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Respi > Thoracic cavity, pleura and lungs (anat) > Flashcards

Thoracic cavity, pleura and lungs (anat) Flashcards

1
Q

What does the mediastinum contain?

A

Heart, large vessels, trachea, esophagus and nerves

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2
Q

What does the pulmonary cavities contain?

A

Lungs and pleurae

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3
Q

Thoracic cavity vs pulmonary cavity

A

Thoracic cavity is within the thoracic cage while pulmonary cavity is part of the thoracic cavity

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4
Q

Are the 2 layers of the pleura continuous?

A

Yes

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5
Q

What is the inner layer of the membrane?

A

Visceral pleura

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6
Q

What is the outer layer of the membrane?

A

Parietal pleura

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7
Q

Where is the costo-diaphragmatic recess located?

A

On both sides of the lung in the space btw costal and diaphragmatic pleura

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8
Q

Purpose of costo-diaphragmatic recess

A

Allows for expansion of lungs during inspiration

Clinical: use this recess to aspirate pleural fluid for diagnostic purpose

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9
Q

Purpose of costo-mediastinal recess

A

During respiratioin, anterior borders of lungs slide in and out of recess

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10
Q

Where does the cervical pleura extend into?

A

Root of the neck (2cm above clavicle) and meet behind the sternal angle at the 2nd intercostal cartilage -> continues down to 4th costal cartilage

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11
Q

What are the reflections of the left parietal pleura?

A

Diverge 1cm away from sternum at 6th costal cartilage -> curves laterally and reaches 8th rib at midclavicular line, 10th rib at midaxillary line and 12th rib at paravertebral line

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12
Q

What are the reflections of the right parietal pleura?

A

Same as the left parietal pleura except that the right layer continues to run till 6th costal cartilage behind sternum

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13
Q

Where is the lower limit of the lungs?

A

2 ribs above parietal pleura at midclavicular, midaxillary and paravertebral lines at level of 6th, 8th and 10th ribs respectively

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14
Q

Where is the upper limit of the lungs?

A

Follow outline of pleura

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15
Q

What kind of blood does pulmonary vein carry?

A

Oxygenated blood
- pulmonary vein is an exception to the rule

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16
Q

Which part of the lung does bronchial artery supply?

A

Lung tissue

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17
Q

What kind of blood does the pulmonary artery carry?

A

Deoxygenated blood
- exception to the rule

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18
Q

How do healthy lungs feel?

A

Light, soft and spongy

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19
Q

Which lung is larger and heavier?

A

Right lung

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20
Q

Why is the right lung shorter and wider?

A

Right dome of diaphragm is slightly higher

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21
Q

What are the 2 groups of blood vessels and what do they supply?

A

Pulmonary circulation -> supply lung

Systemic circulation -> supply rest of the body

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22
Q

Does systemic and pulmonary circulation happen simultaneously?

A

Yes

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23
Q

What does the pulmonary artery transport?

A

Deoxygenated blood from heart to lungs

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24
Q

What does the pulmonary vein transport?

A

Oxygenated blood from lungs to heart

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25
Q

What is the hilum of the lung?

A

Area on the mediastinal surface of the lung through which structures enter/leave the lung

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26
Q

What is the root of the lung?

A

Short tubular collection of structures that emerge at the hilum of each lung

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27
Q

What makes up the root of the lung?

A

Main bronchus, 2 pulmonary veins and 1 pulmonary artery

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28
Q

What surrounds the root of the lung?

A

Mediastinal pleura

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29
Q

Are the lungs inside the pleural cavity?

A

No, it is surrounded by the pleural sac

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30
Q

Which lung has a cardiac notch?

A

Left lung

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31
Q

Arrangement of vessels entering the lungs respectively (superior to inferior)?

A

Right
1) bronchus
2) pulmonary artery
3) pulmonary vein

Left
1) pulmonary artery
2) bronchus
3) pulmonary vein

32
Q

What are the impt structures in close contact w/ the left lung in the apex region?

A

Thoracic spinal nerve

Sympathetic trunk

Phrenic nerve

33
Q

What are the impt structures in close contact w/ the left lung in the hilar region?

A

Heart

Esophagus

Thoracic aorta

Arch of aorta and it’s branches

34
Q

What are the branches of the arch of aorta (medial to lateral)?

A

1) Brachiocephalic trunk

2) Left common carotid artery

3) Left subclavian artery.

35
Q

What are the impt structure in relation to the right lung?

A

SVC

Heart

IVC

Esophagus

Azygos vein

36
Q

Phrenic vs vagus nerve

A

Phrenic nerves pass anterior to the root of the lungs while vagus nerves pass posterior to the root of the lungs

37
Q

What does the phrenic nerve comprise of?

A

Motor, sensory and sympathetic nerve fibers

38
Q

What does phrenic nerve provide?

A

Motor innervation to diaphragm

Sensory innervation to central part of the diaphragm, mediastinal and diaphragmatic pleura

Sympathetic innervation to the blood vessels

39
Q

What innervates the visceral structures in the thorax?

A

Cardiac, pulmonary and esophageal plexuses
- contain both sympathetic and parasympathetic nerve fibers

40
Q

What does the cardiac plexus innervate?

A

Heart

41
Q

What does the pulmonary plexus innervate?

A

Lungs w/ visceral pleura

Trachea

Bronchioles

42
Q

What does the esophageal plexus innervate?

A

Esophagus

43
Q

Innervation of parietal vs visceral pleura and lungs

A

Parietal pleura receives somatic afferent innervation -> sensitive to pain

Visceral pleura and lungs receives visceral afferent innervation (autonomic) -> insensitive to pain

44
Q

What is the source of innervation for the parietal pleura?

A

Intercostal nerves T1 - T11

Phrenic nerve (C3 - C5)

45
Q

What is the source of innervation for the visceral pleura and lungs?

A

Pulmonary plexus

46
Q

What is a dermatome?

A

Area of skin that is mainly supplied by a single spinal nerve where each nerve relays sensation from a particular region of skin to the brain

47
Q

What is referred pain?

A

Pain felt at a site diff from the injured/diseased organ/body part

48
Q

Which spinal nerve supplies the skin over the neck and the shoulder?

A

C3 and C4

49
Q

Which spinal nerve supplies the mediastinal and central part of the diaphragmatic pleura?

A

Phrenic nerve aka C3 to C5

50
Q

Why does the brain mistake pain from the internal organ for pain from the skin?

A

Pain pathways from the skin surface and from internal structure/organ pass very close to each other at dorsal root via ephatic transmission -> brain mistakes pain

51
Q

Where does the trachea begin and end in terms of spinal level?

A

Begins at cervical vertebra 6 (C6) and ends at sternal angle (btw thoracic vertebrae 4 and 5)

52
Q

What are tracheal rings made of and how are they connected?

A

Hyaline cartilage (strong and flexible tissue)

Interconnected by fibroelastic tissue

53
Q

How are tracheal rings shaped?

A

C-shaped

54
Q

Fn of tracheal rings

A

Maintain mechanical stability of trachea -> keeps trachea open and prevent its collapse under negative pressures of respiratory cycle

55
Q

What happens to the cartilage from superior to inferior?

A

Gradually reduces and disappear distally -> no cartilage in the bronchioles but smooth muscle fibres relatively more

56
Q

Anterior relations to the trachea

A

Sternum, left brachiocephalic vein, brachiocephalic trunk and left common carotid artery and arch of aorta

57
Q

Posterior relations to the trachea

A

Esophagus, left recurrent laryngeal nerve

58
Q

Right side relations to the trachea

A

Azygos vein, right vagus nerve

59
Q

Left side relations of the trachea

A

Arch of aorta, left common carotid and left subclavian arteries, left vagus and phrenic nerves

60
Q

How is each bronchopulmonary segment supplied and the clinical relevance?

A

Has their own arterial supply

Venous and lymphatic vessels pass through the intervening septae that separate the segments from each other

Can remove a segment in event of a tumor w/o affecting other segments as they have their own arterial supply

61
Q

How does movement of chest wall change when a lung is collapsed?

A

Movement is decreased -> chest wall moves inequally

62
Q

How does sound differ when you percuss different parts?

A

Air containing organs (i.e: lungs) -> resonant note

Solid organ (i.e: heart) -> dull note

63
Q

What is heard during auscultation if there is a collapsed lung?

A

Nothing -> breath sounds are absent in a collapsed lung

64
Q

Where to place steth to listen to the apex of the lung?

A

Space above the clavicle

65
Q

Where to place steth to listen to the superior lobe of the lung?

A

Ard the 4th rib

66
Q

Where to place steth to listen to the middle lobe of the right lung?

A

Btw 4th and 6th rib

67
Q

Where to place steth to listen to the inferior lobe of the lung?

A

Below 6th rib

68
Q

Complication with lower ribs fracture

A

Tear diaphragm

69
Q

What is a pneumothorax?

A

Entry of air into pleural cavity

70
Q

What does a collapsed lung indicate on a chest x-ray?

A

Hyperlucency and absent vascular markings

71
Q

What is pleural effusion?

A

Accumulation of fluid into pleural cavity

72
Q

What is seen on chest x-ray in the event of paralysis of right hemidiaphragm?

A

Right hemidiaphragm higher than the left during inspiration

73
Q

What is thoracentesis?

A

Insertion of needle through an intercostal space into pleural cavity

74
Q

Precaution to take during thoracentesis

A

Needle to be inserted superior to the rib, high enough to avoid damage to collateral branches

75
Q

What is a bronchogram?

A

Radiological examination of bronchus and its branches

76
Q

What is a bronchoscopy?

A

Examination of the bronchus by illuminated scope

Respi (16 decks)

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