Respiratory System - Dry Room St. 5 and 6

Question 1

How many attachements does the diaphragm have?

Answer 1

4

Question 2

How many major hiatuses (openings) does the diaphragm have?

Answer 2

3

Question 3

Identify

1.

3.

9.

11.

14.

16.

24.

25.

Answer 3

1. Xiphoid
2. Oesophagus
3. Left crus
4. Aorta
5. right crus
6. Medial arcruate ligament
7. Opening for IVC
8. Central tendon

Question 4

What does the term “diaphragm” mean?

Answer 4

A sheet of skeletal muscle stretching across the midline of the body

Question 5

Which of the left or right dome lies more superior on normal expiration and why?

Answer 5

Right dome due to the liver

Question 6

Which cardiac structure is firmly attached to the central tendon?

Answer 6

Fibrous Pericardium

Question 7

Which vertebrae are the left and right crura attached?

Answer 7

L1 - L3

Question 8

What membrane covers the superior surface of the diaphragm?

Answer 8

Parietal Pleura

Question 9

When the diaphragm contracts what happens to the domes?

Answer 9

They descend and flatten

Question 10

What is the shape of the central tendon?

Answer 10

Clover

Question 11

Which costal cartilages is the diaphragm attached to?

Answer 11

Ribs 7-10

Question 12

Which part of the sternum does the diaphragm attach?

Answer 12

Posterior aspect

Question 13

What vertebral level does the opening for the vena cava occur?

Answer 13

T8

Question 14

What vertebral level does the opening for the oesophagus occur?

Answer 14

T10

Question 15

What vertebral level does the opening for the aorta occur?

Answer 15

T12

Question 16

Which part of the diaphragm does the IVC pass and why?

Answer 16

Central tendinous part to assist venous return by making sure it isn’t constricted

Question 17

What other vein transverses the diaphragm?

Answer 17

Azygos

Question 18

What lymphatic duct transverses the diaphragm?

Answer 18

Thoracic duct

Question 19

Which nerve structures transverse the diaphragm?

Answer 19

• Sympathetic trunks
• Phrenic nerves
• Vagus nerve

Question 20

What do the phrenic nerves supply the diaphragm with?

Answer 20

• Motor (efferent)
• Sensory (afferent)

Question 21

What do the lower intercostal nerves do for the diaphragm?

Answer 21

• Provide sensory (afferent) information to the peripheral parts

Question 22

What vertebral levels contribute to the phrenic nerves?

Answer 22

• C3
• C4
• C5

Question 23

What will spinal cord injury above the phrenic nerve levels result in?

Answer 23

• Diaphragm paralysis and therefore the inability to breathe
• Quadrapelegia

Question 24

Identify the vagus and phrenic nerve

Answer 24

• Vagus nerve just above metal instrument and disappears behind structures
• Phrenics clearly running more lateral and stays visible most of the thorax

Question 25

How can breathing be maintained if the phrenic nerve is damaged?

Answer 25

• The intercostal accessory muscles can work to compensate for the loss of passive breathing

Question 26

What should be assumed of penetrating injuries just below the nipple?

Answer 26

• Damage to the diaphragm
• Due to the upward arching of the domes

Question 27

T3 CT thorax

Question 28

T4 CT thorax

Question 29

T5 CT thorax

Question 30

What vertebral level does the trachea bifurcate?

Answer 30

• T4