Respiratory anatomy Flashcards

1
Q

What is thoracic wall made of ?

A

sternum, vertebra T1-T12, ribs 1-12

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2
Q

What is thoracic outlet syndrome?

A

Compression brachial plexus, subclavian artery and vein

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3
Q

What is the thoracic inlet made of?

A

T1, 2 first ribs, superior border of manubrium

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4
Q

What is sternum?

A

Manubrium, body of sternum, xiphoid process

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5
Q

What is the superior border of manubrium called?

A

Jugular notch

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6
Q

At what vertebral level is the sternal angle located?

A

T4

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7
Q

What is located on the sternal angle?

A

The facets for 2nd costal cartilages

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8
Q

At what vertebral angle of xiphoid process located?

A

T10, xiphoid joint is located at T9

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9
Q

How are ribs 3-9 called?

A

Typical ribs

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10
Q

Name the parts of the typical ribs?

A

Head, neck, tubercle, angle, costal groove, rounded superior border and sharp inferior border, pit for costal cartilage

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11
Q

Describe costovertebral joints

A

Head of the ribs articulates demi-facets of the thoracic vertebra, at the same levels and one level above, they are synovial plane joints

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12
Q

Describe costotransverse joints

A

tubercle of the ribs articulates with the costal facets on the transverse processes

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13
Q

Describe the ligaments in these joints

A

lateral costotransverse ligaments (between ribs and transverse processes at the same level), superior costotransverse ligaments (ribs and transverse processes above), interarticular ligaments (between the two vertebra articulating with one rib), radiate ligaments (radiating from the rib to vertebra)

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14
Q

What are true ribs?

A

vertebrosternal ribs, rib 1-7, directly attached to sternum

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15
Q

What are false ribs?

A

vertebrochondral 8-10, they attach to sternum indirectly

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16
Q

What are floating ribs?

A

ribs 11 and 12, they are not attached to sternum at all

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17
Q

What are the most frequently broken ribs?

A

5-10 as they are the most exposed, fractured ribs can result in pneumothorax, dyspnoea

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18
Q

Are ribs levelled with the spinous processes?

A

Yes

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19
Q

What does first rib articulates with?

A

one vertebra and clavicle

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20
Q

Name the parts of first vertebra

A

head, neck, tubercle, scalene arteries tubercle between subclavian artery groove and subclavian vein groove

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21
Q

What is attached to the tubercle of first rib?

A

anterior scalene muscle

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22
Q

What is the position of subclavian artery and vein?

A

anterior is vein, posterior artery

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23
Q

What happens if additional rib develops from C7?

A

compress brachial plexus, this results in parathesia and wasting of muscles in the hand

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24
Q

What does thoracic outlet consist of?

A

T12, 11 and 12 ribs, costal cartilage 7-10, xiphisternal joint

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25
What is costal margin ?
Costal margins from cartilages 7-10
26
Where does the thoracic duct begin ?
L1 at cisterna chill, at T4 crosses from right to left
27
What is in the intercostal space?
3 layers of muscle (external, internal and innermost intercostal muscle) and neuromuscular bundle between the internal and innermost layer, it is located below the first rib in the costal groove, vein, artery and nerve from top to bottom, colateral branch at the top of the bottom rib
28
What is the orientation of muscle fibres in intercostal space?
external is inferior -anterior, internal and innermost are inferior -posterior
29
What are the layers of the skin that needs to be cut when inserting chest drain?
skin, superficial fascia, deep fascia, external, internal, innermost intercostal muscle, parietal membrane to pleural cavity
30
What is external intercostal membrane?
Membrane between costosternal joint and external intercostal muscles
31
What is internal intercostal membrane?
Membrane between costovertebral joint and internal intercostal muscle
32
The innermost intercostal muscle fills only central position, what is the rest?
Subcostalis muscle posteriorly and transversus thoracic muscle anteriorly
33
Which organs are not drained by lymphatics ?
Eye, inner ear, spinal cord, cartilage, brain
34
Name the main groups of lymph nodes
superficial and deep cervical, axillary, pectoral, tracheobronchial, lumbar/pelvic, superficial and deep inguinal
35
Where is the glandular part of the breast located?
Between ribs 2-6 and between the lateral border of sternum and the mid-axillary line, it is divided into 16-20 lobes and smaller lobules and is surrounded by adipose tissue
36
Where does the axillary tail of the breast extends to?
Superolaterally to penetrate the floor of the axilla
37
What is the role of diaphragm?
It is main inspiratory muscle, assist in raising intra-abdominal pressure when coughing, vomiting and defaecation
38
Which dome of diaphragm is higher and why?
Right dome due to large size of liver
39
What are the 3 peripheral attachments of the diaphragm ?
To the thoracic vertebra (right crura L1-L3, left crura L1 and L2), costal cartilages 7-12 and xiphoid process
40
What is the central attachment of the diaphragm?
One central tendon, 3 leaf clover shape is formed
41
What is the shape of the diaphragm?
3 leaf clover
42
How many major hiatuses are there in the diaphragm?
3
43
What does pass through the hiatus at level T8?
Inferior vene cava and right phrenic nerve, in the central tendon
44
What does pass though hiatus at level T10?
oesophagus and both vagus nerves, in the muscular part of right crus
45
What does pass through hiatus at level T12 ?
Aorta, hemiazygous veins, thoracic duct, between left and right crura
46
What is hiatal hernia?
protrusion of structures through diaphragm
47
What do azygos veins drain?
Posterior intercostal veins on the right side of the body
48
What do hemiazygos and accessory hemiazygos vein drain?
Posterior intercostal viens on the left side of body
49
What does phrenic nerve innervates?
pericardium, pleura and inferior surface of diaphragm
50
What type of nerve fibres are there in phrenic nerve ?
Motor (muscles) and sensory nerve fibres (central tendon), sympathetic
51
What other nerves innervate diaphragm?
Lower intercostal nerves innervates peripheral parts of the diaphragm
52
What is quadriplegia?
Paralysis of all 4 limbs, caused by injury below phrenic nerve, breathing still occurs
53
Describe the position of vagus nerve
It is more thick and medial, lies on the oesophagus, posterior to the hilum of lungs
54
What nerve fibres are there in vagus nerve ?
motor, sensory and parasympathetic
55
What is the relative position of the trachea and oesophagus?
trachea is anterior to oesophagus
56
What is role of larynx?
Produces sound from expired air and protects the inlet to the respiratory system
57
Describe the anatomy of the larynx
It is attached to hyoid bone anteriorly at C2/C3, third membrane C4, laryngeal prominence C5, cricoid cartilage C6
58
What is the innervation of larynx?
It is innervated by motor and sensory neurones, by vagus nerve
59
What is laryngeal prominence made of?
thyroid cartilage
60
Describe the innervation of lower respiratory tract
motor though sympathetic fibres from upper spinal nerves, parasympathetic from vagus nerve, sensory from both sympathetic and parasympathetic
61
Describe the anatomy of trachea
It stars at C6 and bifurcates at T4 level
62
How many cartilage rings are there in trachea?
15-20
63
What is the name of final tracheal cartilage ?
carina
64
What is the name of the muscle that completes the C shaped cartilaginous ring?
Trachealis muscle
65
What is the role of tracheal muscle?
Increases pressure during coughing, enables flexibility during swallowing
66
What is the name of the arteries that are lateral to the trachea?
Common carotid arteries
67
Where does inhaled objects commonly lodge?
It right main bronchus, it is wider and more vertical
68
What blood vessels branch over left main bronchus?
Left pulmonary artery and aorta
69
What are the names of the two right bronchi that arise form right main bronchus?
Eparterial (superior lobar) and hyperterial bronchus
70
Describe the tracheobronchial tree
trachea, main bronchus, lobar bronchus (2 on L, 3 on R), segmental bronchus, conducting bronchiole, terminal bronchiole, respiratory bronchiole, alveolar duct, alveolar sac and alveolus
71
What is bronchopumoanry segment?
functional unit of lungs, part of lungs supplied by tertiary bronchus, there are 10 segments in the right and 8 or 9 segments in the left lung
72
What are tracheobronchial lymph nodes ?
Nodes between the two main bronchi that drain trachea, bronchi and lungs
73
What are bronchomediastinal lymph nodes?
Lymph nodes in the hilum of lungs
74
Name the borders of lungs
anterior, posterior and inferior (base)
75
Name the surfaces on lungs
Costal, diaphragmatic, mediastinal
76
Name the lobes in lungs
Right lung has 3 lobes, superior, inferior and middle, left lung has 2 lobes, superior and inferior
77
Which figure forms superior and inferior lobe ?
Oblique
78
Which fissure forms inferior and middle lobe?
Horizontal