Resp. Thorax 1 Flashcards
What makes up the upper respiratory tract?
Nasal Cavity
Mouth
Pharynx
~ Larynx
What makes up the lower respiratory tracT?
~Larynx
Trachea
Primary Bronchi
Lungs
What seperates the upper/lower respiratory tracts?
The sternal angle or cricoid cartilage.
What is the cricoid cartilage?
Ring shaped cartilage of the larynx
What term refers to the branching structure of airways?
The respiratory or Tracheobronchial tree
What is teh differnce between the conducting & respiratory portions of the tracheobronchial tree?
Conducting portion - No gas exchange occurs
Respiratory portion - Gas exchange occurs.
What are the 10 sections of the tracheobronchial tree?
1) TRachea
2) Main Bronchus
3) Lobar Bronchus
4) Segmental Bronchus
5) Conducting Bronchus
6) Terminal Bronchus
7) Respiratory BRonchus
8) Alveolar Duct
9) Alveolar Sac
10) Alveolus
Where is the larynx found?
Anterior Neck
Between C3-C6
What innervates the larynx?
The Vagus Nerve
Where does the larynx extend?
From the epiglottis tip to the inferior border of the cricoid cartilage
What are the important pieces of surface anatomy in the larynx?
Hyoid
Thyrohyoid membrane
Laryngeal Prominence
Cricoid Cartilage
At what vertebral level is the Hyoid?
C2/C3
At what vertebral level is the Thyrohyoid membrane?
C4
At what vertebral level is the Laryngeal Prominence?
C5
At what vertebral level is the cricoid cartilage/start of trachea?
C6
What are the lobes of the left lung?
Superior
Inferior
What are the lobes of the right lung?
Superior
Inferior
Middle
What do we call the inferior surface of the lungs?
Diaphragmatic
What do we call the medial surface of the lungs?
Mediastinal
What are the 3 surfaces of the lung?
Costal
Medial
Inferior
What is the lingula?
A thin tongue like process of the superior lobe in the left lung.
What creates the lingula?
The cardiac notch
What is the lung hilum?
Area on the mediastinal surface where lung root enters
Whats lung root?
Group os structures entering the lung:
- Bronchus
- Artery
- Veins
- Lymphatics
- Nerves
What are the 2 bronchi of the right lung?
Eparterial bronchus supplies superior lobe
Hyparterial bronchus supplies middle/inferior lobe
What structure of the hilum is the most superior?
Pulmonary artery (eparterial bronchus in r. lung)
What structure is most inferior in the hilum?
Inferior Pulmonary Vein
What structure is the most anterior in the hilum?
Superior Pulmonary Vein
What structure is the most posterior in the hilum?
Bronchus
What are the 4 sections f the parietal pleura?
Cupular (cervical)
Mediastinal
Diaphragmatic
Costal
What nerves supply the parietal pleura?
Intercostal
Phrenic
What nerves supply the visceral pleura?
Intercostal nerves (T2-T5)
What is a pleural reflection?
Place at which parietal pleura changes direction
What is a plerual recess?
Increased space between pleura at relfections
What are the names of the pleural reflections/recesses?
Costomediastinal (center)
Costodiaphragmatic (costophrenic angle)
At what level is hte inferior margin of the lung in the midclavicular line?
Rib 6
At what level is hte inferior margin of the lung in the midaxillary line?
Rib 8
At what level is the inferior margin of the lung at the midscapular line?
Rib 10
What the differnece between the inferior marign of the lung and the parietal pleura?
The inferior margin of the parietal pleura is 2 ribs lower.
What rib does the horizontal fissure follow?
4th rib anteriorly
What rib does the oblique fissures follow?
Begin at T3 spine and follow 6th rib anteriorly.
What are the layers of the trachea?
Tracheal cartilage
Submucosa
Mucosa (Lamina propria & Respiratory epithelium)
What is absent from bronchioles?
Cartilage
Glands
Goblet cells
What happens to the epithelial tissue down the airway?
It becomes flatter from trachea -> alveoli:
Columnar
Cuboidal
Squamous
What happens to cartilage down the airway?
Trachea - Rings
Bronchi - Small plates
Bronchioles - absent
What parts make up the thoracic inlet?
T1
1st rib pair
Manubrium
1st pair costal cartilage
How many articular facets are there on a ribs head?
2
Except the 1st rib which has 1
What is the extra tubercle on the 1st rib for?
Attaching to the scalene muscle
What lies in the 1st rib anterior groove?
Subclavian Vein
What leis int he 1st ribs posterior groove?
Subclavian artery & lowest trunk of brachial plexus
With what does the head of the rib articulate?
The body of the vertebrae with the same number andteh one above
What is the name for the rib-vertebra joint?
Costovertebral joint
What kind of joint is the costovertebral joint?
Synovial plane
With what does the tubercle of the rib articulate?
The transverse process of the thoracic vertebra of the same number
Whats the name of the rib-transverse process joint?
Costotransverse joint
What type of joint is the costotransverse joint?
Synovial plane joint
What makes up the thoracic outlet (anatomically)?
T12 vertebra
11th & 12th ribs
Xiphisternal joint
Costal cartilage of tibs 7-10
Where does the left side of the chest wall drain to?
Left side of chest wall
- > Thoracic Duct
- > Left brachiocephalic Vein
What is a brachiocephalic vein?
Vein produced at the merge of the internal jugular vein & subclavian vein
Where does the right side of the chest wall drain to?
Right side of chest wall
- > Right lymphatic Duct
- > Right Brachiocephalic Vein
What are the peripheral attachments of the diaphragm?
Lumbar vertebrae
Arcuate ligaments
Costal cartilage of 7-12 ribs
Xiphisternum
What is the central attachment of the diaphragm?
Central tendon
What re the right and left crura?
Tendinous parts of the diaphragm that arise from the vertebrae
From where does the right crus arise?
L1-L3
From where does the elft crus arise?
L1-L2
How does the right crus prevent gastric reflux?
Some fibres suround the oesophageal opening
What movement does teh diaphragm make in inspiration?
Contracts & descends
i.e. flattens
What nerve roots make up the phrenic nerve?
Anterior rami of the C3, C4, C5
Which part od the phrenic nerve innervates the diaphragm via the inferior surface?
Motor fibres
What part of the diaphragm are supplied by sensory fibres of teh phrenic nerve?
The central part
What part of the diaphragm is innervated by the intercostal nerves?
sensory fibres of Intercostal nerves from T7-T12 innervate the peripheral protion of the dipahragm
What is the name of the hiatus transmitting the IVC?
The caval opening
What does teh caval opening transmit?
The IVC
Right phrenic nerve
What does the aortic hiatus transmit?
- Aorta
- Azygos vein
- Hemiazygos vein
- Thoracic Duct
What does the oesophageal hiatus transmit?
- Oesophagus
- Both Vagus nerves
At what vertberal level is the caval opening?
T8
At what vertebral level is the oesophageal hiatus?
T10
At what vertebral level is the aortic hiatus?
T12
What part of the diaphragm is penetrated by the caval opening?
Caval opening penetrates the central tendon
What part of the diaphragm is penetrated by the oesophageal hiatus?
Muscular sling of the right crus
What part of the diaphragm is penetrated by the Aortic hiatus?
Between the right/left crus.
From where does the phrenic nerve originate?
C3-C5 (but mainly C4)
In whats ways do the phrenic nerves innervate the diaphragm?
Motor supply
Sensory supply to the central tendon
What nerve is repsonsible for innervating the larynx?
The vagus nerve
What are the arcuate ligaments?
Peripheral attachments of the diaphragm
There are 3
Name the 3 arcuate ligaments?
Medial
Median
Lateral
What does the median arcuate ligament do?
It joins the right and left crura
Where do the crura attach?
Right - L1-L3
Left - L1-L2