Session 1-Intro

Question 1

How many ribs do we have and where are they attached to?

Answer 1

12 ribs - 10 to sternum and last 2 are floating ribs

Question 2

How do the movements of the ribs aid inspiration?

Answer 2

Ribcage moves up and out, increasing volume and decreasing pressure below atmospheric pressure so air flows in

Question 3

What are the three layers of intercostal muscles connecting the ribs together?

Answer 3

External, internal and innermost

Question 4

What do the external intercostal muscles do?

Answer 4

Pull ribs upwards and assist in inhalation

Question 5

What do the internal and innermost intercostal muscles do?

Answer 5

Assist forced expiration (antagonists of external muscles)

Question 6

Which intercostal muscles are present laterally?

Answer 6

Innermost

Question 7

Which intercostal muscles are present anteriorly?

Answer 7

Internal

Question 8

Where are the external intercostal muscles present?

Answer 8

Everywhere but anterior

Question 9

Which nerve innervates the diaphragm?

Answer 9

Phrenic nerve

Question 10

Why does irritation of the diaphragm cause shoulder pain?

Answer 10

During development, diaphragm developed in the neck and moved downwards and took its nerve supply with it - phrenic nerve innervates diaphragm and extends up to shoulder

Question 11

Where does the intercostal neurovascular bundle run?

Answer 11

Between internal and innermost intercostal muscles, in costal groove on the lower border of the ribs

Question 12

Where is the intercostal artery in relation to the intercostal vein and nerve in the neurovascular bundle?

Answer 12

Inferior vein superior to artery and nerve inferior to artery

Question 13

Why are the right intercostal arteries longer than the left?

Answer 13

Thoracic aorta is to the left of the thoracic spine so the right intercostal arteries must cross over the thoracic vertebral bodies to reach the right intercostal spaces

Question 14

Through which system does the chest wall drain blood through and which veins are involved?

Answer 14

Azygos system - azygos vein drains into superior vena cava

Question 15

What is the pleural cavity?

Answer 15

Potential space between parietal and visceral pleura which contains a few ml of fluid

Question 16

What is the function of the pleural seal?

Answer 16

Surface tension between molecules of pleural fluid creates a “seal” which ensures that when the thorax expands in respiration, the lungs expand too

Question 17

Which nerves innervate the parietal pleura?

Answer 17

Phrenic and intercostal nerves

Question 18

Which nerves innervate the visceral pleura and how is it different to the parietal pleura?

Answer 18

Pulmonary plexus

Visceral is not sensitive to pain, temperature or touch like the parietal

Question 19

How many lobes does the right lung have?

Answer 19

3 (superior, middle and inferior)

Question 20

Which two fissures does the right lung have?

Answer 20

Oblique and horizontal

Question 21

How many lobes does the left lung have?

Answer 21

2 (superior and inferior)

Question 22

Which fissure does the left lung have?

Answer 22

Oblique

Question 23

What is the lingula?

Answer 23

Remnant of middle lobe in the left lung

Question 24

Where in the lung does the neurovascular bundle pass through?

Answer 24

Hilum

Question 25

Why is it easier to lodge foreign bodies in the right bronchus?

Answer 25

It is more vertical than the left

Question 26

Describe the blood supply to the lungs

Answer 26

Dual blood supply from bronchial and pulmonary arteries: bronchial supplies bronchial tree (not alveoli) and visceral pleura with oxygenated blood. Pulmonary carries output from RV to lungs for gas exchange and to supply alveoli

Question 27

Describe the lymphatic drainage of the lungs

Answer 27

Lungs drain to hilar nodes (bronchopulmonary nodes) -> tracheobronchial nodes

Question 28

What can enlarged tracheobronchial nodes lead to?

Answer 28

Widening of carina = cartilage where trachea splits into two bronchi

Question 29

Describe the nerve supply the lungs

Answer 29

• vagus nerves and sympathetic trunk
• parasympathetics efferents from vagus are motor to bronchial smooth muscle and secretory to mucus glands
• vagus afferents for cough reflex
• sympathetic efferents for bronchodilation and vasoconstriction

Question 30

Describe the grooves in the left and right lungs

Answer 30

Left has groove for aorta and right has smaller groove for oesophagus

Question 31

What is the mediastinum?

Answer 31

Septum between lungs

Question 32

What separates the superior and inferior mediastinum?

Answer 32

Horizontal plane through manubriosternal joint (T4)

Question 33

What does the superior mediastinum include?

Answer 33

Trachea, arch of aorta

Question 34

What does the inferior mediastinum include?

Answer 34

Heart, descending aorta, thoracic duct and oesophagus

Question 35

At which level is the vena cava present?

Answer 35

T8 (8 letters)

Question 36

At which level is the oesophagus present?

Answer 36

T10 (10 letters)

Question 37

At which level is the aortic hiatus present?

Answer 37

T12 (12 letters)