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Cardio-respiratory Studies 1 > Senario Three - The Thorax > Flashcards

Senario Three - The Thorax Flashcards

1
Q

State the boundaries of the thorax

A 
thoracic vertebrae
ribs
costal cartilige
sternum 
diaphragm
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2
Q

state the contents of the thorax

A

lungs, pleura, heart, major vessels, mediastinum

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3
Q

Describe the structure of the sternum

A

three parts - manubrium, body and xiphoid

lateral surface - facets for attachments of costal cartilage
manubriosternal joint - hinge joint that moves in respiration

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4
Q

how many true ribs are there? what are they?

A

upper 7 pairs

attach to sternum via their own CC

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5
Q

how many false ribs are there? what are they?

A

8th, 9th and 10th ribs

attach to a common CC then to sternum

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6
Q

how many floating ribs are there? what are they?

A

11th and 12th ribs

Don’t attach to sternum

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7
Q

Describe the anatomy of the rib

A

anterior end - cup shaped depression for CC

shaft twists along its axis - forms costal groove

posterior end - head - two demi facets to attach to BODY of vertebrae above and below

posterior end - neck - medial oval tubercle - attach to TP & lateral tubercle - ligament attachment

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8
Q

where do the ribs attach to the thoracic vertebrae?

A

at the inferior and superior facets of the body via the head

to the TP via the medial tubercle of the rib – reciprically curved on vertebrae T2 - T8 - allows some movement at the joint

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9
Q

what are the atypical vertebrae and why?

A

T9 - T12 - only one facet on body

T11 and 12 - no facet on TP

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10
Q

what type of joint is the manubriosternal joint?

A

secondary cartilaginous joint

hinge allowing small amounts of movement

no capsule and no ligaments

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11
Q

what type of joint is the sternocostal joint? at rib 1

A

cartilaginous joint between medial end of CC and sternum

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12
Q

what type of joint is the sternocostal joint from ribs 2 - 7?

A

synovial joint

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13
Q

what ligaments support the sternocostal joint?

A

anterior and posterior radiate ligaments

pass from medial end of CC - superiorly, horizontally and inferiorly to the sternum

superior fibres interlace with adjacent and opposite ligaments of the joint

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14
Q

what is the classification of the costocondral joints?

A

joint between the cup shaped depression on anterior rib and the costal cartilage

synovial cartilaginous from ribs 1-8
fibrous cartilaginous from ribs 9 and 10

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15
Q

what is the interchondral joint?

A

between the tips of the 8/9/10 ribs and the cartilage above

  • fibrous capsule surround the joint
  • anterior and posterior radiate ligaments between adjacent CCs
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16
Q

what is the costovertebral joint?

A

synovial plane joint between the convex articular facet on head of rib and concave demifacets on upper and lower vertebrae

loose fibrous capsule thickened anteriorly by radiate ligament of head of rib

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17
Q

what is the radiate ligament of head of rib?

A

runs superiorly to upper vertebral body
transversely to front of IV disc
inferiorly to vertebral body below

blends with posterior longitudinal ligament

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18
Q

what is the costotransverse joint?

A

synovial plane joint - between the tubercles of ribs 1-10 and corresponding TPs

allow gliding movement (and rotation at upper 6 ribs)

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19
Q

what strengthens the costotransverse ligament

A

thin and fibrous capsule

  • lateral costotransverse ligamnet
  • costotransverse ligament
  • superior costotransverse ligament - anterior and posterior bands
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20
Q

what is Boyles law?

A

change in volume = change in pressure

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21
Q

What occurs during inhalation

A

before inhalation pressure in lungs = to pressure in atmosphere - so no air movement

Diaphragm contracts - increased vertical diameter of thorax
external intercostals contract - ribs move up and out -increased AP and transverse diameter of thorax

increased volume of thorax means decreased pressure of thorax

air moves down pressure gradient

75% due to increase vertical diameter
25% due to increase AP and transverse diameter

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22
Q

what are the roles of the accessory movements in forced inhalation

A

SCM and scalene elevate sternum and first 2 ribs

pec minor elevates ribs 3/4/5

23
Q

What occurs during exhalation

A

pressure in lungs = pressure in atmosphere

diaphragm relaxes and shortens due to recoil
external intercostals relax - ribs move down and in

decrease in vertical, lateral and anteposterior diameters - decrease in lung volume

pressure in lungs increases air moves out

24
Q

what are the roles of accessory movements in forces exhalation?

A

abdominals contract - further decrease vertical diameter

internal intercostals - bring ribs down and in - decrease AP and transverse diameter of the ribs

25
Q

what are the movements at the ribs during inhalation?

A

1st rib - fixed
2nd to 5th ribs - move at costotransverse and costovertebral joints - anterior ends raised - lift the sternum forwards and up
8th to 10th ribs move at the costovertebral and sternocostal joints - ribs move up and out

26
Q

what is the bucket handle mechanism

A

side to side movement at costotransverse and sternocostal joint

increases transverse diameter

rib is raised and everted

27
Q

what is the pump handle mechanism

A

backwards rotation of rib at neck causes elevation of anterior rib - pushes sternum forwards - increased AP diameter

movement between costotrasnverse and costovertebral joints

28
Q

what muscles are active in quiet respiration?

A

diaphragm primary contractor

scalene fix first rib

29
Q

what muscles are active in deep respiration?

A

diaphragm
intercostals assist rib movement
scalene fix first rib
quadrates lumborum fixes 12 rib

30
Q

what muscles are active in expiration

A
  • none - passive recoil of diaphragm and lungs
31
Q

what muscles are active in forced expiration

A

abdominals and latissimus dorsi

32
Q

Define and state the volume of: tidal volume

A

the volume of one breath

approx 500ml

33
Q

Define and state the volume of: inspiratory reserve volume

A

the volume when taking a deep breath

1900- 3100 ml

34
Q

Define and state the volume of: expiatory reserve volume

A

the amount of air exhaled forcibly following normal inhilation

1200-1700ml

35
Q

Define and state the volume of: FEV1

A

volume of air exhale forcibly in one second following maximal inhilation

36
Q

Define and state the volume of: Residual Volume

A

amount of air remaining in the lungs following exhilaiton

1100-1200ml

37
Q

Define inspiratory capacity

A

tidal volume + IRC

38
Q

Define functional residual capacity

A

RV + ERC

39
Q

Define vital capacity

A

IRV, ERV and tidal volume

40
Q

define total lung capcaity

A

VC and RV

41
Q

what is the FVC/FEV1 ratio

A

forced expiratory capacity vs forced expiratory volume in one second

42
Q

why would you look at FVC/FEV1?

A

FVC reduced in restrictive diseases - ie. lungs smaller

FEV1 reduced in obstructive diseases - i.e. air is harder to move out

43
Q

attachments of the diaphragm

A

posterior xiphoid, internal CC of lower 6 ribs, R and L crura of lumbar vertebrae and accurate ligaments, pericardium of the heart

inserts onto the central fibrous tendon

44
Q

openings of the diaphragm

A

T8 - vena cava
T10 - oesophagus
T12 - aorta

45
Q

nerve supply to diaphragm

A

phrenic nerve - C3, 4, 5

46
Q

how does the diaphragm descend

A

via the central tendon - 1.5cm in quiet breathing - limited by stomach and liver

5-10cm in deep breathing

47
Q

what are the DoF for external intercostals

A

down and medially - hands in pockets

48
Q

what are the DoF for internal intercostals

A

up and back

49
Q

what is the action of internal intercostals

A

depress ribs - keeps IC spaces rigid

50
Q

what is the action of external intercostals

A

elevate ribs - keeps IC spaces rigid

51
Q

what is the action of the innermost intercostals

A

keep IC spaces rigid

contain the neuromuscular bundle

52
Q

what is the mediastinum

A

central part of the thorax- contains the heart, thymus, oesophagus, trachea

53
Q

what is the plura?

A

double layered serous membrane

  • parietal - attaches to thoracic wall
  • visceral - attaches to surface of the lung

cavity between filled with plural fluid - decreases friction in breathing
fluid keeps the membranes in contact

Cardio-respiratory Studies 1 (5 decks)

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