Pleura and Lungs Flashcards
1
Q
Suprasternal Notch
A
lower border of body of T2 and upper border of manubrium
2
Q
Subcostal Angle
A
between sternum and 7th costal cartilage
3
Q
Costal Margin
A
10th rib at the level of T3
4
Q
Central Tendon
A
opposite T9
5
Q
Diaphragm Right Dome
A
superior border of 5th rib
6
Q
Diaphragm Left Dome
A
inferior border of 5th rib
7
Q
Nipple
A
4th intercostal space; 4 inches from midline
8
Q
Apex Beat
A
5th intercostal space; 3.5 inches from midline
9
Q
Scapula
A
T2: superior angle
T3: spinous process
T7: inferior angle
10
Q
Apex
A
1 inch above junction of medial and intermediate thirds of the clavicle
11
Q
Right Lung
A
from sternoclavicular joint reaches midline behind sternal angle until xiphisternal joint
12
Q
Left Lung
A
from behind sternoclavicular joint deviates laterally at the lateral margin of the sternum at the 4th costal cartilage
13
Q
Inferior Border of the Lungs
A
midclavicular: 6th rib
midaxillary: 8th rib
paravertebral: 10th rib
14
Q
Posterior Border
A
C7-T12; 1.5 in from midline
15
Q
Oblique Fissure
A
from T3 to 6th rib to 6th costochondral junction
16
Q
Oblique Fissure on Lobes of Left Lung
A
upper lobe: above and anterior
lower lobe: below and posterior
17
Q
Horizontal Fissures on Lobes of Right Lung
A
upper lobe: above
middle lobe: below
lower lobe: below and posterior
18
Q
Horizontal Fissures
A
along 4th costal cartilage to meet oblique fissure at midaxillary line
19
Q
Cervical Pleura
A
1 inch above clavicle
20
Q
Anterior Border of Right Pleura
A
behind SC –> midline behind sternal angle –> xiphisternal joint
21
Q
Anterior Border of Left Pleura
A
behind SC –> midline behind sternal angle –> 4th costal cartilage –> deviates laterally –> cardiac notch
22
Q
Lower Border of Pleura
A
midclavicular: 8th rib
midaxillary: 10th rib
paravertebral: 12th rib
23
Q
Costodiaphragmatic Recess
A
between lung and pleura
24
Q
Pleural Reflection
A
midclavicular: rib 8
midaxillary: rib 10
paravertebral: rib 12
25
Apex Beat of the Heart
formed by left ventricle
at 5th left intercostal space; 3.5 in from midline
26
Superior Border of Heart
roots of great blood vessels
2nd left costal cartilage until 3rd right costal cartilage
27
Right Border of the Heart
right atrium
3rd right costal cartilage to 6th right costal cartilage
28
Left Border of the Heart
left ventricle
2nd left costal cartilage to apex beat
29
Inferior Border
right ventricle and apical part of left ventricle
6th right costal cartilage to apex beat
30
Sternum Fracture
not common (sternum held by costal cartilages)
can cause trauma to heart
31
Possible Injury to the Back of the Chest
spinal cord injury
scapula can be fractured in severe trauma
thoracic roots may be affected (everything else below will not function)
32
Rib Contusion
most common injury
bruising
33
Rib Fracture
at the angle of the rib
5th-10th rib
can cause pneumothorax
34
Flail Chest
section of chest has been detached due to multiple fractures
35
Diaphragmatic Hernia
incomplete fusion of the septum, transversum, dorsal mesentery, and pleuroperitoneal membrane
36
Hiccups
involuntary spasmodic contraction
gastric irritation of vagus nerve ending (C10)
37
Hemothorax
blood in pleural cavity
38
Pneumothorax
air in pleural cavity
39
Open pneumothorax
air presses on the lungs (cannot expand)
40
Thoracostomy
insertion of tube
41
Thoracotomy
open lung/ rib cage
42
Safe Triangle Boundaries
anterior: border of latissimus dorsi
laterally: border of pectoralis major
base: apex of axilla
horizontal: line level of nipple
43
Anterior Approach of Needle Thoracostomy
2nd intercostal space
44
Lateral Approach of Tube Thoracostomy
2nd intercostal space
45
Anterior Approach of Tube Thoracostomy
4th-5th intercostal space
46
Kyphosis
degeneration of intervertebral discs or compression fracture
47
Pleural Cavities Boundaries
anterior: above rib 1 to root of neck
inferior: level just above costal margin
medial: mediastinum
48
Pulmonary Ligament
at the hilum
allows movement of pulmonary vessels and large bronchi during respiration
49
Pulmonary Cavity
space between parietal and visceral pleura
lessens friction
50
Cervical Pleura
dome shape of parietal pleura lining the cervical extension
supplied by costal nerve
51
Costal Pleura
inner surface of ribs, costal cartilage, and sides of vertebral bodies and back of sternum
supplied by intercostal nerves
52
Mediastinal Pleura
covers the mediastinum
supplied by phrenic nerve
53
Diaphragmatic Pleura
covers thoracic surface of diaphragm
supplied by phrenic and 6 intercostal nerves
sensitive to pain, touch, temperature, and pressure
54
Visceral Pleura
attached to the surface of the lungs
supplied by visceral afferent nerve
only sensitive to stretch
55
Recesses
provides potential spaces where fluid can accumulate and lungs enlarge
56
Costodiaphragmatic Recess
between costal and diaphragmatic parietal pleura
lung expands during inspiration
57
Costomediastinal Recess
anterior costal margin
largest on the left side
58
Pleural Fluid
5-10ml
lubricates
capillaries absorb pleural fluid
pleural effusion: abnormal accumulation of fluid
59
Pleurisy or Pleuritis
inflammation of pleura
60
Empyema
pus in pleural cavity
61
Pleural Effusion
excess serous fluid in pleural cavity
62
Upper Respiratory Tract
nasal passages and sinuses
pharynx
larynx
upper portion of trachea
63
Lower Respiratory Tract (Tracheobronchial Tree)
lower part of trachea
bronchi
bronchioles
64
Trachea
5 inches long and 1 inch in diameter
from cricoid cartilage (C6) as a continuation of the larynx
divides to right and left bronchi at sternal angle (T4-T5 or carina)
nerve supply: branches from vagus and recurrent laryngeal nerve and sympathetic trunk
not completely covered at the posterior with hyaline
65
Trachealis
made up of fibroelastic wall with U shape hyaline cartilages that keep the lumen patent
66
Trachealis Anterior Relationship
sternum
thymus gland
left brachiocephalic vein
origin of brachiocephalic
left common carotid artery
arch of aorta
67
Trachealis Posterior Relationships
esophagus
left recurrent laryngeal nerve
68
Trachealis Right Relationships
azygous vein
right vagus nerve
pleura
69
Trachealis Left Relationships
arch of aorta
left common carotid artery
left subclavian arteries
left vagus
left phrenic
pleura
70
Carina
end junction of trachea that separates the opening of bronchi
71
Bronchi
bifurcates behind the arch of the aorta
72
Bifurcation of Bronchus
trachea --> primary bronchus --> lobar bronchi ---> segmental bronchi (bronchopulmonary segments) --> terminal bronchioles --> respiratory bronchioles --> alveolar ducts --> alveolar sac --> alveoli
73
Lobar Bronchus (Right)
superior lobar
middle lobar
inferior lobar
wider, shorter, more vertical (1 inch long)
74
Lobar Bronchus (Left)
superior lobe
inferior lobe
narrower, longer, more horizontal (2 inch long)
75
Bronchioles
from division of the smallest bronchi
<1 mm
no cartilage
lined by columnar epithelium
76
Terminal Bronchioles/ Respiratory Bronchioles
gas exchange between blood and air takes place
0.5mm
77
Alveolar Ducts
branches from the respiratory bronchioles
78
Alveolar Sacs
thin walled outpouching that consists of several alveoli opening in single chamber
79
Bronchopulmonary Segments
subdivision of a lung lobe
pyramidal in shape
surrounded by connective tissue
has a segmented bronchus, artery, lymph vessel, and autonomic nerve
segmental vein: between bronchopulmonary segments
80
Bronchopulmonary Segments of the Right Lung
superior: apical, anterior, posterior
middle: medial, lateral
inferior: apical basal, anterior basal, medial basal, lateral basal, posterior basal
81
Bronchopulmonary Segments of the Left Lung
superior: apical, anterior, posterior, superior lingular, inferior lingular
inferior: apical basal, medial basal, anterior basal, posterior basal, lateral basal
82
Lungs
soft, spongy, and elastic
covered with visceral pleura
83
Apex of the Lung
projects upward
84
Base of the Lungs
sits on the diaphragm
85
Costal Surface
corresponds to the concave chest wall
86
Mediastinal Surface
molds into the pericardium and other mediastinal structure
87
Hilum
depression in which the root of lung is attached
center/ middle of the lung
88
Cardiac Notch
concave indentation of the anterior margin of left lung
89
Lingula
tongue like projection from the inferior end of the cardiac notch
90
Root and Hilum
collection of structures that attach the lung to the mediastinum
91
Structures in the Hilum
pulmonary artery
2 pulmonary veins
main bronchus
bronchial vessels
nerves
lymphatics
92
Left Lung
2 lobes and 1 fissure
smaller
oblique fissure: T2 (posterior) to T6 (anterior) angulation
medial surface is adjacent to: heart, aortic arch, thoracic aorta, esophagus
93
Right Lung
3 lobes and 2 fissures
slightly larger, heavier
oblique fissure: T2 (posterior) to T6 (anterior) angulation
horizontal fissure: 4th intercostal space
medial surface is adjacent to: heart, inferior vena cava, superior vena cava, azygous vein, esophagus
94
Non Respiratory Circuit
supplies the tissue
bronchial artery supplies the: bronchi, connective tissue of lungs, parietal pleura
bronchial vein drains to: azygous vein, hemiazygous vein
95
Respiratory or Pulmonary Circuit
where gas exchange occurs
segmental arteries: deoxygenated blood to alveoli
intersegmental vein: oxygenated blood to left atrium
96
Pulmonary Plexus
from efferent and afferent fibers of the autonomic nervous system
sympathetic and parasympathetic efferent fibers
97
Sympathetic Efferent
bronchodilation
vasoconstriction
inhibits alveolar glands
98
Parasympathetic Efferent
bronchoconstriction
vasodilation
secremotor
99
Quiet Inspiration
contraction of diaphragm and intercostal muscles
first rib fixed by scaleni muscles
100
Forced Inspiration
scalenus anterior and medius
sternocleidomastoid
scapula is fixed by trapezius, levator scapula, rhomboids muscles
serratus anterior and pectoralis minor pull ribs up
101
Quiet Expiration
passive
elastic recoil of lungs
relaxation of diaphragm and intercostals
serratus posterior inferior and abdominal muscle
102
Forced Expiration
active
force contraction of the anterior abdominal wall
quadratus lumborum pulls 12th rib downward
serratus posterior inferior and latissimus dorsi
103
Abdominal Type of Respiration
common in babies and young children
104
Thoracic Type of Respiration
common in adults (more common in females)
