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Respiratory System > Resp Pre-Practical Lecture > Flashcards

Resp Pre-Practical Lecture Flashcards

1
Q
  1. Describe the thoracic cage.
A
  • LOOK AT NOTES WITH PICTURES BEFORE DOING THIS* The superior thoracic aperture refers to the opening at the top of the thoracic cavity. It is referred to anatomically as the thoracic inlet and clinically as the thoracic outlet.
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2
Q

What is the superior thoracic aperture/opening/ thoracic inlet bounded by?

A

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

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3
Q

What is the inferior thoracic aperture/ thoracic outlet bounded by?

A

12th thoracic vertebra posteriorly,
11th and 12th pairs of ribs laterally,
Costal cartilage of ribs 7 through 10 and xiphersternal joint anteriorly.

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4
Q

How is the inferior thoracic aperture/thoracic outlet separated from the abdominal (peritoneal) cavity?

A

By the thoraco-abdominal diaphragm.

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5
Q

Diaphragm

A

fibromuscular membrane, stretched across the midline of the body

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6
Q

How do the ribs articulate with the vertebra?

A

Via costovertebral joints (synovial plane joints)

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7
Q

The tubercle of the rib articulates with?

A

Transverse process of the thoracic vertebra of the same number at the costotransverse joint

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8
Q

What type of joint is the costotransverse joint?

A

= synovial plane joint.

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9
Q
  1. Describe the First rib.
A
  • Broad and flat, its surface looking upward and downward

- The head possesses only a SINGLE ARTICULAR FACET, for articulation with the body of the first thoracic vertebra.

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10
Q

First rib- what is the upper surface of the body marked by?

A
  • The upper surface of the body is marked by two shallow grooves which is separated by the scalene tubercle, for the attachment of the anterior scalene muscle.
  • The ANTERIOR GROOVE lodges the subclavian vein, and the POSTERIOR GROOVE lodges the subclavian artery and the lowest trunk of the brachial plexus.
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11
Q
  1. Outline the attachments of the Diaphragm
A

It has three peripheral attachments:

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

One Central attachment:
- Central tendon

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12
Q

Describe the parts of the diaphragm that arise/attach from the vertebrae?

A

Tendinous in structure; known as the right and left crura.

  • Right crus- 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.
  • Left crus- Arises from L1-L2 and their intervertebral discs.
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13
Q

What are the actions of the diaphragm?

A
  • Primary muscle of respiration
  • During inspiration, it contracts and descends (domes flatten), increasing the vertical diameter of the thoracic cavity.
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14
Q

What are the hiatuses/openings of the diaphragm?

A

T8- Caval opening

T10- Oesophageal hiatus

T12- Aortic hiatus

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15
Q

Describe the T8 canal opening of the diaphragm?

A

T8- Caval opening

- Passes through the central tendon of the diaphragm. It transmits the inferior vena cava and the right phrenic nerve.

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16
Q

Describe the T10- Oesophageal hiatus of the diaphragm?

A

T10- Oesophageal hiatus

- Located through the muscular sling of the right crus. It transmits the oesophagus and both vagus nn.

17
Q

Describe the T12- Aortic hiatus of the diaphragm?

A
  • Located between the left and right crus. It transmits the aorta, the azygos vein, the hemiazygos vein and the thoracic duct.
18
Q

Describe the T12- Aortic hiatus of the diaphragm?

A
  • Located between the left and right crus. It transmits the aorta, the azygos vein, the hemiazygos vein and the thoracic duct.
19
Q

What is the Phrenic nerve?

A

The phrenic nerve is a nerve that originates in the neck (C3–C5) and passes down between the lung and heart to reach the inferior surface of the diaphragm.

20
Q

Describe the nerve roots, motor and sensory functions of the phrenic nerve.

A

Nerve roots: Anterior rami of C3, C4 (mainly) and C5.

Motor functions: Pierces and innervates the diaphragm from its inferior surface.

Sensory functions:
 Supplies the central part of the diaphragm.
 (The peripheral portions of the diaphragm are also innervated by sensory fibres of intercostal nerves, T7-T12.)

21
Q
  1. Describe the lymphatic drainage of chest wall.
A
  • Left side of chest wall drains to the thoracic duct => left brachiocephalic v.
  • Right side of chest wall drains to right lymphatic duct -> right brachiocephalic v.
22
Q
  1. Describe the respiratory organs.
A

The upper respiratory tract lies above the sternal angle (outside of the thorax)

  • Nasal cavity
  • Pharynx
  • Larynx

The lower resp tract (inside the thorax):

  • Trachea
  • Bronchi (1y, 2y, 3y)
  • Bronchioles (terminal, respiratory)
  • Lungs (including alveoli)
23
Q
  1. What is the respiratory/tracheobronchial tree?
A

The BRANCHING structure of airways supplying air to the lungs, including the trachea, bronchi and bronchioles.

24
Q

What makes up the conducting portion and respiratory portion?

A

Conducting portion: Respiratory portion

  • Trachea - Respiratory bronchiole
  • Main bronchus - Alveolar duct
  • Lobar bronchus - Alveolar sac
  • Segmental bronchus - Alveolus
  • Conducting bronchiole
  • Terminal bronchiole
25
Q

Describe where the Larynx is found, extends from and innervates.

A
  • Found in anterior neck between C3-6
  • Extends from the tip of the epiglottis to the inferior order of the cricoid cartilage
  • Innervates branches of vagus n.
26
Q

What are the vertebral levels in the larynx?

A
  • Hyoid- C2/C3
  • Thyrohyoid membrane (between the hyoid bone and thyroid cartilage)- C4
  • Laryngeal prominence (Adam’s apple)- C5
  • Cricoid cartilage and the start of the trachea- C6
27
Q
  1. Describe the borders, lobes and surfaces of the lungs.
A

Borders- Anterior, posterior, inferior

Lobes- Superior, inferior, Middle (for right lung only, - Transverse fissure in the right lung. Rib 4.),
Lingula (for left lung only, cardiac notch and below it is a “tongue-like” structure= lingula.)

Surfaces- Costal (internal surface of chest wall), Mediastinal (medial), diaphragmatic (inferior)

28
Q

What is the lung hilum?

A

Area located on medial/mediastinal surface of lung.

  • bronchi
  • pulmonary artery (in front of the bronchus)
  • superior pulmonary vein (most anterior)
  • inferior pulmonary vein (most inferior)
29
Q

What is the lung root?

A

The group of structures (bronchus, artery, veins, lymphatics, nerves) that enter/leave the lung hilum.

30
Q

What does the right lung have additionally?

A

Additional bronchus in the lung hilum called eparterial bronchus above the artery). The right main bronchus=hyparterial bronchus.

31
Q
  1. What is the pleura?
A

Membrane lining the thoracic cavity/ribs (parietal pleura) and covering the lungs (visceral pleura).

32
Q

Name the parts of the Parietal Pleura and its nerve supply.

A

Somatic nerves:

  • Intercostal nerves
  • Phrenic nerve

Pain sensitive.

33
Q

Conversely, Describe the nerve supply of visceral pleura.

A 
Autonomic nerves (T2-T5)
Pain insensitive.
34
Q

Define pleural reflection and pleural recess.

A

Pleural reflection is the place at which parietal pleura changes its direction of travel.

Pleural recess is the increased space between the layers of pleura occurring at the pleural reflections.

35
Q

Describe the two different pleural reflections and recesses.

A
  • Costomediastinal reflection and recess

- Costodiaphragmatic reflection and recess

36
Q
  1. Describe the surface anatomy of lungs and pleurae.
A

The inferior margin of lung (6,8,10):

Midclavicular line- Rib 6
Midaxillary line- Rib 8
Midscapicular line-Rib 10

The inferior margin of parietal pleura (8,10,12):

2 ic spaces difference- Rib 8
2 ic spaces difference- Rib 10
2 ic spaces difference- Rib 12

// 
Where the lung is at 8, the pleura is at ten.
37
Q

Describe where the fissures of the lungs begin.

A
  • Horizontal fissure of the right lung follows line of 4th rib anteriorly.
  • Oblique fissure of both lungs follows the line of the 6th rib anteriorly and begins at the spine of T3.
38
Q
  1. Histology of the Trachea, Bronchi and Lungs.
A

Bronchioles:

  • have a diameter of 1mm or less
  • no cartilage, no glands, no goblet cells in the walls compared to the trachea and the larger bronchi.
  • Epithelium is either columnar or cuboidal

Looking at the picture, we can see that as the tubes becomes smaller within the lung:

  • Epithelium becomes flatter from trachea to alveoli, going from Columnar -> Cuboidal -> Squamous
  • Cartilage reduces going from rings -> small plates -> completely absent in the bronchioles
  • Mucous- secreting glands and goblet cells decrease -> completely absent in the bronchioles

Respiratory System (20 decks)

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