Respiratory Anatomy Flashcards
upper respiratory tract components in order
right and left nasal cavities/ oral cavity
nasopharynx, oropharynx and laryngopharynx
larynx
lower respiratory tract components in order
trachea R and L main bronchi lobar bronchi segmental bronchi bronchioles alveoli
at which landmark does the URT become the LRT?
at the level of C6
clinical significance of sternal angle
this is the level of costal cartilage 2/ rib 2
what provides arterial blood to the lungs?
bronchial artery (and bronchial vein removes deoxygenated)
where can the trachea be palpated?
the jugular notch of the manubrium
which part of the thyroid gland is anterior to tracheal cartilages 2-4?
isthmus
nerve supply to the diaphragm
C3, C4 and C5
female breast regions
superolateral quadrant (contains the axillary tail which goes way up to the armpit)
superomedial quadrant
inferolateral quadrant
inferomedial quadrant
(There is unilateral drainage from lateral quadrants to axillary nodes, and bilateral drainage from medial quadrants to parasternal nodes).
“winged scapula”
paralysis of serratus anterior (through injury to long thoracic nerve) results in winged scapula
structures that pass through the lung root
main bronchus pulmonary artery 2 pulmonary veins lymphatics visceral afferents sympathetic nerves parasympathetic nerves
right lung surface markings
SVC
azygous vein
heart
diaphragm
left lung surface markings
ribs
aorta
heart
diaphragm
which part of the thyroid gland is anterior to tracheal cartilages 2-4?
isthmus
at what stage does the respiratory tree change from being lines with respiratory epithelium to squamous?
level of the terminal bronchioles/ alveoli
sensory nerve supply to mucosa lining the nasal cavities, pharynx and larynx
nasal cavity: sensory are CN V or CN IX (these receptors are stimulated in sneezing)
pharynx and larynx: CN IX or CN X (stimulated in coughing)
define carotid sheath
what does it contain?
these are tubes of fascia from the skull base to the mediastinum, and transmit the vagus nerve, internal carotid artery, common carotid artery, and internal jugular vein
the intrinsic muscles of the larynx are smooth/ skeletal muscle?
skeletal
(they attach between the cartilages of the larynx, are supplied by branches of the vagus nerves, contract to move the vocal cords, close the rima glottides during coughing)
anatomical course of the phrenic nerves
found in the neck on the anterior surface of the scalenus anterior muscle, in the chest descending over the lateral aspects of the fibrous pericardium anterior to the lung root
It supplies somatic sensory and sympathetic axons to the diaphragm and fibrous pericardium, and motor axons to the diaphragm
accessory muscles of inspiration
pectoralis major (if fixed, can pull ribs up and out) pectoralis minor (can oull ribs 3-5 up towards coracoid process of scapula) sternocleidomastoid scalenus anterior, medius and posterior
rima glottidis
where is this?
The opening between the true vocal cords and the arytenoid cartilages.
It is within the thyroid cartilage, and is the narrowest part of the larynx
anatomy of the vagus nerves
mixed cranial nerves
connect with CNS at medulla
base of skull part is the jugular foramen
descend through neck in carotid sheath
supplies larynx (sensory to mucosa and motor to its intrinsic muscles)
descends through chest posteriorly to the lung root
passes through diaphragm on the oesophagus
branches many times on stomach for foregut and midgut organs
give functions of rectus abdominus muscle
has tendinous intersections (divide each of 2 long flat muscles into 3/4 smaller quadrate muscles - 6/8 pack) - for improved mechanical efficiency
simple pneumothorax
air enters the pleural cavity through an injury to the visceral pleura Classified into small (<2cm between parietal and lung), or large (>2cm).
how a simple pneumothorax is formed
visceral pleura injury may be due to asthma causing a build-up of air in alveoli and rupturing visceral pleura, or to the parietal pleura by penetrating injury.
tension pneumothorax
torn pleura creates a one-way valve that allows air to enter pleural cavity on each inspiration but prevents air escaping on expiration. More air enters with each inspiration and pneumothorax expands and applies tension to the mediastinal structures
process for diagnosing pneumothorax
history
examination: reduced ipsilateral chest expansion, reduced ipsilateral breath sounds, hyper-resonance on percussion
investigation: absent lung markings on CXR
hernia
any structure passing through another, so ending up in the wrong place
requirements for hernia formation
- weakness of one structure e.g. normal anatomical weaknesses, congenital abnormalities, surgical scara
- increased pressure on one side of that part of the wall e.g. from chronic cough
areas of weakness in the diaphragm
oesophageal hiatus
aortic hiatus
attachments to the xiphoid
posterior attachments
the two types of hiatus hernia
paroesophageal hiatus hernia (herniated part of stomach becomes parallel to oesophagus in the chest)
sliding hiatus hernia (herniated part of stomach slides through hiatus into the chest WITH gastro-oesophageal junction
route of descent of testis to the scrotum (or round ligament to the labia)
testi guided by gubernaculum into scrotum
first passes through the medial aspect of the inguinal ligament
grabs some fascia from transversalis fascia (now known as internal spermatic fascia)
grabs cremasteric fascia (skeletal muscle fibres from internal oblique)
passes through v-shaped defect in medial end of external oblique aponeurosis, grabbing some
route of descent of testis to the scrotum (or round ligament to the labia)
testi guided by gubernaculum into scrotum
first passes through the medial aspect of the inguinal ligament
grabs some fascia from transversalis fascia (now known as internal spermatic fascia)
grabs cremasteric fascia (skeletal muscle fibres from internal oblique)
passes through v-shaped defect in medial end of external oblique aponeurosis, grabbing external spermatic fascia (from external oblique aponeurosis)
contents of the spermatic cord
the three layers of coverings gained as the testis passed through the inguinal canal
vas deferens
testicular artery
pampiniform venous plexus
direct inguinal hernia
a “finger” of peritoneum is forced through posterior wall of inguinal canal and directly out of superficial ring into scrotum
indirect inguinal hernia
a “finger” of peritoneum is first forced through deep ring into inguinal canal and then out of superficial ring into the scrotum
how do you clinically differentiate between direct and indirect inguinal herniae
1.reduce the hernia
2. occlude the deep ring with fingertip pressure
3. ask patient to cough
If it’s direct, lump will reappear. If indirect, lump will not reappear
