Wet room - practical 2 Flashcards

1
Q

What is pleura?

A

A double layer of serous membranes that surround each lung.

- Consisting of an outer parietal layer and the inner visceral layer, separated by a thin film of fluid.

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2
Q

What is the space between the 2 pleural membranes known as?

A

Pleural space or cavity

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3
Q

Which layer of the pleura enters and lines the fissures of the lungs?

A

Inner visceral pleura

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4
Q

Which layer of the pleura is sensitive to pain?

A

Parietal pleura

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5
Q

Which nerves supply pain sensation to the pleura?

A

Intercostal and Phrenic nerves

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6
Q

What pleura lies on the superior surface of the diaphragm?

A

The diaphragmatic pleura

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7
Q

What pleura lines the inner surfaces of the ribs and sternum?

A

The costal pleura

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8
Q

What could occur when pleural fluid increases due to inflammation/infection?

A

The lungs will collapse

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9
Q

What is a pleural reflection?

A

A pleural reflection occurs when the parietal pleura lining one surface of the chest wall changes its direction to line another surface

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10
Q

What is a pleural recess?

A

Formed from a pleural reflection by the parietal pleura being more widely separated from the visceral pleura during expiration

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11
Q

What is a pleural effusion?

A

Needle aspiration of excessive accumulation of fluid in the pleural space

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12
Q

What nerve supplies the mediastinal and diaphragmatic parietal pleura?

A

The phrenic nerve

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13
Q

What nerve supplies the remainder of the parietal pleura?

A

The intercostal nerves

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14
Q

How is the visceral pleura innervated?

A

The visceral pleura only has autonomic innervation (for stretch).
- Visceral pleura is innervated by the vagus nerve and sympathetic fibres. It is insensitive to pain stimuli.

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15
Q

What are the landmarks for lung-rib attachments?

A

6, 8, 10

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16
Q

What are the landmarks for parietal pleura-rib attachments?

A

8, 10 ,12

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17
Q

How many intercostal spaces difference is there between the inferior border of the lung and parietal pleura at each landmark line?

A

2 spaces

18
Q

What organ occupies the notch seen in the anterior border of the left lung between ribs 4-6?

A

The heart

19
Q

Which rib does the oblique fissure follow?

A

The 6th rib

20
Q

What level of rib does the horizontal fissure lie at?

A

The 4th rib

21
Q

What vertebrae does the posterior border of each lung extend from and to?

A

From vertebra C7 to T10

22
Q

Between which ribs is the cardiac notch present?

A

Between ribs 4-6 anteriorly

- The cardiac notch is only present on the left lung

23
Q

Which of the left or right dome of the diaphragm lies more superior during normal expiration?

A

Right dome due to the liver (which is inferior to the right dome).

24
Q

Which 3 main structures pass through the diaphragm?

A
  • Oesophagus
  • Inferior vena cava
  • Descending aorta
25
Q

What cardiac structure is firmly attached to the central tendon of the diaphragm?

A

Fibrous pericardium

26
Q

Which membrane covers the superior surface of the diaphragm?

A

Costodiaphragmatic

27
Q

What is the shape of the central tendon of the diaphragm?

A

Clover-shaped

28
Q

When the diaphragm contracts, do the domes ascend or descend?

A

They descend

29
Q

To which tendon is the diaphragm attached?

A

The central tendon

30
Q

To which costal cartilages is the diaphragm attached?

A

Costal cartilages & ribs 7-10

31
Q

To which part of the sternum is the diaphragm attached?

A

Xiphoid process

32
Q

To which vertebrae is the diaphragm attached?

A

Lumbar

33
Q

What is a hiatus?

A

A hiatus is a natural fissure in a structure (openings).

34
Q

At what vertebral level is the opening for the inferior vena cava?

A

T8

35
Q

At what vertebral level is the opening for the oesophagus?

A

T10

36
Q

At what vertebral level is the opening for the aorta?

A

T12

37
Q

What is a hiatus hernia?

A

A hiatus hernia is the abnormal protrusion (herniation) of a structure

38
Q

How is the diaphragm innervated?

A

The diaphragm is primarily innervated by the phrenic nerve which is formed from the cervical nerves C3, C4, and C5.
- Diaphragm receives motor and sensory supply on both its left and right sides and its superior and inferior surfaces.

39
Q

Which vertebral levels of the spinal cord contribute to the phrenic nerves?

A

C3-5

40
Q

What provides sensory supply to the peripheral parts of the diaphragm?

A

The lower intercostal nerves

41
Q

What does the T4/5 surface marking contain?

A
Angle of Louis 
Bifurcation of trachea 
Start of aortic arch 
Azygos arch enters 
SVC
42
Q

To which vertebrae are the left and right crura attached?

A

Left L1-L2

Right L1-L3