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1st Year Med > Thorax/Lung Anatomy > Flashcards

Thorax/Lung Anatomy Flashcards

1
Q

what protects the contents of the thoracic cavity?

A

thoracic wall

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2
Q

what are the 3 main functions of the thorax?

A

respiration
protection
conduit (passageway)

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3
Q

what does the thoracic wall consist of?

A

sternum, T1-12 vertebrae, 12 rib pairs + costal cartilages, intercostal muscles (in intercostal spaces), supplying arteries/nerves

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4
Q

what are the 3 types of intercostal muscles?

A

external, internal, innermost

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5
Q

what is the function of the thoracic cage?

A

provides rigidity and flexibility

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6
Q

what are the 3 types of ribs and how do they differ?

A

true ribs - costal cartilage attaches directly to sternum (sternocostal joints)
false ribs - costal cartilage attaches to cartilage above (interchondral joints)
floating ribs - dont attach to sternum

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7
Q

where does the head of the rib articulate?

A

superior demi-facet of corresponding vertebra and inferior demi-facet of vertebra superior to it
(costovertebral joints)

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8
Q

where does the tubercle of the rib articulate?

A

transverse process of corresponding vertebra
(costotransverse joints)

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9
Q

what are the 4 atypical ribs in terms of articulation?

A

1, 10, 11, 12

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10
Q

what separates the thoracic and abdominal cavities?

A

diaphragm

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11
Q

what does the inferior thoracic aperture do?

A

provides attachment for the diaphragm

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12
Q

what does the superior thoracic aperture separate?

A

the thoracic cavity and the neck/upper limb

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13
Q

name the 3 attachments of the diaphragm

A

L1-3 vertebrae
inferior costal cartilages and adjacent ribs
xiphoid process

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14
Q

what nerve is the diaphragm supplied by?

A

phrenic nerve (contributions from C3-5)

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15
Q

what is the purpose of diaphragmatic apertures?

A

permit structures to pass between thorax and abdomen

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16
Q

name the 3 diaphragmatic apertures and what structures pass through

A

canal opening - IVC
esophageal hiatus - oesophagus
aortic hiatus - aorta

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17
Q

describe external intercostal muscles in terms of where they occupy, muscle fibre direction and when they’re most active

A

occupy intercostal spaces from posterior to costochondral junction
fibres run anteroinferiorly
most active during inspiration

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18
Q

describe internal intercostal muscles in terms of where they occupy, muscle fibre direction and when they’re most active

A

occupy intercostal spaces from anterior to angle of ribs
fibres run anteroposteriorly
most active during expiration

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19
Q

where does the intercostal neurovascular bundle lie?

A

between internal and innermost intercostals
(innermost = deep internal layer)

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20
Q

what happens when ribs are elevated?

A

anteroposterior and lateral dimentions of the thorax increase

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21
Q

what happens to the dimentions of the thoracic wall when the diaphragm is contracted?

A

superoinferior dimentions increase

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22
Q

what are the accessory muscles of respiration and how do they assist?

A

arm/pectoral girdle allow neck/arm muscles to assist rib elevation in forced breathing
abdominal muscles assist forced expiration

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23
Q

what forms the intercostal nerves?

A

anterior rami of T1-11 spinal nerves

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24
Q

what forms the subcostal nerve?

A

anterior ramus of T12 spinal nerve

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25
Q

in what order are the major vessels found in the intercostal neurovascular bundle (from S -> I)

A

intercostal vein, intercostal artery, intercostal nerve
VAN

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26
Q

what are the originations of the intercostal arteries?

A

posterior - aorta
anterior - internal thoracic artery (branches)
both IC arteries anastomose

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27
Q

what does the internal thoracic artery originate from and what does it bifurcate into?

A

originates from subclavian artery
bifurcates into musculophrenic and superior epigastric arteries

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28
Q

what 2 blood vessels expand to maintain blood supply when there is a stricture of the proximal aorta?

A

internal thoracic and anterior IC arteries

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29
Q

what are the 3 compartments of the thoracic cavity?

A

pulmonary cavities (L and R)
mediastinum

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30
Q

what 2 layers of pleura surround each lung?

A

parietal (superficial)
visceral (deep)

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31
Q

what is the function of the serous fluid inbetween the serous membranes of the lung? (visceral/parietal pleura)

A

lubrication

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32
Q

what are pleural recesses?

A

potential spaces between costal and diaphragmatic pleura that the lungs can move into during inspiration

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33
Q

what is pectus excavatum?

A

chest wall indentation into thoracic space

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34
Q

what is pectus carinatum?

A

pigeon’s chest - chest wall protrusion

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35
Q

name 3 abnormailities that can occur in the pleural cavity

A

(tension) pneumothorax
hydrothorax/haemothorax
mesothelioma

36
Q

what does tension pneumothorax limit?

A

ventilation and venous return

37
Q

where would you insert a tube/train to decompress a pneumothorax?

A

midclavicular line, 2/3rd intercostal space, closer to lower rib

38
Q

what is a flail segment?

A

3 (or more) consecutive ribs broken in 2 places each

39
Q

what deformities are seen in a flail segment during inhalation?

A

un-coordinated movement, poor inflation (poor gas exchange), pain, wrong direction of movement

40
Q

what is administered when in rib pain?

A

nerve block - image guidance (ultrasound) used to inject local anaesthetic to reduce pain and encourage normal breathing

41
Q

what is lung contusion?

A

bruised lung

42
Q

what comprises the upper respiratory tract?

A

nasal cavity, pharynx, larynx

43
Q

what comprises the lower respiratory tract?

A

trachea, primary bronchi, lungs

44
Q

what are paranasal sinuses?

A

air filled cavities beside the nose

45
Q

what are the differences between the left and right bronchus?

A

right is more vertical, greater diameter and shorter than left

(foreign body more likely to go into right)

46
Q

what are the 3 lobes of the lung?

A

superior (L/R)
middle (R)
inferior (L/R)

47
Q

describe the structure of respiratory epithelium

A

pseudostratified, ciliated, columnar containing goblet cells for mucous secretion

48
Q

what is surfactant and what does it do?

A

secreted by type 2 pneumocytes

increases lung compliance and prevents lung collapse

49
Q

name the structures of the lung from superior to inferior

A

apex
hilum
bronchus
pulmonary artery
pulmonary vein

50
Q

name the borders/surfaces of the lung from medial to lateral

A

mediastinal surface
inferior border
base
anterior border
costal surface

51
Q

what separates the lung lobes?

A

oblique fissure - separates superior/middle from inferior (L/R)

horizontal fissure - separates inferior/middle from superior (R)

52
Q

what does the pulmonary ligament do?

A

holds pulmonary arteries/veins in place

53
Q

what is the function of the nasal cavities and paranasal sinuses in breathing?

A

filter/warm/humidify air and detect smells

54
Q

what is the function of the pharynx in breathing?

A

conducts air to larynx (chamber shared with digestive tract)

55
Q

what is the functions of the larynx in breathing?

A

protects opening to trachea
contains vocal chords

56
Q

what is the function of the trachea/bronchi in breathing?

A

filters air
traps particles in mucous
(cartilages keep airway open)

57
Q

what is the general function of the lungs in breathing?

A

air movement through volume changes during rib/diaphragm movements (in airways and alveoli)

58
Q

what is the function of the alveoli in breathing?

A

acts as gas exchange sites between air and blood

59
Q

what is the respiratory unit?

A

basic physiological lung unit consisting of respiratory bronchioles, alveolar ducts and alveoli

60
Q

what are the functions of type 1 and 2 epithelial cells in alveoli?

A

type 1 - gas exchange site

type 2 - produce pulmonary surfactant to reduce surface tension

61
Q

where are the apex and base of the lungs?

A

apex - above 1st rib and just above clavicle

base - ribs 8-12 (sits on diaphragm)

62
Q

what is the lingula?

A

protruding aspect of the superior left lung

63
Q

what is the cardiac notch?

A

a left lung indentation superior to the lingula protrusion

64
Q

what structures are found in the root of the lung?

A

bronchi
pulmonary artery/vein
nerves
lymphatics

65
Q

what is the hilum?

A

area of lung where each structure enters and leaves

66
Q

what is the general arrangement of the hilum?

A

pulmonary artery superiorly
pulmonary vein inferiorly
bronchi posteriorly

67
Q

explain the segmentation of the bronchi

A

primary bronchi branch into secondary (lobar) bronchi (L2, R3)

secondary bronchi branch into tertiary bronchi (L8, R10)

68
Q

what do tertiary bronchi supply?

A

the bronchiopulmonary segment

69
Q

explain the pulmonary circulation of the lung

A

pulmonary artery enters through hilum

segments into lobar then segmental arteries

goes through capillaries

moves into segmental then lobar veins

enters pulmonary vein then heart

70
Q

explain the course of the left vagus nerve

A

branches into left recurrent laryngeal nerve
hooks around right subclavian artery before travelling to larynx

71
Q

explain the course of the right vagus nerve

A

branches into right recurrent laryngeal nerve
hooks around aortic arch before travelling to larynx

72
Q

explain the function of the recurrent laryngeal nerves and the consequences of damage to these nerves

A

innervate aortic arch

impairment to nerve, speech, breathing and coughing when damaged

73
Q

how can a phrenic nerve injury be sustained?

A

medical harm - surgery, chiropractor

trauma - blunt, penetrating

central - spinal cord injury/compression

74
Q

what are the 2 divisions of the respiratory system?

A

conducting - nasal cavities to terminal bronchioles

respiratory - respiratory bronchioles to alveoli

75
Q

what is the trachea supported by and what are the structures composed of?

A

10-12 C-shaped hyaline cartilages

chondrocytes embedded in cartilage

smooth muscle joins ends of C-shape cartilage posteriorly

76
Q

what is the function of seromucous glands?

A

found in trachea lumen
produce mucous secretions delivered to surface by ducts
supports goblet cell function

77
Q

what changes are observed when bronchi segment from primary to tertiary?

A

size decrease
irregular cartilage plates on walls become smaller and fewer
seromucous glands decrease

78
Q

what are bronchioles composed of?

A

mostly smooth muscle
larger broncioles lined with simple ciliated columnar epithelium with few goblet cells

79
Q

what changes are observed in bronchiole structure as they decrease in size?

A

epithelium changes to simple cuboidal with few ciliated cells and more club cells

80
Q

explain the branching of the terminal bronchioles

A

terminal bronchioles -> respiratory bronchioles (gas exchange begins here) -> alveolar ducts -> alveolar sacs -> 2-3 alveoli

81
Q

explain the structure of type 1 pneumocytes

A

squamous with flat, dark, oval nuclei and very thin cytoplasm
mostly found on alveolar surface

82
Q

explain the structure and additional function of type 2 pneumocytes

A

cuboidal cells mainly in alveolar space

progenitor cells that proliferate to replace pneumocytes after lung damage

83
Q

what does the blood-air barrier contain?

A

type 1 pneumocytes
capillary endothelial cells
fused BM of these cells in the middle

84
Q

what is found in the inferior mediastinum region?

A

anterior - fat, thymus

middle - heart

posterior - aorta, oesophagus

85
Q

what is found in the superior mediastinum region?

A

upper - T1 posteriorly

lower - sternal angle (rib 2 landmark)

86
Q

what are the physical characteristics of arteries in alveoli?

A

thin walled
highly compliant
larger diameter
lower resistance (than systemic)

1st Year Med (52 decks)

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