Resp pre practical lecture

Question 1

What is the superior thoracic aperture?

Answer 1

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

Question 2

What is the superior thoracic aperture bounded by posteriorly, laterally and anteriorly?

Answer 2

• 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.

Question 3

What is the inferior thoracic aperture bounded by posteriorly, laterally and anteriorly?

Answer 3

• 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.

Question 4

What separates the inferior thoracic aperture and the abdominal cavity?

Answer 4

Thoraco-abdominal diaphragm

Question 5

How does the head of the rib articulate with the body of the thoracic vertebra?

Answer 5

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.

Question 6

How does the tubercle of the rib articulate with the thoracic vertebra?

Answer 6

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.

Question 7

Features of the 1st rib

Answer 7

• 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.

Question 8

What is the main action of the diaphragm?

Answer 8

The diaphragm is the primary muscle of respiration.

- During inspiration, it contracts and descends, increasing the vertical diameter of the thoracic cavity.

Question 9

What are the 3 peripheral attachments of the diaphragm?

Answer 9

• Lumbar vertebrae and arcuate ligaments.
• Costal cartilages of ribs 7-12.
• Xiphoid process of the sternum.

Question 10

What is the central attachment of the diaphragm?

Answer 10

Central tendon

Question 11

What are the parts of the diaphragm that arise from the vertebrae and are tendinous in structure known as?

Answer 11

Right and left crura

Question 12

Where does the Right crus arise from?

Answer 12

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.

Question 13

Where does the left crus arise from?

Answer 13

Arises from L1-L2 and their intervertebral disc.

Question 14

Where is the caval opening located and what does it do?

Answer 14

T8
-The caval opening passes through the central tendon of the diaphragm. It transmits the inferior vena cava & the right phrenic nerve.

Question 15

Where is the oesophageal hiatus located and what does it do?

Answer 15

T10
- The oesophageal hiatus is located through the muscular sling of the right crus. It transmits the oesophagus and both vagus nn.

Question 16

Where is the aortic hiatus located and what does it do?

Answer 16

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.

Question 17

What is the function of the phrenic nerve?

Answer 17

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.

Question 18

What are the nerve roots of the phrenic nerve?

Answer 18

Anterior rami of C3, C4 and C5.

• It is both motor and sensory.

Question 19

How does the phrenic nerve pass through the diaphragm?

Answer 19

It pierces and innervates the diaphragm from its inferior surface.

Question 20

Lymphatic drainage of chest wall

Answer 20

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.

Question 21

Where is the Larynx found?

Answer 21

In the anterior neck between C3-C6.

• It extends from the tip of the epiglottis to the inferior border of the cricoid cartilage.

Question 22

How is the Larynx innervated?

Answer 22

By branches of vagus nerve

Question 23

What is the Lung hilum?

Answer 23

It is an area located on the mediastinal area of the lung.

Question 24

What is the Lung root?

Answer 24

It is the group of structures (bronchus, artery, veins, lymphatics, nerves) that enter or leave the lung hilum.

Question 25

What is pleural reflection?

Answer 25

The place at which parietal pleura changes its direction of travel.

Question 26

What is pleural recess?

Answer 26

The increased space between the layers of pleura occuring at the pleural reflections.

Question 27

What is costodiaphragmatic (costophrenic) reflection + recess referred to as?

Answer 27

The costophrenic angle

Question 28

What rib does the Horizontal fissure (of right lung) follow?

Answer 28

Follows the 4th rib anteriorly .

Question 29

What rib does the Oblique fissure (of both lungs) follow?

Answer 29

Begins at spine of T3 and follows 6th rib anteriorly.

Question 30

What changes occur as the tubes become smaller and smaller within the lung?

Answer 30

1. . The epithelium becomes flatter from trachea to alveoli, from columnar > cuboidal > squamous
2. . Cartilage reduces from rings > small plates > complete absence in the bronchioles
3. Mucous-secreting glands and goblet cells decrease > complete absence in the bronchioles