Respiration part 2 (A5)

Question 1

internal thoracic artery in relation to chest wall

Answer 1

run down the posterior aspect of the anterior chest wall

Question 2

mediastinum

Answer 2

contains heart and great vessels

Question 3

diaphragm description

Answer 3

skeletal muscle that forms floor of thorax/roof of abdomen, involved in VOLUNTARY control, sits slightly higher on right hand side as liver pulls it up slightly

Question 4

visceral pleura

Answer 4

touches lung (around lung bud), continuous with parietal pleura

Question 5

parietal pleura

Answer 5

touches chest wall, can be 2 types - diaphragmatic parietal pleura and mediastinal parietal pleura

Question 6

pleural cavity

Answer 6

between lungs and chest wall, creates a vacuum, called a potential space as it is so small

Question 7

how are lungs held to chest wall

Answer 7

pleural cavity holds lungs to chest wall and keeps them filled due to the surface tension created by the pleural fluid

Question 8

costodiaphragmatic recess

Answer 8

extension of pleural cavities

Question 9

vessels travelling to upper limb

Answer 9

subclavian artery/vein and nerves of the brachial plexus

Question 10

position of internal thoracic artery and veins

Answer 10

travel down deep surface of anterior part of ribs

Question 11

route of upper respiratory tract

Answer 11

nasal cavity/ nose or oral cavity/mouth -> larynx/voice box -> trachea/ windpipe -> 2 main bronchi/bronchus -> lungs

Question 12

lung bud

Answer 12

pushes outwards from mediastinum in embryo and grows into lung pushing into pleural cavity (decreases in size)

Question 13

hilum

Answer 13

/lung root contains main bronchus, pulmonary artery and two pulmonary veins (also pulmonary lymph nodes present- appear black due to carbon dioxide deposits)

Question 14

what is the only vessel in the root of the lung that has cartilage within?

Answer 14

bronchus/ main bronchi (hyaline cartilage in walls)

Question 15

surface markings on the medial aspect of right lung

Answer 15

from superior vena cava, and azygous vein

Question 16

surface markings on medial aspect of left lung

Answer 16

due to aorta

Question 17

phrenic nerves

Answer 17

combined anterior rami of cervical spinal nerves c3,4 and 5, found in the neck on the anterior surface of the scalenus anterior muscle and in the chest/thorax descending over the lateral aspects of the heart, supply motor and sensory fibres to the skeletal muscle of the diaphragm (C3,4,5 keep the diaphragm alive). pass through diaphragm then spread out on deep surface to innervate it

Question 18

features of right lung

Answer 18

lung apex, superior lobe, horizontal fissure, middle lobe, oblique fissure, inferior lobe, base

Question 19

features of left lung

Answer 19

lung apex, superior lobe, lingula (of superior lobe) oblique fissure, inferior lobe, base

Question 20

where is the pleural fluid contained

Answer 20

within the pleural cavity/vacuum

Question 21

mechanics of normal inspiration

Answer 21

diaphragm contracts and descends increasing vertical dimensions, intercostal muscles contract elevating ribs which increases A-P and lateral chest dimensions, chest walls pull the lungs outwards with them, causing pressure inside the lungs to drop creating negative pressure gradient and air flows into the lungs

Question 22

why is normal quiet expiration described as passive

Answer 22

all muscles are relaxing, not contracting

Question 23

accessory muscles of inspiration

Answer 23

pectoralis major and minor, sternocleidomastoid, scalene muscles (aid normal muscles of inspiration during forced inspiration eg. heavy exercise, high altitude, asthma etc, attached onto ribs/sternum and change dimensions of chest cavity increasing its size, therefore there is more room to breathe in more air)

Question 24

mechanics of expiration

Answer 24

diaphragm relaxes and rises decreasing vertical chest dimensions, intercostal muscles relax lowering ribs decreasing A-P and lateral chest dimensions, elastic tissue of lungs recoil and air flows out of the lungs

Question 25

accessory muscles of expiration

Answer 25

rectus abdominus (ab muscles) when they contract the diaphragm is actively pushed up into resting position by the compressed abdominus contents

Question 26

carina

Answer 26

ridge between two main bronchi

Question 27

cartilage of trachea

Answer 27

more C shaped than it is a full circle

Question 28

lobar bronchi

Answer 28

one lobar bronchi per lobe of lung therefore the right lung has 3 and left lung only has 2

Question 29

pneumothorax

Answer 29

air in pleural cavity, can be caused by an injury to the chest wall allowing air into the pleural cavity via a tear in the parietal pleura, or lung tissue may rupture causing release of air into the pleural cavity via tear in visceral pleura - both situations cause the vacuum to be lost and the lung collapses due to elastic recoil

Question 30

where does the trachea bifurcate into the two main bronchi

Answer 30

at the level of the sternal angle

Question 31

what is the most likely location to find an inhaled foreign body (if patient is in upright position when inhalation occurs)

Answer 31

lower lobe of right lung as it the right bronchus is wider, shorter and more verticle, if this is a possibility a chest radiograph/bronchoscopy can be carried out