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Flashcards in Anatomy Deck (107):
1

What is the first structure in the lower respiratory tract?

Trachea

2

What happens at the level of the C6 vertebra?

Larynx becomes trachea and pharynx becomes oesophagus

3

Where can the trachea be palpated?

Jugular notch of the manubrium

4

What is anterior to tracheal cartilages 2-4?

Isthmus of the thyroid gland

5

What do the pleura secrete and why?

Pleural fluid to lubricate and provide surface tension

6

Where is the pleural fluid found?

In the pleural cavity

7

Where do the lungs develop from?

Mediastinum and out

8

What does each lobar bronchi supply with air?

A lung lobe

9

What do each segmental bronchi supply?

A bronchopulmonary segment

10

Each lung has how many bronchopulmonary segments?

10

11

What are ribs 1-7 known as and where do they attach?

True ribs- costal cartilage to sternum

12

What are ribs 8-10 known as and where do they attach?

False ribs- costal cartilage above to sternum

13

What are ribs 11-12 known as and where do they attach?

Floating ribs- no attachment to sternum

14

What is the common cartilage bar which attaches the false ribs to the sternum known as?

Costal margin

15

Where does the head of the rib articulate with?

Body of vertebrae

16

Where does the rib tubercle articulate with?

Transverse process of vertebra

17

What is the name of the joint which connects the sternum to the cartilage and what type of joint is it?

Sternocostal joints (synovial)

18

What is the name of the joint which connects the rib end to the cartilage?

Costochondral

19

What is the name of the joints which connect the ribs to the vertebrae?

Costovertebral

20

What are the three layers of skeletal muscle located between the ribs and in intercostal spaces?

External, internal and innermost

21

How do the intercostal muscles make the chest wall expand?

Pull ribs upwards and outwards

22

How many pairs of intercostal spaces are there?

11

23

Each intercostal space contains a neurovascular bundle. Where specifically are these found?

Between internal and innermost intercostal muscles

24

From superior to inferior, what order do the contents of the neurovascular bundle run in?

Vein, artery, nerve (VAN)

25

What is the nerve supply to the intercostal spaces?

Intercostal nerve- anterior ramus of a spinal nerve

26

What is the arterial supply and venous drainage of the intercostal spaces POSTERIORLY?

Arterial supply- thoracic aorta
Venous drainage- azygous vein

27

What is the arterial supply and venous drainage of the intercostal spaces ANTERIORLY?

Arterial supply- internal thoracic artery
Venous drainage- internal thoracic vein

28

What do the intercostal arteries supply?

Chest wall

29

Where do intercostal arteries arise from?

Bilaterally from the thoracic aorta

30

What do the bronchial arteries supply and where do they arise from?

Supply lung tissue, arise from the anterior surface of the thoracic aorta

31

The muscular part of the diaphragm attaches to where?

Sternum, lower 6 ribs and costal cartilages, L1-3 vertebrae

32

The muscular part of the diaphragm is supplied by what?

Phrenic nerve- C3, 4, 5 (anterior rami)

33

Where are the phrenic nerves found in the neck?

Anterior surface of the scalenus anterior muscle

34

Where are the phrenic nerves found in the chest?

Descending over the lateral aspects of the heart

35

What does the phrenic nerve supply to the diaphragm and fibrous pericardium?

Somatic sensory and sympathetic axons

36

What does the phrenic nerve supply just to the diaphragm?

Somatic motor axons

37

Lymph from the lateral quadrants of the breast drain where?

Unilaterally to axillary nodes

38

Lymph from medial quadrants of the breast drain where?

Bilaterally to parasternal nodes

39

Where is the sternal angle?

At the level of rib 2

40

What vein is found in the delto-pectoral groove?

Cephalic vein

41

What nerve supplies the serratus anterior? If this is damaged what can it cause?

Long thoracic nerve, damage can cause a winged scapula

42

Where does the pectoralis minor attach?

Between coracoid process of scapula and ribs 3-5

43

Where does the Scalenus anterior attach?

Cervical vertebrae to the 1st rib

44

What part of the pleural cavity is found between the costal and diaphragmatic parietal pleura?

Costophrenic recess

45

What is the most inferior part of the costophrenic recess?

Costophrenic angle

46

Where is the lung apex auscultated?

Superior to the medial 1/3rd of the clavicle

47

Where is the right middle lobe auscultated?

Between right ribs 4 and 6 in the mid-clavicular and mid-axillary lines

48

Where is the horizontal fissure found?

Right rib 4

49

Where are the oblique fissures found?

Anteriorly- rib 6
Posteriorly- T3

50

Where should the lung base be auscultated?

Scapular line at T11 vertebra

51

Coughing is stimulated by sensory receptors found where?

Oropharyngeal, laryngopharyngeal and laryngeal mucosa

52

What sensory receptors are stimulated in sneezing?

CN V or IX

53

What sensory receptors are stimulated in coughing?

CN IX or X

54

What are carotid sheaths and where are they found?

Protective tubes of cervical deep fascia which attach to the bones of the base of the skull

55

What do the carotid sheaths contain?

Vagus nerve, internal carotid artery, common carotid artery, internal jugular vein

56

What makes up the pulmonary plexus?

Sympathetic axons, parasympathetic axons, visceral afferents

57

Motor axons travel from the tracheal bifurcation to supply what?

All mucus glands and bronchiolar smooth muscles

58

Where do pulmonary visceral afferents travel?

Follow vagus nerve to the medulla of the brainstem

59

What does the phrenic nerve do differently in order to produce a deep inspiration?

Produces a greater outflow of action potentials of longer duration

60

The intercostal nerves are the anterior rami of what spinal nerves?

T1-11

61

What are the accessory muscles of deep forced inspiration?

Pec major, pec minor, sternocleidomastoid and Scalenus anterior/medius/posterior

62

Where does the pectoralis major attach?

Between sternum/ribs and humerus

63

Where does the SCM muscle attach?

Sternum/clavicle and the mastoid process of the temporal bone

64

What type of muscle are the intrinsic muscles of the larynx?

Skeletal

65

What are the intrinsic muscles of the larynx supplied by?

Somatic motor branches of the vagus nerve

66

What do the intrinsic muscles of the larynx do to the vocal cords during a cough?

Adduct

67

Where does the vagus nerve connect with the CNS?

Medulla

68

Where does the vagus nerve pass through the base of the skull?

Jugular foramen

69

The vagus nerve supplies somatic sensory to the ? of the larynx and somatic motor to the ? of the larynx?

Sensory- mucosa
Motor- intrinsic muscle

70

Where is the vagus nerve found in the chest?

Descending posterior to the lung root

71

The vagus nerve supplies parasympathetic axons to the lungs via what?

Pulmonary plexus

72

The vagus nerve passes through the diaphragm attached to what?

Oesophagus

73

What other muscles contract in a deep inspiration to increase intra-thoracic pressure?

Anterolateral abdominal wall muscles

74

Where do the aponeurosis of the external obliques meet?

Midline linea alba

75

Where does the right external oblique attach superiorly?

Superficial aspects of lower ribs

76

Where does the right external oblique attach inferiorly?

Anterior part of iliac crest and pubic tubercle

77

Where does the right internal oblique attach superiorly?

Inferior border of the lower ribs

78

Where does the right internal oblique attach inferiorly?

Iliac crest and thoracolumbar fascia of lower back

79

Where does the transversus abdominus attach superiorly?

Deep aspect of the lower ribs

80

Where does the trasversus abdominus attach inferiorly?

Iliac crest and thoracolumbar fascia of lower back

81

The somatic motor, sensory and sympathetic nerve fibres supplying the abdominal wall are conveyed within what?

Thoracoabdominal nerves

82

What nerves become the thoracoabdominal nerves and where?

7-11 intercostal nerves become thoracoabdominal nerves as they branch in the plane between the internal oblique and transversus abdominus

83

What makes up the subcostal nerve?

T12 anterior ramus

84

What is made from the two halves of the L1 anterior rami?

Iliohypogastric and ilioinguinal nerves

85

A breach in the visceral pleura allows what?

Alveolar air to enter the pleural cavity

86

Dynamic airway compression in asthma makes what difficult?

Expiration

87

What are the two causes of a pneumothorax?

Penetrating injury to the parietal pleura or rupture of the visceral pleura

88

What will a pneumothorax show on examination?

- Reduced breath sounds and chest expansion
- Hyper-resonant percussion

89

What will a deviated trachea cause?

SVC compression which leads to hypotension

90

What is the first step management for a large pneumothorax?

Needle aspiration (thoracentesis)

91

What is the second step management for a large pneumothorax?

Chest drain via the 4th or 5th intercostal space in the midaxillary line

92

What is the emergency treatment for a tension pneumothorax?

Large cannula inserted into the pleural cavity via the 2nd or 3rd intercostal space midclavicular line

93

What two factors are required for a hernia to form?

Weakness of one body structure and increased pressure on one side of this

94

Where are the normal anatomical weaknesses of the diaphragm?

At the xiphoid and posterior attachments

95

What happens in a paraoesophageal hiatus hernia?

Herniated part of the stomach passes through the oesophageal hiatus to become parallel to the oesophagus in the chest

96

What happens in a sliding hiatus hernia?

The herniated part of the stomach slides through the oesophageal hiatus into the chest with the gastro-oesophageal junction

97

Where does the inguinal ligaments range from?

ASIS to pubic tubercle

98

The inguinal ligaments are the inferior borders of what?

External oblique aponeurosis

99

What is the entrance and exit to the inguinal canals?

Entrance- deep ring
Exit- superficial ring

100

The superficial ring lies superiolateral to what?

Pubic tubercle

101

Where is the deep ring located?

Superior to the midpoint of the inguinal ligament

102

What does the inguinal canal contain in adults?

Spermatic cord or round ligament of the uterus

103

Where is the spermatic cord formed?

Deep ring

104

What are the fascial coverings of the spermatic cord?

Normal superficial fascia, external spermatic fascia, cremasteric fascia and muscle, internal spermatic fascia

105

What is the pampiniform plexus?

A network of veins that drains the testis

106

What is contained within the spermatic cord?

Testicular artery, cremasteric artery and vein, artery to the vas deferens, paminiform plexus, genital branch of the genitofemoral nerve, autonomic nerves, lymph drainage, processus vaginalis, vas deferens

107

What does the vas deferens do?

Conveys sperm from the epididymus to the ejaculatory duct