
- innermost intercostal muscles
- levator costarum
- serratus posterior superior
What muscles depress the ribcage?
- internal intercostal muscles
- transversus thoracis
- subcostal muscles
- serratus posterior inferior
Which muscle involved in the movement of the ribcage is the only epaxial derived muscle?
levator costarum
What ultimately decides if a muscle depress or elevates the ribcage?
Direction of muscle fiber, and this can change depending on segment of rib.
Between which two muscle layers do intercostal vein, artery, and nerve, along with collateral branches run?
innermost intercostal and internal intercostal
What is the origin, course, and distribution of the posterior intercostal artery?
- Origin
- supreme intercostal arteries (intercostal spaces 1 and 2)
- thoracic aorta (remaining intercostal spaces
- Course
- pass between internal innermost intercostal muscles
- Distribution
- intercostal muscles and overlying skin
- parital pleura
What is the origin, ourse, and distribution of the anterior intercostal artery?
- Origin
- internal thoracic arteries (intercostal spaces 1-6)
- musculophrenic arteries (intercostal spaces 7-9)
- Course
- pass between internal and innermost intercostal muscles
- Distribution
- intercostal muscles and overlying skin
- parietal pleura
What is the origin, course, and distribution of the internal thoracic artery?
- Origin
- subclavian artery
- Course
- passes inferiorly, lateral to sternum, between costal cartilages and internal intercostal msucles to divide into superior epigastric and musculophrenic arteries
- Distribution
- by way of anterior intercostal arteries to intercostal spaces 1-6 and,
- musculophrenic arteries to intercostal spaces 7-9
What is the origin, course, and distribution of the subcostal artery?
- Origin
- thoracic aorta
- Course
- courses along interior border of 12th rib
- Distribution
- muscles of anterolateral abdominal wall and overlying skin
What are the lungs covered by?
visceral pleura
True or False:
Pulmonary arteries go into the lungs superior and the pulmonary veins come out of the lung inferior to the pulmonary arteries.
True
What structures does the left lung have an area for?
- esophagus
- aorta
- vagus nerve
- phrenic nerve
Does the left lung have a horizontal fissure?
NO, just the right lung has a horizontal fissure.
What does the bronchial veins drain into?
azygos and hemiazygos veins
The heart and the lungs receive sympathetic innervation primarily via which one of the following pathways?
- a) spinal nerve pathway
- b) postganglionic sympathetic pathway
- c) splanchnic nerve pathway
- d) adrenal medulla pathway
B
Where do the left bronchial arteries come from?
aorta
Where do the right bronchial arteries come from?
intercostal arteries, aorta, or left bronchial artery
What does the right lung venous drain into?
azygous vein
What does the left lung venous drain into?
accessory hemiazygos vein or intercostal vein
What is a pulmonary collapse?
- Air infiltrating the pleural cavity (pneumothorax) can break surface tension between the visceral and parietal pleura.
- When this happens, the elastic lung tissue will recoil (collapse) leaving air filled space within the pleural cavity that prevents expansion of the lung during inspiration.
What is a hemothorax, hydrothorax, and chylothorax?
- Blood -> hemothorax
- Serous fluid -> hydrothorax
- Lymph -> chylothorax
caused by penetrating wound and the substances infiltrate the pleural cavity and can also cause the lung to collapse.
What pleuritis (pleurisy)?
- inflammation of the pleura, may cause “scaping sounds” during auscultation, and can cause sharp stabbing pain.
What is a pulmonary embolism (PE)?
- obstruction of pulmonary artery by blood clot, fat globule, or air bubble; often fatal.
- passes from vein into right side of heart via vena cava andthen travels through heart and into pulmonary artery, obstructing blood flow.
- deep vein thrombosis (DVT) common cause
What is bronchogenic carcinoma (lung cancer)?
- common type of lung cancer arising from bronchial epithelium
- smoking a major cause
- highly metastatic due to association of lymphatics in bronchial tissue
- typically metastasizes to brain and cranium
What is malignant mesothelioma?
- rarer type of lung cancer affecting pleura (mesothelium)
- caused by exposure to asbestos
- can affect other internal organs
What is pulmonary tuberculosis (TB)?
- bacterial infection of the lungs (Mycobacterium tuberculosis)
- can spread to other organs
- contagion spread through the air through droplets from an infected individual coughing, sneezing, or talking.
- 1/3 of the world’s population is currently infected with TB, but only 5-10% become sick or infectious (active TB).
