Pulmonary Prosection Flashcards
Parts of the Respiratory System (air passages)
Nose Nasal Cavity Pharynx Larynx Trachea Bronchi Lungs (intrapulmonary bronchi with alveoli)
Diaphragm (general)
Dome-shaped partition of the thoracic and abdominal ca ities
- mainly convex superior surface (facing thoracic cavity)
- concave inferior surface (facing abdominal cavity)
-right and left halves (hemidiaphragms)
Central Tendon of the Diaphragm
Aponeurotic and shaped like a boomer age into which muscle fibers are inserted from all parts of the circumference of the inner aspect of the body wall
It’s dense and fibrous and the pericardium is firmly attached to its upper surface
Sternal Part of the Diaphragm
2 small muscular slips arising from the posterior surface of the xiphoid process and may not always be present
Costal Part of the Diaphragm
Arises from the deep surfaces of the lower six costal cartilages on each side and inserts into the central tendon
The 2 costal parts form the right and left domes of the diaphragm
Lumbar Part of the Diaphragm
Arises as two crura from the anterolateral surfaces of the first three lumbar vertebrae on the right and the first two lumbar vertebrae on the left, including their respective intervertebral discs
-both crura embrace the aorta as it enters the abdominal cavity at the Aortic hiatus and are joined by a tendinous band, the median arcuate ligament
Right Crus of the Diaphragm
Larger and longer, extending from it’s proximal attachments to lumbar vertebrae L1-3 and distally to the central tendon
The esophageal hiatus is an opening in the right crus of the diaphragm at vertebral level T10
The muscle fibers of the right crus decussate and surround the esophageal hiatus
Left Crus of the Diaphragm
Smaller and has Proximal attachments to lumbar vertebrae L1-2 and passes to the left of the esophageal hiatus
Arcuate Ligaments
Thickenings of fascia that serve as a proximal attachment for some of the muscle fibers of the diaphragm
Lateral Arcuate Ligament
Bridges the anterior surface of the quadratus lumborum muscle
Medial Arcuate Ligament
Bridges the anterior surface of the psoas major muscle
Median Arcuate Ligament
Bridges the anterior surface of the aorta at the aortic hiatus
3 large openings (hiatus) in the diaphragm
Vena Caval Foramen: passes thru the central tendon at vertebral level T8
Esophageal Hiatus: passes thru the right crus of the diaphragm at vertebral level T10
Aortic Hiatus: passes behind the diaphragm at vertebral level T12
Right and Left Phrenic Nerves
- on the abdominal surface of the diaphragm
- each phrenic nerve provides motor innervation to one half of the diaphragm (one hemidiaphragm)
- supplies most of the sensory innervation to the abdominal (parietal peritoneum) and thoracic (parietal pleura) surfaces of the diaphragm
- the pleural and peritoneal coverings of the peripheral part of the diaphragm receive sensory fibers from the lower intercostal nerves (T5-T11) and the subcostal nerve
Superior and Inferior Phrenic Arteries
Ramify over the surface of the each hemidiaphragm
Superior: arise from the thoracic aorta
Inferior: arise immediately from the abdominal aorta below the diaphragm
Diaphragm (in the clinic)
Phrenic nerves arise from cervical spinal cord segments (C3-5). Therefore, pain from the diaphragm is referred to the shoulder region (supraclavicular nerve territory)
The diaphragm is paralyzed in cases of high cervical (above C3) spinal cord injuries, but is spared in low cervical spinal cord injuries
A paralyzed hemidiaphragm can’t contract (descend), so it will appear high in the thorax on a chest radiograph
Naris (plural: nares)
External opening of the nose
-separated from each other by the lower border of the nasal septum
Nasal Cavity
-each one begins at the naris and extends back to the choana (plural: choanae), the opening into the nasopharyngeal
Nasal Septum
-composed of cartilage and bone and covered by mucous membrane, separates the 2 nasal cavities. Frequently the nasal septum is deviated to one side
Concha (plural: conchae)
On the Lateral wall of the nasal cavity
- curved shelves of bone covered by mucous membrane that project from the lateral nasal wall and greatly increase the respiratory surface of the nose:
- inferior concha: the longest
- middle concha
- superior: the shortest
Hard and Soft palate
-separate the nasal cavity from the oral cavity
Pharynx
Continuation of the digestive system posterior to the nasal and oral cavities, extending inferiorly posterior to the larynx to the beginning of the esophagus
-extends from the base of the skull to the inferior border of the cricoid cartilage anteriorly and to the inferior border of the C6 vertebra posteriorly
3 parts of the pharynx
Nasopharynx: Posterior to the choanae and superior to the soft palate
Oropharynx: Posterior to the tongue between the soft palate and the epiglottis
Laryngopharynx: continuous with the oropharynx at the upper border of the epiglottis and narrows rapidly below at the level of the cricoid cartilage to become continuous with the esophagus at the border of the cartilage
Larynx
Extending from the epiglottis anterior to the laryngopharynx and inferiorly to the lower border of the cricoid cartilage where it becomes continuous with the trachea
