Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ESA 3 > Resp 2 > Flashcards

Resp 2 Flashcards

1
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Label the boxes from top down

A

Jugular notch

Clavicle

Sternal angle

Costal margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the anterior associations of the ribs and their costal cartilages

A

Ribs 1-7:

Connected by costal cartilages directly to sternum

Ribs 8-10:

Connected by costal cartilage to the costal cartilage above

Ribs 11-12:

Free floating, no connection to sternum/cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Label this diagram from top down

A

The typical rib:

Head

Neck

Shaft

2 articular facets separated by crest

Tubercle (Top = articular, Bottom = non-articular)

Costal groove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What ribs are considered typical?

A

Ribs 3 to 9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Label each of these ribs with their number and features that make them ‘atypical’

A

Top to bottom:

Rib 1:

shortest, broadest, most curved, only has 1 facet on head

Rib 2:

Poorly marked costal groove

Ribs 11 + 12:

Floating

Single facet on head

No tubercle

Tapering anterior end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Label the boxes

A

First set of boxes

Participants in joint of head of rib:

Body of vertebra superior to rib

Intervertebral disk

Body of vertebrae same number as rib

Second set of boxes

Costo-transverse joint:

Transverse process of vertebra of same number as rib

Tubercle of rib

Axis of rib rotation

Movements (the arrows):

Elevation

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Label the black and red boxes

A

Black, top left clockwise:

Axis of movement

Axis of movement

Increase in sagittal diameter

Increase in transverse diameter

Neck of rib

Red, left to right:

Lower rib

Upper rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the three layers of intercostal muscle

Give a brief description of each

A

External intercostals:

Fibre direction is posterior to anterior from the inferior border of the superior rib to the superior border of the inferior rib

Outermost

Internal intercostals:

Fibre direction is anterior to posterior from the inferior border of the superior rib to the superior border of the inferior rib

Middle layer

Innermost intercostals:

Run from the inferior border of the superior rib to the superior border of the inferior rib

Innermost layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Label the boxes top to bottom

A

External intercostal muscles

Internal intercostal muscles

Innermost intercostal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the actions of the external intercostal muscles

A

Elevation of the upper ribs in a ‘pump handle’ movement to increase A-P diameter of thorax

Elevation of lower ribs in a ‘bucket handle’ movement increasing the lateral diameter of the thorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the actions of the internal and innermost intercostal muscles

A

Depress the ribs during forced expiration

Reduces A-P and lateral diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What muscles are responsible for passive expiration?

A

No muscles, passive process driven by elastic recoil of lungs and chest wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What structures are labelled here?

A

Two neurovascular bundles

Main bundle includes intercostal vein, artery and nerve and runs in costal groove of superior rib

Collateral bundle runs along the superior border of the inferior rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the 12 intercostal nerves

A

Course:

Appear from the anterior rami of thoracic spinal nerves (T1 - T12)

Run between internal and innermost intercostal muscles

Supply:

Intercostal muscles in corresponding space

Parietal pleura

Overlying skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Label the boxes from top left clockwise

A

Paravertebral chain

Intercostal nerve

Posterior intercostal artery

Anterior intercostal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is supplied by the intercostal arteries?

A

Intercostal muscles

Parietal pleura

Overlying skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Label boxes in two rows, Left row then right row, top to bottom

A

Left:

Superior vena cavae

Azygous vein

Hemiazygous

IVC

Right:

Anterior intercostal vein

Internal thoracic vein

Posterior intercostal veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

From where do the posterior and anterior intercostal arteries arise?

A

Anterior:

Internal thoracic artery (branch of the subclavian)

Posterior:

Thoracic aorta

Superior intercostal artery (From the costo-cervical traunk, a branch of the subclavian)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the venous drainage of the chest wall

A

Primarily into the Azygous system —> SVC

Some drainage into internal thoracic vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the structure of the diaphragm

A

Central tendon + Peripheral uscle

Peripheral muscle areas:

Sternal - Arising from xiphisternum

Costal - Arising from inner aspects of the 7-12 costal cartilages

Vertebral - Arising from arcuate ligaments (thickenings of fascia over the posterior abdominal wall muscles) + crura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Label black boxes from top left clockwise

A

IVC opening

Central tendon

Oesophaseal opening

Aortic hiatus w/median ligament overlying

Left crus

Right crus

Lateral arcuate ligament

Medial arcuate ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Give the vertebral level of the openings in the diaphragm and attachment sites of the right and left crus

A

Oesophagus:

T10

Vena cava:

T8

Aortic Hiatus:

T12

Right crus:

L4

Left crus:

L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the function of the diaphragm in relation to breathing?

A

Main muscle of inspiration

Contraction causes descent of diaphragm, expanding the thoracic cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe the nerve supply of the diaphragm

Include any additional innervation of that nerve

A

Phrenic nerve

Roots:

C3 - 5 (3-4-5 keep you alive)

Motor innervation:

Diaphragm

Sensory innervation:

Pericardium

Mediastinal and diaphragmatic portions of parietal pleura

Both surfaces of diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What muscles/actions are involved in inspiration?

What are the results of these muscle actions?

A

External intercostals:

Elevation of ribs

Contraction of diaphragm:

Descent

Sternocleidomastoids:

Elevates sternum

Scalenes:

Elevate and fix upper ribs

Results:

Increased transverse and A-P diameter

Increase in vertical dimension

27
Q

Describe the process of expiration in regards to actions/muscles involed

A

Quiet expiration:

No muscles, just elastic recoil

Forced expiration:

Internal and innermost intercostals

Rectus abdominus

External and internal obliques

Transversus abdominus

Results of either passive or forced:

Decrease in AP and transverse diameter

Decrease in the vertical dimension

28
Q

What is the involvement of the pleura in respiration?

Briefly describe how this works

A

As muscle action expands the thorax and the parietal pleura the pleural seal ensures that the visceral pleura and hence the lung also expand

The pleural seal is formed from surface tension between fluid molecules of the serous secretions in the pleural cavity

29
Q

What is the clinical relevance of the pleural seal?

A

Puncture of the parietal pleur breaks the pleural seal, allowing the visceral and parietal pleura to separate, this is a pneumothorax (lung collapse)

30
Q

Decribe the nerve supply of the pleura

A

Parietal:

Somatic innervation (including pain) and autonomic

Visceral:

Only autonomic

31
Q

Describe the blood supply of the pleura

A

Parietal:

Intercostal arteries and internal thoracic artery

Corresponding veins drain

Visceral:

Bronchial arteries

Bronchial veins

32
Q

Describe the anatomical location and important features of the trachea

A

Extends from the lower border of the cricoid cartilage to the division od bronchi at the carina (Spinal level T4/5)

Fibro-cartilagenous tube

18-22 U shaped cartilage rings

Trachealis muscle posteriorly

33
Q

What is the clinical relevance of the angle of tracheal bifurcation?

A

If angle is wider than normal this indicates swollen tracheo-bronchial lymph nodes

34
Q

What is a broncho-pulmonary segment and what is the clinical relevance?

A

Broncho-pulmonary segment:

Area of lung supplied by its own segmental bronchus and segmental branches of pulmonary arteries and veins

Pyrimidal in shape, apex towards hilum, base towards lung surface

Clinical:

Segment can be isolated and removed with little damage to others (E.g. removal of small primary or metastatic tumours)

35
Q

What is the apex of the lung and why is it clinically relevant?

A

Apex:

Superior portion of the lung extending superiorly through the superior thoracic inlet and to the base of the neck

Clinical:

Apical lung tumours can compress structures in root of neck (E.g. brachial plexus, subclavian vessels, sympathetic trunk)

Subclavian vein cannulation can lead to pleural puncture (pneumothorax)

36
Q

What structures pass throught the lung Hilum?

A

Pulmonary and bronchial arteries and veins

Bronchi

37
Q

From where do the bronchial arteries arise? where do they supply?

What is the role of the bronchial arteries in venous drainage of the lungs?

A

Arteries:

Arise from aorta on left and 3rd intercostal on right

Supply bronchial tree from the carina to the respiratory bronchioles, visceral pleura and connective tissue

Veins:

Most drainage is via pulmonary veins rather than bronchial

Superifical bronchial veins drain the visceral pleura and bronchi in the hilar region into the azygous vein on the right and hemiazygous vein on the left

Deep group drain the deeper bronchi into the pulmonary vein

38
Q

Label the black boxes and identify each lung

A

Lung pictured left, boxes from top to bottom, left to right:

Right lung

Pulmonary arteries

Bronchus

Pulmonary veins

Pulmonary ligament

Lung pictured right, boxes from top to bottom:

Left lung

Pulmonary artery

Bronchus

Pulmonary veins

39
Q

PIctured are the right and left mediastinal spaces with lungs removed, identify the structures labelled

A

Left picture, top to bottom:

Sympathetic chain

Vagus nerve

Phrenic nerve

Right picture, top to bottom:

Reccurent larangeal nerve (branch of vagus)

Vagus nerve

Phrenic nerve

Aorta

40
Q

Label the boxes and identify the borders of each mediastinal space

A

Boxes, top to bottom, left to right:

Anterior

Body of sternum

Fibrous pericardium

Superior

Thoracic inlet

Plane passing throught sternal angle and lower border of T4

Middle

Between anterior and posterior

Posterior

Fibrous percardium

Vertebral bodies

41
Q

Describe the nerve supply of the lungs

A

Lung recieves innervation from differnt nerves all via the pulmonary plexuses at each lung hilum

Vagus Efferent:

Parasympathetic nerves provide motor innervation to bronchial smooth muscle (constriction)

Pulmonary vasoldilation

Secretomotor innervation to mucous glands

Vagus afferent:

cough reflex

Subserving pain

Sympathetic trunk:

Bronchodilation

Vasoconstriction

42
Q

Describe the lymphatic drainage of the lungs

A

Superficial sub-pleural lymphatic plexus:

Lies deep to visceral pleura

Drains lung parenchyma and visceral pleura

Drain into hilar lymph nodes at each lung hilum

Deep broncho-pulmonary lymphatic plexus:

Lies in the submucosa of bronchi and peribronchial tissue

Drain into the hilar nodes

43
Q

What si the normal composition of alveolar air? Give partial pressures

A

pO2 = 13.3kPa

pCO2 = 5.3kPa

44
Q

Give the normal gaseous content of mixed venous blood returning to the lungs

A

pO2 = 6kPa

pCO2 = 6.5kPa

Can vary with metabolism

45
Q

Identify the direction of gas gradients across the alveolar membrane and hence give direction of movement of each gas

A

pO2:

13.3kPa > 6.0kPa

Therefore O2 moves into alveolar capillaries

pCO2:

5.3kPa < 6.5kPa

Therefore CO2 diffuses into alveoli

46
Q

Aside from gradient what factors influence diffusion of gases across the alveolar membrane?

A

Surface area (Ideally large)

Diffusion resistance (Ideally low)

47
Q

What factors influence diffusion resistance?

A

Nature of gas

Nature of barrier

48
Q

Describe the diffusion barrier in the lungs

A

Diffusion occurs across alveolar wall and into RBCs therefore barrier made up of:

Epithelium of alveolus

Tissue fluid

Endothelial cells of capillary

Plasma

Red cell membrane

Total = 0.6um

49
Q

Which diffuses faster, Co2 or O2? Why?

A

CO2 (x21):

Gases diffuse at rate proportional to solubility

Therefore CO2 faster

50
Q

Apart from solubility what other feature of gases goes towards determining diffusion rate?

A

Molecular weight:

Gases diffuse at rate inversely proportional to molecular weight

51
Q

Houw long does it take for partial pressures of alveolar gases and blood gases to equilibrate in the lung?

How long do blood cells spend in the alveolar capillaries and why is this relevant?

A

0.5s

1s

Relevance:

Plenty of leeway, diffusion not limiting on lung function

52
Q

What are the partial pressures of gases in blood leaving the alveolar capillaries?

A

pO2 = 13.3kPa

pCO2 = 5.3kPa

53
Q

Describe the process of ventilation and what it achieves

A

Expansion of the lungs increasing the volume of respiratory bronchioles and alveolar ducts, drawing air into them

Air is not drawn directly into alveoli, fresh air is an incorrect mix

Raises pO2 and lowers pCO2 in alveoli

54
Q

Label the boxes and define the terms

A

Top to bottom

Inspiratory reserve:

Extra volume that can be breathed in over that inspired at rest

Tidal volume:

Volume in and out with each breath at rest

Expiratory reserve volume:

Extra volume that can be breathed out over that expired at rest

55
Q

Label the box and define

Give how this volume is measured

A

Residual volume:

Volume left in lungs at maximal expiration

Measured with a helium dilution test

56
Q

Label the box, define it and give it’s typical value

A

Vital capacity:

Measured from maximal inspiration to maximal expiration

About 5L in typical adult

Cn be altered by disease

57
Q

Label the box, define it and give it’s typical value

A

Inspiratory capacity:

Measured from resting expiratory level to maximal inspiration

Typically 3L

58
Q

Label the box, define it and give typical value

A

Functional residual capacity:

Volume of air in lungs at resting expiratory level

(Expiratory reserve + Residual volume)

Typically 2L

59
Q

Define ventilation rate

A

Volume of air moved into and out of a space (lungs) per minute

Product of volume per breath and resp rate

60
Q

Give the exquation of pulmonary ventilation rate and the typical values

A

Tidal volume x resp rate

Typically 8L.min-1

Can exceed 80L.min-1 in exercise

61
Q

How does alveolar ventilation rate differ from pulmonary ventilation rate?

A

Discounts volume of air only moved into dead spaces in the lung where no gas exchange occurs (bronchi etc)

62
Q

Define ‘serial dead space’

How is it measured?

Give a typical value

A

Volume of the airways

Used to be known as ‘anatomical dead space’

Measured via nitrogen washout test

Typically 0.15L

63
Q

Define ‘distributive dead space’ and ‘physiological dead space’

Give typical values

A

Distributive:

Parts of the lungs that do not support gas exchange but are not airways, including:

  • Dead or damaged alveoli
  • Alveoli with poor P/V ration

Physiological:

Distributive + Serial dead space to give total ‘dead space’

Typically 0.17L

64
Q
A

ESA 3 (54 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions