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Monica Respiratory > Respiratory Anatomy > Flashcards

Respiratory Anatomy Flashcards

1
Q

anatomy of upper resp tract

A

right + left nasal cavities
orla cavity
naso-oro + laryngo-pharynx
larynx

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2
Q

lower resp tract anatomy

A 
trachea
right + left main bronchi
lobar bronchi
segmental bronchi
bronchioles
alveoli
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3
Q

C6 verterbra

A

larynx becomes pharynx

pharynx becomes oesophagus

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4
Q

where can the trachea be palpated

A

jugular notch of manubrium

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5
Q

where is the isthmus of the thyroid gland

A

anterior to tracheal cartilage 2-4

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6
Q

roles of chest wall

A

protect lung and heart
make movements of breathing
break tissue - lactation

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7
Q

roles of chest cavity

A

within chest wall
contains vital organs
contains major vessels + nerves
consists of mediastinum + right + left pleural cavities

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8
Q

role of pleurae

A

secrete fluid nto pleural cavity: a lubricant + proves surface tension

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9
Q

describe lung lobe

A

area of lung each lobar bronchi supply with air

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10
Q

what are lung lobes separated by

A

fissures
right lung - oblique + horizontal fissure
left lung - oblique fissure

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11
Q

name lung lobes

A

left - superior and inferior lobe

right - inferior, superior + middle lobe

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12
Q

describe bronchopulmonary segment

A

area of lung lobe that each one of segmental bronchi supply air with
each lung = 10 bronchopulmonary segments

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13
Q

list features of thoracic skeleton

A

12 pairs of ribs
(true ribs 1-7 attach via their costal cartilage to sternum
false ribs 8-10 attach via their costal cartilage above sternum
floating ribs 11 + 12 no attachment to sternum)

intercostal spaces

costal margin

12 thoracic vertebrae

clavicle and scapula

sterum
-manubrium, body, xiphoid, sternal angle

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14
Q

list 3 layers of skeletal muscles located between ribs + within intercostal space

A

external intercostal muscles
internal intercostal muscles
intermost intercostal muscles

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15
Q

where do layers of intercostal muscles attach

A

between adjacent ribs

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16
Q

how do layers of intercostal muscle make chest wall expand

A

pull adjacent ribs upwards and outwards

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17
Q

state another skeletal muscle important in breathing

A

diaphragm

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18
Q

define intercostal

A

between ribs

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19
Q

how many intercostal spaces are there

A

11

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20
Q

what does each intercostal space carry

A

neuro-vascular bundle
(vein, artery + nerve)
between internal and inter-most intercostal muscle layers

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21
Q

Nerve supply of intercostal space

A

anterior ramus of spinal nerve

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22
Q

Blood supply of posterior and anterior intercostal spaces

A

posterior
arterial supply = thoracic aorta
venous drainage = azygous vein

anterior
arterial supply = internal thoracic artery
venous drainage = interna thoracic vein

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23
Q

key features of diaphragm

A

internal
floor of chest cavity
roof of abdominal cavity
openings to permit passage between 2 cavities

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24
Q

what type of tendon does the diaphragm have

A

unusal central tendon

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25
Q

is the right or left dome of the diaphragm more superior

A

right

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26
Q

what does the muscular part of the diaphragm peripherally attach to

A

sternum
lower 6 ribs + costal cartilages
L1-L3 vertebral bodies

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27
Q

what is the muscular part of the diaphragm supplied by

A

phrenic nerve (C3, 4 + 5 = anterior rami)

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28
Q

describe phrenic nerves

A

anterior rami of C3, 4, 5
anterior surface of scalenus anterior muscle = located
descending over later aspects of chest

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29
Q

what keeps the diaphragm alive

A

C3, 4, 5

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30
Q

outline inspiration mechanisms

A
  1. Diaphragm contracts (increases vertical chest dimension)
  2. Intercostal muscles contract = elevated ribs (increase A-P and lateral chest dimensions)
  3. Chest walls pull lungs outwards with them (pleura)
    - air flows into lungs (-ve pressure)
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31
Q

outline expiration mechanism

A
  1. Diaphragm relaxes + rises (decreased vertical thoracic dimension)
  2. Intercostal muscles relax lowering ribs (decrease A-P + lateral chest dimensions)
  3. Elastic tissue of lung recoils
    (air flows out of lungs)
32
Q

4 quadrants of the breast

A

nipple
areola
axillary tail
regiona lymphatics

33
Q

where is the trachea palpated

A

jugular notch of manubrium

34
Q

list the muscles of anterolateral chest wall

A 
skin
clavicle
deltoid
cephalic vein - in delto-pectoral groove
pectoralis major
sensory nerves - intercostal nerves
deep fascia - fibrous, tough, protection
superficial fascia - adipose tissue, insulation
35
Q

list the muscles of anterolateral chest wall

A

pectoralis major
serratus anterior - anchors scapula to ribs
latissimus dorsi
long thoracic nerve - supplies serratus anterior

36
Q

what does paralysis off serratus anterior result in

A

winged scapula

37
Q

what are diaphragm domes covered with

A

parietal fluid

38
Q

where are lungs connected to mediastinum

A

at lung root

39
Q

explain costodiaphragmatic recess

A

most dependent part of pleural cavity
between diaphragmatic parietal pleura +costal parietal pleura
most inferior region - costophrenic angle
abnormal fluid on pleural cavity drains into recess => blunting of angles

40
Q

structure of lung root

A 
1 main bronchus
1 pulmonary artery
2 pulmonary veins
lymphatics
visceral afferents
sympathetic nerves
parasympathetic nerves
41
Q

define asucltation

A

listening to sound of air moving through larynx

42
Q

normal breath sounds are what in nature

A

rustling

43
Q

auscultating areas anterior

A

lung apex
middle lobe (mid-clavicular + midaxillary)
horizontal fissure
oblique fissures

44
Q

auscultating areas posterior

A 
T11 vertebral bases
left costodiaphragmatic recess of the pleural cavity
left scapular line
oblique fissure
inferior lobe
45
Q

coughing = stimulation of sensory receptors in

A

oropharyngeal mucosa
laryngopharyngeal mucosa
laryngeal mucosa

46
Q

what are the sensory rectors stimulated in sneezing

A

CN V

CN IX

47
Q

sensory receptors stimulated in coughing

A

CN IX

CN X

48
Q

describe carotid sheaths

A

protective tubes of deep fascia
attach superiorly bones of base of skull
blends inferiorly to bones of skull base
blends inferiorly with fascia of mediastinum

49
Q

what do carotid sheaths contain

A

vagus nerve
internal carotid artery
common carotid artery
interbal jugular veins

50
Q

how does the CNS respond

A

rapidly

51
Q

muscles of normal inspiration

A

external intercostal
internal intercostal
intermost intercostal

52
Q

accessory muscles of DEEP inspiration

A

pectoralis major
pectoralis minor
sternicleidomastoid
scalenus anterior, medius + posterior

53
Q

accessory muscles use clinical sign suggesting

A

dyspnoea

54
Q

outline CNS reponse

A
  1. DEEP inspiration using diaphragm, intercostal muscles + accessory muscles of inspiration
  2. Adduction of vocal cords close to rima glottides
  3. Contraction of anterolateral abdominal wall muscles = builds intra-abdominal pressure - pushes diaphragm superiorly + builds up pressure in chest/respiratory tree inferior to adducted vocal cords
  4. vocal cords abduct + open rima glottides
  5. soft palate tenses + elevates + closes nasopharynx + direct air through oral cavity as cough not nasal cavity as sneeze
55
Q

pulmonary consequence of chronic cough

A

dynamic airway compression in asthma - expiration = difficult
build up of air trapped in alveoli = rupture of lung + visceral pleura
breach in visceral pleura = alveolar air enters pleural cavity

56
Q

small pneumothorax

A

small amount air enters pleural cavity via
a= penetrating injury to parietal pleura
b= rupture of visceral pleura the vacuum is lost, elastic lung tissue recoils towards lung root

57
Q

small pneumothorax measurement

A

<2cm gap between lung + aprietal pleura

58
Q

large pneumotorax

A

large amount air enters pleural cavity via
a= penetrating injury to parietal pleura
b= rupture of visceral pleura vacuum = lost, lung tissue recoils towards lung root = large pneumothorax

59
Q

large pneumothorax measuremnet

A

> 2cm gap between lung + parietal pleura

60
Q

diagnosing pneumothorax

A

history

examination
= reduced ipsilateral chest examination
= reduced ipsilateral breath sounds
= hyper- resonance on percussion

investigation
=absent lung markings peripherally
=lung edge visible

61
Q

tension pneumothorax

A

1 way valve allowas air to enter but not escape
each inspiration = more air in pleural cavity
pneumothorax expands + collapses towards its root ====> tension created to mediastinal structure

62
Q

what type of pneumothorax can cause mediastinal shift

A

tension pneumothorax

63
Q

explain tracheal deviation

A

deviation away from side of unilateral tension pneumothorax

64
Q

where is mediastinal shift papable

A

jugular notch

65
Q

what does SVC reduce

A

venous return to heart ==> hypotension

66
Q

management of large pneumothorax

A 
needle aspiration
chest drain (4th/5th intercostal space in midaxillary line)
67
Q

list safe triangles

A

anterior borders of latissimus dorsi
posterior border pectoralis major
axial line superior to nipple

68
Q

emergency management of tension pneumothorax

A

large gauge cannula into pleural cavity (2nd/3rd intercostal space in midclavicular line on side of tension pneumothorax)

69
Q

define herniae

A

any structure passing through another = ending up in wrong place

70
Q

2 factors required for herniae development

A
  1. weakness of 1 structure normally part of body wall

2. increased pressure on 1 side of that part of the wall

71
Q

parts of body with normal anatomical weakness

A

diaphragm = diaphragmatic hernia
umbilicus = umbiical hernia
inguinal canal = inguinal hernia
femoral canal = femoral hernia
congenital abnormalities = congenital diaphragmatic hernia
surgical scars = weaken body wall = incisional hernia

72
Q

increased pressure on 1 side of that part of wall

A

chronic cough

repeated bouts of increased pressure = structures pushed through wall = hernia

73
Q

diaphragmatic herniae

A

xiphoid attachment

74
Q

inguinal herniae

A

medial half of inguinal region
unilateral or bilateral
-weakness in inguinal area = presence of inguinal canal
-increased pressure = intra-abdominal

75
Q

increased pressure in intra-abdominal

A

chronic cough
chronic obstruction
occupational lifting of heavy weights
athletic effort

76
Q

how to differentiate direct + indirect herniae

A

‘reduce’ herniae
occlude the deep ring with finger tip pressure
ask patient to cough

direct = lump will reappear
indirect = herniae will not reappear
77
Q

explain spermatic cord

A

3 layers of coverings gained as the testis passes through inguinal canal + structures contained within

Monica Respiratory (21 decks)

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