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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

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

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

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?

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?

95
Q

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

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)

97
Q

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

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?

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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