Resp pre practical lecture Flashcards
What is the superior thoracic aperture?
It refers to the opening at the top of the thoracic cavity.
- It is also referred to anatomically as the thoracic inlet and clinically as the thoracic outlet
What is the superior thoracic aperture bounded by posteriorly, laterally and anteriorly?
- The first thoracic vertebra (T1) posteriorly.
- The first pair of ribs laterally.
- The costal cartilage of the first rib and the superior border of the manubrium anteriorly.
What is the inferior thoracic aperture bounded by posteriorly, laterally and anteriorly?
- The 12th thoracic vertebra posteriorly.
- The 11th and 12th pairs of ribs laterally,
- Costal cartilages of ribs 7 through 10 and the xiphisternal joint anteriorly.
What separates the inferior thoracic aperture and the abdominal cavity?
Thoraco-abdominal diaphragm
How does the head of the rib articulate with the body of the thoracic vertebra?
The head of the rib articulates with the body of the thoracic vertebra of the same number as well as the body of the vertebra above (ie, with 2 vertebral bodies) at the costovertebral joints = synovial plane joints.
How does the tubercle of the rib articulate with the thoracic vertebra?
The tubercle of the rib articulates with the transverse process of the thoracic vertebra of the same number at the costotransverse joint = a synovial plane joint.
Features of the 1st rib
- It is broad and flat, its surfaces looking upward and downward.
- The head possesses only a single articular facet.
- The upper surface of the body is marked by two shallow grooves, separated by the scalene tubercle.
- The anterior groove lodges the subclavian vein, and the posterior groove the subclavian artery and the lowest trunk of the brachial plexus.
What is the main action of the diaphragm?
The diaphragm is the primary muscle of respiration.
- During inspiration, it contracts and descends, increasing the vertical diameter of the thoracic cavity.
What are the 3 peripheral attachments of the diaphragm?
- Lumbar vertebrae and arcuate ligaments.
- Costal cartilages of ribs 7-12.
- Xiphoid process of the sternum.
What is the central attachment of the diaphragm?
Central tendon
What are the parts of the diaphragm that arise from the vertebrae and are tendinous in structure known as?
Right and left crura
Where does the Right crus arise from?
Arises from L1-L3
-Some fibres from the right crus surround the oesophageal opening, and help prevent reflux of gastric contents back into the oesophagus.
Where does the left crus arise from?
Arises from L1-L2 and their intervertebral disc.
Where is the caval opening located and what does it do?
T8
-The caval opening passes through the central tendon of the diaphragm. It transmits the inferior vena cava & the right phrenic nerve.
Where is the oesophageal hiatus located and what does it do?
T10
- The oesophageal hiatus is located through the muscular sling of the right crus. It transmits the oesophagus and both vagus nn.
Where is the aortic hiatus located and what does it do?
T12
- The aortic hiatus is between the left and right crus.
It transmits the aorta, the azygos vein, the hemiazygos vein, and the thoracic duct.
What is the function of the phrenic nerve?
It supplies the central part of the diaphragm.
- The peripheral portions of the diaphragm are also innervated by sensory fibres of intercostal nerves, T7-T12.
What are the nerve roots of the phrenic nerve?
Anterior rami of C3, C4 and C5.
- It is both motor and sensory.
How does the phrenic nerve pass through the diaphragm?
It pierces and innervates the diaphragm from its inferior surface.
Lymphatic drainage of chest wall
Left side of chest drains to thoracic duct to left brachiocephalic vein.
Right side of chest wall drains to right lymphatic duct to right brachiocephalic vein.
Where is the Larynx found?
In the anterior neck between C3-C6.
- It extends from the tip of the epiglottis to the inferior border of the cricoid cartilage.
How is the Larynx innervated?
By branches of vagus nerve
What is the Lung hilum?
It is an area located on the mediastinal area of the lung.
What is the Lung root?
It is the group of structures (bronchus, artery, veins, lymphatics, nerves) that enter or leave the lung hilum.
What is pleural reflection?
The place at which parietal pleura changes its direction of travel.
What is pleural recess?
The increased space between the layers of pleura occuring at the pleural reflections.
What is costodiaphragmatic (costophrenic) reflection + recess referred to as?
The costophrenic angle
What rib does the Horizontal fissure (of right lung) follow?
Follows the 4th rib anteriorly .
What rib does the Oblique fissure (of both lungs) follow?
Begins at spine of T3 and follows 6th rib anteriorly.
What changes occur as the tubes become smaller and smaller within the lung?
- . The epithelium becomes flatter from trachea to alveoli, from columnar > cuboidal > squamous
- . Cartilage reduces from rings > small plates > complete absence in the bronchioles
- Mucous-secreting glands and goblet cells decrease > complete absence in the bronchioles
