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General Anatomy 1 > Mediastinum, Pleura and Organs of Respiration (Part 2) > Flashcards

Mediastinum, Pleura and Organs of Respiration (Part 2) Flashcards

1
Q

The mediastinum, though thick, is a movable partition that extends where? (borders)

A

Superior - thoracic outlet and root of the neck
Inferiorly - diaphragm
Anterior - sternum
Posterior - vertebral column

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2
Q

What does the mediastinum contain?

A 
(10)
remnants of thymus
heart and large blood vessels
trachea and esophagus 
thoracic duct and lymph nodes
vagus and phrenic nerves
 sympathetic trunks
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3
Q

The divisions of the mediastinum

A 
Superior
Inferior
      - Middle
      - Anterior
      - Posterior
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4
Q

What divides the superior and inferior mediastinum?

A

by an imaginary plane passing from:

- anteriorly: sternal angle 
- posteriorly: T4 vertebra lower border
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5
Q

It consists of the pericardium and heart

A

middle mediastinum

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6
Q

a space between the pericardium and the sternum

A

anterior mediastinum

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7
Q

lies between the pericardium and the vertebral column.

A

posterior mediastinum

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8
Q

What does potential space contain and what for?

A

minimal fluid presence to prevent too much friction

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9
Q

What are the borders of superior mediastinum?

A

superiorly - oblique plane of the first rib

inferiorly - imaginary line running from the sternal angle to the intervertebral disk between T4 and T5 vertebra

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10
Q

What contains the superior mediastinum?

A 
(10)
superior vena cava (SVC), and brachiocephalic veins
arch of the aorta
thoracic duct
trachea
esophagus
vagus nerve
left recurrent laryngeal nerve
phrenic nerve 
thymus
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11
Q

Where is the site at which immature lymphocytes develop into T lymphocytes and secretes thymic hormones?

A

Thymus

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12
Q

What does secretion of thymic hormones cause?

A

cause T lymphocytes to gain immunocompetence

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13
Q

Where is thymus prominent in children?

A

at lower mediastinum (looking like a boat/ sail sign)

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14
Q

Lies anterior to the pericardium and posterior to the sternum and the transverse thoracic muscles

A

Anterior Mediastinum

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15
Q

What does the Anterior Mediastinum contain?

A 
(4)
remnants of the thymus gland
lymph nodes
fat
connective tissue
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16
Q

Lies between the right and left pleural cavities

A

Middle Mediastinum

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17
Q

What does Middle Mediastinum contain?

A 
(6)
heart
pericardium
phrenic nerves
roots of the great vessels (aorta, pulmonary arteries and veins, and vena cavae)
arch of the azygous vein
main bronchi.
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18
Q

Lies posterior to the pericardium between the mediastinal pleurae

A

Posterior Mediastinum

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19
Q

What contains the Posterior Mediastinum?

A 
(8)
esophagus
thoracic aorta
azygos and hemiazygos veins
thoracic duct
vagus nerves
sympathetic trunk
splanchnic nerves
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20
Q

Where is the recurrent branch of left laryngeal nerve?

A

arch on the arch of the aorta

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21
Q

Where is the recurrent branch of right laryngeal nerve?

A

arch through brachiocephalic artery

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22
Q

What are the boundaries of the inferior mediastinum?

A

Anterior: body of sternum
Posterior: vertebra
Inferior: diaphragm

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23
Q

Begins at the inferior border of the cricoid cartilage as a continuation of the larynx and ends by bifurcating into the right and left main stem bronchi at the level of the sternal angle

A

Trachea

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24
Q

At what level is the cricoid cartilage?

A

C6

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25
Q

At what level is the hyoid bone?

A

C2

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26
Q

At what level is the thyroid cartilage?

A

C4

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27
Q

Trachea is approximately 12 cm in length and what does it have that open posteriorly toward the esophagus and prevent the trachea from collapsing?

A

16 to 20 incomplete hyaline cartilaginous rings

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28
Q

It may be compressed by an aortic arch aneurysm, a goiter, or thyroid tumors, causing dyspnea

A

Trachea

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29
Q

What does the trachea have which is a downward and backward projection of the last tracheal cartilage, which lies at the level of the sternal angle and forms a keel-like ridge separating the openings of the right and left main bronchi?

A

carina

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30
Q

It is the internal landmark where trachea bifurcates into right and left mainstem bronchi

A

carina

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31
Q

What surgical procedure requires carina to be known?

A

Bronchoscopy

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32
Q

Carina may be distorted, widened posteriorly, and immobile in the presence of a?

A

bronchogenic carcinoma

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33
Q

What is one of the most sensitive areas of the tracheobronchial tree and is associated with the cough reflex?

A

The mucous membrane over the carina

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34
Q

Where is the direct origin of inferior thyroid artery?

A

thyrocervical trunk

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35
Q

What supplies blood in the upper trachea?

A

inferior thyroid artery

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36
Q

What supplies blood in the lower part of trachea?

A

Branches of the bronchial artery

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37
Q

Where is the venous drainage of trachea?

A

Inferior thyroid venous plexus

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38
Q

It is the shorter, wider and more vertical bronchus.

A

Right main (Primary) Bronchus

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39
Q

Runs under the arch of the azygos vein and divides into 3 lobar or secondary bronchi and finally into 10 segmental bronchi

A

Right main (Primary) Bronchus

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40
Q

The right superior lobar (secondary) bronchus is known as?

A

eparterial (above the artery) bronchus

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41
Q

All other types of secondary bronchus are?

A

hyparterial (below artery) bronchi.

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42
Q

What are the 3 lobar bronchus of right main bronchi?

A

superior, middle, and inferior

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43
Q

Runs inferolaterally inferior to the arch of the aorta, crosses anterior to the esophagus and thoracic aorta, and divides into 2 lobar or secondary bronchi, the upper and lower, and finally into 8 to 10 segmental bronchi.

A

Left Main (Primary) Bronchus

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44
Q

Which main bronchi are more foreign bodies likely to enter through the trachea?

A

Right main (Primary) Bronchus

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45
Q

Longer, narrower, and more angulated bronchus

A

Left Main (Primary) Bronchus

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46
Q

What does the left main bronchus crosses superiorly on its proximal and distal parts respectively?

A

Proximal: arch of the aorta
Distal: left pulmonary artery

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47
Q

Chronic obstruction of airflow through airways and lungs

A

Chronic obstructive pulmonary disease (COPD)

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48
Q

inflammation of airways, resulting to excessive mucus production that plugs up airways

A

Chronic bronchitis

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49
Q

accumulation of air in the terminal bronchioles and alveolar sacs

A

Emphysema

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50
Q

chronic inflammation of bronchi that causes swelling and narrowing of airways

A

Asthma

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51
Q

general term for chronic dilation of bronchi and bronchioles

A

Bronchiectasis

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52
Q

A thin serous membrane that consists of a parietal pleura and a visceral pleura

A

Pleura

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53
Q

Lines the inner surface of the thoracic wall and the mediastinum and has costal, diaphragmatic, mediastinal, and cervical parts.

A

Parietal Pleura

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54
Q

The dome of the pleura, projecting into the neck above the neck of the first rib

A

cervical pleura (cupula)

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55
Q

What reinforced the cupula?

A

Sibson fascia/ suprapleural membrane

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56
Q

What innervates parietal pleura?

A

intercostal nerves

phrenic nerves

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57
Q

What supplies the parietal pleura?

A

branches of the internal thoracic (1)

superior (2), phrenic (3), posterior intercostal artery (4), and superior intercostal artery (5)

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58
Q

What do the veins of parietal pleura join?

A

systemic veins

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59
Q

What does the parietal pleura form, which is a two-layered vertical fold of mediastinal pleura, which extends along the mediastinal surface of each lung from the hilus to the base and ends in a free falciform border?

A

pulmonary ligament

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60
Q

Intimately invests the lungs and dips into all of the fissures

A

Visceral pleura (Pulmonary Pleura)

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61
Q

What supplies visceral pleura?

A

bronchial arteries

62
Q

What drains the venous blood of visceral pleura?

A

pulmonary veins

63
Q

Which pleura is sensitive to pain and which is sensitive to stretch?

A

pain: parietal pleura
stretch: visceral pleura

64
Q

It contains vasomotor fibers and sensory endings of vagal origin, which may be involved in respiratory reflexes

A

Visceral pleura (Pulmonary Pleura)

65
Q

lower border of lung midclavicular lines, midaxillary lines, and sides of vertebral column (paravertebral line) respectively?

A

midclavicular: 6th rib
midaxillary: 8th rib
paravertebral: 10th rib

66
Q

lower border of pleura midclavicular lines, midaxillary lines, and sides of vertebral column (paravertebral line) respectively?

A

midclavicular: 8th rib
midaxillary: 10th rib
paravertebral: 12th rib

67
Q

• A potential space between the parietal and visceral pleurae
• Represents a closed sac with no communication between right and left parts
Contains a film of fluid that lubricates the surface of the pleurae and facilitates the movement of the lungs

A

Pleural Cavity

68
Q
  • Pleural recesses formed by the reflection of the costal and diaphragmatic pleurae
    * Can accumulate fluid when in the erect position
    * Allow the lungs to be pulled down and expanded during inspiration
A

Costodiaphragmatic Recesses

69
Q

Are part of the pleural cavity where the costal and mediastinal pleurae meet

A

Costomediastinal Recesses

70
Q

accumulation of air in the pleural cavity, the lung collapses because the negative pressure necessary to keep the lung expanded has been eliminated.

A

Pneumothorax

71
Q

Can be treated by draining the pleural air collection by simple aspiration using an intravenous catheter or chest tube thoracostomy (needling)

A

Pneumothorax

72
Q

abnormal accumulation of fluid in the pleural cavity

A

Pleural effusion

73
Q

Usually seen in car accidents, blunt trauma to the thorax

A

Pneumothorax

74
Q

clear watery fluid

A

Transudate

75
Q

cloudy viscous fluid

A

Exudate

76
Q

How is pleural effusion treated?

A

thoracentesis

77
Q

A surgical puncture of the thoracic wall into the pleural cavity for aspiration of fluid

A

Thoracentesis (pleuracentesis or pleural tap)

78
Q

Where are the ideal sites in thoracentesis?

A

7th, 8th, or 9th intercostal space, inserted above the superior margin of a rib

79
Q

What sites are avoided during thoracentesis?

A

lung, spleen, liver, diaphragm

intercostal neurovascular bundle

80
Q

Essential organs of respiration and are attached to the heart and trachea by their roots and the pulmonary ligaments

A

Lungs

81
Q

What nourishes and drains nonrespiratory tissues respectively?

A

nourished by: bronchial arteries
drained by: bronchial veins for the larger subdivisions of the bronchi
pulmonary veins for the smaller subdivisions of the bronchial tree

82
Q

Parasympathetic indication of lungs

A

bronchoconstrictor and secretomotor

83
Q

Sympathetic indication of lungs

A

bronchodilator and vasoconstrictor

84
Q

Have some sensory endings of vagal origin, which are stimulated by the stretching of the lung during inspiration and are concerned in the reflex control of respiration

A

Lungs

85
Q

Larger and heavier but is shorter and wider

A

Right lung

86
Q

Why is the right lung shorter and wider?

A

because of the liver presence in the diaphragm

87
Q

Right lung has 3 lobes which are divide by?

A

oblique and horizontal (accessory) fissures

88
Q

usually begins at the head of the fifth rib and follows roughly the line of the sixth rib.

A

oblique fissure

89
Q

runs from the oblique fissure in the midaxillary line at the sixth rib level and extends forward to the fourth costal cartilage level

A

horizontal fissure

90
Q

How many is the bronchial artery of right lung?

A

1

91
Q

Has 3 lobar (secondary) bronchi and 10 segmental (tertiary) bronchi

A

Right lung

92
Q

Has grooves for various structures (e.g., SVC, arch of azygos vein, esophagus)

A

Right lung

93
Q

What divides the left lung?

A

an oblique fissure

94
Q

Where is an oblique fissure usually more vertical?

A

Left lung

95
Q

a tongue-shaped portion of the upper lobe that corresponds to the middle lobe of the right lung

A

lingula

96
Q

Contains a cardiac impression, a cardiac notch (a deep indention of the anterior border of the superior lobe of the left lung), and grooves for various structures (e.g., aortic arch, descending aorta, left subclavian artery)

A

Left lung

97
Q

Has 2 lobar (secondary) bronchi and 8 to 10 segmental bronchi

A

Left lung

98
Q

The anatomic, functional, and surgical unit (subdivision) of the lungs

A

Bronchopulmonary Segment

99
Q

What consists the Bronchopulmonary Segment?

A

segmental (tertiary or lobular) bronchus
segmental branch of the pulmonary artery
segment of the lung tissue

100
Q

Refers to the portion of the lungs supplied by each segmental bronchus and segmental artery. The pulmonary veins are said to be intersegmental.

A

Bronchopulmonary Segment

101
Q

What drains the Bronchopulmonary Segment?

A

intersegmental part of the pulmonary vein

102
Q

What does the intersegmental pulmonary veins form which allows the removal of a bronchopulmonary segment without seriously disrupting the surrounding lung tissue and major blood vessels?

A

surgical landmarks

103
Q

What are the main bronchopulmonary segments of the right lung?

A

Superior lobe: apical, posterior, anterior
Middle lobe: lateral, medial
Inferior Lobe: superior (apical), medial basal, anterior basal, lateral basal, posterior basal

104
Q

What are the main bronchopulmonary segments of the left lung?

A

Superior: apical, posterior, anterior, superior lingular, inferior lingular
Inferior lobe: superior (apical), medial basal, anterior basal, lateral basal, posterior basal

105
Q

Includes the nasal cavity, nasopharynx, larynx, trachea, bronchi, bronchioles (possess no cartilage), and terminal bronchioles

A

Conducting Portion

106
Q

Includes the respiratory bronchioles, alveolar ducts, atria, and alveolar sacs.

A

respiratory portion

107
Q

Vital exchange of oxygen and carbon dioxide that occurs in the lungs.

A

Respiration

108
Q

What does the air-blood barrier contain?

A

alveolar type I cells,
basal lamina, and
capillary endothelial cells

109
Q

What does The alveolar type II cells secrete?

A

Surfactant

110
Q

When is the surfactant completed?

A

34 weeks

111
Q

What does the surfactant do?

A

Increases surface tension of lungs

112
Q

Occurs when the ribs and sternum (or thoracic cage) are elevated by the following muscles: diaphragm; external, internal (interchondral part), and innermost intercostal; sternocleidomastoid; levator costarum; serratus anterior; scalenius; pectoralis major and minor; and serratus posterior superior muscles.

A

Inspiration

113
Q

Pulls the dome inferiorly into the abdomen, thereby increasing the vertical diameter of the thorax

A

Contraction of the Diaphragm

114
Q

Reduces the intrapulmonary pressure (creates a negative pressure), thus allowing air to rush into the lungs passively because of atmospheric pressure

A

Enlargement of the Pleural Cavities and Lungs

115
Q

Involves contraction off the intercostal muscles and elevation of ribs (superolateral movement), with the sternum moving anteriorly like a bucket handle. (When the handle is raised, the convexity moves laterally)

A

Forced Inspiration

116
Q

Results in increased transverse and anteroposterior diameters of the thoracic cavity. The abdominal volume is decreased with an increased abdominal pressure

A

Forced Inspiration

117
Q

What is the primary muscle of inspiration and its innervation?

A

Diaphragm

Innervated by C2-C4

118
Q

Involves the following muscles: muscles of the anterior abdominal wall, internal intercostal (costal part) muscles, and serratus posterior inferior muscles

A

Expiration

119
Q

Involves relaxation of the diaphragm, the internal intercostal muscles (costal part), and other muscles; decrease in thoracic volume; and increase in the intrathoracic pressure.

A

Overall Process

120
Q

What happens to the abdominal pressure and position of ribs in expiration?

A

abdominal pressure - decreased

ribs - depressed

121
Q

Produces a subatmospheric pressure in the pleural cavities. Thus, much of the air is expelled.

A

Elastic Recoil of the Lungs

122
Q

A passive process caused by the elastic recoil of the lungs

A

Quiet expiration

123
Q

It results from contraction of the diaphragm

A

quiet inspiration

124
Q

Requires contraction of the anterior abdominal muscles and the internal intercostals (costal part)

A

Forced Expiration

125
Q

What is the primary muscle of expiration?

A

No primary muscle, because it is a passive process

126
Q

Drain the bronchial tree, pulmonary vessels, and connective tissue septa

A

Lymphatic Vessels of the Lungs

127
Q

Direction of drainage in the bronchiole and bronchi

A 
bronchopulmonary nodes
tracheobronchial nodes
tracheal nodes
bronchomediastinal nodes 
thoracic duct on the left and right lymphatic duct on the right
128
Q

Extends upward from the conus arteriosus of the right ventricle of the heart and carries poorly oxygenated blood to the lungs for oxygenation

A

Pulmonary Trunk

129
Q

Passes superiorly and posteriorly from the front of the ascending aorta to its left side for approximately 5 cm and bifurcates into the right and left pulmonary arteries within the concavity of the aortic arch at the level of the sternal angle

A

Pulmonary Trunk

130
Q

Has much lower blood pressure than that in the aorta and is contained within the fibrous pericardium

A

Pulmonary Trunk

131
Q

Serves as landmark to distinguish eparterial and hyparterial bronchi

A

Pulmonary Trunk

132
Q

Carries deoxygenated blood to the left lung, is shorter and narrower than the right pulmonary artery, and arches over the left primary bronchus

A

Left Pulmonary Artery

133
Q

Connected to the arch of the aorta by the fibrous remains of the ductus arteriosus called?

A

ligamentum arteriosum

134
Q

Runs horizontally toward the hilus of the right lung under the arch of the aorta behind the ascending aorta and SVC and anterior to the right bronchus

A

Right Pulmonary Artery

135
Q
  • Carry oxygenated blood from the respiratory part (alveoli) of the lung
  • Intersegmental in drainage
  • only four veins enter the left atrium
A

Pulmonary Veins

136
Q

Arise from the thoracic aorta; usually there is one artery for the right lung and two for the left lung

A

Bronchial Arteries

137
Q

Supply oxygenated blood to the nonrespiratory conducting tissues of the lungs and the visceral pleura.

A

Bronchial Arteries

138
Q

Receive blood from the bronchi and empty into the azygos vein on the right and in accessory hemiazygos vein or the superior intercostal vein on the left

A

Bronchial Veins

139
Q

May receive twigs (small vessels) from the tracheobronchial lymph nodes

A

Bronchial Veins

140
Q

An obstruction of the pulmonary artery or one of its branches by an embolus (air, blood clot, fat, tumor cells, or other foreign material)

A

Pulmonary embolism (pulmonary thromboembolism)

141
Q

Bed-ridden people and people with varicose veins are at risk to this

A

Pulmonary embolism (pulmonary thromboembolism)

142
Q

Receives afferent and efferent (parasympathetic preganglionic) fibers from the vagus nerve, joined by branches (sympathetic postganglionic fibers) from the sympathetic trunk and cardiac plexuses

A

Pulmonary Plexus

143
Q

What are the two divisions of Pulmonary Plexus?

A

anterior pulmonary plexus

posterior pulmonary plexus

144
Q

Arises from the third through fifth cervical nerves (C3-C5) and lies in front of the anterior scalene muscle

A

Phrenic Nerve

145
Q

It supplies the central diaphragm, mediastinal pleura, and pericadium.

A

Phrenic Nerve

146
Q

What part of diaphragm is supplied by the 6th to 12tg intercostal nerves

A

Peripheral diaphragm

147
Q

The conducting (airway) system through the terminal bronchioles develops. Respiration is not possible

A

Glandular Period (Prenatal Weeks 5 to 17)

148
Q

Luminal diameter of the conducting system increases, and respiratory bronchioles, alveolar ducts, and terminal sacs begin to appear. Premature fetuses born before week 20 rarely survive

A

Canalicular Period (Prenatal Weeks 13 to 25)

149
Q

More terminal sacs form, and alveolar type I cells and surfactant-producing alveolar type II cells develop. Respiration is possible, and premature infants can survive with intensive care

A

Terminal Sac Period (Prenatal Weeks 24 to Birth)

150
Q

Respiratory bronchioles, terminal sacs, alveolar ducts, and alveoli increase in number

A

Alveolar Period (Late Fetal Stage to 8 Years)

General Anatomy 1 (31 decks)

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