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ANATOMY > The Thoracic Cage, Pleura and Lungs (CV2) > Flashcards

The Thoracic Cage, Pleura and Lungs (CV2) Flashcards

1
Q

what does the intercostal space contain

A

3 layers of intercostal muscle
neuromuscular bundle bundle

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2
Q

What are the constituents of the neurovascular bindle

A

intercostal Vein
intercostal Artery
intercostal nerve

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3
Q

External intercostal is most superficial. Its fibres are orientated ______ ______

A

Antero inferiorly

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4
Q

The external intercostal muscle is most active in

A)Inspiration
B)expiration

A

inspiration

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5
Q

Internal intercostal muscle run ______ _____

A

posterio inferiorly

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6
Q

which direction does the internal intercostal run in comparison to external intercostal

A) parallel
B) perpendicular

A

B

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7
Q

the internal intercostal is most active in

A)Inspiration
B)Expiration

A

B

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8
Q

the innermost intercostal runs _____ _____

A

posterio inferior

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9
Q

which direction does the innermost intercostal run to the internal intercostal

A)parallel
B)perpendicular

A

parallel

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10
Q

what lies deep to the innermost intercostal

A

endothoracic fascia

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11
Q

what lies deep to the endothoracic fascia

A

parietal pleura

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12
Q

where on the rib does the neurvascular bundle lie

A

Inferior border od the rib, superior to the costal space

Coastal groove

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13
Q

the anterior intercostal arteries are branches of the ______ _______ ______

A

Internal thoracic artery (ITA)

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14
Q

the posterior intercostal arteries are branches of the _____ _____

A

Descending aorta

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15
Q

Anterior intercostal veins drain into the _______ ______ _____

A

Internal thoracic vein

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16
Q

posterior intercostal veins drain into the _____ _____

A

azygous system

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17
Q

The intercostal nerves are somatic and contain ______ & _______ fibres

A

Sensory
Motor

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18
Q

intercostal nerves are
A)sympathetic
B)parasympathetic
C)Somatic

A

c

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19
Q

what does the pleura cover

A

Lungs
structures passing in and out the lungs

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20
Q

what lies between the parietal and visceral pleura

A

pleural space

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21
Q

which pleura is visible

A

parietal

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22
Q

The diaphragmatic pleura lies adjacent to the

A

diaphragm

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23
Q

The mediastinal pleura lies adjacent to the

A

heart

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24
Q

The costal pleura lies adjacent to the

A

ribs

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25
Q

The cervical pleura covers the

A

apex of lungs

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26
Q

what is the costodiaphragmatic recess

A

sharp gutter at the junction of costal and diaphragmatic pleurae

potential space that the lungs expand into during deep inspiration.

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27
Q

what is the costomediastinal reces

A

lies at the junction of the costal and mediastinal pleura.

potential space that the lungs expand into during deep inspiration.

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28
Q

what nerve innervates the parietal pleura

A

phrenic and intercostal nerves that innervate the overlying skin of the chest wall

these nerves contain somatic sensory fibres

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29
Q

what nerve innervates the visceral pleura

A

purlamanory plexus visceral afferents (autonomic sensory)

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30
Q

why is the visceral pleura insensitive in comparison to pain felt in the parietal pleura

A

visceral pleura contains visceral afferent fibres which are autonomic this this does reach conscious perception and only detects stretch

Parietal pleura is highly sensitive to pain due to somatic sensory fibres

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31
Q

how many lobes in L and R lungs

A

L 2
R 3

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32
Q

what is the name of the anterior
extension of the superior lobe of the lung that extends over the heart called

A

the lingula

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33
Q

how many fissures does the R lung have and name them

A

2
Oblique and horizontal

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34
Q

many fissures does the L lung have on them and name them

A

1
oblique

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35
Q

What are the 3 surfaces of the lungs

A

costal
mediasternal
diaphragmatic

36
Q

what are the 3 borders of the lungs

A

anterior
posterior
inferior

37
Q

what is the root of the lung comprised of

A

pulmonary artery,
pulmonary veins,
main bronchus

38
Q

what is the hilum of the lung

A

region on the mediastinal surface of the lung where pulmonary artery, pulmonary veins and main bronchus enter and exit the lung

39
Q

At the hilum of the right lung, the main bronchus lies ______ to the pulmonary artery

A)Anterior
B)Posterior

A

A

40
Q

in the hilum of right lung where does the main branches lie to the pulmonary artery

A

Anterior

41
Q

At the hilum of the left lung, the main bronchus lies ________ to the pulmonary artery.

A)superior
B)inferior

A

inferior

42
Q

The trachea bifurcates into the left and right main bronchi at the level of the _____ _____

A

sternal angle/angle of Louis

43
Q

describe the difference between the main L and R bronchus

A

The right main bronchus is shorter, wider and descends more vertically than the left main bronchus

44
Q

A foreign body entering the trachea is more likely to descend through the right main bronchus than the left main bronchus – what is the anatomical explanation for this?

A

The right main bronchus is wider and more vertical than the left.

45
Q

Each main bronchus divides into _____ bronchi

A

lobar

46
Q

how many lobar bronchi go into each lung and why

A

L 2
R 3
1 lobar bronchi for each lobe of each corresponding lung

47
Q

lobar bronchi divide into

A

semental bronchi

48
Q

how many segments bronchi per lung

A

10

49
Q

why is there 10 segmental bronchi per lung

A

each one supplies 1 of the 10 functionally independent segments of the lung called bronchopulmonary segments

50
Q

what do segmental bronchi break into

A

bronchioles

51
Q

The walls of the trachea and bronchi contain _______ muscle and cartilage

A)circular
B) cardiac
C)skeletal
D)smooth

A

D

52
Q

Contraction and relaxation of the smooth muscle is under _____ control.

Pick best answer
A)sympathetic
B)parasympathetic
C)autonomic
D)somatic

A

A

53
Q

what is the blood supply of the lungs

A

pulmonary arteries
bronchial arteries

54
Q

what innervates the lungs autonomic or somatic

A

autonomic

55
Q

in the ANS, parasympathetic fibres stimulate what in the lungs

A

constricting bronchial smooth muscle

bronchial tree gland section

56
Q

in the ANS, sympathetic fibres stimulate what in the lungs

A

relaxing bronchial smooth muscle

inhibiting bronchial tree gland secretion

57
Q

Lymph from the lungs ultimately drains into the venous system via the ______ duct or right ________ duct.

A

thoracic
lymphatic

58
Q

describe where inferior border of the lungs lies anteriorly, posteriorly, laterally at rib levels

A

Ant=6th rib
Lat=8th rib
Post=10th rib

59
Q

describe where parietal pleura extends anteriorly, posteriorly, laterally at rib levels

A

ant= 8
lat=10
post=12

60
Q

what rib/costal cartilage level does oblique fissures on both lung extend from posteriorly

A

4 rib to 6 costal

61
Q

Horizontal fissure in lung Runs horizontally from the sternum, at the level of the ____ rib, to meet the oblique fissure.

3rd
4th
5th
6th

A

4th

62
Q

describe the diaphragm with accordance to the following bullet points

-thickness
-shape
-what its made out of

A

thin
domed
skeletal muscle

63
Q

what are the 3 foramen in the diaphragm

A

aortic hiatus
oesophageal hiatus
caval foreman

64
Q

what innervates the diaphragm

A

phrenic never from C3,4,5

65
Q

what places is diaphragm attached to

A

xiphoid process
costal margin
tips 11-12 ribs
lumbar vertebrae

66
Q

the diaphragm contracts during ________

A)inspiraation
B)expiration

A

inspiration

67
Q

describe what happens to diaphragm during inspiration and the intrathoracic volume

A

diaphragm contracts

muscles fibres are pulled towards their peripheral attachments

dome flattens

intre-thoracic vol increases

68
Q

what is the central, fibrous part of the diaphragm called

A

central tendon

69
Q

describe what happens to diaphragm during expiration and the intrathoracic volume

A

diaphragm relaxes

diaphragm domes superiorly

70
Q

During ventilation, the dimensions of the thoracic cavity change in which three planes

A

vertically
laterally
anteroposteiorly

71
Q

The pleural fluid creates s______ t______ between the parietal pleura lining the thoracic cavity and the visceral pleura on the surface of the lung.

A

surface tension

72
Q

If the surface tension is ‘broken’ (e.g. by a penetrating injury of the chest that punctures the parietal pleura and introduces air into the pleural cavity - pneumothorax) what happens

A

ventilation may become dysfunctional

73
Q

explain inspiration with reference to
-diaphragm
-intercostal muscles
-ribs
-intrathoracic volume
-lungs expansion, pressure and volume

A

diaphragm and external intercostals contract which increases intrathoracic volume

ribs pull sternum superorly and anteriorly

lungs expand due to increases volume

pressure in lungs decreases below atm pressure and air is drawn into the lung

74
Q

explain expiration with reference to

-diaphragm
-intercostal muscles
-ribs
-intrathoracic volume
-lungs expansion, pressure and volume

A

diaphragm and external intercostals relax

internal intercostals contract

intrathoracic vol decreases

internal intercostals pull ribs inferiorly and posteriorly

lung vol decreases

pressure in lungs increases above atm pressure and air is expelled from the lungs.

75
Q

what are the muscles used In normal, quiet breathing

A

diaphragm for inspiration and expiration is passive

76
Q

describe Pleuritic chest pain

A

when pleura has become inflamed/injured sharp pain can be pinpointed and is worst non inspiration

77
Q

describe the differences and similarities between Pneumothorax and haemothorax

A

pneumothorax is air in the pleural cavity vs haemothorax is blood in pleural cavity

pneumothorax occurs due to trauma causing a tear in the pleura (e.g fractured rib) and air rapidly enters that lung and compresses the lung, heart, great vessels and the other lung

Haemothorax is a collection of blood in the pleural cavity and occurs after trauma when blood vessels are torn or cut.

both are disturbances to pleural cavity

78
Q

describe pleural perfusion and how to fix it, also why you must be careful while attempting to fix it

A

excess fluid in pleural cavity

can be removed with a chest drain by making am incision in lower part of chosen intercostal space, to avoid the neurovascular bundle

surface anatomy of the heart and lungs must be considered to ensure the tip of the drainage tube doesnt injure them

79
Q

what is mesothelioma

A

malignancy in the pleura

80
Q

injury to the phrenic nerves could cause

consider ipsilateral and bilateral injury

A

ipsilateral may go innoticed since only paralyses 1 side

bilateral paralysis will need ventilatory support

81
Q

Which nerves carry sensation from the parietal and visceral pleura?

A

parietal- intercostal nerves
visceral-visceral afferent fibres

82
Q

What is a bronchopulmonary segment?

A

anatomically and functionally separate segment of the lung of which there are 10 of

has a feeding artery and bronchus running through centre of segment

draining being run along surface

83
Q

What structures pass through the hilum of the lung?

A

pulmonary artery
2 pulmonary veins
main bronchus
Lymphatic vessels
Branches of the vagus nerve and sympathetic nerves.

84
Q

how does contraction of the diaphragm assist in returning blood to the heart?

A

Contraction of diaphragm decreases intra-thoracic pressure and
increases intra-abdominal pressure

blood therefor flows form abdomen to chest

85
Q

What is the sensory and motor nerve supply to the diaphragm?

A

phrenic

86
Q
A

ANATOMY (29 decks)

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