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Clinical Anatomy > Thorax 2 > Flashcards

Thorax 2 Flashcards

1
Q

label the 5 divisions of the mediastinum

A
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2
Q

Where does the trachea bifurcate?

A

At the level of the sternal angle into the bronchi - carina t4/5

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3
Q

what are the 5 lobes and fissures of the lungs?

A
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4
Q

which lung does not have a middle lobe and why?

A

left
apex of heart (ventricle) projects to the left

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5
Q

what is lung cardiac notch and lingula?

A

a concave impression molded to accommodate the shape of the heart

The lingula is not technically a lobe, but is the left lung equivalent of the right lung’s middle lobe.

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6
Q

How and why are the costal surfaces separated from the ribs?

A

Serous lining
Prevent damage during respiration

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7
Q

What is a bronchopulmonary segment?
What is the clinical significance of a bronchopulmonary segment?
How many bronchopulmonary segments do we have?

label them

A

An area of lung supplied by a segmental (tertiary) bronchus and accompanying pulmonary artery branch + pulmonary vein

Smallest, functionally independent unit of a lung and smallest area that can be isolated and removed without affecting adjacent regions

10 in each lung (8-10 in left) as some of them fuse in the left lung

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8
Q

Give the 3 sites of potential fusion in the left lung

A

-Fusion between apical and posterior segments of the superior lobe
-Fusion between superior and inferior lingular segments
-Fusion between medial and anterior basal; collectively termed as the anteromedial basal

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9
Q

label what u can

A
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10
Q

what does parietal and visceral pleura line?

what is the pleural cavity?

whats in it?

A

parietal - thoracic cavity
visceral - organs/ lungs

The pleural cavity is a potential space between the parietal and visceral layers.

pleural fluid

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11
Q

Where do the bronchial arteries originate from?

A

right bronchial artery x1 = from the posterior 3rd intercostal artery

left bronchial artery x2 = from aorta (descending throacic)

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12
Q

Where do the pulmonary arteries originate from?

Compare the pressure between the bronchial and pulmonary arteries

How do the bronchial and pulmonary arteries join together?

A

From the heart itself

Much higher pressure in bronchial

-Connection between the two at the capillary bed level, allows for nourishment of pulmonary as bronchial is highly oxygenated

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13
Q

Identify impressions on the lung made by adjacent structures

A

Right lung: Superior vena cava; arch of azygos vein

o Left lung: Arch of the aorta, left common carotid and subclavian arteries

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14
Q

what is in the hilum? (lung root) and how do they differ in each lung?

A

Bronchus at the BACK
Artery ABOVE the vein

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15
Q

label the divisions of the parietal pleura

A

1 - cervical
2 - costal
3 - diaphragmatic
4 - mediastinal
5 - pulmonary ligament

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16
Q

what does the pulmonary ligament do?

A
  • Allows increased
    mobility during
    respiration
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17
Q

what are the recesses of the pleural cavity? what is occupied during respiration?

A

Costodiaphragmatic recess:
* Between costal and diaphragmatic parietal pleura
* Occupied by lungs during inspiration

  • Costomediastinal recess:
  • Between costal and mediastinal parietal pleura
  • Occupied by anterior border of lungs during inspiration
18
Q

Where do important nerves pass in relation to the lung root?

A

Vagus nerve passes immediately posterior to root
Phrenic nerve immediately anterior

19
Q

Locate the pulmonary arteries, veins and bronchi in the hilum of the lungs

A
20
Q

Explain the difference in bronchus branching between the 2 lungs

A

Right: the lobar bronchus to the superior lobe branches from the main bronchus in the root
Left: branches within the lung itself

21
Q

Give the 4 layers of the trachea

A

MSCA

*Mucosa - goblet cells (mucin)
*Submucosa
*Fibrocartilage
*Adventitia - binds trachea to adjacent structures in the neck and mediastinum

22
Q

What is the function of mucous and serous glands in the trachea?

A

Secretions of mucous and serous glands moisten the air, which protects the alveoli from desiccation

23
Q

How is the trachea kept patent (open and unobstructed) ?

A

U-shaped rings of hyaline cartilage

24
Q

What is the importance of the trachealis muscle?

A

Oesophagus expansion during swallowing

25
Q

Where does the trachea begin? and while we r here, where does the eosophogus begin and end?

A

cricoid cartilage (C6) to

c6 to t11 (not t10 - thsi where it pierces diaphragm)

26
Q

What are the 3 components of the carotid sheath?

A

Carotid artery, internal jugular vein and vagus nerve

27
Q

Compare the main bronchi

A

Right main bronchus is wider and shorter (2.5cm length)
Left is narrower and longer and more horizontal (5cm length)
Foreign bodies more likely to go in right lung into middle/lower lobe bronchi

28
Q

What structures can we examine in bronchoscopy?
Give 2 functions of a bronchosopy

A

Trachea to carina
View segmental and lobar bronchi

Biopsy of mucous membrane
Removal of inhaled foreign bodies

29
Q

Give the 6 divisions of the trachea

A
30
Q

Explain the innervation of the different surfaces of the parietal pleura

A

SOMATIC nerve supply:
*Costal pleura by intercostal nerves
*Mediastinal pleura by phrenic nerve (C3-C5)
*Central diaphragmatic pleura by phrenic nerve
*Peripheral diaphragmatic pleura by lower 6 intercostal nerves
Response to touch, temperature and pressure (PAIN)

31
Q

How is the visceral pleura innervated?
What does the visceral pleura respond to?

A

ANS: pulmonary plexus from sympathetic trunk and vagus nerve
Distension, not sensitive to pain
Difficult to diagnose visceral pain therefore

32
Q

What is pleural effusion?

A

Collection of pleural fluid in the pleural cavity
Can occur during infections or cardiac surgery
Causes collapsed lung

33
Q

What is a pneumothorax?

A

Air in the pleural cavity
Collapsed lung

34
Q

Why are the lungs more resistant to infarction (lack of blood flow)?

A

Dual blood supply from bronchial and pulmonary arteries

35
Q

How many bronchial arteries are there in each lung?

A

2 in left lung (superior and inferior)
1 in right lung

36
Q

Where does the right bronchial artery arise from?
Where does the left bronchial artery arise from?

A

3rd posterior intercostal artery
Directly from the aorta

37
Q

How does the right bronchial vein drain?
How does the left bronchial vein drain?

A

Azygous then SVC

Accessory hemiazygous vein then Azygous then SVC

38
Q

Give the 5 groups of lymph nodes in the lungs

A

*Pre-tracheal and paratracheal nodes are located anterior to, and along the sides of the trachea (respectively);
*Superior tracheobronchial nodes, are seen at the superior border of the bifurcation of the trachea;
*Bronchopulmonary or hilar nodes, are located in the hilum of the lungs where the main-stem bronchi enter the lungs,
*Pulmonary or intrapulmonary nodes, are just deep to the hilum and surround the bronchi;
*Inferior tracheobronchial or subcarinal nodes are inferior to the carina of the trachea.

39
Q

Transverse thoracic plane - level

A

T4-T5

40
Q

how does a surgeon isolate the pulmonary trunk and ascending aorta

A

Transverse pericardial sinus (the pericardial cavity behind aorta and pulmonary trunk)
- During cardiac surgery, the transverse pericardial sinus allows a surgeon to isolate the pulmonary trunk and ascending aorta and apply a temporary ligature or clamp.

41
Q

Tension pneumothorax

A

Air in the pleural cavity has pushed the heart and left lung over to the right (a tension pneumothorax). Tension pneumothorax is a life-threatening condition.

Clinical Anatomy (22 decks)

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