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Structure And Function III > Thoracic Wall And Pleural Cavity > Flashcards

Thoracic Wall And Pleural Cavity Flashcards

1
Q

Most superficial intercostal muscle fibers, innervated by intercostal nerves (t1-t11)

Fibers directed antero-inferiorly

A

External layer

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2
Q

Intercostal fibers directed postero-inferiorly

A

Internal

Innermost

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3
Q

Neurovascular supply for the intercostal muscles are where?

A

Located between the internal and innermost muscle layers

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4
Q

The interior intercostal membrane is where

A

From the angle of the ribs to the vertebral column

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5
Q

The external intercostal membrane is where?

A

Near the sternum and costal margins

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6
Q

Located on the deep surface of anterior thoracic wall

Attach to posterior surface of lower sternum and ribs 3-6

Deep to internal thoracic vessels

A

Transversus thoracis muscles

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7
Q

Located at lower regions of posterior thoracic wall

Spans multiple ribs

A

Subcostal muscles

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8
Q

Order of intercostal neurovascular bundle structures from superior to inferior

A

Vein

Artery

Nerve

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9
Q

What muscles is the intercostal neurovascular bundles in between ?

A

Between internal and innermost muscles.

It is at the inferior border of rib in costal groove

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10
Q

Where should you put chest tubes?

A

Between the anterior axillary line and the mid-axillary lines. At the 4th or 5th intercostal spaces, on the superior border of the rib.

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11
Q

Indication for chest tube? (Thoracostomy)

A

Indicated to drain abnormal air or fluid in the pleural cavity

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12
Q

Intercostal arteries are?

A

Posterior intercostal artery (branch of aorta)

Anterior intercostal artery (branch of internal thoracic, which is branch of subclavian)

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13
Q

Origin of the 1st and 2nd posterior intercostal arteries are where?

A

They are from the supreme intercostal artery which are a branch of the costocervical trunk from the subclavian artery.

[Not from the aorta]

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14
Q

Supplies anterior intercostal arteries to 7-9th intercostal spaces and to the diaphragm

Terminal branch of the internal thoracic artery

A

Musculophrenic artery

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15
Q

Continues inferiorly into the anterior abdominal

Terminal branch of internal thoracic artery

A

Superior epigastric arteries

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16
Q

Posterior intercostal veins drain into ?

A

The azygos vein on the right

Hemiazygous and accessory hemiazygous veins on the left

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17
Q

Anterior intercostal veins drain into ?

A

Internal thoracic vein and musculophrenic vein

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18
Q

Types of innervation in the intercostal nerve

A

Sympathetic

Somatic sensory innervation

Somatic motor innervation

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19
Q

What dermatome is at roughly the level of teh nipples

A

T4

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20
Q

Potential space between the parietal pleura and visceral pleura

Contains a thin layer of serous fluid

A

Pleural cavity

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21
Q

Pleural cavity develops from ?

A

Coelomic space

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22
Q

Slit-like spaces of reflection of costal pleurae to diaphragmatic pleurae

A

Costodiaphragmatic recesses

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23
Q

Air enters into pleural cavity from channel through thoracic wall made by knife wound

A

Open pneumothorax

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24
Q

Air enters into pleural cavity from rupture of air tubes at surface of lungs

A

Closed pneumothorax

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25
Q

Blood in pleural cavity

A

Hemothorax

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26
Q

Pus in pleural cavity

A

Pyothorax

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27
Q

Excess tissue fluid in pleural cavity duue to CHF

A

Hydrothorax

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28
Q

Milky lymph fluid from the intestines?

A

Chylothorax

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29
Q

Chyle in pleural cavity due to tear in thoracic duct

A

Chylothorax

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30
Q

Inflammation of pleura; fibrous adhesions on pleura can result in audible friction rub

A

Pleurisy

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31
Q

The visceral pleura is relatively _________ to pain

A

Insensitive

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32
Q

Costal pleura is innervated by ?

A

Intercostal nerves,

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33
Q

Mediastinal diaphragmatic pleura are innervated by ?

A

Phrenic nerve

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34
Q

Visceral pleura is formed from ?

A

Intraembryonic sphlanchnic mesoderm

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35
Q

____ forms linings of the airways

A

Endoderm

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36
Q

Forms connective tissue, cartilage, and muscle of airways

A

Splanchnic mesoderm

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37
Q

The horizontal fissure follows which rib from the sternum until it reaches the oblique fissue?

A

4th rib

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38
Q

Tracheea divides into main bronchi at the level of the ___-

A

Sternal angle

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39
Q

Bronchial arteries branch from ? ?

A

Either the aorta or right 3rd posterior intercostal artery

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40
Q

The right bronchial artery branches off of the ?

A

Right 3rd posterior intercostal artery

41
Q

The left bronchial arterys arise from ?

A

The aorta

42
Q

Parasympathetic pulmonary nerves do what?

A

Constrict respiratory passageways

Dilate blood vessels

Increase mucous secretion

43
Q

Sympathetic pulmonary nerves do what?

A

Dilate respiratory passageways

Constrict blood vessels

Decrease mucous secretion

44
Q

Palpable ribs

A

2-10

45
Q

Floating ribs

A

11 and 12

46
Q

True ribs are which ones

Why are they called true?

A

Ribs 1-7

Because the articulate with the sternum

47
Q

False ribs

A

8-12

48
Q

Intercostal spaces are numbered for /

A

The rib immediately superior of the space

49
Q

Formed by the costal cartilages of ribs 8,9, 10 joining costal cartilage of rib above

A

Costal margin

50
Q

Where is the nipple

A

Approximately 4th intercostal space (think chest tube)

Depending on breast size

At the midclavicular line

51
Q

Located only in the lateral half of an intercostal space

Muscle fibers span only one intercostal space

Muscle fibers oriented in same direction as internal intercostals

A

Innermost intercostals

52
Q

Branch of subclavian artery
Located parasternally, between internal intercostal and transversus thoracis muscles

Divides into two terminal branches at level of 6th intercostal space

A

Internal thoracic artery

53
Q

Originate from internal thoracic artery in upper 6 intercostal spaces

Originate from musculophrenic artery in the 7th - 9th intercostal spaces

A

Anterior intercostal arteries

54
Q

Lungs invaginate the

A

Pleural cavity

55
Q

Closed, separate cavity w/in each side of the thoracic cavity.
Potential space under negative pressure
Located between parietal pleurae and visceral pleura

A

Pleural cavity

56
Q

Separates the parietal pleura from the ribs and intercostal muscles of the thoracic wall

Allows surgeons to easily separate pleura from the thoracic wall and avoid entering the pleural cavity

A

Endothoracic fascia

57
Q

Only thing present within the pleural cavity

A

Serous substance that acts as a lubricant and forms a film on the visceral and parietal pleurae

58
Q

Inferior borders of pleura

A

Rib 8 at midclavicular line

Rib 10 at midaxillary line

Rib 12 at vetebra

59
Q

Superior border of pleura

A

About 1 inch above costal cartilage of rib 1 (above the clavicle

60
Q

Where is the cardiac notch of pleurae

A

Rib 4 around to just past sternal margin then turns down and goes to rib 6

61
Q

Posteriorly marks the superior extent of the pleura

A

Spinous vertebrae of C7

62
Q

Sensory innervation to costal pleura and peripheral part of diaphragmatic pleura

A

Intercostal nerves

63
Q

Sensory innervation to mediastianl pleura and central part of diaphragmatic pleura

A

Phrenic nerve

64
Q

______ pleura is insensitive

A

Visceral

65
Q

When does the laryngotracheal groove appear in the floor of the endodermal foregut?

A

Week 4

66
Q

The laryngotracheal tube bifurcates into long buds which form:

A
  1. Main Bronchi (primary)
  2. Lobar Bronchi (secondary)
  3. Segmental Bronchi (teriary)
67
Q

Laryngotracheal tube grows _____, divides into right and left lung buds, which grow into pleural sacs.

A

Caudally

68
Q

Describe tracheoesophageal fistula with esophageal atresia.

I

A

Improper fusion at tracheoesophageal folds (tracheoesophageal septum) which requires surgical intervention.
-1 in 2500 births

Results in polyhydramnios since amniotic fluid drank by fetus cannot enter stomach and small intestine which is the site of absortion by fetal circulation

69
Q

Fistula

A

Abnormal channel between two structures

70
Q

Atresia

A

Absence of normal lumen or opening

71
Q

Polyhydramnios

A

Excess amniotic fluid in the amniotic sac

72
Q

Where is the cardiac notch

A

Rib 4-6

73
Q

Right lung has __- lobes

A

3

74
Q

Left lung has __ lobes

A

2

75
Q

Separates middle lobe from superior lobe in right lung

A

Horizontal fissure (follows 4th rib from sternum to oblique fissure

76
Q

In both lungs, separates inferior and superior lobe.

Starts about at spinous process of T4, then moves laterally and downward across 4th and 5th intercostal space and anteriorly runs along the contour of thee 6th rib

A

Oblique fissure

77
Q

Tongue of the left superior lobe located inferior to cardiac notch.

Extends into left costomediastinal recess during normal inspiration

A

Lingula

78
Q

The base of the lung is ____ rib levels higher than parietal pleura

A

2

79
Q

Where are paracentesis done?

A

Needle is inserted in midaxillary line at intercostal space 4 to lessen possibility of puncturing diaphragm.

80
Q

Part of the lung wehre nerves and vessels enter and leave

Contains bronchi, pulm A., Pulm V., bronchial arteries, and veins to and from stroma of lung, lymph vessels and autonomic nerves

A

Hilum of lung

81
Q

The eparterial bronchus is only on the____ side

A

Right side

It goes to right upper lobe

Superior to pulmonary artery

82
Q

Right and left pulmonary arches send branches that divide and follow what to supply respiratory cells

A

They follow the bronchial trees

83
Q

Oxygenated blood supply to non-respiratory lung tissue comes from?

A

Bronchial arteries
- two branches from aorta to left lung

  • one branch from posterior intercostal artery to 3rd intercostal space

(Leaves through bronchial veins)

84
Q

How is non-respiratory tissue supplied in the left lung?

A

Two bronchial arteries branch from aorta to left lung

85
Q

Surgical/function unit of lung

Has 1 pulm A branch and one bronchial A.

Two of these share 1 pulmonary vein.

Can be removed surgically without pneumothorax or excessive bleeding (in case of abscess/cancer)

A

Bronchopulmonary segments

86
Q

Aeration of lungs brought about by actively increasing the size of the thoracic cavity which decreases pressure in the pleural cavity

A

Inspiration

87
Q

Ways that the thoracic cavity is enlarged for inspiration

A

Vertical

Transverse

Anterior and posterior

88
Q

How is vertical diameter of thoracic cavity changed

A

Contraction of the muscular diaphragm, resulting in flattening of its domes

89
Q

How is anteroposterior diameter increased in thoracic cavity?

A

Raising the inferior sloping ribs at their sternal attachmens, thrusting inferior end of sternum anteriorly.
Due to fixing first rib by neck muscles and contraction of intercostal muscles.

90
Q

How is transverse diameter increased in thoracic cavity

A

Raising the inferior sloping ribs at their sternal attachmens, thrusting inferior end of sternum anteriorly.
Due to fixing first rib by neck muscles and contraction of intercostal muscles.

91
Q

Two types of inspiration

A

Quiet inspiration

Forced inspiration

92
Q

Type of inspiration;
First rib fixed by contraction of scalene muscles. Intercostals contract and draw ribs toward rib 1 and the diaphragm contracts.

These cause increase in size of thoracic cavity

A

Quiet inspiration

93
Q

Type of inspiration that involves powerful, contraction of the neck muscles raising rib 1

A

Forced inspiration

94
Q

Type of expiration.

Passive

Due to relaxation of intercostal muscles and diaphragm and elastic recoil of lungs

Thoracic cavity returns to its pre-inspiratory volume

A

Quiet expiration

95
Q

Type of expiration

Active

Posterior abdominal muscles (quadratus lumborum) contract to pull down rib 12 and ant abd muscles contract to force abdominal organs upwards against diaphragm

A

Forced expiration

96
Q

Two layers of pleura in direct contact w/ each other inferior to the root of the lung

Does not contain major neurovascular structures

A

Pulmonary ligament

97
Q

At the end of week ____ of development, the coelom is a horseshoe shaped cavity in the trilaminar embryo prior to head, tail, and lateral folding

A

3

98
Q

Lateral folding of the embryo after week 3 does what?

A

Brings right and left sides of horse-shoe shaped coelomic spaces together to form single coelom

Structure And Function III (24 decks)

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