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MD3001 > Respiratory anatomy > Flashcards

Respiratory anatomy Flashcards

1
Q

location of the left recurrent laryngeal nerve

A

between the trachea and oesophagus

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2
Q

right vagus nerve

A

lies on the trachea

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3
Q

right phrenic

A

lies on SVC

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4
Q

left vagus

A

lies on the aortic arch

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5
Q

phrenic nerve

A

lies anterior to lung roots

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6
Q

vagus

A

posterior to lung roots

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7
Q

blood supply to trachea

A

inferior thyroid arteries and bronchial arteries

inferior thyroid vein

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8
Q

lymph drainage from trachea

A

pre and para tracheal nodes

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9
Q

nerve supply of trachea

A

vagi, reccurent laryngeal and sympathetic trunk

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10
Q

describe the numbers of lung segments

A

10 in total
3 superior lobe
2 middle or lingual
5 lower lobe

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11
Q

oblique fissure

A

spine of T4 to rib 6

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12
Q

horizontal fissure

A

4th intercostal space until it meets the oblique fissure at the mid axillary line

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13
Q

describe the parts of the hilum

A

bronchi- posterior
pulmonary arteries- anterior superior
pulmonary veins- anterior inferior

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14
Q

pulmonary ligament

A

allows hilar movement

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15
Q

origin of the right bronchial artery

A

3rd posterior intercostal artery from the descending aorta

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16
Q

origin of two left bronchial arteries

A

direct branch from the descending aorta

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17
Q

drainage of bronchial arteries

A

may anastomose with pulmonary arteries

drains to azygous system

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18
Q

where does the deep lymphatic plexus drain to?

A

pulmonary nodes, located in the hila

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19
Q

where do the pulmonary nodes drain to?

A

bronchopulmonary nodes (around the main bronchi)

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20
Q

where do the bronchopulmonary nodes drain to?

A

inferior and superior tracheobronchial nodes ( around the carina)

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21
Q

where do the tracheabronchial and posterior mediastinal nodes drain to?

A

paratracheal nodes and bronchomediastinal lymph trunks

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22
Q

where would a chest drain be inserted

A

just above the rib to avoid damage to NV bundle

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23
Q

what nerve supplies the axilla wall and upper medial part of UL and is at risk in breast surgery

A

Intercostobrachial Nerve

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24
Q

what dermatomes supple the skin and muscles of the abdo wall

A

T7- 12

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25
Q

what does the ventral rami of t2-11 make

A

the intercostal nerves

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26
Q

what is the subcostal nerve made of

A

T12

runs along the border of the twelfth rib

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27
Q

where may a breast tumour spread to

A

anterior grp, central grp, apical grp mostly

but also to internal mammary nodes

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28
Q

where does the breast receive its blood supply from

A

internal thoracic artery
anterior intercostal branches

superior thoracic
thoraco acromonial and lateral thoracic branches of the axillary artery

so most lymph drains to apical nodes

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29
Q

where does thoracic wall lymph drain to

A

parasternal nodes

intercostal nodes

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30
Q

what veins drain the intercostal spaces

A

anterior intercostal veins
posterior intercostal veins
(both venae comitantes- int thoracic art and post intercostal art)

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31
Q

what muscles are described here:
lower ribs
posterior
internal surface

A

subcostales

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32
Q

what muscles are described here:
internal aspect of ribs and costal cartilages 3-6
downwards and medially to the sternum and costal margin
anterior ribs, internal surface

A

transversus thoracis

33
Q

in what direction do the external intercostal muscles go

A

downwards and medially

34
Q

what direction do the internal intercostal muscles go

A

downwards and laterally

35
Q

what lies on top of the parietal pleura

A

endothoracic fascia

36
Q

what type of joint is between a rib and costal cartilage

A

primary cartilaginous joint (hyaline)

37
Q

what features can be seen on the first rib

A

scalene tubercle of scalenus anterior
groove for subclavian vein
groove for subclavian artery and lower trunk of the brachial plexus

38
Q

where does the diaphragm attach

A

anterior to xiphoid process - T8/9

deep surfaces of ribs and costal cartilages 7-12

39
Q

where is the median arcuate ligament

A

T12

sympathetic trunk goes behind

40
Q

where is the medial arcuate ligament

A

body of L1 to transverse process L1

41
Q

where is the lateral arcuate ligament

A

tip of L1 to transverse process t12 rib

subcostal vessels and nerve go behind

42
Q

where is the left crus

A

L1 and 2 bodies

43
Q

where is the right crus

A

L1, 2, 3 bodies

44
Q

what comes through the diaphragm at t8

A

IVC

right phrenic nerve

45
Q

what comes through the diaphragm at t10

A

oesophagus
vagus nerves
left gastric vessels

46
Q

what comes through the diaphragm at t12

A

aorta
thoracic duct
azygous veins

47
Q

what goes through the crura

A

splanchnic nerves

48
Q

what is the arterial supply of the diaphragm

A

internal thoracic => pericardiophrenic
musculophrenic
sup phrenic arteries from aorta
lower internal intercostal arteries

49
Q

where does bucket handle inspiration occur

A

ribs 8 -10 due to flat costo transverse joints that allow gliding

50
Q

describe the pleural surface markings of reflections

A 
Rise to level of neck of 1st rib, 2 cms above clavicle
•2nd cc lie adjacent in the mid line
•4th Lcc notch for the heart
•6th cc deviate laterally
•8th rib lie in the midclavicular line
•10th rib lie in the mid axillary line
•12th rib lie in the mid scapular line
•Mid line level with T12 (just below the 12th rib)
51
Q

what is the costomediastinal recess

A

anteriorly where pleura wraps around the mediastinum but lungs does not fill the recess

52
Q

describe the surface markings of the lungs

A

Rise to level of neck of 1st rib, 2 cms above clavicle
•2nd cc lie adjacent in the mid line
•4th Lcc cardiac notch
•6th cc deviate laterally
•6th rib lie in the midclavicular line
•8th rib lie in the mid axillary line
•10th rib lie in the mid scapular line and mid line

2 spaces higher than the pleura

53
Q

what segment is particularly prone to pneumonia

A

apical segment of the inferior lobe- inferolateral to the upper posterior position of the oblique fissure

listen below and lateral to the spine of T4

54
Q

what is extension

A

a superimposed acute MI following a large MI

55
Q

what nerves supply the intercostal spaces

A

intercostal nerves t1-11
ventral rami of t2 - 11 are the intercostal nerves

t12 is the subcostal nerve

56
Q

in what direction do external intercostals go

A

downwards and medially

57
Q

what direction do internal intercostals go

A

downwards and laterally

58
Q

where are subcostales found

A

lower ribs, internal surfaces, posterior

59
Q

where is transversus thoracis

A

anterior

60
Q

what does the supreme intercostal artery supply

A

1st two ic spaces

from costocervical trunk

61
Q

what does the intercostobrachial nerve supply

A

t2- supplies the thorax wall in the axilla and upper medial UL

62
Q

what are the 3 segments of the upper lobe

A

post, ant, apical

63
Q

what are the 2 segments of the middle lobe of the right lung

A

medial and lateral

64
Q

what are the 2 segments of the lingual of the left lung

A

sup and inf

65
Q

what are the 5 segments of the lower lobe

A

apical

med lat ant post

66
Q

where does the single right bronchial artery arise

A

3rd posterior intercostal artery

67
Q

where do the two left bronchial arteries arise

A

directly from the aorta

68
Q

where do the bronchial arteries drain

A

azygous or pulmonary veins

69
Q

describe lung lymph drainage

A 
pulmonary 
bronchopulmonary
tracheobronchial 
paratracheal 
bronchomediastinal 
thoracic duct
or right lymphatic trunk
70
Q

what is the nerve supply of the lung

A

pulmonary plexus
visceral pleura has no sensory supply
parietal pleura has sensory from intercostal and phrenic

71
Q

what could lung tumours impinging on nerves cause

A

phrenic nerve- diaphragm paralysis
cervical sympathetic trunk - horners

left side only- LRLN -horseness

72
Q

describe the int mammary

A

branch of first part of the subclavian
lies along the margins of the septum
terminates as the superior epigastric and musculophrenic arteries
supplies medial 1/2 breast

73
Q

how many anterior intercostal arteries are there per space

A

2 per space in space 1-6

7-10 supplied by musculophrenic

11 and 12 have no anterior supply

74
Q

what is the blood supply to the intercostal spaces

A 
supreme intercostal 
ant intercostals 
post intercostals 
musculophrenic 
subcostal arteries
75
Q

what is the venous drainage of the intercostal spaces

A

BCV
superior intercostal vein (2nd and 3rd spaces)
azygos venae comitantes

76
Q

lymph drainage of the IC spaces

A

parasternal nodes

intercostal nodes on the rib heads

77
Q

where would you listen for pneumonia

A

below and lateral to t4 spinous process- apical segment of inferior lobe

78
Q

where does the horizontal fissure meet the oblique fissure

A

mid axillary line

MD3001 (33 decks)

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