Unit 7 Trachea Lungs, Posterior Mediastinum

Question 1

Where does the trachea begin and end in adults?

Answer 1

CV6-TV5 (10-12cm long)

Question 2

What is the last cartilage of the trachea called?

Answer 2

carina

Question 3

What is the subcarinal angle? Which bronchus is more angles?

Answer 3

about 62 degrees, the left has a more acute angle, longer, and less wide

Question 4

Where is the location of the apex of the lung?

Answer 4

superior, projects above the clavicle, but not above the first rib

Question 5

At what point in the pleural cavity is the lung not free?

Answer 5

hilus, which contains the lung root and pulmonary ligament (3)

Question 6

How many fissures/lobes does the right lung have?

Answer 6

2 fissues (oblique and horizontal), 3 lobes

Question 7

What are the segments of the upper lobe of the right lung?

Answer 7

apical, posterior and anterior

Question 8

What are the segments of the middle lobe of the right lung?

Answer 8

lateral and medial

Question 9

What are the 5 segments of the lower lobe of the right lung?

Answer 9

superior, medial basal, anterior basal, lateral basal, posterior basal

Question 10

Where does the oblique fissure of the right lung begin?

Answer 10

at the fifth rib

Question 11

Where is the horizontal fissure located?

Answer 11

begins at 6th rib in mid axillary line

Question 12

How many fissures/ lobes does the left lung contain?

Answer 12

the left lung has 1 fissure with 2 lobes

Question 13

What is the bronchopulmonary segement of the lung?

Answer 13

a part of a lung serve by one segmental bronchus

Question 14

What supplies the blood to the lung?

Answer 14

right and left pulmonary arteries, bronchial arteries, inferior and superior pulmonary veins

Question 15

What are the main lymphatics of the pumonary system?

Answer 15

superficial and deep plexus

Question 16

What are the three nodes of the deep pulmonary plexus, and where are they located?

Answer 16

pulmonary located in bronchopulmonary segments, bronchopulmonary located near lobar bronchi, tracheobronchial nodes near primary bronchi (both superior and inferior)

Question 17

Where does the esophagus begin? What structure is it a continuation of?

Answer 17

C6, continuation of the pharynx

Question 18

What are the four layers of the esophagus?

Answer 18

the tunica mucosa, the tunica submucosa, the muscularis mucosa, and adventitia

Question 19

What arteries supply the esophagus?

Answer 19

inferior thyroid supplies the upper; bronchial, esophageal, and mediastinal supply middle; esophageal branch of left gastric supplies lower

Question 20

What veins drain the esophagus?

Answer 20

the inferior thyroid and azygos drain to the superior vena cava (upper), lower veins drain into the portal system via the esophageal branches of the left gastric

Question 21

What innervates the esophagus? What forms this?

Answer 21

esophageal plexus, both vagus nerves

Question 22

What does the descending aorta become as it passes through the diaphram?

Answer 22

the abdominal aorta

Question 23

What are the branches of the descending thoracic aorta?

Answer 23

3rd through 11th intercostal arteries, two left bronchial arteries, esophageal arteries, mediastinal and pericardial, superior phrenic

Question 24

Into which veins could the first intercostal space drain?

Answer 24

brachiocephalic or vertebral

Question 25

Where do the 2 or 3 spaces below the 1st intercostal space drain on each side of the body?

Answer 25

left side drains into the brachiocephalic through superior intercostal vein, on the right side it drains into the azygos through the superior intercostal vein

Question 26

from where does the azygos vein proper originate?

Answer 26

from right ascending lumbar vein

Question 27

What veins does the azygos proper receive?

Answer 27

receives right subcostal vein, lower 7 or 8 right intercostal veins, hemiazygos, accessory hemiazygos veins, and several esophageal, mediastinal, pericardial, and bronchial veins and right superior intercostal veins

Question 28

What does the azygos proper drain into?

Answer 28

superior vena cava

Question 29

From where does the hemiazygos originate? What veins drain into the hemiazygos? Where does it terminate?

Answer 29

a. begins as a continuation of the left ascending lumbar vein b. enters the thorax through the left crus of the diaphragm c. drains left subcostal and lower 3 intercostal veins d. crosses TV9 to empty into the azygos vein.

Question 30

What veins the accessory hemiazygos drain? Where does it terminate?

Answer 30

accessory hemiazygos vein drains the middle intercostal veins on the left, crossing TV8 to empty into the azygos vein

Question 31

What are the three types of parietal lymph nodes of the thorax?

Answer 31

sternal (parasternal or internal thoracic) nodes near internal thoracic vessels; intercostal nodes related to the heads and necks of the ribs; phrenic nodes lie on the diaphragm

Question 32

What are the three types of phrenic nodes?

Answer 32

a. anterior nodes lie in the region of the xiphoid process (1) receive lymph from liver, diaphragm, anterior abdominal wall and middle phrenic nodes (2) drain upward to sternal or internal thoracic nodes b. lateral or middle nodes - located near the points where the phrenic nerves pierce the diaphragm (1) receive lymph from the diaphragm and on the right side from the liver HA-7-5 (2) most drain into the anterior phrenic nodes, but some goes to the posterior phrenic nodes c. posterior nodes - related to crura of the diaphragm adjacent to the thoracic aorta (1) receive lymph from diaphragm and middle phrenic nodes (2) drain upwards to the posterior mediastinal nodes

Question 33

What are the visceral lymph nodes of the thoracic cavity?

Answer 33

**1. anterior mediastinal lymph nodes** - lie in relationship to the brachiocephalic veins and are in the superior mediastinum a. includes the brachiocephalic nodes b. sternal nodes tend to join these **2. tracheobronchial nodes** a. located in the vicinity of the tracheal bifurcation and hilus of lungs b. receive paratracheal vessels from above and superficial and deep vessels from the lungs **3. posterior mediastinal lymph nodes** a. located around esophagus, aorta, and soft tissues of the posterior mediastinum 4. the above 3 sets of nodes drain into the **bronchomediastinal lymph trunk** a. empties into right **lymphatic duct or thoracic duc**t, or directly into terminal part of the subclavian vein b. joined by jugular and subclavian lymph trunks 5. **thoracic duct** - major lymph vessel of the body

Question 34

Where does the thoracic duct drain?

Answer 34

empties into the angle of junction of the internal jugular vein and the left subclavian vein or the subclavian vein itself

Question 35

Which nerves contribute white rami to the sympathetic drunk?

Answer 35

all 12 thoracic nerves and the first two lumbar nerves contribute white communicating rami to the trunk

Question 36

What fibers are found in the white rami?

Answer 36

(1) fibers of preganglionic neurons carrying impulses from the spinal nerve to the sympathetic trunk (2) visceral sensory impulses back to the spinal nerve

Question 37

Which spinal nerves receive grey rami?

Answer 37

all spinal nerves receive gray communicating rami from the trunk

Question 38

What type of nerve fibers are contained within the grey rami?

Answer 38

fibers of postganglionic sympathetic neurons carrying impulses to smooth muscle and glands in the skin areas served by the spinal nerves

Question 39

What type of nerve fibers are found in the greater splanchnic nerve?

Answer 39

contains mainly preganglionic sympathetic, some postganglionic sympathetic fibers and sensory fibers

Question 40

What is given off the greater splanchnic nerve, and what do these contain?

Answer 40

esophageal branches are given off along the way which contain postganglionic sympathetic fibers

Question 41

What is formed by visceral branches of the 10th and 11th thoracic segments?

Answer 41

visceral branches from the 10th and 11th thoracic segments form the lesser splanchnic nerve which also goes to the abdominal cavity

Question 42

What can be formed by the 12th thoracic segment?

Answer 42

least splanchnic

Question 43

From which spinal nerves does the phrenic nerve originate from?

Answer 43

CV3,4,5