Anatomy

Question 1

what bones are there within the resp system?

Answer 1

sternum
12 pairs of ribs
12 thoracic vertebrae

Question 2

what is the thorax inlet?

Answer 2

located at cross roads of sternum and clavicle and ribs.
important anatomical landmark
the space at the top of the rib cage to allow access

Question 3

what is the costal facet?

Answer 3

site connection between rib and vertebrae

Question 4

how are ribs 1 to 10 attached to sternum?

Answer 4

via costal cartilage

Question 5

describe the 12 ribs

Answer 5

7 true pairs
3 false pairs
2 floating pairs

Question 6

where is rib 1?

Answer 6

flat and under clavicle

Question 7

describe thoracic vertebrae shape

Answer 7

• Heart shaped body
• Small circular, vertebral foraman
• Laminae are broad and overlap with those of the vertebrae
• Long downward pointing spinous process

Question 8

what is the sternal angle?

Answer 8

important landmark
point at which costal cartilage of second rib articulates with sternum

Question 9

where is the 2nd ICS?

Answer 9

below the 2nd Rib

Question 10

what is the superficial IC?

Answer 10

external

Question 11

how do the external IC muscles run?

Answer 11

fibres run downwards and forwards

Question 12

what is the middle layer of IC?

Answer 12

internal IC

Question 13

describe internal IC

Answer 13

fibres run downwards and backwards

Question 14

why do the IC muscles run in different directions?

Answer 14

provide stability and strength

Question 15

what is the deep IC layer?

Answer 15

innermost IC muscles

Question 16

where do the posterior IC arteries arise from?

Answer 16

thoracic aorta

Question 17

where do the anterior IC arteries arise from?

Answer 17

internal thoracic and musclephrenic

Question 18

where do the posterior intercostal veins drain into ?

Answer 18

azygos system

Question 19

what is the azygous system?

Answer 19

locates either side of vertebrae column and drains viscera within mediastinium as well as back of thoracic/ abdo walls.

Question 20

where do the anterior IC veins drain into?

Answer 20

internal thoracic or musclophrenic

Question 21

where do the intercostal nerves arise from?

Answer 21

ventral rami at T1-T11 to supply muscle, adjacent skin and pleura

Question 22

describe the diaphragm

Answer 22

• Dome shaped skeletal muscle with a central tendon (anchors heart in place)
• Attached to xiphisternum, costal margin, 11th and 12th ribs and lumbar vertebrae
• Openings for IVC, oesophagus and aorta
• Fibrous pericardium fused to central tendon –

Question 23

what innervates the diaphragm?

Answer 23

phrenic nerve

Question 24

where do muscle fibres of the diaphragm arise from?

Answer 24

radially from margins of inferior thoracic aperture and converge at central tendon

Question 25

what happens to the dome height, when the diaphragm contracts?

Answer 25

decreases so that thorax volume increases

Question 26

what percentage of breathing is caused by diaphragm?

Answer 26

70-75%

Question 27

what does the pectoralis major allow movement for?

Answer 27

adduction and medial rotation, flexion of humerus at shoulder joint

Question 28

what is the role of the pectoralis minor?

Answer 28

depresses tip of shoulder and protracts scapula

Question 29

where are the sternocleidomastoid and scalenes muscles?

Answer 29

deep - running from chest up to neck

Question 30

describe the lungs shape

Answer 30

- Conical shaped with soft, spongy texture - Apex of lung lies above the clavicle – rises 3-4cm above level of the first costal cartilage. The highest point of the apex is up to 2cm above medial third of clavicle/ just above neck of first rib.

Question 31

where is the costal surface of the lungs?

Answer 31

adjacent to the ribs - smooth and convex as it is adapted to thoracic wall shape

Question 32

what is the mediastinum surface of the lungs?

Answer 32

faces mediastinum deeply concave - as it is moulded to cardiac impression

Question 33

which lung is wider and shorter?

Answer 33

right lung

Question 34

how many lobes does the right lung have?

Answer 34

three - superior middle and inferior

Question 35

how many fissures does the right lung have?

Answer 35

2 - oblique (downwards) and horizontal (across)

Question 36

how many lobes does the left lung have?

Answer 36

2 - superior and inferior

Question 37

how many fissures does the left lung have?

Answer 37

one - oblique

Question 38

where is the hilum of the lung?

Answer 38

located on mediastiatinal surface, where pulomanary vessels, bronchi, lymphatic vessels enter/ leave the lung

Question 39

what are the characteristics of the lungs?

Answer 39

- Compliance (distensibility) : ability of lungs to expand – connective tissue structure, level of surfactant, mobility of thoracic cage - Elasticity – elastic tissue allows lung expansion during inspiration and recoil during expiration

Question 40

what is the pleural cavity lined with?

Answer 40

mesothelial membrane called pleura

Question 41

how many layers of serous membrane does pleura contain?

Answer 41

2

Question 42

what are the two layers of serous membrane in pleura?

Answer 42

visceral - adheres to heart parietal - adheres to thoracic wall

Question 43

what innervates the pleura?

Answer 43

visceral - innervated by CNS - autonomic parietal - innerved by somatic - helps expansion

Question 44

what is the pleural cavity?

Answer 44

potential space between parietal and visceral layers containing thin serous fluid

Question 45

accessory muscles are used during heavy breathy/ resp pathology, which muscles are these?

Answer 45

scalene, sternocleidomastoid, pectoralis major, trapezius, external intercostal

Question 46

describe the pathway of external intercostal muscles?

Answer 46

from back and come toward the middle (down slope)

Question 47

describe the structure of the internal intercostal muscles?

Answer 47

from front and slope downwards towards the back

Question 48

describe the diaphragm movement during inhalation and exhalation

Answer 48

at rest - relaxed inhalation - contracting exhalation - relaxed

Question 49

what is resp rate influenced by?

Answer 49

stress, blood gases, infection

Question 50

what is the function of the conduction zone?

Answer 50

filters, warms and moistens

Question 51

what is included within the conduction zone?

Answer 51

trachea, primary bronchi, secondary bronchi, tertiary bronchi

Question 52

what is the trachea made up of?

Answer 52

hyaline cartilage in a horse shoe shape - prevents closure , back of the trachea is trachelis muscle - can constrict

Question 53

what cells make up the trachea and following structures of the conduction zone and why?

Answer 53

modified pseudostratified columnar epithelial cells with goblet cells - goblet produce mucus - epithelial produce cilia

Question 54

what are the non cilia cell types within the end of the conduction zone (tertiary bronchi)

Answer 54

non-ciliated columnar cells

Question 55

what occurs within the respiratory zone?

Answer 55

gas exchange

Question 56

what does the respiratory zone consist of?

Answer 56

bronchioles, terminal bronchioles, alveoli

Question 57

what are the cell types within respiratory zones?

Answer 57

simple cupboidal ciliated epithelium no cartilage elastic fibres and smooth muscle

Question 58

can bronchioles constrict?

Answer 58

yes

Question 59

how many alveoli cells do we have?

Answer 59

enough to cover a tennis court 500 million

Question 60

what is tidal volume?

Answer 60

breathing volume at rest - 500ml

Question 61

what is total lung capacity?

Answer 61

total amount of air lungs can hold

Question 62

can all air leave the lungs?

Answer 62

no - alveoli would collapse if all the air was removed

Question 63

what is vital capacity?

Answer 63

purposeful large breath out and then breath in

Question 64

what is normal O2 partial pressure?

Answer 64

10.3-13.5KPa

Question 65

what is normal CO2 partial pressure?

Answer 65

4.5-6.0 kPa

Question 66

what does VQ> 1 mean

Answer 66

well ventilated but poorly perfused

Question 67

what does VQ< 1 mean?

Answer 67

poorly ventilated, well perfused

Question 68

how can alveolar ventilation (V) and perfusion (Q) match?

Answer 68

altering bronchiole and pulmonary ateriole radius - bronchiole dilate and due to hypercapnia (HIGH CO2) - pulmonary arterioles constrict due to hypoxia - diverting blood to alveoli with more oxygen

Question 69

how does CO2 travel in the body?

Answer 69

9% in plasma 10-13% in carbamino haemoglobin 78% in bicarbonate

Question 70

what is a pneumothorax?

Answer 70

air/ fluid entering pleural cavity and will compress and collapse lung

Question 71

what is a haemothorax?

Answer 71

blood in pleural cavity causing lungs to collapse

Question 72

what is a tension pneumothorax?

Answer 72

air continues to enter pleural cavity and can not escape pushes trachea towards contralateral side

Question 73

what is the aortic knuckle on a chest X ray?

Answer 73

distal ascending aorta

Question 74

what is the costophrenic angle - seen in CXR?

Answer 74

edge of diaphragm where meets other organs

Question 75

what is costocardiac angle - seen on CXR?

Answer 75

angel between edge of heart and diaphragm

Question 76

where does trachea sit in relation to other organs?

Answer 76

sits anterior to oesophagus can be palpated above suprasternal notch left main bronchus passes under arch of aorta and is longer and narrower than right