Respiratory System Thorax 1 (WHITE BOOKLET) Flashcards
Where can you locate a demifacet?
On the vertebral body
Why can gall bladder illness present itself as shoulder pain?
Compression of C3,4,5 phrenic nerve which supplies shoulder
Why does the vena cava travel through the central tendon?
No contraction of central tendon - therefore there is no impedence of blood flow
Which bones articulate with the manubrium at its superolateral angles?
Clavicle
What type of joint is the sternocalvicular joint?
Saddle joint
What is the name of the notch at the superior border of the manubrium?
Jugular notch
What vertebral level is the xiphoid process located?
T9-T10
What vertebral level is the sternoclavicular joint?
Disc of T4 - so between T4 and T5
Which rib articulates with the manubiosternal joint?
2nd
What does the tubercule of a rib articulate with?
Transverse process of the vertebrae of the same level
Which structures lie in the intercostal groove?
VAN
Vein, arteries, nerve (intercostal)
What is meant by a true rib?
Attach to sternum with costal cartilage
Ribs 1-7
What is meant by a false rib?
Cartilage attaches to cartilage superior
What is the joint found between costal cartilage?
Interchondral joint
Which ribs are floating ribs?
No connection to the sternum
What two parts of the vertebra form the neural arch?
Pedicle and the lamina
What is dyspnoea?
Difficulty breathing
Which intercostal muscle layer is orientated inferoanteriorly?
Intercostal externus
Which intercostal muscle layers are orientated inferoposteriorly?
Intercostal internus
Intercostal innermost
What space does the external intercostal muscle fill up?
All the space as far as the costochondral junction anteriorly
What fills up the remaining part of the space between the between the sternum and the costochondral junction?
External intercostal membrane
What space does the internal intercostal muscle fill up?
Sternum to costal angle
What extends the internal intercostal muscle?
Internal intercostal membrane
What extends the innermost intercostal muscle?
Transversus thoracis muscles (most anterior)
Subcostalis muscles
Where can you find a collateral branch?
Just above the top of each rib
What are the tissue layers of the chest wall?
Skin Superficial fascia Deep fascia External intercostal muscle Internal intercostal muscle Innermost intercostal muscle Parietal pleura of the lung Pleaural cavity Visceral pleura
Where are axillary lymph nodes?
Root of the upper limb
Where are the superficial and deep inguinal lymph nodes?
Root of the lower limb
Where are the pectoral lymph nodes?
Around the pectoralis major muscle
What lymph nodes are found around the bifurcation of the trachea of the thorax?
(Tracheobronchial)
Where are lumbar and pelvic lymph nodes?
Around the root of arteries in the abdomen and pelvis
Where do you find superficial and deep cervical lymph nodes?
Superficial and deep groups in the head and neck
Where does over 75% of lymph particularly from the lateral quadrants drain?
First to anterior (pectoral) group of axillary lymph nodes.
Where does the remainder of lymph drain to (that doesn’t drain into the anterior group of axillary lymph nodes)?
Parasternal lymph nodes - Anterior ends of the intercostal spaces Opposite breast Abdominal nodes (lower quadrants)
Where is the base of the breast located (the glandular part)?
Between the ribs 2-6
Between the lateral border of the sternum and the midaxillary line
Describe the structure of the base of the breast
Divided into 16-20 lobes, surrounded by extensive adipose tissue
What is the placement of the axillary tail?
Extends superolaterally to penetrate the floor of the axilal
Lies in close proximity to the auxiliary lymph nodes
What cardiac structure is firmly attached to the central tendon?
Fibrous pericardium
What is a hiatus hernia?
Abnormal protrusion of a structure through into the thorax through a tear or weakness in the diaphragm.
What is forced inspiration?
Involves the action of accessory muscles
Where do you find accessory muscles?
Attach to the superior and inferior boundaries of the thoracic cavity
Muscles of the neck attaching to the sternum and upper ribs, muscles of the abdomen that attach to the lower ribs
What supplies the larynx?
Supplies almost entirely by the branches of the vagus nerve for both motor and sensory innervation.
Which cartilage forms the adam’s apple?
Thyroid cartilage
Where does the LRT receive motor innervation from?
Sympathetic fibres originating in the upper thoracic spinal levels, via pulmonary plexuses located at the termination of the main bronchi, and the parasympathetic fibres of the vagus nerve.
What type of sensory fibres travel from the LRT to spinal cord?
Sympathetic and parasympathetic fibres
Where does arterial supply arise in the LRT?
Via bronchial arteries arising from the thoracic aorta and intercostal arteries.
Where do bronchial veins drain to?
Azygous venous system
How many half complete hyaline cartilage rings compose the trachea?
Between 15 and 20
What is the name of the muscle that completes the ring of the trachea posteriorly?
Trachealis muscle
What is the keel shaped cartilage ring at the bifurcation of the trachea?
Carina of trachea
What are the arteries lying lateral to the trachea in the neck?
Common carotid arteries
What is the nerve lying lateral to the trachea on both sides of the trachea?
Vagus nerve
What is the name of the grooves lying between the trachea and the oesophagus on both sides
Tracheo-oesophageal grooves
Which of the two main bronchi is the shorter, wider and more vertical?
Right
Aspirated objects are more likely to pass through here
Which two major arteries pass over the left bronchus?
Pulmonary artery and the aorta
What fascial membrane covers the apex of the lung?
The cervical pleura
Does the lung extend above the first rib and clavicle?
Yes
What makes up the functional segment of a lung?
Bronchopulmonary segment
Supplied by a tertiary bronchus and an accompanying branch of the pulmonary artery and bronchial artery and vein
How many bronchopulmonary segments exist in the right lung and left?
10 segments in the right
8 or 9 in the left
What do the two visceral layers attach to ?
Parietal - Inner wall of chest cavity
Visceral- adherent to lung tissue
What does the mediastinal pleura line?
The structures situated between the two pleural cavities
What does the diaphragmatic pleura line?
Superior surface of the diaphragm
What does the costal pleura line?
The inner surfaces of the ribs and sternum
What is a pneumothorax?
Air in the intrapleural space
Which parts of the parietal pleura does the phrenic nerve supply?
Mediastinal and diaphragmatic
Remainder supplied by intercostal nerves
Where is the best space for a pleural aspiration?
9th intercostal space in the midaxillary line
If performed in the 10th intercostal space there is a risk of penetrating the abdominal cavity
What is the structure of the extrapulmonary tubes?
Mucosa, submucosa, cartilage and adventitia
What is the mucosa comprised of?
2 layers
Epithelium
Loose connective tissue called lamina propria
What type of cells are found in the epithelial layer?
Goblet cells
Basal cells
Ciliated cells
What is the epithelium of the bronchiole?
Columnar or cuboidal
Is there smooth muscle in the bronchiole?
Yes, and cilia
No glands or cartilage though
What three types of cells are found in the wall of the alveolus?
Type 1 + 2 pneumocytes
Macrophages - ingests foreign material that reaches the alveoli
What two types of connective tissue fibres predominate in the respiratory portion of the lung tissue?
Reticular and elastic fibres
