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CVR-UL > Lungs + Thorax > Flashcards

Lungs + Thorax Flashcards

1
Q

What makes up the thoracic cage?

A

Posterior end: vertebral column
Lateral: 12 pairs of ribs
Anterior: Sternum + costal cartilage
Opening at both ends (superior + inferior thoracic aperture)

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2
Q

Purpose of thoracic cage?

A

Protection of thoracic viscera (heart + lungs)

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3
Q

Which ribs are true ribs and what do they attach to anteriorly?

A

Ribs 1-7: attach to costal cartilage

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4
Q

Which ribs are false ribs and what do they attach to anteriorly?

A

8-10: attach to cartilage of rib above

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5
Q

Which ribs are floating ribs and what do they attach to anteriorly?

A

11 & 12: no anterior attachment

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6
Q

Features of typical rib?

A

Head, neck, body, tubercle, angle

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7
Q

Tubercle attachment?

A

Transverse process of same number vertebra

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8
Q

Why are there 2 articular facets on head of rib?

A

One to articulate with corresponding vertebra and other for vertebra above it

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9
Q

Superior and inferior demifacets?

A

Superior: articulation of head of rib to own vertebrae
Inferior: articulation of head of rib to below vertebrae

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10
Q

What 2 joints show the thoracic vertebrae articulation with ribs?

A

Costotransverse: rib (tubercle) with transverse process
Costovertebral: rib (head) with vertebral body

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11
Q

Purpose of costal groove?

A

Protection of vessels and nerve that pass through thorax

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12
Q

Is angle of rib closer to head or sternochondral end?

A

Head (more curved there)

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13
Q

List all contents of superior thoracic aperture.

A
  1. Subclavian veins
  2. Internal jugular veins
  3. Subclavian arteries
  4. Carotid arteries
  5. Phrenic Nerves
  6. Vagus nerves
  7. Sympathetic chain
  8. Trachea
  9. Esophagus
  10. Apex of lungs
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14
Q

Borders of superior thoracic aperture?

A

T1 vertebral body, 1st ribs, manubrium of sternum

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15
Q

Atypical features of rib 1?

A

Structure: smaller, flatter, thicker
Has scalene tubercle: anterior groove holds subclavian vein and posterior groove holds subclavian artery
Brachial plexus also passes through

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16
Q

What is cervical rib and what does it cause?

A

Congenital abnormality of extra rib at C7.

Causes thoracic outlet syndrome

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17
Q

What is thoracic outlet syndrome?

A

Compression: subclavian vessels and brachial plexus

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18
Q

What makes up the intercostal groove/space?

A

Neurovascular bundle of intercostal VAN.

Intercostal muscles: external and internal and innermost

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19
Q

Purpose of innermost intercostal muscle layer?

A

Cover neurovascular bundle

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20
Q

Movement of internal intercostal muscles?

A

Downwards and posteriorly (backwards) to depress ribs

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21
Q

Movement of external intercostal muscles?

A

Downwards and anteriorly (forwards) to elevate ribs

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22
Q

What is the thoracic wall innervated by?

A

Intercostal nerves

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23
Q

What innervates the parietal pleura?

A

Outer: intercostal
Inner: phrenic

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24
Q

Innervation of diaphragm?

A

L/R Phrenic nerves (C3,4,5)

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25
Q

All nerves innervating thorax?

A
  1. Phrenic
  2. Intercostal
  3. Vagus
  4. Sympathetic thoracic visceral nerves
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26
Q

Function of vagus nerve?

A

Parasympathetic control: heart + lungs

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27
Q

Arterial supply of thorax: posterior + anterior?

A 
Posterior:
1. posterior intercostal arteries
2. branches of aorta
Anterior: 
1. anterior intercostal arteries
2. branches of internal thoracic arteries
28
Q

Collateral circulation?

A

Alternate circulation due to blocked vessel

29
Q

Pancoast’s tumour?

What is affected?

A 
Tumour of lungs in around apex region.
Compression of nerves around 1st rib region:
1. Brachiocephalic vein
2. Subclavian artery
3. Phrenic nerve
4. Vagus nerve
5. Sympathetic chain
30
Q

Treatment of Pancoast’s tumour and possible issues with treatment?

A

Surgery to remove part of upper lobe of lung.

Problem: could damage vessels nearby

31
Q

Venous drainage of thorax: posterior + anterior?

A

Posterior: posterior intercostal veins → azygos (right) + hemiazygos (left)
Anterior: anterior intercostal veins → internal thoracic vein → brachiocephalic vein

32
Q

Pneumothorax?

A

Hole in lung causing collapse of lung

33
Q

Treatment of pneumothorax?

A

Thoracocentesis: tube inserted into pleural space from 4/5th ICS to remove fluid, blood, air

34
Q

What does visceral pleura cover?

A

Lungs

35
Q

What does parietal pleura cover?

A

Thoracic wall, mediastinum, diaphragm

36
Q

Cardiophrenic angle?

Costophrenic angle?

A

Cardiophrenic: angle between heart/diaphragm
Costophrenic: angle between rib/diaphragm

37
Q

In what conditions is lung X-ray taken?

A

Inspiration

38
Q

Lower borders of pleural cavity?

A

AM: Apex above Midclavicular point

6: Midline 6th CC
8: Midclavicular line 8th rib
10: Midaxillary line 10th rib
12: Paravertebral line of back 12th rib

39
Q

Borders of lung?

A

AM: Apex above midclavicular point

4: Midline 4th CC
6: Midclavicular line 6th rib
8: Midaxillary line 8th rib
10: Paravertebral line of back 10th rib

40
Q

What does the trachea divide into?

A

Trachea → Bronchi → Lobar bronchi → Bronchopulmonary segments

41
Q

What does mediastinum contain?

A

Thoracic viscera, except lungs

42
Q

What separates superior/inferior mediastinum? At what level?

A

Transverse thoracic plane at T4/5 level

43
Q

Contents of superior mediastinum

A 
Thymus gland (in child)
Brachiocephalic veins
Arch of aorta + branches
Trachea
Esophagus
44
Q

3 constrictions of esophagus?

A
  1. Cervical constriction: pharyngesophageal
  2. Thoracic constriction: aortic arch/bronchus
  3. Diaphragmatic constriction: esophagus hiatus (T10)
45
Q

Most common site of perforation of esophagus during gastroscopy?

A

Posterior wall of esophagus

46
Q

Perforation of esophagus causes?

A

Mediastinitis

47
Q

What do dorsal root ganglion contain?

A

Cell bodies of sensory nerve fibres

48
Q

Anulus fibrosis and Nucelus pulposus?

A

Anulus fibrosis: tough outer fibrocartilage on intervertebral disc.
Nucleus pulposus is soft inner layer surrounded by anulus fibrosis

49
Q

What’s the process called to obtain CSF?

A

Lumbar puncture

50
Q

Parasympathetic control on lungs causes?

A

Bronchoconstriction

51
Q

Parasympathetic supply to heart/lungs etc. through?

A

Vagus nerve

52
Q

SA node supplied by which vagus nerve?

A

Right

53
Q

AV node supplied by which vagus nerve?

A

Left

54
Q

Impaired sympathetic activity causes what syndrome?

Features of syndrome?

A

Horner’s syndrome:

  1. Ptosis
  2. Miosis (constricted pupil)
  3. Anhidrosis (no sweating face)
55
Q

During inspiration, what is effect on intrapleural pressure?

A

Negative pressure created by sucking in air into the larger space created by diaphragm flattening

56
Q

Why is expiration passive?

A

Elastic recoil of lungs + thorax walls

57
Q

Forced inspiration muscles?

A
  1. Anterior scalene
  2. Sternocleidomastoid
  3. Serratus anterior
  4. P. major
58
Q

Forces expiration muscles?

A
  1. External/internal oblique

2. Transversus abdominus

59
Q

Where are Type 1 alveolar cells found?

A

Wall of alveolus

60
Q

Where are pulmonary endothelial cells found?

A

Capillary surfaces (for increased gas exchange)

61
Q

Effect of surfactant on surface tension and compliance of lung?

A

Surfactant reduces surface tension + increases compliance of lung

62
Q

Surfactant exported as what to surface of alveolus?

A

Lamellar bodies

63
Q

Major component of lung surfactant?

A

DPPC (dipalmitoyl phosphatidylcholine)

64
Q

What is Neonatal Respiratory Distress Syndrome (RDS)?

A

When fetus is born early, haven’t developed respiratory mechanism to produce sufficient surfactant, causing laboured breathing

65
Q

What is the relation of alpha-1-antitrypsin with emphysema?

A

Reduced alpha-1-antitrypsin levels related to emphysema.

Less inhibition of leukocyte elastase (which breaks down elastin in alveolar walls)

CVR-UL (17 decks)

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