Respiratory Anatomy Flashcards
What is the function of the thoracic wall?
- to protect the lungs/heart
- to permit the movements associated with respiration
What structures comprise the thoracic wall?
- sternum
- vertebrae T1-T12
- ribs 1-12
List the six parts of the sternum.
- jugular notch
- clavicular notch
- manubrium
- sternomanubrial joint
- body of sternum
- xiphoid process
Where do the clavicles articulate with the manubrium?
- superolateral angles at the sternoclavicular joint in the clavicular notch
Name the type of joint present in the sternoclavicular joint.
- synovial saddle
Where would you find the jugular notch?
- superior border of the manubrium
At which vertebral level is the sternomanubrial joint located?
- T4/5
At which vertebral level is the xiphoid process located?
- T9
What articulates with the manubrium and the body of the sternum?
- the facets for the second costal cartilages
Give features of the typical ribs.
- rounded superior border
- sharp inferior border
- head
- neck
- tubercle
- angle
- costal sulcus/groove
- pit for costal cartilage
- attachment of ribs/costal cartilage
With which vertebrae do the ribs articulate?
- the vertebrae of the same number as the rib
- the one above this one
What articulates with the tubercle of the rib?
- the transverse process
What lies within the costal groove?
- intercostal nerves
- intercostal veins
- intercostal arteries
Which ribs are termed true ribs?
- Ribs 1-7
Which ribs are termed false ribs?
- Ribs 8-10
Which ribs are termed floating ribs?
- Ribs 11 and 12
Describe the first rib.
- atypical, true rib
- short, wide and flat
- articulates with a single vertebra - T1
- two shallow, hortizontal grooves crossing its superior surface
- a scalene tubercle
What is the scalene tubercle?
- present for the attachment of the anterior scalene muscle of the neck
What lies in the shallow grooves of the first rib?
- the subclavian vein and artery
Which ribs are directly attached to the sternum and how to the other ribs attach?
- ribs 1-7 attach directly
- the false ribs attach to the preceding costal cartilage
What is the primary muscle used for breathing in the newborn?
- the diaphragm
What is found within the intercostal space?
- three layers of intercostal muscle
- intercostal nerve
- posterior and anterior intercostal vein and artery
Name the muscles and their orientation that reside in the intercostal space.
- external intercostal - inferio-anteriorly
- internal intercostal - inferio-posteriorly
- innermost intercostal - varying
Where is the neurovascular bundle located?
- between the internal and the innermost intercostal muscles, in the costal groove
What is the neurovascular bundle is comprised of?
- intercostal vein
- intercostal artery
- intercostal nerve
Where is the normal placement for a chest drain and why?
- the 5th intercostal space in the mid-axillary line
- the needle should be inserted above the rib to avoid damaging the neurovascular structures
What is a dermatome?
- an area of skin supplied by a single spinal nerve
List the dermatome areas of the sternal angle, nipple area, umbilicus and the inguinal region.
- sternal angle - T2
- nipple area - T4
- umbilicus - T10
- inguinal region - L1
The ventral rami supplies which dermatomes?
- those of the anterolateral thoracic wall
The dorsal rami supplies which dermatomes?
- those of the posterior thoracic wall
What is lymph?
- essentially plasma which has leaked from capillary beds due to high hydrostatic pressures
Which tissues do not have lymphatic drainage?
- cartilage
- eyes
- inner ear
- brain
- spinal cord
List the locations of the major groups of lymph nodes.
- Axillary - root of upper limb
- Superficial and deep inguinal - root of the lower limb
- Pectoral - around the pectoralis major
- Tracheobroncial - bifurcation of the trachea in the thorax
- Lumbar/pelvic - around the root of the arteries in the abdomen and pelvis
- Superficial and deep cervical - superficial and deep groups in the head and neck
Where does lymph ultimately drain to?
- thoracic duct or right lymphatic duct
- they then return to the venous system
Describe the diaphragm.
- sheet of skeletal muscle
- forms the boundary between the thoracic and abdominal cavities
How many attachments and hiatuses does the diaphragm have?
- four attachments
- three major hiatuses and a number of minor ones
What is the function of the diaphragm?
- main muscle of respiration
- also assists in raising intra-abdominal pressure during coughing, vomiting and defaecation
List the structures found in the diaphragm.
- left and right domes
- central tendons
- left and right crura
- openings for inferior vena cava, oesophagus and aorta
Which dome of the diaphragm lies more superiorly?
- the right dome
At which vertebral levels do the left and right crura attach?
- L2
What happens to the domes of diaphragm when they contract?
- they descend
Name the membrane that covers the superior surface of the diaphragm.
- parietal pleura
List the locations of the three major hiatuses and name what passes through them.
- T8 - inferior vena cava
- T10 - oesophagus
- T12 - aorta
Name the most important nerve that supplies the diaphragm.
- The phrenic nerve
Where does the phrenic nerve originate?
- C3/4/5
What structures contribute to the upper respiratory tract?
- nasal cavity
- pharynx
- larynx
Describe the larynx.
- set of cartilages, membranes and ligaments
- provides sound from expired air
- protects the inlet to the respiratory system
What resides superiorly and inferiorly to the larynx?
- superiorly - hyoid bone
- inferiorly - continuous till the trachea at C6
What nerve supplies the larynx?
- vagus nerve
What forms the laryngeal prominence?
- thyroid cartilage
What structures form the lower respiratory tract?
- trachea
- primary bronchi and their branches
- lungs
- pleurae
True or False?
The bronchial veins drain into the superior vena cava.
False
- the bronchial veins drain into the azygos vein
Where does the trachea originate and terminate?
- originates at C4
- bifurcates at T4
Describe the structure of the trachea.
- 16-20 rings of incomplete hyaline cartilage
- the muscle that completes them is called the trachealis
- the final ring at the bifurcation of the trachea is called the carina
What is the difference between the right main bronchus and the left main bronchus?
- the right main bronchus is shorter, wider and more vertical
Which bronchus is more likely to be blocked with an accidentally aspirated object?
- the right main bronchus
Describe the left lung.
- two lobes, superior and inferior, separated by an oblique fissure
- cardiac notch
- aortic and cardiac impressions
- lingula
Describe the right lung.
- three lobes, superior, middle and inferior
- oblique fissure separates the inferior lobe
- transverse fissure separates the superior and middle lobe
Where is the hilum of the lung and what is its purpose?
- found on the mediastinal surface of the lung
- only site of exit and entrance for bronchi and blood vessels
Name the structures that make up the root of the lung and give their positions relative to each other.
- bronchus (most posterior)
- pulmonary artery (most superior)
- superior pulmonary vein (most anterior)
- inferior pulmonary vein (most inferior)
What is the name given to the membrane that covers the apex of the lung?
- cervical pleura
True or False?
The lung extends above the first rib and clavicle.
True.
Which lung is the shortest?
- the right lung
Define the pleura.
- serous membranes that surround each lung
Name the pleura which lines the inner wall of the chest cavity.
- the parietal pleura
Name the pleura which adheres to the lung tissue.
- viscerol pleura
What is contained within the pleural space?
- pleural fluid
True or False?
The viscerol pleura does not enter and define the fissures of the lungs.
False.
- the viscerol pleura enters and defines the fissures of the lungs
When does a pleural reflection occur?
- where the parietal pleura lining one surface of the chest wall changes its direction to line another surface
Give an example of pleural reflection.
The costodiaphragmatic reflection.
Where does a pleural recess form?
- were pleural reflections occur and the parietal pleura is more widely separated from the viscerol pleura during expiration.
Why are pleural recesses clinically useful?
- for needle aspiration of excessive accumulation of fluid in the pleural space
True or False?
The parietal pleura is sensitive to pain, while the viscerol pleura has no sensory innervation.
True.
Which lung fissure follows the course of the 6th rib?
- oblique fissure
Which rib does the horizontal fissure follow the course of?
- 4th rib
List the structure of the extrapulmonary tubes from the lumen to the outside of the tube.
- mucosa
- submucosa
- cartilage
- adventitia
What two layers comprise the mucosa?
- epithelium
- lamia propria (a thin loose connective tissue layer)
What kind of epithelium is present in the mucosa?
- pseudostratified ciliated columnar epithelium
If the trachea has cartilage rings, what does the bronchus have?
- a discontinuous arrangement of cartilage plates
What type of cartilage is present in the larynx and the bronchus?
- hyaline cartilage