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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
is the right or left dome of the diaphragm more superior
right
26
what does the muscular part of the diaphragm peripherally attach to
sternum lower 6 ribs + costal cartilages L1-L3 vertebral bodies
27
what is the muscular part of the diaphragm supplied by
phrenic nerve (C3, 4 + 5 = anterior rami)
28
describe phrenic nerves
anterior rami of C3, 4, 5 anterior surface of scalenus anterior muscle = located descending over later aspects of chest
29
what keeps the diaphragm alive
C3, 4, 5
30
outline inspiration mechanisms
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)
31
outline expiration mechanism
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
4 quadrants of the breast
nipple areola axillary tail regiona lymphatics
33
where is the trachea palpated
jugular notch of manubrium
34
list the muscles of anterolateral chest wall
``` 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
list the muscles of anterolateral chest wall
pectoralis major serratus anterior - anchors scapula to ribs latissimus dorsi long thoracic nerve - supplies serratus anterior
36
what does paralysis off serratus anterior result in
winged scapula
37
what are diaphragm domes covered with
parietal fluid
38
where are lungs connected to mediastinum
at lung root
39
explain costodiaphragmatic recess
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
structure of lung root
``` 1 main bronchus 1 pulmonary artery 2 pulmonary veins lymphatics visceral afferents sympathetic nerves parasympathetic nerves ```
41
define asucltation
listening to sound of air moving through larynx
42
normal breath sounds are what in nature
rustling
43
auscultating areas anterior
lung apex middle lobe (mid-clavicular + midaxillary) horizontal fissure oblique fissures
44
auscultating areas posterior
``` T11 vertebral bases left costodiaphragmatic recess of the pleural cavity left scapular line oblique fissure inferior lobe ```
45
coughing = stimulation of sensory receptors in
oropharyngeal mucosa laryngopharyngeal mucosa laryngeal mucosa
46
what are the sensory rectors stimulated in sneezing
CN V | CN IX
47
sensory receptors stimulated in coughing
CN IX | CN X
48
describe carotid sheaths
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
what do carotid sheaths contain
vagus nerve internal carotid artery common carotid artery interbal jugular veins
50
how does the CNS respond
rapidly
51
muscles of normal inspiration
external intercostal internal intercostal intermost intercostal
52
accessory muscles of DEEP inspiration
pectoralis major pectoralis minor sternicleidomastoid scalenus anterior, medius + posterior
53
accessory muscles use clinical sign suggesting
dyspnoea
54
outline CNS reponse
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
pulmonary consequence of chronic cough
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
small pneumothorax
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
small pneumothorax measurement
<2cm gap between lung + aprietal pleura
58
large pneumotorax
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
large pneumothorax measuremnet
>2cm gap between lung + parietal pleura
60
diagnosing pneumothorax
history examination = reduced ipsilateral chest examination = reduced ipsilateral breath sounds = hyper- resonance on percussion investigation =absent lung markings peripherally =lung edge visible
61
tension pneumothorax
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
what type of pneumothorax can cause mediastinal shift
tension pneumothorax
63
explain tracheal deviation
deviation away from side of unilateral tension pneumothorax
64
where is mediastinal shift papable
jugular notch
65
what does SVC reduce
venous return to heart ==> hypotension
66
management of large pneumothorax
``` needle aspiration chest drain (4th/5th intercostal space in midaxillary line) ```
67
list safe triangles
anterior borders of latissimus dorsi posterior border pectoralis major axial line superior to nipple
68
emergency management of tension pneumothorax
large gauge cannula into pleural cavity (2nd/3rd intercostal space in midclavicular line on side of tension pneumothorax)
69
define herniae
any structure passing through another = ending up in wrong place
70
2 factors required for herniae development
1. weakness of 1 structure normally part of body wall | 2. increased pressure on 1 side of that part of the wall
71
parts of body with normal anatomical weakness
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
increased pressure on 1 side of that part of wall
chronic cough | repeated bouts of increased pressure = structures pushed through wall = hernia
73
diaphragmatic herniae
xiphoid attachment
74
inguinal herniae
medial half of inguinal region unilateral or bilateral -weakness in inguinal area = presence of inguinal canal -increased pressure = intra-abdominal
75
increased pressure in intra-abdominal
chronic cough chronic obstruction occupational lifting of heavy weights athletic effort
76
how to differentiate direct + indirect herniae
'reduce' herniae occlude the deep ring with finger tip pressure ask patient to cough ``` direct = lump will reappear indirect = herniae will not reappear ```
77
explain spermatic cord
3 layers of coverings gained as the testis passes through inguinal canal + structures contained within

Monica Respiratory (21 decks)

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