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Anatomy Respiratory Medicine > Practical 1&2 > Flashcards

Practical 1&2 Flashcards

1
Q

What does the thoracic wall comprise of

A

Sternum (anteriorly)
Vertebrae T1-T12 (posteriorly)
Ribs 1-12 (laterally)

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2
Q

Which bones articulate with the manubrium at it superolateral angles

A

1st ribs

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3
Q

What name is given to the joint between the manubrium and first ribs

A

Sternocostal joint

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4
Q

What type of joint is the sternocostal joint

A

synovial plane joints (Synchondrosis)

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5
Q

What is the name given to the notch formed by the superior angle of the manubrium

A

Jugular notch

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6
Q

What vertebral level is the xiphoid process loctaed

A

T10

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7
Q

At what vertebral level is the sternomanubrial joint (sternal angle) found

A

T4 and T5

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8
Q

The facets for the 2nd costal cartilage articulate with what part of the sternum

A

Sternal angle (sternomanubrial joint)

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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
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10
Q

What structures lie in the costal groove

A

Intercostal vein, artery and nerve (VAN)

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11
Q

Which ribs are true ribs (vertebrosternal)

A

1-7 (directly attache to sternum)

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12
Q

Which ribs are false ribs (vertebrochondral)

A

8-10 (indirect connection)

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13
Q

Which ribs are floating ribs (vertebral)

A

11-12 (do not connect to sternum)

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14
Q

Features of the 1st rib

A

Scalene tubercle
Groove for subclavian artery
groove for subclavian vein

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15
Q

What order do the vessels and muscles lie on the first rib

A

Vein
Muscle
Artery

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16
Q

What structures pass through the vertebral foramen

A

Spinal Cord

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17
Q

What structures pass through the intervertebral foramen

A

Spinal nerve root
Spinal artery and vein
Plexuses

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18
Q

What part of the rib articulates with the articular facet on the transverse process

A

Tubercle

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19
Q

Which 2 parts of the vertebra form the neural (vertebral arch) that enclose the spinal cord

A

Lamina and pedicle

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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

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21
Q

Which ribs are most prone to fractures and why?

A

5-10 as they are relatively more exposed and fixed

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22
Q

The thorax is bounded superiorly by the

A

Thoracic inlet

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23
Q

the thorax is bounded inferiorly by the

A

Thoracic outlet

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24
Q

Which bones form the boundaries of the thoracic inlet

A

1st ribs, manubrium, T1 vertebra, costal cartilages

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25
Q

Which bones/costal cartilages form the boundaries of the thoracic outlet

A

T12 vertebra, 11-12th rib, costal cartilages of ribs 7-10, Xiphisternal joint

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26
Q

Which costal cartilages are directly attached to the sternum

A

1-7

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27
Q

Which costal cartilages are indirectly attached to the sternum

A

8-10

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28
Q

Which muscle is primarily used for breathing in the newborn

A

Diaphragm

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29
Q

Muscle fibre orientation of external intercostal muscle (superficial)

A

Inferoanteriorly

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30
Q

Muscle fibre orientation of internal intercostal muscle (intermdiate)

A

Inferoposteriorly

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31
Q

Muscle fibre orientation of innermost intercostal (deep_

A

Inferoposteriorly

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32
Q

Between which two intercostal muscles is the neurovascular bundle located

A

Innermost (deep) and internal (intermediate) intercostal muscles

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33
Q

From superior to inferior which structures comprise the neurovascular bundle

A

Intercostal vein, artery and nerve

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34
Q

In which area of the rib is the neurovascular bundle located

A

Costal groove

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35
Q

In relation to the rib where does the neurovascular bundle sit

A

Inferiorly

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36
Q

Role of intercostal muscle

A

Contribute to respiratory movements of chest wall

Assist in preventing the lungs and pleura from ballooning out between the ribs during these movements

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37
Q

What structure due the neurovascular bundles give off

A

small collateral branch located at the top of each rib

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38
Q

Where is the normal location for placement of a chest drain

A

5th intercostal space (below 5th rib) in the mid-axillary line

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39
Q

Where in the intercostal space do you think a chest drain needle should be inserted to avoid damaging the neurovascular structures

A

inserting on upper border of 5th rib

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40
Q

layers of chest wall (9)

A 
Skin
Superficial fascia
Deep fascia
External intercostal muscle
Internal intercostal muscle
Innermost intercostal muscle
Parietal pleura
Pleural cavity
Visceral pleura
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41
Q

What are the structure of extrapulmonary tibes (trachea, bronchi outside of the lung) lumen to outside of tube

A

Mucosa
Submucosa
cartilage
Adventitia

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42
Q

What 2 layers is the mucosa comprised of

A

Epithelium

Lamina propria

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43
Q

What type of cartilage is found in the respiratory tratc

A

Hyaline

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44
Q

What connective tissue fibre predominates the respiratory tract

A

Elastin

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45
Q

What type of muscle fibre (skeletal, smooth) is found in the respiratory tract

A

smooth

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46
Q

name the two cell types found in the epithelial layer

A

Goblet and Ciliated cells

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47
Q

What type of epithelium is found

A

pseudostratifies ciliates columnar

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48
Q

What the small hair-like structures projecting from the epithelial cells into the lumen

A

Cilia

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49
Q

What substance is secreted by the glands in the submucosa

A

mucous

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50
Q

What tubular structure lies immediately posterior to the trachea

A

Oesophagus

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51
Q

What name is given to the smooth muscle found in the posterior wall of the trachea

A

Trachealis muscle

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52
Q

What is the function of the posterior strip of smooth muscle found in the tracheal wall

A

Constrict the trachea, allowing air to be expelled with more force

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53
Q

What type of glands are located in the mucosa

A

Exocrine

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54
Q

Upper respiratory tract

A

Nasal cavity
Pharynx
Larynx

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55
Q

Lower respiratory tract

A

Trachea
Primary Bronchi
Lungs

56
Q

What cartilage forms the laryngeal prominence

A

Thyroid cartilage

57
Q

What structure prevents solids and liquids entering laryngeal inlet

A

Epiglottis

58
Q

What cartilages are attached to the vocal cords

A

Thyroid and Arytenoid Cartilage

59
Q

Where does the LRT receive motor innervation from

A

Sympathetic fibres originating in the upper thoracic spinal levels, via pulmonary plexuses, and parasympathetic fibres from the vagus nerve

60
Q

Where does the LRT receive arterial supply via

A

Bronchial arteries arising from the thoracic aorta and intercostal arteries

61
Q

Wjat drains the azygous venous system

A

Bronchial veins

62
Q

Where does the trachea extend from

A

Inferior continuation of larynx (C6) to T4 (sternal angle) where it birfurcates to form left and right main bronchus

63
Q

How many rings does the trachea have

A

15-20

64
Q

What is the muscle that completes the tracheal rings posteriorly

A

Involuntary trachealis muscle

65
Q

What is the final, keel-shaoed cartilage ring at the bifurcation of the trachea

A

Carina

66
Q

What is the tubular organ lying immediately posterior to the trachea

A

oesophagus

67
Q

What are the arteries called that lie immediately lateral to the trachea in the neck

A

Common carotid arteries

68
Q

What is the name of the nerve that lies immediately laterally to the trachea on both sides

A

Vagus nerve

69
Q

The grooves lying between trachea and oesophagus on both sides

A

Tracheo-oesophagus grooves

70
Q

At what vetebral level does the trachea divide into the two main bronchi

A

T4

71
Q

Which of thr 2 main bronchi are shorter, wider and more vertical

A

Right

72
Q

Two major arteries that arch above the left main bronchus

A

Aorta and Left pulmonary artery

73
Q

What is the superior branch of the right lung called

A

Eparietal or superior lobe bronchus

74
Q

What are the lymph nodes called that lie in between the 2 main bronchi

A

Tracheibronchial lymph nodes

75
Q

What are the lymph nodes called that lie at the hilum

A

Bronchomediastinal lymph nodes

76
Q

Unique features of left lung

A 
Cardiac notch
Cardiac impression
Lingula
Aortic impression
2 lobes (upper and lower)
77
Q

Unique features of right lung

A

Horizontal (transverse fissure)
3 lobes (upper, middle and lower lobe)
Superior lobar bronchus

78
Q

On which surface is the hilum found

A

Mediastinal

79
Q

What is the hilum

A

an area located on the medial surface of the lung that contains openings for the bronchi, pulmonary artery, sup and inf pulmonary vein

80
Q

What is the root of the lung

A

The group of structures that enter or leave the lung

81
Q

What 4 structures constitute the root of the lung

A

Bronchi, Pulmonary artery, Superior pulmonary vein, Inferior pulmonary vein

82
Q

What fascial membrane covers the apex of the lung

A

Cervical pleural membarne

83
Q

Do lungs extend above the 1st rib and clavicle

A

No, only the pleura does to protect the lungs

84
Q

Which lung is shorter and broader of the 2 and why

A

Right lung due to the liver pushing the diaphragm up

85
Q

Describe the lymphatic drainage of the lungs

A

Bronchopulmonary LN
Tracheobronchial LN
Thoracic duct and Right Lymphatic Duct

86
Q

Right Lung structures

A 
Inferior Pulmonary Vein
Bronchi
Bronchi (eparietal)
Artery
Superior Pulmonary Vein
87
Q

Left Lung Structures

A

Inferior Pulmonary Vein
Bronchi
Artery
Superior Pulmonary Vein

88
Q

Where does deoxygeneated blood travel to

A

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
Q

What is a dermatome

A

Unilateral area of skin innervated by the general sensory fibres of a single spinal nerve

90
Q

What explains the discontinuity between dermatomes on the chest wall at this level between T2 and C4

A

Brachial Plexus

91
Q

What dermatome overlies the sternal angle

A

T2

92
Q

What dermatome overlies the nipple

A

T4

93
Q

What dermatome overlies the umbilicus

A

T10

94
Q

What dermatome overlies the inguinal region

A

L1

95
Q

Location of the major groups of lymph nodes (6)

A 
Axillary
Superificial and deep inguinal
Pectoral
Tracheobronchial
Lumbar/Pelvic
Superficial cervical and Deep Cervical
96
Q

How many lobes does the glandular part of the breast divided into

A

16-20 lobes

97
Q

What type of epithelium is found in the bronchioles

A

Columnar or Cuboidal

98
Q

Are there glands, cartilage or smooth muscle in bronchioles

A

They only have smooth muscle

99
Q

The absence of which 3 main features in the wall of a bronchiole distinguishes it from bronchus

A

Goblet cells, cartilage and mucosal glands

100
Q

What does the patency of bronchioles rely on

A

Smooth muscle tone

101
Q

What are the names and functions of cells found in the wall of the alveolus

A

Type 1- gas exchange
Type 2- Surfactant
Macrophages- engulf invading pathogens and foreign bodies

102
Q

Which layer of the pleura enters and lines the fissures of the lungs

A

Visceral Pleura

103
Q

What layer of the pleura is sensitive to pain

A

Parietal

104
Q

Parts of the parietal pleura

A

Apical (cervical)
Costal
Mediastinal
Diaphragmatic

105
Q

The costal pleura reflects onto the superior part of the diaphragm to form the

A

Costodiaphragmatic recess and reflection

106
Q

Behind the sternum where costal pleura doubles back to become the mediastinal pleura

A

Costomedialstinal Reflection

107
Q

T4/T5

A 
Sternal angle/angle of Louis
Bifurcation of trachea
Start of aortic arch
Azygous arch enters
SVC
108
Q

In the mid-clavicular line the inferior border of the lung is ___ and Parietal Pleura is _____

A

rib 6 and 8

109
Q

In the mid-axillary line the inferior border of the lung is____ and Parietal pleura is____

A

rib 8 and 10

110
Q

In the mid-scapular line the inferior border of the lung is___ and parietal pleura is__

A

rib 10 and 12

111
Q

What organ occupies the notch seen in the anterior border of the left lung between ribs 4-6

A

Heart

112
Q

The oblique fissures follows the course of rib___

A

6

113
Q

The horizontal fissure follows the course of rib___

A

4

114
Q

The posterior border of each lung extends from vertebra

A

C7 to T10

115
Q

Suitable place for pleural aspiration

A

9th intercostal space in the midaxillary line

116
Q

Features of the diaphagm

A

Left and right domes
Central tendon
Left and right crus

117
Q

Openings of the diaphragm

A

IVC
Oesophagus
Aorta

118
Q

What cardiac structure is firmly attached to the central tendon

A

Fibrous pericardium

119
Q

To which vertebrae are the left and right crura attached

A

Left: L1-L2/3

Right- :L1-L3/4

120
Q

Which membrane covers the superior surface of the diaphragm

A

Diaphragmatic parietal pleura

121
Q

What is the shape of the central tendon

A

Clover

122
Q

To which tendon is the diaphragm attached to

A

Central tendon

123
Q

To which costal cartilage is the diaphragm attached to

A

7/8-10

124
Q

To which part of the sternum is the diaphragm attached

A

Xiphoid Process

125
Q

To which vertebrae is the diaphragm attached

A

L1-L4

126
Q

Opening of IVC on diaphragm

A

T8

127
Q

Opening of Oesphagus on Diaphragm

A

T10

128
Q

Opening of aorta on diaphragm

A

T12

129
Q

Through which part of the diaphragm does the inferior cava pass

A

Central tendon

130
Q

Which vertebral levels of the spinal cord contribute to the phrenic nerves

A

C3, C4, C5

131
Q

Where does the base of the breast lie

A

ribs 2-6 and between the lateral border of the sternum and midaxillary line

132
Q

Where is the tail of spence located

A

Extends superolaterally to penetrate the floor of the axilla

133
Q

What nerves supplies the parital pleura

A

Phrenic nerve and intercostal nerves

134
Q

Lungs extend _ rib spaces less than pleura

A

2

135
Q

Pleura extend

A

2 4 6 8 10 12

136
Q

Fissures- Oblique

A

Spine of T3 to rib 6 along medial border of scapula

137
Q

Fissures- Horizontal (on R only)

A

rib/costal cartilage 4 to rib 5 in mid axillary line

Anatomy Respiratory Medicine (1 decks)

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