Thoracic Wall, Pleural Cavity, Lungs Flashcards
1
Q
what makes up the skeleton of the thoracic wall?
A
osteocartilaginous thoracic cage, 12 pairs of ribs/cartilage, 12 thoracic vertebrae/IV discs, sternum
2
Q
other name for vertebrocostal ribs? what number ribs?
A
true ribs, 1-6
3
Q
other name for vertebrochondral ribs? what number ribs?
A
false ribs, 7-10
4
Q
other name for vertebral ribs? what number ribs?
A
free ribs, 11-12
5
Q
which ribs are ‘typical’ ribs?
A
3-9
6
Q
what makes rib 1 ‘atypical’?
A
broad and short
7
Q
what makes rib 2 ‘atypical’?
A
thin and long
8
Q
what make ribs 10-12 ‘atypical’? what is different about ribs 11-12?
A
only one facet
no necks or tubercles
9
Q
what are defining characteristics of thoracic vertebrae?
A
costal facets/demifacets on bodies and transverse processes, long spinous processes
10
Q
what are the parts of the sternum?
A
manubrium, body, xiphoid process
11
Q
what is different about the sternocostal joint of the 1st rib?
A
synchondrosis (an immovable joint)
12
Q
what is the name of the joint between the manubrium and the body of the sternum? what is the landmark for this joint?
A
manubriosternal joint
sternal angle
13
Q
what are the boundaries of the superior thoracic aperture/inlet?
A
1st thoracic vertebra, 1st pair of ribs/costal cartilage, superior order of manubrium sternum
14
Q
what are the boundaries of the inferior thoracic aperture/outlet?
A
12th thoracic vertebrae, 11th and 12th pairs of ribs, costal cartilage of ribs 7-10, xiphisternal joint
15
Q
what is the name of the joint between the body of the sternum and the xiphoid process?
A
xiphisternal joint
16
Q
where are the costovertebral joints?
A
between head of ribs and adjacent bodies of thoracic vertebrae + IV disc
17
Q
what ligament helps support the articulation of the costovertebral joints?
A
interarticular ligament
18
Q
there is an envelope surrounding the costovertebral joints - what is this called? what is it supported by?
A
articular capsule
radiate ligament
19
Q
where are the costotransverse joints?
A
between the tubercle of the rib and transverse costal facet
20
Q
what are the ligaments that help support the costotransverse joints?
A
costotransverse ligament, lateral costotransverse ligament, superior transverse ligament (anterior and posterior)
21
Q
where are the costochondral joints?
A
between the ribs and costal cartilage (~midaxillary line)
22
Q
what type of joint are the costochondral joints?
A
plane-type synovial joints
23
Q
where are the interchondral joints?
A
between the cartilage of the ribs with one another
24
Q
what type of joint are the interchondral joints?
A
plane-type synovial joints
25
where are the sternocostal joints?
between the costal cartilage and the sternum
26
what type of joint are the sternocostal joints?
primary cartilaginous joints
27
vertical diameter of the thorax, also known as the superior-inferior diameter, increases with what movement?
contraction of the diaphragm
28
transverse diameter of the thorax increases with what movement?
contraction of the intercostal muscles
29
anterior-posterior diameter of the thorax increases with what movement?
contraction of the intercostal muscles
30
the transverse diameter produces a movement known as what?
bucket handle movement
31
the anterior-posterior diameter produces a movement known as what?
pump handle movement
32
the caval opening is the opening in the central tendon of the diaphragm for what structure? what level of the vertebrae is it at?
superior vena cava
T8
33
the esophageal hiatus is the opening in the diaphragm for what structure? what level of the vertebrae is it at?
esophagus
T10
34
the aortic hiatus is the opening in the diaphragm for what structures? what level of the vertebrae is it at?
aorta, thoracic duct, azygos vein
T12
35
what is the main action of the diaphragm and what does it help create?
contraction of the diaphragm lowers it, helping to create pleural cavities
36
what is the purpose of the structure of the diaphram?
separate thoracic and abdominal cavities
37
the lumbar part of the diaphragm is supported by what structures?
medial arcuate ligament, lateral arcuate ligament
38
what are the two crura in the diaphragm and what do they help create?
right crura, left crura
esophageal hiatus, aortic hiatus
39
what are the main arteries and veins that are present in the diaphragm?
pericardiacophrenic, musculophrenic, superior phrenic
40
what innervates the diaphragm?
phrenic nerve
41
what are the serratus posterior superior attachments, innervation, and actions?
C7-T3 spinous processes, ribs 2-5
2nd-5th intercostal nerves
increase anterior-posterior diameter of thorax, proprioception
42
what are the serratus posterior inferior attachments, innervation, and actions?
T11-L2 spinous processes, ribs 9-12
T9-12 anterior rami
depress inferior ribs, proprioception
43
what are the levatores costarum attachments, innervation, and actions?
transverse processes T1-11, ribs 1-11
posterior primary rami C8-T11
elevate ribs
44
what are the external intercostal attachments, innervation, and actions?
inferior border of ribs, superior border of adjacent rib
intercostal nerve
elevate ribs during forced inspiration
45
what is found between the intercostal muscles and the sternum in the intercostal spaces?
external intercostal membrane, internal intercostal membrane
46
what are the internal intercostal/innermost intercostal attachments, innervation, and actions?
inferior border of ribs, superior border of adjacent rib
intercostal nerve
depress ribs during forced expiration (interosseous part), elevate ribs during forced inspiration (interchondral part)
47
what are the accessory respiratory muscles?
subcostal, transverse thoracic, sternocleidomastoid, scalene, trapezius, pectoralis major, pectoralis minor, serratus anterior, latissimus dorsi, iliocostalis, quadratus lumborum
48
where are the intercostal nerves located?
costal groove
49
what are the branches of the intercostal nerves?
collateral, lateral cutaneous, anterior cutaneous, muscular
50
do intercostal nerves provide myotome (motor) or dermatome (sensory) functions?
myotome AND dermatome
51
what is the name of the connecting branch between the intercostal nerves and the sympathetic trunk?
rami communicantes (white and gray)
52
what is the name of the intercostal nerve from the anterior ramus T12?
subcostal nerve
53
T7 dermatome is at the level of what structure?
xiphoid process
54
each intercostal space is supplied by three arteries - what are they?
posterior intercostal, axillary artery, subclavian artery
55
what does the posterior intercostal artery arise from?
thoracic aorta
55
the supreme thoracic artery is a branch of what artery?
axillary artery
55
the internal thoracic artery is a branch of what artery?
subclavian artery
56
what are the spaces that make up the thoracic cavity?
pulmonary cavities, mediastinum
57
what are the two pleura within the thoracic cavity?
visceral, pleural
58
what are the components of the parietal pleura?
costal, mediastinal, diaphragmatic, cervical
59
what innervates the costal and diaphragmatic pleura?
intercostal nerves
60
what innervates the mediastinal pleura?
phrenic nerves
61
what are the lines of pleural reflection?
sternal, costal, vertebral
62
what are the recesses found in the pleural cavity?
costodiaphragmatic, costomediastinal
63
what is the function of the pleural cavity?
prevention of lung recoil
64
what increases the surface tension of the lungs to prevent recoil?
subatmospheric pressure and pleural fluid within pleural space
65
during inspiration, the diameter of the thoracic wall increases - what happens to air pressure in lungs?
becomes subatmospheric
66
during expiration, the diameter of the thoracic wall decreases - what happens to the air pressure in the lungs?
excesses atmospheric pressure
67
changes in the diameter of the thoracic wall change the air pressure in the lungs - what causes this?
contraction of the muscles and compliance of the lungs
68
what keeps the lungs from being completely deflated?
residual volume
69
lungs expand due to surface tension of visceral and parietal pleura - what causes this?
thin serous fluid in the pleural cavity
70
what creates a negative pressure in the pleura with lung expansion?
lymphatic circulation of pleural fluid
71
the surface tension between the pleura allows the lungs to do what?
affix to the internal thoracic wall
72
what disrupts the lymphatic flow and breaks surface tension?
air, fluid, or blood in the pleural space
73
pneumothorax is caused by what?
a penetrating wound that causes a rupture of visceral pleura
74
what is emphysema?
damage to alveoli (lung disease)
75
what is hydrothorax?
water in the pleural cavity
76
what is hemothorax?
blood in the pleural cavity
77
hydrothorax and hemothorax can lead to what condition?
pulmonary edema
78
what is pneumothorax?
air in the pleural cavity
79
what can occur due to pulmonary edema?
cardiac failure and thus, increased capillary pressure
80
where is the inferior lung and parietal pleura along the midclavicular line?
lung - 6th rib
pleura - 8th rib
81
where is the inferior lung and parietal pleura along the midaxillary line?
lung - 8th rib
pleura - 10th rib
82
where is the inferior lung and parietal pleura along the midscapular line?
lung - 10th rib
pleura - 12th rib
83
what is the root of the lung?
group of structures that enter and exit the lung at the hilum
84
what are the structures that make up the root of the lung?
bronchus, pulmonary artery and vein, bronchial artery and vein, lymphatic vessels, nerves
85
what is the function of the pulmonary artery and vein?
circulation between right and left sides of the heart
86
what is the function of the bronchial artery and vein?
circulation to lung tissue
87
what are the impressions on the mediastinal surface of the right lung?
esophagus, azygos vein, brachiocephalic vein, superior vena cava, cardiac impression
88
what is present in the hilum on the mediastinal surface of the right AND left lungs?
pulmonary artery and vein, bronchus, bronchial vessels
89
what are the impressions on the mediastinal surface of the left lung?
aorta, subclavian artery, 1st rib, left ventricle, trachea, esophagus
90
what is dead space? what is the volume of dead space?
air in respiratory tract that does not reach the point of exchange
150 mL
91
what is the path air takes along the tracheobronchial tree?
trachea - main bronchi - lobar bronchi - segmental bronchi - conducting bronchioles - terminal bronchioles - respiratory bronchioles - pulmonary alveolus - alveolar duct - alveolar sac
92
what is the first sign of alveoli in the tracheobronchial tree?
respiratory bronchioles
93
what is the bronchopulmonary segment?
portions of the lungs supplied with air by the segmental bronchi
94
how many bronchopulmonary segments are in the superior lobe of the right lung?
3
95
how many bronchopulmonary segments are in the middle lobe of the right lung?
2
96
how many bronchopulmonary segments are in the inferior lobe of the right lung?
5
97
how many bronchopulmonary segments are in the superior lobe of the left lung?
5
98
how many bronchopulmonary segments are in the inferior lobe of the left lung?
5
99
how many pulmonary veins are on each side of the lungs? what is their function?
2
carry oxygenated blood to the heart
100
what are the pulmonary arteries that travel to the lungs?
lobar and segmental arteries
101
what is compliance? what is it related to?
change in volume / change in pressure
elasticity of the lungs
102
what do you need surface tension in the pleural cavity?
counteract elasticity/recoil of lungs
103
what is decreased by surfactant?
alveolar air-liquid interface
104
what is tidal volume? how much in a healthy adult?
volume of air inhaled and exhaled with each breath
500 mL
105
what is inspiratory reserve volume? how much in a healthy adult?
additional volume of air inhaled beyond tidal volume
2500-3000 mL
106
what is expiratory reserve volume? how much in a healthy adult?
additional volume of air exhaled beyond tidal volume?
1000 mL
107
what is residual volume? how much in a healthy adult?
amount of air remaining in the lungs after forceful respiration
500-1000 mL
108
what is inspiratory capcity?
tidal volume + inspiratory reserve volume
109
what is functional residual capacity?
expiratory reserve volume + residual volume
110
what is vital capacity?
inspiratory reserve volume + tidal volume + expiratory reserve volume
111
what is total lung capacity?
tidal volume + residual volume + inspiratory reserve volume + expiratory reserve volume
112
what is the relationship between the blood flowing through the lungs and blood flowing through cardiac output?
equal
113
arterial pressures in the lungs are how much greater than the arterial pressures in the systemic circulation?
25%
114
what does increased arterial pressure cause in pulmonary circulation?
vasodilation
115
higher pressure in the lungs helps prevent what from occuring?
edema
116
what is the primary purpose of the lungs?
remove CO2 that is generated by oxidative metabolism from the body
117
by removing CO2, the lungs help to do what two things?
maintain proper pH in the body and oxygenate venous blood in pulmonary circulation
118
failure to maintain proper body pH results in what conditions?
respiratory acidosis or alkalosis
119
gases will diffuse across membranes (i.e., alveoli, capillaries) from what types of areas to what other types of areas?
high partial pressure to low partial pressure
120
O2 partial pressures
alveoli - 105 mmHg
capillary - 40 mmHg
121
CO2 partial pressures
alveoli - 40 mmHg
capillary - 45 mmHg
122
what is the exchange space in the alveoli?
0.75 m^2
123
why is O2 saturation in the blood slow than in the alveoli?
not all blood in the lungs is oxygenated due to anatomical dead space and effects of gravity on blood flow
124
what lobes of the lungs continuously participate in respiration?
lower
125
when do the apex of the lungs participate in respiration?
during systole when pressures in capillaries are greater than pressures in alveoli
126
what factor of respiration can be affected by edema in interstitial fluid and lung fibrosis?
thickness of respiratory membrane
127
what factor of respiration can be affected by emphysema and lung cancer?
surface area of respiratory membrane
128
what does the bronchial artery arise from and where?
aorta on left
superior intercostal artery, aorta, or left superior bronchial artery on right
129
what is the function of the bronchial veins?
drain a portion of the blood supplied to lungs by bronchial arteries (other deoxygenated blood drains into pulmonary veins)
130
where does the bronchial veins drain into?
azygos and hemiazygos venous system
131
where do the parasympathetic fibers come from in the lungs? what are they responsible for?
vagus nerve
bronchoconstriction, vasodilation, secretomotor function
132
where do the sympathetic fibers come from in the lungs? what are they responsible for?
paravertebral ganglia
bronchodilation, vasoconstriction, inhibition to secretory glands
133
what is the name of the plexus innervates the lungs?
anterior and posterior pulmonary plexus
