Anatomy

Question 1

Name the joint between the sternum and manubrium

Answer 1

manubrial sternum joint, also known as angel of louis. Convex point at rib II

Question 2

Three bony parts of midline thorax

Answer 2

Manubrium, sternum, xiphisternum

Question 3

Name the ridge at the top of the manubrium

Answer 3

Jugular notch

Question 4

Name the part of the rib where the neuromuscular bundle sits

Answer 4

Costal groove

Question 5

How many cervical, thoracic, lumbar and sacral vertebrae

Answer 5

7 cervical, 12 thoracic, 5 lumbar, sacrum, coccyx

Question 6

Name the ligaments in the diaphragm

Answer 6

Median arcuate, medial arcuate (left and right), lateral arcuate (left and right)

Question 7

Name the structure on the left and right sides of the median arcuate ligament that attached part of the diaphragm to LIII vertabrae

Answer 7

Left and right crus

Question 8

Name the connective tissue in the centre of the diaphragm

Answer 8

Central tendinous area

Question 9

What structure passes inferior to the median arcuate ligament

Answer 9

The aorta

Question 10

What structure passes through the central tendinous area

Answer 10

The inferior vena cava

Question 11

What travels with the inferior vena cava

Answer 11

The right phrenic nerve

Question 12

Where does the right phrenic nerve pass

Answer 12

Pierces anterior to hilum of lungs and then alongside vena cava at T8

Question 13

Where does the oesophagus pass

Answer 13

Through the oesophageal hiatus superior to the median arcuate ligament

Question 14

What travels with the aorta

Answer 14

lymphatic plexus

Question 15

What is the parasympathetic supply for the respiratory system

Answer 15

Vagus nerve from Cranial nerve X

Question 16

What effect does parasympathetic (vagal) stimulation have

Answer 16

Decrease heart rate, decrease CO, constrict bronchioles

Question 17

Name the somatic supply for respiratory system

Answer 17

Intercostal nerves (1-12), phrenic nerves.

Question 18

Where does the phrenic nerves branch from

Answer 18

Cranial nerves 3, 4, 5 (keep you alive)

Question 19

Sympathetic supply

Answer 19

Sympathetic chain T1-L2

Question 20

Name the structure that passes under the medial arcuate ligaments

Answer 20

The psoas major muscles

Question 21

Name the structure that passes under the lateral arcuate ligaments

Answer 21

The quadrates lamborum muscles

Question 22

Name the three structures that exit the diaphragm and at what spinal level

Answer 22

T8 inferior vena cava , T10 oesophagus, T12 Aorta

Question 23

Describe the path of left phrenic nerve

Answer 23

From C3, C4, C5, anterior to hila of the lungs, travels along left side of pericardium and pierces diaphragm

Question 24

Describe the path of the right phrenic nerve

Answer 24

C3, C4, C5, runs in front of anterior scalene muscles, enters the thorax by passing deep to subclavian vein, anterior to hila of the lungs, travels with IVC through vena cava hiatus at T8

Question 25

Describe the path of the vagus nerve

Answer 25

Posterior to hila of lungs

Question 26

What happens if you get right side phrenic nerve damage

Answer 26

The right side of the fails to contract (where it moves down increasing thoracic cavity)

Question 27

Name and describe the joint connecting the sternum and the clavicle

Answer 27

Sternoclavicular joint; clavicular notches on sternum meet sternum ends of clavicle separated by an articular disc of fibrocartilage

Question 28

Clinical significance of the angle of louis

Answer 28

2nd rib, Between T4, T5 vertebrae. Marks where the aortic arch begins Where bifurcation of the trachea to left and right main bronchi occurs

Question 29

Describe primary and secondary curvatures of the spine

Answer 29

Primary curvatures are anteriorly concave include thoracic curvature and pelvic curvature Secondary curvatures are anteriorly convex include the cervical and lumbar curvatures

Question 30

Identify key features of the thoracic vertebrae and why it differs from cervical and lumbar vertebrae.

Answer 30

Circular vertebral foramen, transverse processes bear facets for ribs (except T11 and T12 where ribs are floating), no transverse foramen

Question 31

Identify features of the ribs including identifying atypical ribs

Answer 31

Head of ribs articulates with superior and inferior costal facets on vertebrae. The tubercle articulates with the costal facets of the transverse processes. There is a costal groove running along the inferior edge where the neuromuscular bundle sits. Costal cartilage joins anterior end of ribs. Ribs 1 and 2 are different shapes with grooves allowing for the subclavian vesssels (1) and tuberosities for muscle attachments (scalene 1 and serrates ant 2). Ribs 11 and 12 are floating and don't have tuberosities

Question 32

Describe the costosternal and costovertebral joints

Answer 32

Costosternal where the cartilage meets the sternum | Costovertebral where the heads and tubercles of the ribs meet the vertebrae and transverse processes of vertebrae

Question 33

Describe the movements of the ribs in respiration

Answer 33

The inspiratory muscles which include the diaphragm, the external intercostal, the scalene, and the sternocleidomastoid move the ribs laterally and upwards increasing the diameter of the thorax

Question 34

Describe the boundaries of the thoracic cavity

Answer 34

Superior: Superior thoracic aperture consisting of posteriorly T1 vertebrae, laterally ribs 1, anteriorly manubrium (suprasternal notch). Inferior: Inferior thoracic aperture consisting posteriorly of vertebrae T12, anteriorly of the cartilage of false ribs (ribs 8-12), inferiorly the diaphragm.

Question 35

Identify the intercostal muscles and fibre directions

Answer 35

External, internal, and innermost. Fibres run superior medially, inferior medial, transverse respectively.

Question 36

Identify the relationships of vessels and nerves within the intercostal spaces

Answer 36

The neuromuscular bundle sits in the intercostal groove between the internal and innermost intercostal muscle. The order is VAN. Vein superior, artery, then nerve most inferiorly.

Question 37

Describe the costodiaphragmatic recess

Answer 37

A potential space in the pleural cavity, the lungs expand into this space during forced inspiration. A pleural effusion collect here when the patient is upright

Question 38

Pneumothorax

Answer 38

When air enters the pleural cavity. This causes the pleura to no longer adhere and the lung can collapse.

Question 39

Name the lobes in the right and left lungs

Answer 39

Right lung: superior, middle, inferior. | Left lung: Superior, inferior and lingula

Question 40

Name the fissures in the right lung

Answer 40

RIGHT Horizontal (between superior and middle lobes) Oblique (between middle and inferior lobes) LEFT Oblique fissure (between superior and inferior lobe)

Question 41

Name the reflection of pleura that surronds the hilla of the lung

Answer 41

Pulmonary ligament

Question 42

Name the divisions of the conducting zone airways in order

Answer 42

Trachea, main stem bronchi (left and right), lobar bronchi, segmental bronchi, smaller bronchi, bronchioles, terminal bronchioles

Question 43

Name the divisions of the respiratory zone airways

Answer 43

Respiratory bronchioles, alveolar ducts, alveolar sacs

Question 44

Describe the process of a chest drain

Answer 44

Insert needle between 9th and 10th ribs closet to the tenth so as to avoid the larger superior neurovascular bundle. Insert into costodiaphragmatic recess.

Question 45

Describe the autonomic innervation of the trachea, bronchi and lungs

Answer 45

Nerve supply to the trachea is through the recurrent laryngeal nerve. The bronchial tree and visceral pleura are innervated by the pulmonary plexus which contains sympathetic fibres from the sympathetic trunk and parasympathetic vagus nerve fibre.