Respiratory, Breast, Thorax Flashcards
Muscle in trachea
Trachealis muscle
Trachea - type of cartilage
Hyaline cartilage - collagen 2
Trachea begins at what level
C6
- along with esophagus
- cricoid cartilage also here
- ends at T4
Aspiration when lying down flat
Via right lower lobe bronchus
Into superior BPS of right lower lobe
Aspiration when sitting or stranding
Through right lower lobe bronchus
Into posterobasal BPS of right lower lobe
Aspiration when lying on right side
Through right upper lobe bronchus
Into posterior BPS of right upper lobe
Aspiration when lying on left side
Into left upper bronchus
Into left inferior/ lingular segment of left upper lobe
Another name for secondary bronchus
Lobar bronchus
Another name for tertiary bronchus
Segmental bronchus
Epithelium of the trachea
Pseudostratified columnar ciliated with goblet cells (respiratory epithelium)
Bifurcation of trachea at what vertebral level
T4
Epithelium of terminal bronchioles
Simple columnar - simple cuboidal (not respiratory anymore) with cilia and Clara cells
Epithelium of alveoli
Simple squamous - for exchange!
Reid’s index
Ratio between thickness of submucosal mucus secreting glands and thickness between epithelium and cartilage
NV: < 0.4
If > 0.4, chronic bronchitis
Dust cells
Alveolar macrophages
Pores of Kohn?
Allows passage of bacteria and exudates between adjacent alveoli
Kon-nects!
Structures traversed in thoracentesis
Skin, Superficial fascia, External IC, internal IC, innermost IC, parietal pleura, thoracic cavity
Sudden occlusion of descending aorta will occlude which intercostal arteries
Lower 6 posterior intercostals
Muscles for quiet inspiration
Diaphragm
Muscles for quiet expiration
None. Quiet exhalation is passive c/o elastic recoil of lungs
Blood supply of lungs
Bronchial arteries - from descending aorta
Pulmonary arteries - from pulmonary trunk
Where do the posterior intercostal veins drain
Azygous, Hemiazygous
Contents of intercostal space
Vein
Artery
Nerve
VAN - downward
So insert needle above the rib
Tube thoracostomy - where?
4th-5th ICS MAL (Schwartz)
Forms the pulmonary ligament which supports the lung
Mediastinal pleura
Shape of type 1 alveolar cells? Function?
Flat
Barrier
Shape of type 2 alveolar cells? Function?
Cuboidal
Release surfactant
Non-ciliated secretory cells which interrupt ciliated epithelial lining of bronchial mucosa
Clara cells - within bronchioles
Neuroendocrine cells in lungs
Kulchitsky cells
Neuroendocrine cells in GIT
Enterochromaffin cells
Size of bronchioles
Less than 1 cm
Where are Clara cells located?
Bronchioles
They divide to regenerate epithelium
Retraction of nipple - pulls on what structure
Lactiferous duct
Skin dimpling
Shortening of suspensory ligament/ Cooper’s ligament
Blood supply to breast
Internal thoracic - subclavian
Lateral thoracic - thoracoacromial
Post intercostals - thoracic aorta
Medial quadrant of beast - LN drainage
Parasternal
Nerve supply of breast
4-6 intercostal nerves
Lymph drainage of deep surface of breast
Apical group of axillary
Central LN - what level?
Level 2
Apical LN - what level?
Level 3
Right Apical LN drains to?
Right lymphatic duct - opens to right brachoicephalic
Left apical LN drains to
Thoracic duct - to left brachoicephalic
4cm breast mass with 4 axillary lymph nodes. Stage?
Stage 3
4cm breast mass with 1-3 nodes. Stage?
Stage 2
Floating ribs
11th and 12th
The tubercle of the rib articulates with what part of the vertebra?
Transverse process
Tubercle –> transverse process
MC site of rib fracture
Anterior to the angle of the rib (weakest part)
Anterior, posterior and lateral boundaries of thoracic inlet
Posterior: 1st thoracic vertebra
Lateral: medial border of 1st rib
Anterior: Manubrium
Muscles that depress the ribs (3)
Serrated posterior inferior
Internal intercostal
Transverse thoracis
Depress the ribs–> decrease AP, transverse and vertical diameters
Which division of mediastinum - thymus gland?
Superior and Anterior
What division of mediastinum - arch of aorta
Superior
What division of mediastinum - ascending aorta
Middle
What division of mediastinum - descending aorta
Posterior
What division of mediastinum - thoracic duct
Superior and posterior
What division of mediastinum - esophagus
Posterior
What division of mediastinum - left RLN
Superior
What division of mediastinum - main bronchi
Middle
Inferior SURFACE of the heart formed by?
RV and LV but mainly LV
Inferior BORDER of the heart
RV
Sternocostal surface of heart
RV
Blood supply to left atrium and ventricle
Left coronary circumflex
Blood supply to right ventricle
LAD and marginal branch of RCA
Blood supply of right atrium
RCA
Most posterior heart chamber
Left atrium
Where do you auscultate for breath sounds from the SUPERIOR LOBE
Anterior and superior aspects of thoracic wall
Where do you auscultate for breath sounds from the INFERIOR LOBE
Posterior and inferior back
Where do you auscultate for breath sounds from the MIDDLE LOBE
Anterior chest wall near sternum, inferior to right 4th costal cartilage
Left brachoicephalic vein drains into?
SVC
along with right brachoicephalic