Practical 1&2 Flashcards
1
Q
What does the thoracic wall comprise of
A
Sternum (anteriorly)
Vertebrae T1-T12 (posteriorly)
Ribs 1-12 (laterally)
2
Q
Which bones articulate with the manubrium at it superolateral angles
A
1st ribs
3
Q
What name is given to the joint between the manubrium and first ribs
A
Sternocostal joint
4
Q
What type of joint is the sternocostal joint
A
synovial plane joints (Synchondrosis)
5
Q
What is the name given to the notch formed by the superior angle of the manubrium
A
Jugular notch
6
Q
What vertebral level is the xiphoid process loctaed
A
T10
7
Q
At what vertebral level is the sternomanubrial joint (sternal angle) found
A
T4 and T5
8
Q
The facets for the 2nd costal cartilage articulate with what part of the sternum
A
Sternal angle (sternomanubrial joint)
9
Q
What are the features of a typical rib (8)
A
Crest of head (articulates with vertebrae) Superior articular facet Inferior articular facet Neck Tubercle Angle Site of articulation with costal cartilage Costal groove
10
Q
What structures lie in the costal groove
A
Intercostal vein, artery and nerve (VAN)
11
Q
Which ribs are true ribs (vertebrosternal)
A
1-7 (directly attache to sternum)
12
Q
Which ribs are false ribs (vertebrochondral)
A
8-10 (indirect connection)
13
Q
Which ribs are floating ribs (vertebral)
A
11-12 (do not connect to sternum)
14
Q
Features of the 1st rib
A
Scalene tubercle
Groove for subclavian artery
groove for subclavian vein
15
Q
What order do the vessels and muscles lie on the first rib
A
Vein
Muscle
Artery
16
Q
What structures pass through the vertebral foramen
A
Spinal Cord
17
Q
What structures pass through the intervertebral foramen
A
Spinal nerve root
Spinal artery and vein
Plexuses
18
Q
What part of the rib articulates with the articular facet on the transverse process
A
Tubercle
19
Q
Which 2 parts of the vertebra form the neural (vertebral arch) that enclose the spinal cord
A
Lamina and pedicle
20
Q
What vertebral bodies does a typical rib articulate with
A
The vertebral body of the same number as the rib and the vertebral body above
21
Q
Which ribs are most prone to fractures and why?
A
5-10 as they are relatively more exposed and fixed
22
Q
The thorax is bounded superiorly by the
A
Thoracic inlet
23
Q
the thorax is bounded inferiorly by the
A
Thoracic outlet
24
Q
Which bones form the boundaries of the thoracic inlet
A
1st ribs, manubrium, T1 vertebra, costal cartilages
25
Which bones/costal cartilages form the boundaries of the thoracic outlet
T12 vertebra, 11-12th rib, costal cartilages of ribs 7-10, Xiphisternal joint
26
Which costal cartilages are directly attached to the sternum
1-7
27
Which costal cartilages are indirectly attached to the sternum
8-10
28
Which muscle is primarily used for breathing in the newborn
Diaphragm
29
Muscle fibre orientation of external intercostal muscle (superficial)
Inferoanteriorly
30
Muscle fibre orientation of internal intercostal muscle (intermdiate)
Inferoposteriorly
31
Muscle fibre orientation of innermost intercostal (deep_
Inferoposteriorly
32
Between which two intercostal muscles is the neurovascular bundle located
Innermost (deep) and internal (intermediate) intercostal muscles
33
From superior to inferior which structures comprise the neurovascular bundle
Intercostal vein, artery and nerve
34
In which area of the rib is the neurovascular bundle located
Costal groove
35
In relation to the rib where does the neurovascular bundle sit
Inferiorly
36
Role of intercostal muscle
Contribute to respiratory movements of chest wall
| Assist in preventing the lungs and pleura from ballooning out between the ribs during these movements
37
What structure due the neurovascular bundles give off
small collateral branch located at the top of each rib
38
Where is the normal location for placement of a chest drain
5th intercostal space (below 5th rib) in the mid-axillary line
39
Where in the intercostal space do you think a chest drain needle should be inserted to avoid damaging the neurovascular structures
inserting on upper border of 5th rib
40
layers of chest wall (9)
```
Skin
Superficial fascia
Deep fascia
External intercostal muscle
Internal intercostal muscle
Innermost intercostal muscle
Parietal pleura
Pleural cavity
Visceral pleura
```
41
What are the structure of extrapulmonary tibes (trachea, bronchi outside of the lung) lumen to outside of tube
Mucosa
Submucosa
cartilage
Adventitia
42
What 2 layers is the mucosa comprised of
Epithelium
| Lamina propria
43
What type of cartilage is found in the respiratory tratc
Hyaline
44
What connective tissue fibre predominates the respiratory tract
Elastin
45
What type of muscle fibre (skeletal, smooth) is found in the respiratory tract
smooth
46
name the two cell types found in the epithelial layer
Goblet and Ciliated cells
47
What type of epithelium is found
pseudostratifies ciliates columnar
48
What the small hair-like structures projecting from the epithelial cells into the lumen
Cilia
49
What substance is secreted by the glands in the submucosa
mucous
50
What tubular structure lies immediately posterior to the trachea
Oesophagus
51
What name is given to the smooth muscle found in the posterior wall of the trachea
Trachealis muscle
52
What is the function of the posterior strip of smooth muscle found in the tracheal wall
Constrict the trachea, allowing air to be expelled with more force
53
What type of glands are located in the mucosa
Exocrine
54
Upper respiratory tract
Nasal cavity
Pharynx
Larynx
55
Lower respiratory tract
Trachea
Primary Bronchi
Lungs
56
What cartilage forms the laryngeal prominence
Thyroid cartilage
57
What structure prevents solids and liquids entering laryngeal inlet
Epiglottis
58
What cartilages are attached to the vocal cords
Thyroid and Arytenoid Cartilage
59
Where does the LRT receive motor innervation from
Sympathetic fibres originating in the upper thoracic spinal levels, via pulmonary plexuses, and parasympathetic fibres from the vagus nerve
60
Where does the LRT receive arterial supply via
Bronchial arteries arising from the thoracic aorta and intercostal arteries
61
Wjat drains the azygous venous system
Bronchial veins
62
Where does the trachea extend from
Inferior continuation of larynx (C6) to T4 (sternal angle) where it birfurcates to form left and right main bronchus
63
How many rings does the trachea have
15-20
64
What is the muscle that completes the tracheal rings posteriorly
Involuntary trachealis muscle
65
What is the final, keel-shaoed cartilage ring at the bifurcation of the trachea
Carina
66
What is the tubular organ lying immediately posterior to the trachea
oesophagus
67
What are the arteries called that lie immediately lateral to the trachea in the neck
Common carotid arteries
68
What is the name of the nerve that lies immediately laterally to the trachea on both sides
Vagus nerve
69
The grooves lying between trachea and oesophagus on both sides
Tracheo-oesophagus grooves
70
At what vetebral level does the trachea divide into the two main bronchi
T4
71
Which of thr 2 main bronchi are shorter, wider and more vertical
Right
72
Two major arteries that arch above the left main bronchus
Aorta and Left pulmonary artery
73
What is the superior branch of the right lung called
Eparietal or superior lobe bronchus
74
What are the lymph nodes called that lie in between the 2 main bronchi
Tracheibronchial lymph nodes
75
What are the lymph nodes called that lie at the hilum
Bronchomediastinal lymph nodes
76
Unique features of left lung
```
Cardiac notch
Cardiac impression
Lingula
Aortic impression
2 lobes (upper and lower)
```
77
Unique features of right lung
Horizontal (transverse fissure)
3 lobes (upper, middle and lower lobe)
Superior lobar bronchus
78
On which surface is the hilum found
Mediastinal
79
What is the hilum
an area located on the medial surface of the lung that contains openings for the bronchi, pulmonary artery, sup and inf pulmonary vein
80
What is the root of the lung
The group of structures that enter or leave the lung
81
What 4 structures constitute the root of the lung
Bronchi, Pulmonary artery, Superior pulmonary vein, Inferior pulmonary vein
82
What fascial membrane covers the apex of the lung
Cervical pleural membarne
83
Do lungs extend above the 1st rib and clavicle
No, only the pleura does to protect the lungs
84
Which lung is shorter and broader of the 2 and why
Right lung due to the liver pushing the diaphragm up
85
Describe the lymphatic drainage of the lungs
Bronchopulmonary LN
Tracheobronchial LN
Thoracic duct and Right Lymphatic Duct
86
Right Lung structures
```
Inferior Pulmonary Vein
Bronchi
Bronchi (eparietal)
Artery
Superior Pulmonary Vein
```
87
Left Lung Structures
Inferior Pulmonary Vein
Bronchi
Artery
Superior Pulmonary Vein
88
Where does deoxygeneated blood travel to
From the SVC and IVC they travel to right atrium and pumped through tricupsid valves to right ventricle and pumped through pulmonary valve to the pulmonary artery to the lungs
This blood is returned via the pulmonary vein to the left atrium and ventricle of the heart to be pumped to the rest of the body
89
What is a dermatome
Unilateral area of skin innervated by the general sensory fibres of a single spinal nerve
90
What explains the discontinuity between dermatomes on the chest wall at this level between T2 and C4
Brachial Plexus
91
What dermatome overlies the sternal angle
T2
92
What dermatome overlies the nipple
T4
93
What dermatome overlies the umbilicus
T10
94
What dermatome overlies the inguinal region
L1
95
Location of the major groups of lymph nodes (6)
```
Axillary
Superificial and deep inguinal
Pectoral
Tracheobronchial
Lumbar/Pelvic
Superficial cervical and Deep Cervical
```
96
How many lobes does the glandular part of the breast divided into
16-20 lobes
97
What type of epithelium is found in the bronchioles
Columnar or Cuboidal
98
Are there glands, cartilage or smooth muscle in bronchioles
They only have smooth muscle
99
The absence of which 3 main features in the wall of a bronchiole distinguishes it from bronchus
Goblet cells, cartilage and mucosal glands
100
What does the patency of bronchioles rely on
Smooth muscle tone
101
What are the names and functions of cells found in the wall of the alveolus
Type 1- gas exchange
Type 2- Surfactant
Macrophages- engulf invading pathogens and foreign bodies
102
Which layer of the pleura enters and lines the fissures of the lungs
Visceral Pleura
103
What layer of the pleura is sensitive to pain
Parietal
104
Parts of the parietal pleura
Apical (cervical)
Costal
Mediastinal
Diaphragmatic
105
The costal pleura reflects onto the superior part of the diaphragm to form the
Costodiaphragmatic recess and reflection
106
Behind the sternum where costal pleura doubles back to become the mediastinal pleura
Costomedialstinal Reflection
107
T4/T5
```
Sternal angle/angle of Louis
Bifurcation of trachea
Start of aortic arch
Azygous arch enters
SVC
```
108
In the mid-clavicular line the inferior border of the lung is ___ and Parietal Pleura is _____
rib 6 and 8
109
In the mid-axillary line the inferior border of the lung is____ and Parietal pleura is____
rib 8 and 10
110
In the mid-scapular line the inferior border of the lung is___ and parietal pleura is__
rib 10 and 12
111
What organ occupies the notch seen in the anterior border of the left lung between ribs 4-6
Heart
112
The oblique fissures follows the course of rib___
6
113
The horizontal fissure follows the course of rib___
4
114
The posterior border of each lung extends from vertebra
C7 to T10
115
Suitable place for pleural aspiration
9th intercostal space in the midaxillary line
116
Features of the diaphagm
Left and right domes
Central tendon
Left and right crus
117
Openings of the diaphragm
IVC
Oesophagus
Aorta
118
What cardiac structure is firmly attached to the central tendon
Fibrous pericardium
119
To which vertebrae are the left and right crura attached
Left: L1-L2/3
| Right- :L1-L3/4
120
Which membrane covers the superior surface of the diaphragm
Diaphragmatic parietal pleura
121
What is the shape of the central tendon
Clover
122
To which tendon is the diaphragm attached to
Central tendon
123
To which costal cartilage is the diaphragm attached to
7/8-10
124
To which part of the sternum is the diaphragm attached
Xiphoid Process
125
To which vertebrae is the diaphragm attached
L1-L4
126
Opening of IVC on diaphragm
T8
127
Opening of Oesphagus on Diaphragm
T10
128
Opening of aorta on diaphragm
T12
129
Through which part of the diaphragm does the inferior cava pass
Central tendon
130
Which vertebral levels of the spinal cord contribute to the phrenic nerves
C3, C4, C5
131
Where does the base of the breast lie
ribs 2-6 and between the lateral border of the sternum and midaxillary line
132
Where is the tail of spence located
Extends superolaterally to penetrate the floor of the axilla
133
What nerves supplies the parital pleura
Phrenic nerve and intercostal nerves
134
Lungs extend _ rib spaces less than pleura
2
135
Pleura extend
2 4 6 8 10 12
136
Fissures- Oblique
Spine of T3 to rib 6 along medial border of scapula
137
Fissures- Horizontal (on R only)
rib/costal cartilage 4 to rib 5 in mid axillary line
