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ESA3 > Resp 3 - Anatomy 3 > Flashcards

Resp 3 - Anatomy 3 Flashcards

1
Q

Name the intercostal muscles from superficial to deep:

A

External
Internal
Innermost

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2
Q

In what direction do the fibres of the External Intercostal muscles run? What is their role?

A

Down and anteriorly

Pull ribs up and out = 30% chest expansion during quiet respiration

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3
Q

In which direction do the fibres of the Internal and Innermost Intercostal muscles run? What is their role?

A

Down and posteriorly

Pull ribs down during forced expiration

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4
Q

What do the intercostal nerves supply?

A
  • Intercostal muscles
  • Parietal pleura
  • Overlying skin
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5
Q

Define the origins of the diaphragm:

A
  • Xiphoid process
  • Interior 7-12 costal cartilages
  • Arcuate ligament
  • Crura of diaghragm
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6
Q

What is the insertion of the diaphragm?

A

Central tendon of the diaphragm

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7
Q

Which 2 muscles are responsible for chest expansion in quiet respiration?

A

1) External Intercostal muscles ~ 30%

2) Diaphragm ~ 70%

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8
Q

Which nerve supplies the diaphragm? What are its roots?

A

Phrenic nerve

C3, C4, C5 keeps the diaphragm alive

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9
Q

How many openings does the diaphragm have, what structures pass through them?

A

3:
@ T8 = Inferior Vena Cava
@ T10 = Oesophagus
@ T12 = Abdominal Aorta

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10
Q

At which spinal level does the Aorta pass through the diaphragm?

A

T12

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11
Q

At which spinal level does the IVC pass through the diaphragm?

A

T8

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12
Q

At which spinal level does the oesophagus pass through the diaphragm?

A

T10

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13
Q

In what order do the intercostal nerves, arteries and veins run along the ribs from superior to inferior?

A

Vein, Artery, Nerve (VAN)

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14
Q

Where should a needle be inserted for pleural aspiration/chest drain, and why?

A

Upper border of rib, to avoid intercostal neurovascular supply

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15
Q

Which arteries supply the parietal pleura?

A

Intercostal arteries

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16
Q

Where do the Intercostal arteries arise from?

A

Anterior segment = Internal Thoracic artery

Posterior segment = Superior Intercostal artery

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17
Q

Where do the intercostal veins drain into?

A

Anterior segment = Internal Thoracic vein

Posterior segment: RHS = Azygos, LHS = Hemiazygous

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18
Q

How much pleural fluid is usually present?

A

~ 10-20 ml

19
Q

Name the 3 reflections of the pleura:

A 
Anterior = Sternal
Posterior = Vertebral
Inferior = Costal
20
Q

What is responsible for producing and absorbing pleural fluid?

A

Capillaries of parietal surface = Produce pleural fluid

Parietal lymph nodes = Absorb pleural fluid

21
Q

What are the main functions of the pleural fluid?

A
  • Reduce friction

- Create surface tension = cohesion (when chest expands, so does lungs)

22
Q

What is the blood supply to and from the visceral pleura?

A

Bronchial arteries

Bronchial veins

23
Q

What is the main difference between the nerve supply to the parietal and visceral pleura?

A 
Parietal = Somatic and Autonomic
Visceral = Autonomic only (no pain)
24
Q

What is the Carina?

A

Ridge at the base of the trachea which separates the L and R bronchi

25
Q

What is the name of the ridge separating the entrances to the R and L bronchi?

A

Carina

26
Q

How many lobar bronchi are there in each lung?

A

Right lung = 3

Left lung = 2

27
Q

What is the name of the airway supplying each bronchpulmoanry segment?

A

Segmental bronchi

28
Q

What is a bronchopulmonary segment?

A

Pyramidal area of lung, each supplied by a segmental bronchus, artery and vein. (Branches of pulmonary and bronchial)

29
Q

How are bronchopulmonary segments useful in surgery?

A

Can be isolated and removed with minimal bleeding, air leakage or interference with other segments

30
Q

Where do the Bronchial arteries arise from?

A 
Right = 3rd Intercostal artery
Left = Aorta
31
Q

How is the blood supply to the lungs maintained after a pulmonary embolus?

A

Anastamoses are present between the pulmonary and bronchial arteries (dual blood supply)

32
Q

Which veins drain most of the blood supplied by the Bronchial arteries?

A

Pulmonary veins

33
Q

Name the parasympathetic nerve which has afferent and efferent fibres in the lungs:

A

Vagus nerve

34
Q

Name the 2 lymphatic plexuses in the lungs, and the lymph node they drain to:

A

1) Superficial sub-pleural lymphatic plexus (deep to visceral pleura)
2) Deep bronchopulmonary lymphatic plexus (in submucosa of bronchi and peribronchial tissue)

Hilar lymph nodes

35
Q

Define the mediastinum:

A

Central compartment of thoracic cavity, between the 2 pleural sacs

36
Q

Name the 4 divisions of the mediastinum:

A

1) Superior
2) Anterior
3) Middle
4) Posterior

37
Q

Name the borders of the superior mediastinum:

A 
Superior = Thoracic inlet
Inferior = Sternal angle line
Anterior = Manubrium
Lateral = Pleural sacs
Posterior Vertebral bodies T1-4
38
Q

Name the contents of the superior mediastinum:

A
  • Great vessels
  • Nerves (Vagus, Phrenic, Cardiac and sympathetic trunk)
  • Oesophagus
  • Trachea
  • Thymus
  • Thoracic duct
39
Q

Name the borders of the anterior mediastinum:

A 
Superior = Sternal angle line
Inferior = Diaphragm
Anterior = Body of sternum and Transverse Thoracis muscles
Lateral = Mediastinal pleura (part of parietal pleura)
Posterior = Pericardium
40
Q

Name the contents of the anterior mediastinum:

A

Nothing

Except Thymus in childhood - receeds in adulthood

41
Q

Name the borders of the middle mediastinum:

A 
Superior = Sternal angle line
Inferior = Diaphragm
Anterior = Anterior margin of Pericardium
Lateral = Mediastinal pleura
Posterior = Posterior margin of Pericardium
42
Q

Name the contents of the Middle Mediastinum:

A
  • Heart + Pericardium
  • Tracheal bifurcation + L/R bronchi
  • Great vessels
  • Nerves (cardiac plexus + phrenic)
  • Tracheobronchial lymph nodes
43
Q

Name the borders of the Posterior Mediastinum:

A 
Superior = Sternal angle line
Inferior = Diaphragm
Anterior = Posterior margin of the Pericardium
Lateral = Mediastinal pleura
Posterior = Vertebral bodies T5-12
44
Q

Name the contents of the Posterior Mediastinum:

A
  • Thoracic Aorta
  • Thoracic duct
  • Oesophagus
  • Azygos vein system
  • Sympathetic trunk

ESA3 (48 decks)

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