Respiratory Flashcards
What will the head of rib 7 articulate with?
Vertebral body of T6 and T7
What does the costal sulcus contain?
Intercostal veins, arteries and nerves
What ribs are true ribs?
1-7
What ribs are false ribs?
8-10
What ribs are floating?
11 and 12
What is the atypical true rib?
First rib
What are the grooves on the first rib?
Post -> Ant = Subclavian artery, scalene anterior, subclavian vein
What type of joints are costochondral joints?
Primary cartilaginous
What type of joints are costovertebral and costotransverse joints?
Synovial plane/gliding
What forms the vertebral arch?
2 x peduncles and 2 x laminae
What forms the subcostal angle?
Ribs 7-10
What is primarily used for breathing in newborns?
Diaphragm
What muscles are located in the intercostal space from superficial to deep?
External intercostal muscle
Internal intercostal muscle
Innermost intercostal muscle
What direction do the fibres of the intercostal muscles run?
External = anteromedial Internal = posterolateral Innermost = posterolateral
Between which muscles does the neuromuscular bundle lie?
Between internal and innermost (VAN)
Where is the neuromuscular bundle located in relation to the ribs?
Inferior
Where would you insert a chest drain?
Above 5th rib mid-axillary line
Where does 75% of lymph from the breasts drain?
Anterior (pectoral) group of axillary lymph nodes
Where is the base of the breast normally located?
Between ribs 2-6
At what levels are the diaphragmatic openings/
T8 - Vena cava
T10 - Oesophageal hiatus
T12 - Aortic hiatus
What shape is the central tendon of the oesophagus?
Clover
What level does the left crus of the diaphragm extend?
L1-2
What level does the left crus of the diaphragm extend?
L1-3
What covers the superior surface of the diaphragm?
Parietal pleura
What dies the canal opening of the diaphragm do?
Assists venous return during inspiration
What is a hiatus hernia?
Abnormal protrusion into throat through tear or weakness in diaphragm
What is the innervation to the diaphragm?
Phrenic nerves (C3,4,5) Lower intercostal nerves
At what level is the larynx?
C3-6
What nerve supplies the larynx?
Vagus
At what level is the hypoid bone?
C3
At what level is the cricoid cartilage and start of the trachea?
C6
At what level is the thyroid cartilage?
C4
What type of cartilage is the epiglottis?
Elastic
What is the blood supply to the lower respiratory tract?
Bronchial arteries from thoracic aorta and intercostal arteries
What veins drain the lower respiratory tract?
Bronchial veins into azygous
Where does the trachea bifurcate?
T4
What muscle is posterior to the trachea?
Trachealis
Which bronchus is shorter?
Right
Where are bronchomediastinal lymph nodes located?
At the hilum
How many lobes are there in the right lung?
3
Where is the lingual and cardiac notch located?
Left lung
Between which ribs is the cardiac notch located?
4-6
What are the names of the fissure of the lungs?
Oblique (in both) and transverse (in right)
What is the root of the hilum?
Group of structures that enter/leave the hilum
Describe the structures in the root of the hilum.
Artery = anterior
Bronchus = posterior
Superior pulmonary vein = superior
Inferior pulmonary vein = inferior
What is the apex of the lung covered in?
Sibson’s fascia
Why can injuries to the neck damage the lungs?
The lungs extend above the first ribs
How many bronchopulmonary segments are there in the right and left lungs?
Right = 10 Left = 8 or 9
Describe the pulmonary circulation from deoxygenated blood in the RV.
RV -.> pulmonary artery -> lungs (oxygenation) -> pulmonary veins -> LA -> LV -> Aorta -> rest of body
What part of the pleura is sensitive to pain?
Parietal
What pleural layer enters and lines the fissures?
Visceral
Excluding the visceral and parietal pleura, what other pleura are there?
Mediastinal
Diaphragmatic
Costal
Apical/cervical
What is a prothorax?
Pus in pleural space
What is the name of the two pleural recesses caused by reflection sand expiration.
- Costodiaphragmatic
2. Costomediastinal
What recess is used to aspirate a pleural effusion and where is it located?
Costodiaphragmatic at T9 above rib
What supplies the mediastinal and diaphragmatic parietal pleura?
Phrenic nerve
What supplies the rest of the parietal pleura?
Intercostal nerves
Where can you aspirate a pericardial effusion?
Between ribs 4-6 anteriorly at the cardiac notch
What are the levels of the lung and parietal pleura at the midclavicular, midaxillary and mid scapular lines respectively?
Lung 6, 8, 10
Parietal pleura 8, 10, 12
How many intercostal spaces of a difference is there between the lungs and parietal pleura?
2
What rib does the oblique fissure follow the course of?
6
What rib does the oblique fissure follow the course of?
4
The posterior border of each lung extends from and to what levels?
C7-T10
Describe the change in hyaline cartilage from the trachea to the bronchioles.
Trachea = rings Bronchi = small plates Bronchioles = no cartilage
Where does no gas exchange occur?
Terminal bronchioles
