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Anatomy > Test 4 Lecture 2 > Flashcards

Test 4 Lecture 2 Flashcards

1
Q

Resting Respiratory Rate

A

12-20 breaths a minute

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2
Q

Inhalation is a/an _____ process

A

ACTIVE- you have to contract muscles so that you can expand lungs so air can come in

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3
Q

Inhalation requires which muscles to contract?

A

Diaphragm, External Intercostals

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4
Q

exhalation is a/an _____ process in the resting state

A

PASSIVE

  • requires muscle relaxation as lungs rebound off the chest wall and diaphragm
  • Surface tension in the airways causes to partial collapse (surface in airways stick and come together to help you push the air out to complete exhalation)
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5
Q

what does the diaphragm do during inhalation?

A

it moves down to the 6 intercostal space on right side, 7th rib on left side. It flattens out allowing the lungs to expand vertically

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6
Q

what does the diaphragm do during exhalation?

A

moves up to about the 4th rib on right side, and 4th interspace on the left side.

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7
Q

what do lungs do during exhalation

A

they kind of bounce of the diaphragm and the surface tension causes the lungs to get smaller as we force the air out as we exhale

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8
Q

transverse thoracis

A

Lies on the posterior surface of the anterior thoracic wall
Originates on side of sternum, Inserts on Ribs 2-6
a modified innermost intercostal
-helps with forced exhalation

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9
Q

Levatores Costarum

A

origin - transverse processes of cervical vertebra 7 and thoracic vertebrae 1-11.
insertion - rib below.
when they contract they lift ribs up, so they help you inhale

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10
Q

Serratus Posterior Superior

A

-thin as paper

origin - ligamentum nuchae.
insertion - ribs 2-5.
might help with inhalation, pull ribcage up to help us expand lungs to inhale

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11
Q

Seratus Posterior Inferior

A

-thin as paper
helps us to forcefully exhale because it pulls the rib spaces down
origin - supraspinous ligament of T11-L3.
insertion - ribs 9-12.

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12
Q

Scalenes

A

can lift ribcage up and help ribs expand
i. anterior
origin - transverse processes of cervical vertebrae 3-6.
insertion - first rib.
ii. middle
origin - transverse processes of cervical vertebrae 2-7.
insertion - first rib.

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13
Q

Sternocleidomastoid

A

STRONG MUSCLE- ELEVATES YOUR CHEST WALL/ RIBCAGE! and allow you to expand your chest and expand your lungs.
origin - sternal manubrium, sternal end of the clavicle.
insertion - mastoid process.

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14
Q

Subcostales

A

behind thoracic viscera, modified innermost intercostals.
Might help with forceful exhalation
Ribs 10-12

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15
Q

Abdominal Muscles

A

Best muscles to help with forceful exhalation. When you contract, it forces the diaphragm upwards.

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16
Q

Best muscles specifically to help with forceful exhalation?

A 
The abdominal muscles. Specifically:
Rectus Abdominas
External Abdominal Oblique 
Internal Abdominal Oblique (deep to external)
Transverse Abdominas (deep to the internal)
-when they contract they compress your abdomen, abdominal wall, so it slams your diaphragm up causing your lungs to contract
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17
Q

Top of the lung is called the

A

apex

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18
Q

bottom of the lung is called

A

the broad concave BASE. It sits right onto of the diaphragm

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19
Q

The lung base covers the

A

Diaphragmatic Surface

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20
Q

tissue that covers the lung is called (deepest layer)?

A

visceral pleura (very thin)

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21
Q

layer over the visceral pleura is called

A

the parietal pleura

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22
Q

the space between visceral pleura and the parietal pleura

A

the pleural space or cavity- a potential space.

-on exams they’ll ask what lies within this space, and the answer is nothing, its a potential space that’s all

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23
Q

Costodiaphragmatic Recess

A

recess is the extension of the inferior pleural space into the area formed between the posterior body wall and the posterior dome of the diaphragm.

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24
Q

External Oblique O/I

A

origin - lower borders and outer surfaces of the lower 8 ribs.
insertion - lower 2 ribs, anterior half of the iliac crest, and the external abdominal oblique aponeurosis.

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25
Q

External Oblique O/I

A

origin - lower borders and outer surfaces of the lower 8 ribs.
insertion - lower 2 ribs, anterior half of the iliac crest, and the external abdominal oblique aponeurosis.

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26
Q

Internal abdominal oblique O/I

A

origin - posterior layer of the thoracolumbar fascia, anterior 2/3 of the iliac crest, lateral 2/3 of the inguinal ligament, and from the iliacus fascia.
insertion - forms an aponeurosis around the rectus abdominis to insert into the linea alba, lower 3 - 4 ribs and their cartilages, and the pubis.

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27
Q

Transversus abdominis O/I

A

origin - costal cartilages of the lower six ribs, thoracolumbar fascia, anterior 3/4 of the iliac crest, form the lateral 1/3 of the inguinal ligament, and from the iliacus fascia.
insertion - superior border of the pubis and pectin pubis, aponeurosis of the transversus abdominis to the linea alba.

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28
Q

Visceral pleura

A

shiny serous layer, which tightly adheres to the lungs

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29
Q

Parietal pleura

A

fibrous connective tissue layer that is attached to the bony thorax and diaphragm, and lies next to the fibrous layer of the pericardium

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30
Q

The parietal layer of the pleura is

___ applied, and descends about 2 rib spaces below the inferior extent of the lungs

A

loosely

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31
Q

pleural effusion

A

Sometimes fluid may accumulate in the Costodiaphragmatic Recess and settle into this pleural space

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32
Q

Parietal Pleura is divided into 4 regional parts:

A
  1. Costal Pleura (the largest portion, in contact with chest wall, and ribs)
  2. Diaphragmatic Pleura (on the base of the lung that’s in contact with the diaphragm)
  3. Cervical Pleura (tightly covers apex of the lung)
  4. Mediastinal Pleura (medial surface of lungs)
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33
Q

Lung apex- parietal pleura covers ___

A

tightly

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34
Q

The space between where the lungs base ends and the space that the pleura goes to is the

A

costodiapragmatic recess

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35
Q

the parietal pleura dips down about ________ further than the end of the lungs

A

2 RIB SPACE DIFFERENTIAL
(base of lung at following midclavicular line = 6th rib, base of parietal pleura = 8th rib

-important because it allows your lungs to expand!

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36
Q

midaxillary line-
lungs base goes to
parietal pleural base goes to

A

lungs base goes to: 8th rib

parietal pleural base goes to: 10th rib

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37
Q

paravertebral line
lungs base goes to
parietal pleural base goes to

A

lungs base goes to: 10th rib

parietal pleural base goes to: 12th rib

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38
Q

the 2 rib space differential between the parietal pleura and the lung base creates the

A

diaphragmatic recess

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39
Q

When a person has fluid build up in the diaphragmatic recess what do they do?

A

they go to the 11th rib area and go over- so they don’t hit the lungs but they don’t hit the intercostal artery and nerve

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40
Q

pleural effusion

A

inflammation of fluid

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41
Q

pleural effusion can lead to

A

pneumonia, or even nowadays COVID

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42
Q

A normal lung extends to where

A

1 inch above the clavicle (technically in posterior triangle!)

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43
Q

in an xray, normal lungs are

A

radioluctent

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44
Q

Hilum

A

where the blood vessels come in and deliver blood to the organ, and where blood vessels an organ

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45
Q

Hilum of the lung contains

A

pulmonary artery, pulmonary vein, and an airway as well

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46
Q

At the hilum of the lung, what do the vein and artery do?

A

the vein carries arterial blood (take bloods from the lungs, back to the heart oxygenated)
the arteries carrie venous blood (take blood into lungs from heart, so not oxygenated yet)

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47
Q

Hilum of the left lung

A

the airway lies immediately under the pulmonary artery, so we call it hypoarterial
-very consistent, this doesn’t change

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48
Q

Hilum of the right lung

A

the airway lies above and around the pulmonary artery, so we call it epiarterial

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49
Q

The cardiac notch is found on the

A

left lung

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50
Q

the cardiac depression is found on the

A

left lung, caused by the heart

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51
Q

the aortic arch impression can be found on the

A

left lung

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52
Q

the impression of the azygos vein can be found on the

A

right lung

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53
Q

the esophageal impression can be found on the

A

right lung

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54
Q

Lobes:

A

Subdivisions of the Lungs separated by fissures

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55
Q

Bronchopulmonary Segments:

A

Subdivisions of the Lobes separated by fibrous septa

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56
Q

Right lung has how many lobes?

A

3 (Upper, Middle, Lower)

57
Q

Left lung has how many lobes?

A

2 (upper and lower)

-lingula (bottom part of upper)

58
Q

Horizontal Fissure

A

separates the upper lobe from the middle lobe of the right lung

59
Q

Oblique Fissure

A

separates the middle lobe from the lower lobe of the right lung

60
Q

How many fissures on right lung?

A

2- the horizontal and oblique fissure

61
Q

How many fissures on the left lung?

A

1- left oblique fissure

62
Q

lingula

A

tongue like projection on the bottom of the left lungs upper lobe

63
Q

Right Lung Bronchopulmonary segments

A 
10 bronchopulmonary segments
upper lobe:
apical 
anterior
posterior

middle lobe:
medial
lateral

lower lobe:
superior
medial & lateral basal
anterior & posterior basal

64
Q

Left Lung Bronchopulmonary segments

A

Upper Lobe:
anterior
apieco-posterior

Lingula:
superior
inferior

Lower Lobe:
superior
posterior basal 
lateral basal
antero-medial basal
65
Q

REMINDER TO LOOK

A

AT NETTERS BRONCHOPULMONARY SEGMENTS

66
Q

pulmonary hygiene or postural drainage

A

cystic fibrosis- a disease when you produce a lot of mucous in lungs
-if you know where bronchopulmonary segments lie, then you can pound on patients chest and help drain bronchopulmonary segment. It can help them cough the mucous out

67
Q

a wedge resection is

A

someone who has cancer of the lungs, sometimes they can just take out a bronchopulmonary segment, rather than a lobectomy where they take our an entire lobe of a lung, or pneumoectomy where they take out an entire lung

68
Q

What supplies blood to the lungs?

A

your bronchial arteries

69
Q

the right side of the lungs has how many arteries and what does it or they branch off of?

A

1 Right-off the 3rd Posterior Intercostal A.

Follow the airway progression

70
Q

the left side of the lungs has how many arteries and what does it or they branch off of?

A

2 Left-off the aortic arch

Follow the airway progression

71
Q

What gets the blood out of the lungs?

A

the bronchial veins

72
Q

Bronchial Veins

  • what do they run with?
  • what do they empty into?
A

Variable-run with bronchial arteries. They kind of create a plexus.
Empty into the Superior Vena Cava

73
Q

costalphrenic recess

A

is a potential space in the pleural cavity, at the posterior-most tips of the cavity, located at the junction of the costal pleura and diaphragmatic pleura
-where the diaphragm comes to meet the thoracic wall

74
Q

trachea normal size

A

the cervical part is 2 inches, the thoracic part is about 2 inches. So 4 inches total

75
Q

How many cartilaginous rings does the trachea have

A

20 C shaped rings (incomplete posterior)

76
Q

what completes the back of the trachea that has no cartilage?

A

tracheal (smooth) muscle

77
Q

what runs behind the trachea?

A

the esophagus. It literally touches the trachea

78
Q

what does the trachea bifurcate into?

A

Left/Right Mainstem Bronchi

79
Q

Where does the trachea bifurcate?

A

Birfurcates at Sternal Angle

80
Q

How is the right Mainstem Broncus different from the left mainstem bronchus?

A

the right is:
Shorter
Larger Diameter
More Vertical

81
Q

How is the left mainstem bronchus different from the right?

A

the left is:
Longer
Smaller Diameter
More Horizontal

82
Q

degree angle between the left and right mainstem bronchus?

A

62 degrees

83
Q

If someone has a pathogen go into lungs, which side mainstem bronchi would they likely go in?

A

the right side because of gravity, its steeper. So that’s why people get pneumonia more on the right side

84
Q

Fiber-optic Flexible Bronchoscopy

A

a broncoscopie is used to view the airways and check for abnormalities in the trachea or in the mainstem bronchi

85
Q

the carina

A

the ridge that divides the trachea and separates it into the left from the right mainstem bronchus
-it’s not the last tracheal ring

86
Q

how do mainstem bronchi divide?

A

they divide into the amount of lobes in that side of the lung (but the left side also has the lingular broncus)

  • Right side= (3 Lobar Bronchi) upper, lower, middle lobar bronchi
  • Left side= (2 Lobar Bronchi+ Lungular ) upper and lower LOBAR bronchi AND Lingual has it’s own called the lingular bronchus
87
Q

How do lobar bronchi then divide?

A

Right: 10 Segmental Bronchi
Left: 8 Segmental Bronchi

88
Q

describe the bronchi from the trachea down?

A

left and right mainstem bronchi divide into lobar bronchi (right side has upper, middle lower, left side has upper, lower and a lingular bronchus), then they divide into segmental bronchi (Right has 10, Left has 8), then they divide into Subsegmental Bronchi (20-25 Generations), which eventually divide into bronchioles

89
Q

cartilage over bronchi goes from the trachea down to

A

the subsegmental bronchi, ends at bronchoioles

90
Q

bronchioles

A

HAVE NO CARTILAGE. Just smooth muscular tubes

<1mm in diameter

91
Q

why do we have cartilage around all of our bronchi but the bronchioles?

A

to keep our airway from collapsing and expanding every time we breath out.

92
Q

Where do people with asthma have their difficulties?

A

Down in your little tiny bronchioles, when they swell

93
Q

Where is carbon dioxide and oxygen exchanged with the blood?

A

at the alveoli level, NO EARLIER.

94
Q

What do bronchioles terminate into

A

alveoli (the most distal end)

95
Q

Where does cartilage of the trachea into the bronchi end?

A

at the bronchioles. They and the alveoli have no cartilage

96
Q

Pulmonary arteries carry

A

venous blood

97
Q

Pulmonary veins carry

A

arterial blood

98
Q

Alveolar Capillaries

A

where we give off oxygen into our bloodstream

super thin- 0.2-0.5 microns thick

99
Q

Capillaries have both

A

venous blood and arterial blood

100
Q

What is the mediastinum?

A

it’s the space in between lungs

101
Q

Why is the mediastinum space important?

A

it allows “placement” and location of the various internal structures of the Thorax

102
Q

Are your lungs in your mediastinum?

A

No! You can’t be a boarder and a content at the same time

103
Q

Subdivisions of the Mediastinum

A
  1. Superior mediastinum
  2. Inferior mediastinum
    - anterior compartment
    - middle compartment
    - posterior compartment
104
Q

superior mediastinum

A

your superior thoracic aperture formed by the first rib.
SUPERIOR BOUNDARY-draw line from super sternum notch straight up and back until it intersects with C7 and T1. The line should run parallel with the first rib
INFERIOR BOUNDARY-
draw line from the sternal angle of Louis straight back between intervertebral disc of T4 & T5

105
Q

Inferior mediastinum

A

superior border- the line between the sternal angle and back to T4-T5

Inferior border- the diaphragm

-has the 3 compartments

106
Q

Anterior Compartment

A

Space anterior to the heart up to the boney thorax

107
Q

Middle Compartment

A

Space containing the heart

108
Q

Posterior Compartment

A

Space posterior to the heart up to the vertebral column

109
Q

What is found in the superior mediastinum?

A

anterior -> posterior (peel 1 off, and find 2, so on down)

  1. the thymus gland (reminant)
  2. Brachiocephalic Veins as they form the Superior Vena Cava
  3. Aortic arch and roots of it’s branches (brachiocephalic trunk, left common carotid artery, subclavian artery)
  4. trachea (thoracic portion)
  5. esophagus
110
Q

Termination of the Thoracic (Lymphatic) Duct

A
  • Begins below the diaphragm
  • Thoracic Duct passes through the aortic hiatus
  • Termination is at the junction of the Left Subclavian and Left Internal Jugular Veins which is called the left brachial cephalic vein. The majority of our lymph takes this pathway and is channeled back into bloodstream here
111
Q

discuss the lymphatic system

A

it carries lymph, which is derived from your capillaries, and these lymphatic vessels carry it all over your body until it dumps back into your bloodstream where it gets swished through the capillaries

112
Q

**Where is termination of the thoracic (lymphatic) duct? ***

A

in the superior mediastinum

113
Q

Thoracic duct starts just under the diaphragm at the

A

Cisterna Chyli in the Abdomen

114
Q

Cisterna Chyli gives rise to the

A

thoracic duct (keep in mind this is going superior)

115
Q

the thoracic duct passes through the

A

diaphragm as it ascends the posterior thorax

116
Q

When the thoracic duct gets into the superior mediastinum what happens?

A

it curves where it turns into the left subclavian vein, where it joins the left internal jugular vein, which forms the left brachiocephalic vein

117
Q

termination of the right lymphatic duct occurs in the

A

superior mediastinum (same as left, but to the right side. so it drains into the right subclavian vein and right internal jugular vein into the right brachiocephalic vein_)

118
Q

The thoracic duct drains

A

your left head, left neck, left upper trunk, left arm down to hand and waste down all by the thoracic duct (so like 3/4’s of your body)

119
Q

the right lymphatic duct drains

A

your right head, right neck, right upper arm and thoracic region down to your right fingers. THATS IT (only maybe a quarter of your body

120
Q

structures that pass through superior mediastinum to get where they need to go

A

vagus nerve
phrenic nerve
recurrent laryngeal nerves (left around aortic arch, right around subclavian artery)

121
Q

anterior compartment of the inferior mediastinum contains

A

Lower Portion of the Thymus (or Thymic Remnant)
Internal Thoracic Vessels (internal thoracic artery)
Lymph Nodes

122
Q

middle compartment of the inferior mediastinum contains

A

Heart, Coronary Vessels, and Pericardium
AND
Roots of the Great Vessels that originate/terminate in the heart:
Superior/Inferior Vena Cava (termination)
Pulmonary Veins (termination)
Ascending Aorta (originate)
Pulmonary Trunk (originate)
AND
Bifurcation of the trachea into 2 mainstem bronchi
-creates arch called Arch of the Azygos Vein and Termination in the SVC
-Phrenic Nerves-Pericardial Portion
Also, the Pericardicophrenic Artery (feeds the pericardial sac and diaphragm. It runs right with the phrenic nerve

123
Q

space surrounding the heart is called

A

pericardium

124
Q

essentially, the Middle Compartment of Inferior Mediastinum contains

A

anything regarding the heart

125
Q

What runs under the Arch of the Azygos Vein

A

the right mainstem bronchus and right Pulmonary artery and vein

126
Q

Pericardicophrenic Arteries

run with the phrenic nerve. The Pericardicophrenic Arteries supply blood to the

A

pericardium sac and the diaphragm

127
Q

Posterior Compartment-Inferior Mediastinum contents

A

posterior to anterior:

Descending Portion-Thoracic Aorta

Continuation of the Esophagus from Superior Mediastinum

Thoracic Duct and Vagus Nerves (Runs with the Esophagus as a “plexus”)

Azygos Vein-right side

Hemiazygos/Accessory Hemiazygos Veins-left side

Origination of Greater, Lesser, & Least Splanchnic Nerves

Posterior Mediastinal Lymph Nodes

128
Q

The sympathetic chain is NOT part of the mediastinum

A

because it is outside of the chest and it’s covered in parietal pleura

129
Q

thoracic aorta creates an arch in the left and posterior, what does it bridge over?

A

Left Pulmonary Artery & Vein and Left Mainstem Bronchus passing under the aortic arch

130
Q

azygos vein begins in the

A

diaphragm at the aortic hiatus and goes up

131
Q

Hemiazygos and Accessory Hemiazygos Vein relationship

A

hemiazygos (LEFT) (starts and diaphragm and goes up) anastomoses with a vein that comes up from above down called the accessory vein

132
Q

hemiazygos veins are formed by

A

the ascending lumbar vein (ones they pass the lumbar they are named right, Azygos and left, Hemiazygos)

133
Q

formation of the communicating vein

A

joins hemiazygos and accessory Accessory Hemiazygos Vein with the Azygos vein

134
Q

thoracic duct runs with your

A

esophagus and azygos

135
Q

Greater Splanchnic Nerve

A

pre-ganglionic sympathetic that supplies sympathetic innervation to abdominal viscera
(T5-T9)

136
Q

Lesser Splanchnic Nerve

A

(T10-T11)

pre-ganglionic sympathetic that supplies sympathetic innervation to abdominal viscera

137
Q

Least Splanchnic Nerve

A

(T12)

pre-ganglionic sympathetic that supplies sympathetic innervation to abdominal viscera

138
Q

Structures Found in More than One Subdivision of the Mediastinum

A

Thoracic Duct (Superior & Posterior compartment)

Phrenic Nerves (Superior & Middle compartment)

Esophagus (Superior & Posterior compartment)

Trachea (Superior & Middle-compartment for Bifurcation)

Thymus Gland (Superior & Anterior compartment)

Aorta (Superior, Middle compartment, Posterior compartment)

Anatomy (23 decks)

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