Resp anatomy Flashcards
What are the peripheral attachments of the diaphragm?
Lumbar vertebrae and arcuate ligaments.
Costal cartilages of ribs 7-10 (attach directly to ribs 11-12).
Xiphoid process of the sternum.
Where does the right crus arise from?
L1-L3 and their intervertebral discs
Where does the left curs arise from?
L1-L2 and their intervertebral discs
Which dome of the diaphragm (left or right) lies slightly higher and why?
The right due to the presence of the liver
What are the three openings that act as conduit in the diaphragm?
Caval hiatus (T8) Oesophageal Hiatus (T10) Aortic Hiatus (T12)
What passes through the caval Hiatus?
inferior vena cava
Terminal branches of the right phrenic nerve
What passes through the oesophageal hiatus?
Oesophagus
Right and left vagus nerves
Oesophageal branches of left gastric artery/vein
What passes through the aortic hiatus?
Aorta
Thoracic duct
Azygous vein
What is the motor innervation of the diaphragm?
The left half by the left phrenic nerve and right half by the right phrenic nerve
What is the root of the phrenic nerve?
Formed in the neck within the cervical plexus, containing fibres from C3-C5
What is the arterial supply to the diaphragm?
The inferior phrenic arteries which arise directly from the abdominal aorta. Minor supply from the superior phrenic, pericardiacophrenic, and musculophrenic arteries.
How can a lesion of the phrenic nerve occur?
Mechanical trauma
Compression
Myopathies
Neuropathies
What are the symptoms of a paralysis of both sides of the diaphragm?
Poor exercise tolerance, orthopnoea and fatigue
In adolescence, what is the role of the thymus gland?
Development of the immune system
What is the embryological derivative of the thymus gland?
The third pharyngeal pouch
What is the shape of the thymus gland?
An asymmetrical, flat shape with a lobular structure
Describe the cortical portion of the thymus
Located peripherally within each follicle. It is largely composed of lymphocytes, supported epithelial reticular cells.
Describe the medullary portion of the thymus
Located centrally within each follicle. It contains fewer lymphocytes than the cortex, and an increased number of epithelial cells. Hassall’s corpuscles are also present – these are concentric arrangements of epithelial reticular cells. Their function is unclear.
Where is the thymus located?
Within the thoracic superior mediastinum, posterior to the manubrium of the sternum. In some individuals, it can extend superiorly into the neck, and inferiorly into the anterior mediastinum
What is the arterial supply to the thymus?
The anterior intercostal arteries and small branches of the internal thoracic arteries
What is the venous supply from the thymus?
The left brachiocephalic and internal thoracic veins
What is DiGeorge syndrome?
A genetic syndrome caused by the deletion of part of chromosome 22
What are the common features of DiGeorge syndrome?
Congenital heart defects Abnormal facies Thymic aplasia Cleft palate Hypoparathyroidism
What are the two regions of the breast?
Circular body- Largest and most prominent part of the breast
Axillary tail- Smaller part, runs along the inferior lateral edge of the pectoralis major towards the axillary fossa
What is the pigmented area of skin surounding the nipple?
Areolae
What are mammary glands?
Modified sweat glands consisting of a series of ducts and secretory lobules. Each lobule consists of many alveoli drained by a single lactiferous duct. These ducts converge at the nipple.
What are the roles of the ligaments formed by the fibrous stroma surounding the mammary glands?
Attach and secure the breast to the dermis and underlying pectoral fascia
Seperate the secretory lobules of the breast
What is the retromammary space?
A layer of loose connective tissue between the breast and pectoral fascia
What is the arterial supply to the medial aspect of the breast?
The internal thoracic artery- a branch of the subclavian artery
What vessels supply blood to the lateral part of the breast?
Lateral thoracic and thoracoacromial branches
Lateral mammary branches
Mammary branch
What do the lateral thoracic and thoracoacromial branches originate from?
The axillary artery
What does the lateral mammary branches originate from?
The posterior intercostal arteries (derived from the aorta)
What does the mammary branch originate from?
The anterior intercostal artery
What are the groups of lymph nodes that receive lymph from breast tissue?
Axillary nodes (75%) Parasternal nodes (20%) Posterior intercostal nodes (5%)
What is the lymphatic drainage of the skin of the breast?
Drains into the axillary, inferior deep cervical and infraclavicular nodes
What is the lymphatic drainage of the nipple and areola?
The subareolar lymphatic plexus