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Respiratory phase 1 > Respiratory anatomy > Flashcards

Respiratory anatomy Flashcards

1
Q

What are the 3 parts of the sternum?

A

Manubrium
Body
Xiphoid process

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2
Q

What are the borders of the manubrium?

A

Superior: jugular notch

Lateral: Clavicle at sternoclavicular joint and the first rib

Inferior: sternal angle formed with the articulation of the body at the sternum at the sternoclavicular joint

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3
Q

What ribs do the sternum body articulate with?

A

Articulates with ribs 2-7

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4
Q

At which joints of the ribs articulate with their costal cartilage?

A

Costochondral joints

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5
Q

Describe the true ribs…

A

Ribs 1-7
The costal cartilages articulate directly with the sternum at sternocostal joints.

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6
Q

Describe false ribs…

A

Ribs 8-10
They unite and join the 7th costal cartilage

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7
Q

Which ribs form the costal margin?

A

ribs 7-10

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8
Q

What are the floating ribs?

A

Rib 11 &12

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9
Q

What are the typical ribs?

A

ribs 3-9

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10
Q

What are the atypical ribs?

A

ribs 1-2, 10-12

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11
Q

At what joints do the ribs articulate with the thoracic vertebrae?

A

The costovertebral joints

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12
Q

What structures form the boundary of the superior thoracic aperture?

A

The manubrium, the first ribs and the first thoracic vertebrae.

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13
Q

What is a dermatome?

A

An area of skin innervated by a single spinal nerve.

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14
Q

How does sensation arise in the skin of the thoracic wall?

A

The skin is innervated by spinal nerves T1-T12. Sensation reaches conscious perception via somatic sensory fibres in the spinal nerves.

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15
Q

What do the somatic motor fibres and sympathetic fibres of the spinal nerves do?

A

Somatic motor fibres in spinal nerves T1-12 innervate the skeletal muscles of the thoracic wall.

Sympathetic fibres innervated sweat glands and the smooth muscle of blood vessels and hair follicles in the skin.

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16
Q

Describe the neurovascular supply of the breast:

A

Internal thoracic artery- arises from the subclavian artery and gives rise to the anterior intercostal arteries

Axillary artery

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17
Q

Describe the somatic nerves and sympathetic fibres of the breast…

A

Somatic sensory fibres innervated the skin of the breast

Sympathetic fibres innervate smooth muscle in the blood vessel walls and nipple.

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18
Q

What are the 5 groups of lymph nodes in the axilla?

A

Apical, central, humeral, pectoral, subscapular

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19
Q

Which axillary nodes receive lymph from all other lymph nodes?

A

The apical nodes receive lymph from all other lymph nodes.

As they drain most they lymph, they are more often involved in the spread of breast cancer.

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20
Q

What are the 3 layers of intercostal muscles?

A

External intercostal /
Internal intercostal \
Innermost intercostal |

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21
Q

Which muscles can also function as accessory muscles?

A

Pectoralis major/ minor and seratus anterior as they attach to the ribs and can move the ribs if the humerus and scapula are fixed.

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22
Q

Describe the external intercostal muscles…

A

The most superficial.

Its fibres are oriented antero-inferiorly.

Contraction pulls the ribs superiorly so involved in inspiration

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23
Q

Describe the internal intercostal muscles…

A

Lies deep to the external intercostal muscles.

Fibres are perpendicular to the external intercostal muscles and run in a poster-inferior direction.

Contraction pulls the ribs inferiorly so most involved in expiration.

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24
Q

Describe the innermost intercostal muscles…

A

Lies in the posterior part of the intercostal space deep to the internal intercostal.

Its fibres are oriented in the same direction as the internal intercostal muscles.

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25
Q

Where does the endothoracic fascia lie?

A

Deep to the innermost intercostal and superficial to the parietal pleura.

26
Q

Where does the neurovascular bundle for each intercostal space lie?

A

Along the inferior border of the rib superior to the space.

27
Q

Where do the anterior intercostal arteries arise from?

A

Branches from the internal thoracic artery which branches from the subclavian artery.

28
Q

Where do the posterior intercostal arteries arise from?

A

The descending aorta.

29
Q

What are the 2 layers of membranes covering the lungs?

A

Parietal pleura - lines the inside of the thorax

Visceral pleura - covers the surface of lungs and extends into the fissures.

30
Q

What is the function of the pleural fluid?

A

It fills the pleural cavity which is integral to the mechanics of breathing.

31
Q

What are the parts of the parietal pleura and where do they lie?

A

Cervical pleura - covers the apex of the lungs

Costal pleura - lies adjacent to the ribs

Mediastinal pleura - lies adjacent to the heart

Diaphragmatic pleura - lies adjacent to the diaphragm

32
Q

What does the costodiaphragmatic recess refer to?

A

Where the costal pleura becomes continuous with the diaphragmatic pleura.

33
Q

What does the costomediastinal recess refer to?

A

These lie at the junction of the costal and mediastinal pleura. These are space that the lungs expand into during deep inspiration.

34
Q

How is the parietal pleura innervated?

A

By the intercostal nerves that innervate the overlying skin of the chest wall. They reach conscious perception via somatic sensory fibres.

35
Q

How is the visceral pleura innervated?

A

Innervated by autonomic sensory nerves. These don’t reach consciousness.

36
Q

Where does the pulmonary artery lie at the hilum of the right lung?

A

Artery: Anterior to the main bronchus

Vein: most anterior and inferior vessels

37
Q

Where does the pulmonary artery and vein lie at the hilum of the left lung?

A

Artery: Superior to the main bronchus

Vein: most anterior and inferior vessels

38
Q

Where does the trachea bifurcate into the left and right bronchi?

A

At the level of the sternal angle.

39
Q

What is the point of bifurcation of the trachea marked by?

A

A ridge of cartilage called the carina.

40
Q

Why is a foreign body more likely to enter the right bronchus?

A

The right main bronchus is shorter, wider and descends more vertically than the left bronchus.

41
Q

Describe what parasympathetic fibres stimulate in the lungs…

A

Constriction of bronchial smooth muscle

Secretion from the glands of the bronchial tree

42
Q

Describe what sympathetic fibres stimulate in the lungs…

A

Stimulate relaxation of bronchial smooth muscle

Inhibit secretion from the glands

43
Q

What fibres relay sensory information from the lungs and visceral pleura to the CNS?

A

Visceral afferents (visceral sensory fibres)

44
Q

Where do lymph from the lungs drain into?

A

The venous system via the thoracic duct or the right lymphatic duct.

45
Q

The inferior border of the lungs lies at the level of the:

A

6th rib anteriorly (midclavicular)
8th rib laterally (midaxillary)
10th Rib posteriorly (at the vertebral column)

46
Q

The parietal pleura extends to the:

A

8th rib anteriorly (midclavicular)
10th rib laterally (midaxillary)
12th rib posteriorly (at the vertebral column)

47
Q

Where does the oblique fissure lie on both lungs?

A

Extends from the 4th rib posteriorly to the 6th costal cartilage anteriorly.

The fissure runs deep to the 5th rib

48
Q

Where does the horizontal fissure of the right lung lie?

A

Extends anteriorly from the 4th costal cartilage and intersects the oblique fissure

49
Q

What is the diaphragm?

A

A broad thin sheet of skeletal muscle

50
Q

What is the function of the diaphragm?

A

Mechanics of breathing and it separates the thoracic and abdominal cavities.

51
Q

What is the diaphragm attached to?

A

Xiphoid process,
costal margin,
lumbar vertebrae

52
Q

What is the central tendon?

A

The central part of the diaphragm. It is not muscular but fibrous.

53
Q

What happens during inspiration?

A

The diaphragm contracts; muscle fibres of the domes are pulled towards their peripheral attachments, the domes flatten; increases intrathoracic volume for lungs to expand

54
Q

What happens during expiration?

A

The diaphragm relaxes; domes superiorly; decreases intrathoracic volume

55
Q

What nerves innervate the diaphragm?

A

The phrenic nerves, somatic nerves which are formed in the neck by fibres from the c3, c4, c5 spinal nerves.

56
Q

What are the 3 openings in the diaphragm?

A

Caval hiatus T8 (inferior vena cava & terminal branches of right phrenic nerve)

Oesophageal hiatus T10 (Oesophagus, right and left vagus nerve, and oesophageal branches of left gastric artery/vein)

Aortic hiatus T12 (Aorta, thoracic duct, azygous vein).

57
Q

What are the 3 planes in which the thoracic cavity change during ventilation?

A

Vertically: due to the contraction and relaxation of the diaphragm

Laterally: due to contraction of the intercostal muscles which move the ribs

Antero-posteiorly: due to the movement of the sternum secondary to movement of the ribs.

58
Q

What is the relevance of the pleural fluid?

A

It creates surface tension. This keeps the lung and thoracic wall together which is important during pressure and volume changes.

59
Q

What muscles are important in vigorous breathing?

A

The intercostal muscles. Active inspiration uses the internal intercostal muscles.

60
Q

What muscles are important in very vigorous/ forced breathing?

A

The accessory muscles (sternocleidomastoid, pectorals major, minor, serratus anterior) contribute to the movement of the ribs.

The anterior abdominal muscles contribute to forces expiration.

61
Q

What structures do both the right and left hilum contain?

A

Pulmonary artery, pulmonary veins and bronchial arteries.

62
Q

What is the differences between the right and left hilum?

A

In the left hilum, there is one bronchus (principal bronchus) and in the right hilum there are 2 bronchi (eparterial and hyparterial bronchi).

Right bronchus is more vertically disposed. 1-2.5cm long and related to the pulmonary artery.

Left bronchus is 5cm long and related to the aortic arch.

Respiratory phase 1 (8 decks)

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