Anatomy

Question 1

Where would you palpate for the trachea?

Answer 1

In the jugular notch of the manubrium

Question 2

Name the chest walls, in order from superficial to deep.

Answer 2

Skin
Fascia (superficial and deep)
Skeletal muscle
Bones and joints
Parietal pleura

Question 3

What do the chest walls do?

Answer 3

Protect internal organs
Make movements of breathing
Include breast tissue

Question 4

What is the chest cavity?

Answer 4

It is located within the chest walls.
It contains vital organs, great vessels and nerves.
It consists of the mediastinum and the right and left pleural cavities

Question 5

WHat is the function of pleural fluid?

Answer 5

Acts as lubricant

Provides surface tension

Question 6

What is the pleural cavity between?

Answer 6

The visceral pleura and the parietal pleura.

Question 7

What level is the sternal angle at?

Answer 7

The level of rib 2

Question 8

Where is the costal margin?

Answer 8

Combined lower costal cartilages

Question 9

What does the rib tubercle do?

Answer 9

Articulates with the transverse process of the vertebra of the same number.

Question 10

What does the head of the rib do?

Answer 10

Articulates with the body of the vertebra of the same number and the body of the vertebra superiorly

Question 11

What does the azygous vein do?

Answer 11

Drains the posterior parts of the intercostal spaces.

Question 12

What does the thoracic aorta do?

Answer 12

Supplies the posterior parts of the intercostal spaces.

Question 13

What supplies the anterior parts of the intercostal spaces?

Answer 13

The internal thoracic artery and veins. These course vertically either side of the deep surface of the sternum.

Question 14

What is the 4th intercostal nerve also called? What would this do?

Answer 14

T4 anterior ramus. This would supply all the layers/structures of the right 4th intercostal space

Question 15

What does the muscular part of the diaphragm attach do?

Answer 15

The sternum
The lower 6 ribs and their costal cartilages
L1 -L3 bodies.

Question 16

What supplies the diaphragm?

Answer 16

The phrenic nerve; C3, 4 & 5

Question 17

What is the phrenic nerve?

Answer 17

The combined anterior anterior rami of spinal nerves C3, 4 and 5

Question 18

Where would you find the phrenic nerve?

Answer 18

In the neck, on the anterior surface of the scalenus anterior.
In the chest, descending over the lateral aspect of the fibrous pericardium

Question 19

What does the phrenic nerve supply?

Answer 19

Somatic sensory nerve
Sympathetic axons tot he diaphragm and fibrous pericardium
Somatic motor axons to the diaphragm

Question 20

What is the visceral pleura?

Answer 20

The outermost layer of the lung and the internal lining of the pleural cavity

Question 21

Describe the five stages of inspiration:

Answer 21

1. Diaphragm contracts and descends increasing the vertical chest cavity dimension
2. Intercostal muscles contract elevating the ribs and pulling the ribs anteriorly and laterally. This increases chest dimension.
3. The chest walls pulls the lungs outwards with them due to surface tension and the potential vacuum becoming an actual vacuum.
4. The lungs expand
5. Air flows into the lungs down a pressure gradient,

Question 22

Describe the mechanism by which potential vacuum becomes an actual vacuum?

Answer 22

The chest walls begin to move and suck the visceral pleura towards the moving parietal pleura.

Question 23

Describe the five stages of expiration:

Answer 23

1. Diaphragm relaxes and ascends decreasing th vertical chest cavity dimension
2. The intercostal muscles relax returning the ribs to a resting position and decreasing chest cavity dimension
3. Chest walls return to resting position, relaxing the stretch on the lungs and so surface tension decreases and actual vacuum becomes potential vacuum
4. Lungs elastically recoil
5. Air flows out of the lungs down a pressure gradient

Question 24

What are the branches of the intercostal nerves called?

Answer 24

Lateral and anterior cutaneous nerves.

Question 25

Where does the cephalic vein lie?

Answer 25

In the top of the arm, in the delto - pectoral groove

Question 26

What is the origin of the long thoracic nerve?

Answer 26

Brachial plexus

Question 27

What does the long thoracic nerve supply?

Answer 27

The serratus anterior via superficial surface

Question 28

What does the serratus anterior muscle do?

Answer 28

Anchors the medial border of the scapula to ribs 1 to 8

Question 29

What does injury to the long thoracic nerve result in?

Answer 29

Paralysis of the serratus anterior and a winged scapula.

Question 30

What structures are in the root of the lung?

Answer 30

``` 1 main bronchus 1 pulmonary artery 2 pulmonary veins Lymphatics Visceral afferents Sympathetic nerves Parasympathetic nerves ```

Question 31

What sensory receptors need to be stimulates in order for a cough to occur?

Answer 31

In the… 1. oropharynx 2. larynogopharynx 3. Larynx 4. Respiratory tree

Question 32

Briefly describe the five stages involved in coughing.

Answer 32

1. Deep inspiration 2. Adduction of vocal chords 3. Contraction of anterolateral abdominal wall muscles by intercostal nerves 4. Vocal chords abduct to open rima glottidis (vagus) 5. Soft palate tenses and elevates (vagus) to close of entrance into nasopharynx

Question 33

What cranial nerves sensory receptors are stimulated in coughing?

Answer 33

9 and 10 | Glossopharyngeal and vagus

Question 34

What is the carotid sheath and what does it contain (right side)

Answer 34

It is a protective tube of cervical deep fascia and attaches superiorly to the base of the skull. Contains - Vagus nerve - Internal carotid artery - Common carotid artery - Internal jugular vein

Question 35

What is contained within the pulmonary plexus?

Answer 35

Sympathetic axons Parasympathetic axons Visceral afferents

Question 36

How do the pulmonary visceral afferents reach the CNS?

Answer 36

They travel from the visceral pleura and respiratory tree to the plexus and then follow the vagus nerve to the medulla of the brainstem.

Question 37

How do motor axons travel to the lungs?

Answer 37

Motor axons travel from the tracheal bifurcation along the branches of the respiratory tree to supply all the mucous glands and bronchiolar smooth muscles.

Question 38

Where does the phrenic nerve supply somatic sensory and sympathetic axons to?

Answer 38

1. The fibrous pericardium 2. The mediastinal parietal pleura 3. The diaphragmatic parietal pleura 4. The diaphragmatic parietal peritoneum Somatic motor axons to the diaphragm

Question 39

What are the accessory muscle of inspiration?

Answer 39

1. Pectoralis major 2. Pectoralis minor 3. Sternocleidomastoid 4. Scalenus anterior, posterior and medius

Question 40

How does the vagus nerve descend through the neck?

Answer 40

Carotid sheath

Question 41

Where does the vagus nerve descend in the chest?

Answer 41

Posterior to the lung root to supply parasympathetic axons to chest organs including the lungs (pulmonary plexus)

Question 42

How doe stye vagus nerve pass into the diaphragm?

Answer 42

On the oesophagus

Question 43

Where does the vagus nerve finally divide?

Answer 43

On the surface of the stomach, into many parasympathetic branches for the foregut and midgut organs.

Question 44

What is the rectus sheath?

Answer 44

Surrounds the rectus abdominus muscles and is made from the aponeuroses of the other abdominal wall muscles (obliques and transversus abdominus)