Flashcards in Anatomy Deck (109):
What is the order of the respiratory tree?
What are the parts of the pharynx?
What level of the vertebra does the larynx become the trachea?
What level of the vertebra does the pharynx become the oesophagus?
From superficial to deep, name the parts of the chest wall?
What fluid does the pleura secrete?
What is the function of the pleural fluid?
Provides surface tension
Name the lobes and fissures of the right lung?
Lobes: superior, middle, inferior
Fissures: horizontal and oblique
Name the lobes and fissures of the left lung?
Lobes: superior, inferior
How many bronchopulmonary segments does each lung have?
The sternal angle is at the level of what rib?
What are the spaces between each rib called?
Describe the 12 thoracic ribs.
1-7: True ribs
8-10: False ribs
11+12: Floating ribs
What is the name of the combined lower costal cartilages?
The ribs articulate with the sternum via what?
the rib's costal cartiglage
What is the name of the joints that join the rib to the vertebra?
What is the name of the joints that join the rib to costal cartilage?
What is hte name of the joints that join the sternum to the costal cartilage?
What are the 3 layers of skeletal muscles located between the ribs?
external intercostal muscle
internal intercostal muscle
innermost intercostal muscl
what are the muscles of passive breathing?
What is the blood supply of the anterior parts of the intercostal spaces?
Internal thoracic artery and veins
What is the blood supply of the 11 pairs of intercostal spaces?
(ie chest wall?)
bilateral posterior intercostal arteries
What is the arterial blood supply for the lungs?
where do the bronchial arteries arise from?
thoracic aortas anterior surface
There are 2 domes of the diaphragm. Which dome is more superior?
the right dome due to the presence of the liver inferiorly
What type of muscle is the diaphragm?
(skeletal or smooth)
What is the muscular part of the diaphragm's nerve supply?
(combined C3,4,5 anterior rami)
What is the route of the phrenic nerve?
-Anterior surface of the scalenus anterior
-Lateral aspects of the fibrous pericardium
During inspiration, how does the diaphragm move?
Contracts and descends thus increasing the vertical chest cavity dimension
During inspiration how do the intercostal muscles move?
Contract, elevating the ribs and pulling the ribs laterally and anteriorly thus increasing AP and lateral chest caivty dimensions
What 2 things cause the lungs to be pulled outwards with the chest wall?
1. surface tension created by the pleural fluid
2. the potential vacuum in the pleural cavity
During expiration how does the diaphragm move?
relaxes and ascends thus decreasing the vertical chest cavity dimension
During expiration how do the intercostal muscles move?
relax and return ribs to the resting position thus decreasing the AP and lateral chest cavity dimensions.
The elastic tissue within the lungs allow what?
elastic recoil of the lungs during inspiration and expiration
From superficial to deep, name the tissue of the breast.
Lateral quadrants of the breast drain to which nodes?
Unilateral drainage to axillary nodes
Medical quadrants of the breast drain to which nodes?
Bilateral drainage to parasternal nodes
Name the two heads of the pectoralis major.
The two heads of the pectoralis major attach laterally to where?
The lateral side of the intertubercular groove of the humerous
What is the muscle that anchors the medial border of the scapula to ribs 1 to 8?
What nerve supplies the serratus anterior?
The long thoracic nerve
(a nerve from the brachial plexus)
Within the costal groove what is the order of the neurovascular bundle?
(superficial to deep)
vein, artery, nerve
What is located between the diaphragmatic parietal pleura and the costal parietal pleura?
The horizontal fissure of the right lung follows which rib?
Right rib 4
The oblique fissures run from which rib to which vertebra?
(anterior to posterior)
rib 6 anteriorly to T3 posteriorly
Why do we cough?
To protect and clear our respiratory tract
Sensory receptors in the mucosa of the respiratory tree are stimulated by what 4 things?
1. inflammatory mediators
2. irritant chemicals
3. a build up of mucus
4. certain drugs
in an up right patient, which lobe are foreign bodies most likely to be inhaled?
inferior lobe of the right lung
What is the name of the internal aspect of tracheal bifurcation?
What 2 ways can air enter the pleural cavity?
1. penetrating injury to the parietal pleura
2. rupture of the visceral pleura
how big must the gap between lung and parietal pleura be to be called a 'large' pneumothorax?
What would you find on percussion of a pnemothorax?
What would find on bilateral expansion of the chest of a pneumothorax?
reduced ipsilateral expansion
What would you find on auscultation of a pneumothorax?
reduced breath sounds
What might a tension pneumothorax cause?
tracheal deviation, SVC compression (leading to hypotension)
What 2 methods are used for managing a large pneumothorax managed?
1. needle aspiration (thoracentesis)
2. chest drain via 4/5 intercostal space in the midaxillary line)
What are the borders of the safe triangle?
-the anterior border of the latissimus dorsi
-the posterior border of the pectoralis major
-the axial line superior to the nipple
How do you manage an emergency tension pneumothorax?
large gauge cannula into the 2/3 intercostal space, midclavicular line
2 factors required for the development of the hernia?
1. weakness (usuallly of the body wall)
2. increased pressure on one side of the wall
What is it called when the herniated part of the stomach passes through the oesophageal hiatus and becomes PARALLEL to the oesophagus?
paraoesophageal hiatus hernia
What is it called when the herniated of stomach slides through the oesophageal hiatus WITH the gastrooesophageal junction?
sliding hiatus hernia
What is the weakness that is a factor for inguinal hernias?
the inguinal canal
What are possible causes for the increased intra-abdominal pressure leading to an inguinal hernia?
chronic cough, chronic constipation, lifting of heavy weights, athletic effort
What do the inguinal ligaments attach between?
ASIS and the pubic tubercle
What is the inferior border of the external oblique aponeurosis?
What is the passageway through the anterior abdominal wall in the inguinal regions called?
Where is the deep ring of the inguinal canal?
superior to the midpoint of the inguinal ligament
Where is the superficial ring?
in the external oblique aponeurosis, superolateral to the pubic tubercle
what does the spermatic cord contain?
vas deferens, testicular artery and the pampiniform venous plexus
where do the round ligaments of the uterus pass through?
the inguinal canals into the labium majus
What is a direct inguinal hernia?
Herniation through the anterior abdominal wall via the inguinal triangle
(medial to the inferior epigastric artery and vein)
What is an indirect hernia?
herniation through the inguinal canal via the deep ring (lateral to the inferior epigastic artery and vein)
what does adduction of the vocal cords cause?
closes the rima glottidis
what nerve stimulated the adduction and abdution of the vocal cords?
vagus nerve (CN X)
What does abduction of the vocal cords cause?
opens the rima glottidis
What nerve causes the soft palate to tense?
Trigeminal (CN V)
what nerve causes the soft palate to elevate?
What nerve supplies the sensory receptors of the oropharynx involved in coughing?
What nerves supplies the sensory receptors of the oropharynx, larynpharynx and larynx involved in sneezing?
Trigeminal (V) and Glosopharyngeal (Ix)
What does the carotid sheath contain?
The vagus nerve, internal carotid artery, common carotid artery and the internal jugular vein.
What nerve supplies the sensory receptors of the laryngopharynx and the larynx involved in coughing?
The vagus nerve (X)
what are the 4 sets of accessory muscles of deep inspiration?
scalenus (anterior, medius and posterior)
what type of muscle are the intrinsic muscles of the larynx?
(smooth or skeletal)
the intrinsic muscles of the larynx are supplied by which nerve?
Vagus nerve (CN x)
which foramen in the base of the skull does the vagus nerve pass through?
(then descends through carotid sheath)
Do the vagus nerves descend anterior or posterior to the lung root?
what are the 3 anterolateral abdominal wall muscles?
external oblique, internal oblique, transversus abdominus
the aponeurosis's of the anterolateral abdominal muscle blend at what midline structure?
what is the name of where the anterolateral abdominal muscle fibres end and the aponeurosis begins?
the linea semilunaris
the external intercostal and external obliques run in which direction?
inferomedially (as if hands go in pockets)
the internal intercostal and internal obliques run in which direction?
the external obliques attach inferiorly where?
anterior part of the iliac crest and the pubic tubercle
the external obliques attach superiorly where?
superficial aspects of the lower ribs
the internal obliques attach inferiorly where?
the iliac crest and the thoracolumbar fascia of the lower back
the internal obliques attach superiorly where?
inferior border of the lower ribs
the transversus abdominus muscle fibres run in what direction?
the transversus abdominus attaches superiorly where?
deep aspects of the lower ribs
the transversus abdominus attaches inferiorly where?
the iliac crest and the thoracolumbar fascia of the lower back
the rectus sheath is composed of what?
the aponeuroses of the external oblique, internal obliqe, transvesus abdominus
what divides the rectus abdominus? (ie to form a 6 pack)
from what vertebra do the thoracoabdominal nerves that originate as intercostal nerves leave?
T7 to T11
the thoracoabdominal nerves run in a plane between what muscles?
internal oblique and transversus abdominus
what vertebra does the subcostal nerve (a thoracoabdominal nerve) leave from?
T12 anterior ramus
what vertebra does the iliohypogastric nerve (a thoracoabdominal nerve) leave from?
half of L1 anterior ramus
What type of nerves do the thoracoabdominal nerves contain?
somatic motor, somatic sensory and sympathetic nerve fibres
What vertebra does the ilioinguinal nerve (a thoracoabdominal nerve) leave?
half of L1 anterior ramus
tonic contractions of the abdominal muscles do what?
maintain posture and support the vertebral column
What do guarding contractions of abdominal muscles do?
protect the abdominal viscera