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Clinical Anatomy > Thoracic Wall, Pleura, Lungs > Flashcards

Thoracic Wall, Pleura, Lungs Flashcards

1
Q

Superior thoracic aperture

A
  • Opening at top of thoracic cage

- Could be ‘inlet’ or ‘outlet’ depending on which structures you are looking at

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2
Q

Inferior thoracic aperture

A
  • Opening at bottom of thoracic cage
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3
Q

Sternal angle

A
  • Where manubrium meets sternum
  • Where CC of rib #2 meets sternum
  • At level of T4
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4
Q

ID features of a typical rib

A
  • Head w/ 2 facets (sup + inf)
  • Neck
  • Tubercle w/ articular facet (for TP)
  • Angle of rib
  • Shaft/body of rib
  • Costal groove (for neurovascular bundle)
  • Site of articulation w/ costal cartilage
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5
Q

Synchondrosis

A

Articulation of rib w/ costal cartilage

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6
Q

What kind of joint is between articular facets of rib head + VB?

A

Synovial joint

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7
Q

Where are intercostal nerves in relation to their corresponding ribs?

A

Travel under same rib

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8
Q

How does the thorax move on inspiration?

A
  • Ribs angle up (bucket handle effect) –> transverse diameter
  • Sternum moves forward + up (pump handle effect) –> anterior-posterior diameter
  • Vertical dimension increased by diaphragm
  • This creates decreased pressure in pulmonary cavity. to draw air in.
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9
Q

Layers of thoracic wall

A

1) Skin
2) SC tissue
3) Serratus anterior
4) Ribs
5) External intercostal muscle
6) Internal intercostal muscle
7) Innermost intercostal muscle
8) Endothoracic fascia
9) Parietal pleura

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10
Q

How is intercostal neurovasculature ordered?

A

Vein
Artery
Nerve

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11
Q

Where does the intercostal neurovascular bundle lay?

A

In costal groove, NOT intercostap space

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12
Q

Name main components of blood supply to the thoracic wall

A
  • Aorta gives off posterior intercostal arteries
  • Subclavian gives off anterior intercostal arteries
  • They anastomose more anteriorly (will bleed from both ends when cut)
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13
Q

Internal thoracic arteries

A
  • Arises from subclavian
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14
Q

Anterior intercostal arteries

A
  • Small
  • Arise from internal thoracic + musculophrenic arteries
  • Supply anterior portion
  • Give off anterior cutaneous branches
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15
Q

Posterior intercostal arteries

A
  • Large
  • Arise from aorta
  • Supply posterior + medial + some anterior
  • Gives off dorsal & lateral cutaneous branches
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16
Q

Subcostal arteries

A
  • 12th rib
  • Arises from aorta
  • Supply muscles of anterolateral abdominal wall + overlying skin
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17
Q

What does the internal thoracic artery become once it crosses into the abdomen?

A

1) Superior epigastric artery

2) Musculophrenic artery

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18
Q

Name main components of nerve supply of the thoracic wall

A
  • Posterior rami (sensory) gives off lateral + medial cutaneous branches
  • Anterior rami (motor) form intercostal nerves
  • Have lateral cutaneous + anterior cutaneous branches
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19
Q

3 types of ribs

A

1) True = 1-7
2) False = 8-10
3) Floating = 11-12

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20
Q

Dermatomes

A
  • Bandlike skin areas each supplied by sensory fibers of a single posterior root
  • Considerable overlapping occurs
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21
Q

Sympathetic trunk

A
  • Intercostal + subcostal nerves connected by rami communicantes
  • Presynaptic fibers leave anterior rami by a white ramus communicans + pass to sympathetic ganglion
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22
Q

What is innervated by the intercostal nerves?

A

1) Skin and subcutaneous tissue
2) Intercostal muscles
3) Costovertebral and sternocostal joints
4) Parietal pleura
5) Peripheral parts of diaphragm (sensory)

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23
Q

Thoracentesis

A
  • Remove excessive fluid in pleural cavity
  • Do NOT pierce visceral pleura –> pierce lung
  • Needle pierces on superior portion of rib to avoid hitting neurovascular bundle
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24
Q

Tracheoesophageal fistulas

A
  • Most common group of malformations
  • Abnormal separation of tracheal bud from esophagus
  • Varieties of tracheoesophageal fistulas
    all involve stenosis or atresia of a segment of trachea or esophagus with abnormal connection between them

Clinical presentation:
- Newborn’s choking or regurgitation of milk when feeding

25
Q

4 regional names of parietal pleura

A

1) Costal pleura
2) Diaphragmatic pleura
3) Mediastinal pleura
4) Cervical/apical pleura

26
Q

Visceral pleura

A
  • Inner layer directly on lungs

- Extends into fissures dividing the lobes of the lung (tightly attached)

27
Q

Parietal pleura

A
  • Outer, deep to endothoracic fascia
28
Q

Pleural cavity

A

In between parietal + visceral pleura

29
Q

Costodiaphragmatic recess

A
  • Space where diaphragm meets ribs
  • Most lateral on frontal view
  • Most posterior on lateral view
  • Costophrenic angle

*Becomes blunted on imaging

30
Q

Costomediastinal recesses

A
  • Space where mediastinum meets ribs

- Most anterior on axial view

31
Q

Sternal line of pleural reflection

A

Where costal pleura becomes mediastinal pleura

32
Q

Lines of pleural reflection

A

Edges of the pleural cavity

33
Q

What significant impressions are on the right lung?

A

Vena cava

34
Q

What significant impressions are on the left lung?

A
  • Cardiac notch

- Aorta + branches

35
Q

Right lung hilum

A
  • Find right bronchus
  • Pulmonary artery should be ANTERIOR
  • Rest are pulmonary veins
36
Q

Left lung hilum

A
  • Find left bronchus
  • Pulmonary artery should be SUPERIOR
  • Rest are pulmonary veins
37
Q

Pleural effusion

A

Excessive fluid collection in pleural cavity

38
Q

Hemothorax

A

Blood in pleural cavity

39
Q

Chylothorax

A

Lymph in pleural cavity

40
Q

Empyema

A

Pus in pleural cavity

41
Q

Pneumothorax

A

Air in pleural cavity

42
Q

What sort of cells prevent airway collapse in bronchioles?

A

Club cells

43
Q

Terminal bronchioles

A
  • Smallest part of conducting part of bronchial tree

- Gives rise to several respiratory bronchioles

44
Q

Respiratory bronchioles

A
  • 1st part of bronchial tree that allows gas exchange

- Each provides several alveolar ducts

45
Q

What makes up bronchi?

A

Cartilage plates + circular layer of smooth muscle

46
Q

Do bronchioles contain cartilage plates or glands?

A

No

47
Q

Alveoli

A

Terminal air spaces in respiratory system

48
Q

Interalveolar septa

A

Location for gas exchange between air + blood (air-blood barrier)

49
Q

Alveolar epithelium (2 types)

A

1) Type I - pneumocytes (squamous cells) lining 95% of alveolar surface
2) Type II - secretory cells that produce + secrete surfactant to lower surface tension in alveoli

50
Q

Alveolar macrophages

A

Present in alveolar air spaces

51
Q

Right lung lobes

A

1) Upper
2) Middle
3) Lower

52
Q

Left lung lobes

A

1) Upper

2) Lower

53
Q

Lingula

A

Thin anterior portion of LUL that corresponds to RML

*Gives the heart a hug

54
Q

Right lung fissures

A

1) Horizontal

2) Oblique

55
Q

Left lung fissure

A

Oblique

56
Q

Pleuritis

A
  • Inflammation of pleura

- Can hear pleural rub on auscultation

57
Q

Carina

A
  • Ridge at bifurcation of trachea into main bronchi
58
Q

Pulmonary alveolus

A

Basic structural unit of gas exhange in the lung

Clinical Anatomy (25 decks)

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