Respiratory system Flashcards
What type of joint is the sternoclavicular joint?
Synovial saddle
At what vertebral level is the xiphoid process?
T9
At what vertebral level is the sternomanubrial joint?
T4 (sternal notch)
With the bodies of which thoracic vertebrae will the head of rib 7 articulate with?
T6 and T7
What structures lie in the costal grooves of the ribs?
Intercostal blood vessels and nerves
Which ribs are true ribs (vertebrosternal)?
Ribs 1-7 (costal cartilage attached to sternum directly)
Which ribs are false ribs (vertebrochondral)?
Ribs 8-10 (costal cartilage attaches to preceding costal cartilages)
Which ribs are floating ribs?
Ribs 11 + 12 (sometimes 10)
On rib 1, what vessel runs anterior to the scalene tubercle?
subclavian vein
On rib 1, what vessel runs posterior to the scalene tubercle?
subclavian artery
What % of the population develop an additional “rib” which grows from the transverse process of C7?
0.5%
Can result in compression of the brachial plexus, paraesthesia of the medial side of the upper limb and wasting of the small muscles of the hands
What shape is the body of thoracic vertebra?
Heart shaped
What structures pass through the vertebral foramen?
Spinal cord surrounded by the 3 meninges - dura, arachnoid and pia matter
What structures pass through the intervertebral notches?
Spinal nerve roots
What do the facets on the transverse processes of vertebrae articulate with?
Tubercules of the ribs
Describe thoracic spinous processes
Long
Slender
Downwards pointing
Non-bifid
Which two parts of the vertebrae form the neural/vertebral arch (parts of vertebrae which enclose the spinal cord)?
Pedicle
Lamina
Describe what makes up the thoracic inlet
T1
1st rib
Superior border of manubrium
What makes up the thoracic outlet?
T12 vertebrae
Posterolaterally by 11th and 12th ribs
Costal cartilages of ribs 7-10 anterolaterally
Xiphosternal joint
Which ribs/costal cartilages make up the costal margin?
Ribs 7-10
Which muscle is primarily used for breathing in the newborn?
Diaphragm
Describe the orientation of the muscle fibres in the external intercostal muscle
Infero-anteriorly
Describe the orientation of the muscle fibres in the internal intercostal muscle
Infero-posteriorly
Between which two intercostal muscles are the neuromuscular bundles located?
Internal and innermost intercostal muscles
Each are found lining either side of rib
From superior to inferior, which structures are in the neuromuscular bundles found between the intercostal muscles?
Vein
Artery
Nerve
Where are the neuromuscular bundles found?
Inferior to each rib, in the costal grooves, between internal and innermost intercostal muscles
Where does the external intercostal muscles become the external intercostal membrane?
Anterior of the thorax
Where does the internal intercostal muscles become the internal intercostal membrane?
Posterior of the thorax
What does the innermost intercostal muscle become anteriorly and posteriorly?
Anteriorly - transversus thoracis muscle
Posteriorly - subcostalis muscle
Which nerves innervate the diaphragm?
C3-5
Phrenic nerves
Where are chest drains usually inserted?
5th intercostal space in mid axillary line
aim just above 6th rib to avoid neurovascular bundle
What makes up the brachial plexus?
C5-T1
What dermatome is the sternal angle in?
T2
What dermatome are the nipples in?
T4
What dermatome is the umbilicus in?
T10
What dermatome is the inguinal region in?
L1
What can be a useful sign when diagnosing shingles?
Shingles - herpes viral infection of a nerve and its root. Manifests as rash on skin corresponding to the dermatome of the nerve affected, useful in diagnostics
Where in the body does not have lymphatic drainage?
Cartilage
inner ear
brain
spinal cord
Where are the major groups of lymph nodes?
Root of upper limb - axillary
root of lower limb - superficial + inguinal
around pectoralis major - pectoral
bifurcation of trachea - tracheobronchial
root of arteries in abdomen - lumbar/pelvic
head and neck - superficial and deep cervical
Where do lymph nodes tend to be found?
Near large veins
Between what ribs is the base/glandular part of the breasts located?
Ribs 2 and 6 and between lateral border of the sternum and the midaxillary line
Which dome of the diaphragm lies more superior during normal expiration?
Right - presence of liver
What cardiac feature is attached to the central tendon of the diaphragm?
Pericardium
To which vertebra are the right and left crura attached to?
Right - L1-3
Left - L1-2
To which costal cartilages is the diaphragm attached?
ribs 7-10
At what vertebral level is the opening for the vena cava in the diaphragm?
T8
At what vertebral level is the opening for the oesophagus in the diaphragm?
T10