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Semester 3 - Respiratory > Session 2 - The lungs and the mediastina > Flashcards

Session 2 - The lungs and the mediastina Flashcards

1
Q

Describe the surface structure of the lungs

A 
○ An apex 
	○ Three surfaces: a costal surface, a diaphragmatic surface and a mediastinal surface
	○ Three borders 
		§ Anterior, inferior, posterior 
	○ A base
	○ Lobes
		§ Two (left lung) or three (right lung) 
		§ Created by one or two fissures
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2
Q

What is the oblique fissure in the right lung?

A

• Separates the right upper and middle lobes from the lower lobe of the right lung

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3
Q

What is the oblique fissure in the left lung?

A

Separates the upper and lower lobes

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4
Q

What is the horizontal fissure in the right lung?

A

• Separates the right upper and middle lobes

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5
Q

What extends into the fissures of the lungs?

A

The visceral pleura

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6
Q

What do the lungs receive nervous supply from?

A

• The vagi and sympathetic trunk via the pulmonary plexuses, situated in the hilum

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7
Q

What enters the lung through the hilum

A
  • Pulmonary arteries and veins
  • Bronchial arteries and veins
  • Nerves
  • Lymphatics
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8
Q

What is the hilum of the lung?

A

A wedge shaped area on the mediastinal surface of each lung through which structures forming the roots of the lung pass to enter or exit

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9
Q

What do the roots of the lung consist of?

A
  • Bronchi
  • Pulmonary arteries
  • Superior and inferior pulmonary veins
  • Pulmonary plexus of nerves
  • Lymphatics
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10
Q

What is the mediastinum?

A

• The central compartment of the thoracic cavity

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11
Q

What is the mediastinum covered by?

A

• Mediastinal plueura

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12
Q

Where does the mediastinum extend to and from?

A
  • Superior thoracic arpeture to the diaphragm

* Sternum and costal cartilages anteriorly to the bodies of the thoracic vertebrae posteriorly

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13
Q

What two sections is the mediastinum divided into?

A

• Superior and inferior parts

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14
Q

Where does the superior mediastinum extend to and from?

A

• Superior thoracic aperture to the transverse thoracic plane

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15
Q

What is the transverse thoracic plane?

A

• Horizontal plane that includes the sternal angle anteriorly and passes approximately through the junction of T4 and T5 posteriorly

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16
Q

Where does the inferior mediastinum extend to and from?

A

• Transverse thoracic plane to the diaphragm
• Further subdivided by the pericardium
○ Anterior
○ Middle

Posterior

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17
Q

Give one structure which lies in more than one compartment of the mediastinum

A

Oesophagus

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18
Q

Where do the pulmonary arteries carry mixed venous blood?

A

• From the right ventricle for gas exchange at the alveoli

19
Q

What does the main pulmonary artery divide into?

A

The right and left pulmonary arteries

20
Q

What structure do the pulmonary arteries divide with?

A

The bronchial tree

21
Q

What do the pulmonary arteries supply?

A

• The alveoli only

22
Q

Are there any anastamoses between bronchial and pulmonary arteries?

A

Yes, at pre capillary and capillary level

23
Q

How does the path of the pulmonary veins differ from that of the pulmonary arteries?

A
  • Do not follow divisions of bronchi

* Tend to run into intersegmental septa

24
Q

How many pulmonary veins leave each hilum?

A

• Two

25
Q

What is the name of the two lymphatic plexi that drain the lungs?

A

• Subpleural lymphatic plexus

Deep bronchopulmonary lymphatic plexus

26
Q

What is the diaphragm?

A

A dome shaped muscle which divides the thoracic cavity from the abdominal cavity.

27
Q

Why is the large size of the diaphragm clinically important, as pertaining to the position of other organs?

A
  • Means kidneys, liver, spleen, parts of the stomach and upper kidneys lie in the abdominal cavity and are covered by the ribs
  • Lower chest injuries significant
28
Q

Outline the structure of the diaphragm

A

• A peripheral muscular part and a central tendon

29
Q

What is the peripheral muscular part of the diaphragm made up of?

A
  • The crura tendons which arise from L1-L3

* Arcuate ligaments, which are thickening of the fascia

30
Q

What are the three parts of the diaphragm?

A
  • Vertebral arising from the crura and acruate ligaments
  • Costal part arising from inner aspects of 7-12 costal cartilage

Sternal part arising from deep surface of xiphissternum

31
Q

What happens if you have cervical spinal damage from C2 downwards

A

• Severs link to phrenic nerve (C3, C4, C5), so lose function of the diaphgragm

32
Q

What is the phrenic nerve sensory for?

A
  • Both surfaces of diaphragm
  • Medialstinal part of the pleura
  • Diaphragmatic part of the parietal pleura
33
Q

What are the three parts of the thoracic cavity?

A

• Two lateral pulmonary cavities and one central compartment - the mediastinum

34
Q

What compartments is the mediastinum divided up into?

A
  • Superior
  • Middle
  • Posterior

Inferior

35
Q

What is the purpose of the parietal pleura?

A

• Secretes fluid, which sticks it to the visceral pleura

This means everything moves at once

36
Q

What proportion of chest expansion is done by the diaphragm?

A

70%

37
Q

What proportion of chest expansion is governed by the chest wall?

A

30%

38
Q

What does inspiration involve?

A

• Elevation of external intercostal muscles

39
Q

What does inspiration result in?

A
  • Increase in transverse diameter of thoracic cavity
  • In the A=P diameter of thoracic cavity
  • Increase in vertical dimension
40
Q

What occurs in expiration?

A

• In quiet respiration it simply relaxes elastic of chest wall and lungs

In forced expiration, internal and innermost intercostal muscle and abdominal muscle are used

41
Q

What muscles are used in quiet inhalation?

A
  • Diaphragm

* External intercostals

42
Q

What muscles does forced inhalation involve? (6)

A 
• Diaphragm
• External Intercostals
• Scalene
• Pectoralis Minor
• Sternocleidomastoid
Serratus Anterior
43
Q

What muscles does forced exhalation involve?

A
  • Internal intercostals
  • Innermost intercostals
  • Abdominal muscles

Semester 3 - Respiratory (18 decks)

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