Pulm Anatomy Flashcards
(105 cards)
Laryngopharynx is continuous with what structure?
esophagus
Follow the flow of air from the larynx to the bronchial tree.
Larynx -> trachea -> R/L mainstem bronchi -> bronchial tree
What structure keeps the trachea open?
The trachea has cartilaginous rings. The carina helps with this as well.
What area of the larynx is really sensitive?
The carina; if touched during intubation, the patient will VIOLENTLY cough.
What are the 3 major compartments?
L pleural cavity, R pleural cavity, and mediastinum
What are the structures in the pulmonary system?
Anterior: sternum (top manubrium, T2/3)
Posterior: vertebral column
Lateral: ribs and costochondral cartilage
Inferior: diaphragm/inferior thoracic aperture
Superior: neck/superior thoracic aperture
Which ribs are true ribs?
1-7, because of their direct connection with the sternum.
What are the false ribs?
8-10, because of their indirect connection to the sternum. They connect with each other and then have some cartilage that connects them to the sternum.
What are the floating ribs?
11 and 12
Which part of the sternum ossifies with age?
Xiphoid process
What is important about the costal facet of the transverse process?
Patients can get joint arthropathy here, and we can give them steroid injections for the pain.
What are the parts of the sternum?
manubrium, body, xiphoid process
jugular notch, sternal angle
What is the sternal angle? What does it define?
The superior portion of the pericardium, beginning and end of the aortic arch, entrance of superior vena cava to the heart, bifurcation of the trachea, and superior limit of the pulmonary trunk.
What is the superior thoracic aperture?
Entry point of the Esophagus, trachea, L/R internal jugular, L/R common carotid.
What is the inferior thoracic aperture?
Diaphragm (penetration of aorta- passes more posteriorly while the esophagus and IVC actually penetrate, esophagus, and IVC).
What is the arterial supply from the aorta?
Intercostal arteries anastomose with internal thoracic arteries (branch of subclavian) - internal thoracic runs inferiorly and supplies the musculophrenic artery. Costal groove on the inferior rib margin where the arteries run on the ribs.
What does the musculophrenic artery supply?
Supplies diaphragm and abdomin with blood.
What is the venous drainage of intercostal veins needed to get to the R side of the body/SVC?
Azygous vein of the R side of thorax drains into the SVC. Hemiazygos (inferiorly) and accessory hemiazygos (superiorly) veins on the L side of the thorax drain into the azygous. Internal thoracic vein drains into the brachiocephalic veins which becomes SVC.
Describe the lymphatic drainage of the thoracic wall.
Maintain blood volume and return lymph to circulation. Parasternal and intercostal nodes drain into the bronchomediastinal trunk -> thoracic duct -> junction of internal jugular vein/subclavian. Easy way for lung cancer to spread.
Describe the lymphatic drainage of the structure of the thorax.
Tracheobronchial nodes drain into the bronchomediastinal trunk -> thoracic duct -> junction of the internal jugular vein/subclavian. Easy way for lung cancer to spread.
What are the intercostal nerves?
(T1-T11 spinal nerves; T12 is known as subcostal nerve). Provide motor innervation to intercostal and abdominal muscles. Sensory innervation (aka dermatomes) to the skin and parietal pleura of the thoracic wall.
Out of VAN, which structure is most exposed?
The nerve, then the artery, then the vein.
For chest tube insertion, where do we want to go?
Between 4th or 5th intercostal space, typically in the mid-axillary line.
What is the main function of the intercostal muscles?
Breathing and protection.