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Anatomy > Thorax > Flashcards

Thorax Flashcards

1
Q

What type of joint is intervertebral

A

symphysis (secondary cartilaginous) articulates with vertebral bodies and intervertebral disc

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2
Q

costotransverse/ costovertebral

A

synovial plane of joint ribs and vertebrae

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3
Q

sternocostal

A

primary cartilaginous (1st) synovial plan joints (2nd-7th) sternum and costal cartilages

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4
Q

sternoclavicular

A

saddle type of synovial joint sternum and clavicle

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5
Q

costocartilage

A

primary cartilaginous joint ribs and costal cartilages

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6
Q

interchrondal

A

synovial plane joint costal cartilages

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7
Q

boundaries of superior thoracic aperture

A

posteriorly by T1 vertebra laterally by ribs 1 and CC anteriorly by superior border of manubrium

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8
Q

boundaries of inferior thoracic aperture

A

thoracic cavity communicated with abdomen posteriorly T12 v posterolaterally 11 and 12 ribs anteriolaterally by joined CC by ribs 7-10 (costal margin) anteriorly xiphisternal joint

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9
Q

True ribs

A

1-7 attach directly to sterunm

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10
Q

false ribs

A

8-10 cartilages join to cartilage of rib above

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11
Q

floating ribs

A

11 and 12

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12
Q
A
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13
Q

Atypical ribs

A

1,2, 10-12

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14
Q

typical rib

A

3-9

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15
Q
A
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16
Q

rib 1 vs rib 10 to 12

A

similar but one facet on heads

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17
Q

characterstic features of thoracic vertebrae

A
  • bilateral superior and inferior costal facets
  • atypical thoracic vertebrae have single whole facet instead of demifacets
  • costal facets on transverse process for ribs
  • long inferior slanting spinous process
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18
Q
A
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19
Q
A
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20
Q

structures that pass through superior thoracic aperture

A

trachea

oesophagus

lung apex

thoracic duct

common carotid and subclavian aa L and R

subclavian, brachiocephalic and internal jugular vv

phrenic and vagus nn

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21
Q

structures that pass through inferior thoracic aperture

A

oeseophagus

thoracic duct

abdominal aorta

inferior VC

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22
Q

movements of thoracic wall during inspiration

A
  • bucket handle movements of superior ribs
  • pump handle movement of sternum
  • contraction of external and internal muscles raise rib towards the rib above- raises rib cage
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23
Q

movements of thorax during expiration

A

passive

diaphragm, intercostals and other muscles relax decreasing intrathoracic volume and increasing intrathoracic pressure expelling air from lungs

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24
Q

role of costal cartilages

A

contribute to elasticity of thoracic wall preventing blows from fracturing sternum

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25
Q

where is the weakest part of the rib

A

anterior to angle

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26
Q

surface markings of the parietal pleura

A

lie closest behind sternal angle

parallel down to 4th CC

L indented due to cardiac notch to 6th CC

R continues down to 6th CC

both go to rib 8 at mid clavicular line

rib 10 at mid axillary line

rib 12 lateral border of erector spinal muscle

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27
Q

surface markings of the visceral pleura

A

reflections closest at plane of sternal angle

parallel down to rib 4

L intended (cardiac notch) R continues to CC6

crosses rib 8 at mid axillary line

cross rib 10 lateral border erector spinae muscle

28
Q

what is a pleural reflection and where are they

A

lines along which the (parietal) pleura change direction (reflect) from one wall of tje pleura cavity to another

sternal- anteriorly: sharp, costal to mediastinal

costal- inferiorly: sharp, costal to diaphagmatic

vertebral- posterioly: rounder, costal to mediastinal

29
Q

What are the recesses in the pleural cavity

A

pleural cavities not full in expiration

costodiaphragmatic recess

costomediastinal recess (L is larger than R)

30
Q

parts of the parietal pleura

A

cervical

costal

diaphragmatic

mediastinal

31
Q

surface markings of oblique fissure

A

rib 2 posteriorly to rib 6 anteriorly

32
Q

surface markings of horizontal fissure of R lung

A

rib 4 to oblique fissure

33
Q

what is the ligula and where is it

A

tongue like process on the superior lobe of the left lung

34
Q

what is the endothoracic fascia

A

thin fibro-areolar layer between internal aspect of thoracic cage and lining of pleural cavities

37
Q

what are the three borders of the lungs

A

anterior where costal and mediastinal surfaces meet

inferior border where diaphragmatic surface separates from costal and mediastinal

posterior border where costal and mediastinal surfaces meet

38
Q

what are the three surfaces of the lungs

A

costal surface

mediastinal surface

diaphragmatic surface

39
Q

what supports trachae and bronchi

A

C shaped rings of hyaline cartilage

42
Q

What is the difference between the right and left main bronchus

A

the right is wider and shorter and runs more vertically

  • more likely for foreign bodies to enter right bronchus

the left passes to arch of aorta and anterior to oesophagus and thoracic aorta to reach the left hilum

43
Q

what do main bronchus divide to?

A

lobar bronchi (secondary)

segmental bronchi (tertiary) supply bronchopulmonary segments

terminal bronchioles

respiratory bronchioles supply alveolar ducts which give rise to alveolar sacs

44
Q

vascular supply of bronchopulmonary segments

A

(segmental bronchus)

tertiary branch of pul. artery

intersegmental parts of pul. veins

45
Q

how many arteries and veins supplies the lungs?

A

1 pul artery

2 pul veins

46
Q

which level does the pulmonary trunk arise from

A

sternal angle

47
Q

describe the course of the pulmonary arteries

A

pass to the root of lung and give of a branch to the superior lobe before entering hilum

divides into lobar and segmental arteries

48
Q

what do the bronchial arteries supply

A

blood to the structures of roots of lungs, supporting tissues of lung and visceral pleura

small bronchial arteries supplies superior oesphagus, main bronchi and respiratory bronchioles

49
Q

where does the right bronchial artery arise from

A

superior posterior intercostal artery

thoracic aorta with right 3rd posterior IC artery

left superior bronchial artery

50
Q

what do the bronchial veins drain

where do they drain

A

proximal part of the roots of lungs

right drains into azygous vein

left drains into accessory hemi-azygous vein

51
Q

What do the superfical lymphatic plexus drain

and where do the vessels drain into

A

lies deep to visceral pleura

drains lung parenchyma (tissue) and visceral pleura

vessels drain into bronchopulomnary (hilar) lymph nodes

52
Q

what do the deep lymphatic plexus drain and where do vessels drain into

A

located on submucosa of bronchi and peribronchial connective tissue

drains structures that form root of lung

drain into pulmonary lymph nodes with drain into bronchopulmonary hilar lymph nodes

53
Q

where does the bronchopulmonary lymph nodes drain into and then what happens

A

tracheobronchial lymph nodes

superior and inferior to bifurcation of trachea

these then drain into right and left bronchomediastinal lymph trunks that terminate at venous angles (junction of subclavian and internal jugular)

right merges with branches to form right lymphatic duct

left terminates in the thoracic duct

55
Q

What are the nerves of the visceral pleura and what are their functions?

A

pulmonary plexus located anterior and posterior to root of lungs

parasympathetic: vagus
- motor to SM of bronchioles (bronchiolecontrisctor)
- inhibitory to pulmonary vessels (vasodilator)
- secretory to glnds of bronchial tree (secretomotor)
sympathetic: sympathetic trunk/ sympathetic ganglion cells in paravertebral sympathetic ganglia
- inhibtory to bronchial msucles (bronchodilator)
- motor to pul. vessels (vasoconstrictor)
- inhibitory to alveolar glands

56
Q

which nerves supply to parietal pleura?

A

phrenic

intercostal nerves

57
Q

How many bronchopulmonary segments does the right and left lungs have?

what is the clinical important of these segments?

A

R: 10 lobes

L: 8-10 as some fuse

smallest functionally independent region of a lung

smallest area that can be isolated and removed

58
Q

pneumothorax

A

air fills pleural cavity due to punctured lung

may result in collapsed lung

59
Q

postural drainage of lungs

A

gravity and percussion (clapping on the chest and/or back) to loosen the thick, sticky mucus in the lungs so it can be removed by coughing.

60
Q

carcinoma of bronchus and lungs

A

bronchial: arises from epithelium of bronchial tree

metastasises widley due to arrangement of lymphatic

transported through pulmonary veins, left heart and to aorta to brain/ body

lung cancer caused by smoking

61
Q

drainage of fluid from lungs

A

thoracentesis:hypodermic needle through IC space into cavity

must avoid damage to IC nerves and vessels- high enough to avoid collateral branches

pneumo thorax: safe triangle Lower border of axilla to the 5th intercostal space; the lateral edge of pectorails major and the lateral edge of latissimus dorsi

62
Q

which bronchopulmonary segments do bronchial secretions tend to drain when the patient is nursed in supine position? what are these segments most commonly the sites of?

A

superior and posterior segment of inferior lobe

pneumonia

63
Q

site of puncture of cricothryoid membrane to gain direct access to airways

what structures might be damaged

why is the site used different for an in dwelling airway

A

between thyroid prominence and cricoid cartilage

trachea

doesnt damage vocal chords

life saving if not possible to intubate and ventilate

64
Q

what structures would you see with a bronchoscope down the airway if cancer had spread?

A
  • carina- sagittal plane
  • tracheobronchial lymph nodes in angle between main bronchi are enlarged- cancer
  • if carina is distorted and widened and immobile
65
Q

the importance of carina clinically

A

changes are important diagnostic signs

Anatomy (9 decks)

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