Respiratory System - Dry Room St. 5 and 6 Flashcards
How many attachements does the diaphragm have?
4
How many major hiatuses (openings) does the diaphragm have?
3
Identify
1.
3.
9.
11.
14.
16.
24.
25.
- Xiphoid
- Oesophagus
- Left crus
- Aorta
- right crus
- Medial arcruate ligament
- Opening for IVC
- Central tendon
What does the term “diaphragm” mean?
A sheet of skeletal muscle stretching across the midline of the body
Which of the left or right dome lies more superior on normal expiration and why?
Right dome due to the liver
Which cardiac structure is firmly attached to the central tendon?
Fibrous Pericardium
Which vertebrae are the left and right crura attached?
L1 - L3
What membrane covers the superior surface of the diaphragm?
Parietal Pleura
When the diaphragm contracts what happens to the domes?
They descend and flatten
What is the shape of the central tendon?
Clover
Which costal cartilages is the diaphragm attached to?
Ribs 7-10
Which part of the sternum does the diaphragm attach?
Posterior aspect
What vertebral level does the opening for the vena cava occur?
T8
What vertebral level does the opening for the oesophagus occur?
T10
What vertebral level does the opening for the aorta occur?
T12
Which part of the diaphragm does the IVC pass and why?
Central tendinous part to assist venous return by making sure it isn’t constricted
What other vein transverses the diaphragm?
Azygos
What lymphatic duct transverses the diaphragm?
Thoracic duct
Which nerve structures transverse the diaphragm?
- Sympathetic trunks
- Phrenic nerves
- Vagus nerve
What do the phrenic nerves supply the diaphragm with?
- Motor (efferent)
- Sensory (afferent)
What do the lower intercostal nerves do for the diaphragm?
- Provide sensory (afferent) information to the peripheral parts
What vertebral levels contribute to the phrenic nerves?
- C3
- C4
- C5
What will spinal cord injury above the phrenic nerve levels result in?
- Diaphragm paralysis and therefore the inability to breathe
- Quadrapelegia
Identify the vagus and phrenic nerve
- Vagus nerve just above metal instrument and disappears behind structures
- Phrenics clearly running more lateral and stays visible most of the thorax
How can breathing be maintained if the phrenic nerve is damaged?
- The intercostal accessory muscles can work to compensate for the loss of passive breathing
What should be assumed of penetrating injuries just below the nipple?
- Damage to the diaphragm
- Due to the upward arching of the domes
T3 CT thorax
T4 CT thorax
T5 CT thorax
What vertebral level does the trachea bifurcate?
- T4
