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Block 2 Exam 3 > Lungs, Pleura, Superior and Posterior Mediastinum > Flashcards

Lungs, Pleura, Superior and Posterior Mediastinum Flashcards

1
Q

There are essentially 3 spaces in the chest. What are they?

A

Right and left pulmonary cavities and the mediastinum

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2
Q

The inferior thoracic aperture is closed by this structure

A

The diaphragm

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3
Q

Two things enclosed in the pulmonary cavity

A

The lungs and the pleural sacs

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4
Q

The (blank) lines the chest wall, and adheres to the contours of the chest wall all the way to the diaphragm

A

parietal pleura

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5
Q

Which lung has three lobes?

A

The right lung

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6
Q

What is the name of the fissure that divides the superior lobe from the middle lobe?

A

Horizontal fissure

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7
Q

What is the name of the fissure that divides the inferior lobe from the superior lobe?

A

Oblique fissure

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8
Q

What kind of nerve is the phrenic?

A

Just a basic spinal nerve.

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9
Q

Do the phrenic nerves have sympathetic fibers?

A

Yes. They DO have sympathetic fibers on them, because the phrenic nerve goes to the diaphragm and the diaphragm has blood vessels, which need sympathetic innervation.

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10
Q

Which layer of pleura, visceral or parietal, can feel pain?

A

Parietal

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11
Q

The phrenic nerve is sandwiched between which two structures?

A

Parietal pleura and fibrous pericardium of the pericardial sac

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12
Q

Where is the costal part of the parietal pleura?

A

Along the intercostal muscles (laterally)

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13
Q

This is the space where the lung does not fill the entire parietal pleura

A

Costodiaphramatic recess

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14
Q

If you peel the parietal pleural away from the fibrous layer of the pericardial sac, you will find the phrenic nerves, which are passing down from the spinal cord at what level?

A

C3-C5 (“C 3, 4, and 5 keep the person alive)

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15
Q

Are there somatomotor and sensory fibers on the phrenic nerves?

A

Yes

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16
Q

The lung does not expand all the way out to the midline border of the mediastina. What is the extra space called?

A

costomediastinal recess

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17
Q

At the midclavicular line, how low do the lungs (visceral pleura) extend during quiet respiration? How about the parietal pleura?

A

6th rib; 8th rib

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18
Q

At the mid-axillary line, how low do the lungs (visceral pleura) extend during quiet respiration? How about the parietal pleura?

A

8th rib; 10th rib

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19
Q

At the paravertebral line (posteriorly), how low do the lungs (visceral pleura) extend during quiet respiration? How about the parietal pleura?

A

10th rib; 12th rib

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20
Q

Potential spaces which can fill with blood, air and water in pathological states. The spaces can be blunted or increased depending on the pathology.

A

Pleural recesses

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21
Q

Consists mainly of pulmonary arteries, bronchi and pulmonary veins, but anything entering or leaving the lung could also be considered part of this.

A

Root of the lung

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22
Q

On which side does the primary bronchus enter the hilum?

A

Left side

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23
Q

On which side do the secondary bronchi for upper and lower lobes enter the hilum?

A

Right side

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24
Q

Phrenic runs (blank) to the hilum, while the vagus runs (blank) to the hilum.

A

anterior; posterior

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25
Q

The superior vena cava branches to become the

A

Right and left brachiocephalic vein

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26
Q

On the right side, the pulmonary arteries lie (blank) to the bronchi and the pulmonary veins lie (blank) and (blank) to all other structures in the root

A

anterior; inferior and anterior

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27
Q

On the left side the pulmonary arteries lie (blank) to the bronchi and the pulmonary veins lie (blank) and (blank) to all other structures in the root

A

superior; inferior and anterior

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28
Q

the most anterior and most inferior major structures in the hilum of both lungs

A

Branches of the pulmonary vein

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29
Q

In the right (R) lung, the artery is (blank) to the airway. In the left (L) lung, the artery is (blank) to the airway

A

anterior; superior

30
Q

The unit of lung supplied by one tertiary (segmental) bronchus and its accompanying artery

A

bronchopulmonary segments

31
Q

In relation to bronchopulmonary segments, the pulmonary arteries are considered (blank), while the pulmonary veins are considered (blank).

A

intrasegmental; intersegmental

32
Q

How many segments are there in the right lung? Left lung?

A

10; 8-10

33
Q

What airway supplies each bronchopulmonary segment?

A

A tertiary bronchus supplies each segment.

34
Q

Each lung segment and each tertiary bronchus is paired up with a branch of the pulmonary artery. So, the pulmonary artery and the tertiary bronchi travel side by side. Their supplies are considered (blank).

A

Intrasegmental

35
Q

Which main bronchus is more vertical and wider, which allows for aspirated objects to get lodged more readily?

A

Right primary bronchus

36
Q

On which side does the main stem bronchus divide before entering the lung?

A

The right side

37
Q

What is the name for the point where the main stem bronchus bifurcates?

A

Carina

38
Q

Where does the trachea divide into primary bronchi?

A

At the junction of the ascending aorta and the arch

39
Q

Trachea is limited to the (blank), but many structures traverse the superior and some component of the inferior.

A

superior mediastina

40
Q

The (blank) pleura doesn’t feel pain whereas the mediastinal, costal and diaphragmatic plurae do

A

visceral

41
Q

Most lung tissues get their nutrients from the pulmonary circulation but structures comprising the root and supporting tissues get nutrients from (blank)

A

the bronchiole arteries

42
Q

The subpleural plexus drains the parenchyma and drains to the (blank)

A

bronchopulmonary nodes

43
Q

Explain the pathway that lymph takes in the lungs.

A

All lymph drains back to bronchopulmonary lobes, and then it passes from there up to the tracheobronchial nodes, the paratracheal nodes, and ultimately drains back to the thoracic duct on the left side or lymphatic duct on the right side

44
Q

Things in the superior mediastinum

A 
Aortic arch and roots of its three superior branches (B,C,S)
some pulmonary trunk with left and rt. arteries, some SVC with the arch of azygos draining in
rt. and lt. brachiocephalic veins
phrenic and vagus nerves
lt. recurrent laryngeal
trachea
esophagus
some thymus.
45
Q

Which brachiocephalic vein is more vertical? Which is more transverse?

A

right; left

46
Q

Five layers of superior mediastinum from superficicial to deep

A 
Glandular (thymus)
Venous
Arterial (arch of the aorta and the great vessels BCS)
Respiratory (trachea)
Digestive (esophagus)
47
Q

The esophagus travels (post) to the root of the lung

A

Posterior

48
Q

The vagus nerves on both sides both contribute to the (blank).

A

esophageal plexus

49
Q

Phrenics pass (blank) to the root of the lung.

A

anterior

50
Q

What vertebrae mark the boundaries of the posterior mediastinum?

A

T5-T12

51
Q

Contents of the posterior mediastinum

A

Thoracic descending aorta and its branches esophagus and esophageal plexus
azygos and hemi azygos system of veins
thoracic duct and associated lymph nodes greater, lesser and least thoracic splanchnic nerves
(sympathetic chain)

52
Q

Is the trachea found in the posterior mediastinum?

A

No, because it has already bifurcated.

53
Q

What is the main job of the azygos system?

A

Azygos main job is to drain the body wall. For example, in the region of the thorax, the intercostal veins have no place to drain. So, they drain to the azygos before entering the SVC.

54
Q

T/F: Technically, the sympathetic trunk and the roots of the splanchnic nerves are not in the posterior because they lie along side the vertebrae

A

True

55
Q

What happens to the left and right vagus nerves after they reach the esophageal plexus?

A

The fibers reconvene on their way to the stomach as the anterior and posterior VAGAL TRUNKS.

56
Q

The esophageal plexus also receives (blank) from thoracic splanchnics

A

sympathetics

57
Q

The right vagus contributes mostly to the (blank) esophageal plexus

A

posterior

58
Q

Important branches of the thoracic aorta

A 
esophageal arteries
bronchial arteries
posterior intercostal arteries
superior phrenic arteries
two subcostal arteries
59
Q

Three things that the azygos system drains

A

the body wall, esophagus and bronchial veins

60
Q

The azygos system connects to the (blank) indirectly through the esophageal venous plexus

A

portal system

61
Q

Both the azygos and hemiazygos veins communicate with the abdominal cavity via direct connection to (blank)

A

the ascending lumbar veins

62
Q

Plexus of veins close to the internal surface of the esophagus

A

esophageal venous plexus

63
Q

Arch of azygos runs (blank) to the root of the lung on the (blank) side

A

superior; right

64
Q

Where is the thoracic duct located?

A

It lies between the esophagus and the thoracic aorta

65
Q

How is flow in the thoracic duct facilitated?

A

By pressure changes created through respiration

66
Q

The thoracic duct ultimately receives lymph from…

A

The entire body, except for upper right quadrant of the chest and the right side of the head

67
Q

At what rib can the oblique fissure be found in both lungs?

A

6th rib

68
Q

The horizontal fissure of the right lung can be found between which two ribs?

A

3rd and 4th

69
Q

Describe the pathway lymph takes from the lungs to its final destination.

A

subpleural lymph plexus–>pulmonary nodes–>bronchiopulmonary nodes–>tracheobronchial nodes–>paratracheal nodes–>right lymphatic duct or left thoracic duct

70
Q

At what level should a chest tube be entered for a pneumothorax? For a hemothorax?

A

2nd or 3rd intercostal space at midclavicular line (higher for pneumothorax because air rises); 5th intercostal space at midaxillary line

71
Q

With chest tube insertion, you want to insert the tube at an angle to avoid hitting the (blank) or (blank)

A

diaphragm or liver

72
Q

In the superior mediastinum, the esophagus is the most (blank) structure. However, in the inferior mediastinum, it lies (blank) to the aorta.

A

posterior; anterior and medial

Block 2 Exam 3 (19 decks)

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