Anatomy

Question 1

at level c6 vertebrae

Answer 1

Larynx becomes trachea

Pharynx becomes oesophagus

Question 2

Thorax

Answer 2

Chest Walls and Chest Cavity

Question 3

Chest walls

Answer 3

Protect heart and lungs
Make movement of breathing
Breast tissue

Question 4

Chest Cavity

Answer 4

Within chest walls
Contains vital organs
Contains major vessels and nerves
Consists of mediastinum and right and left pleural cavities

Question 5

Embryonic Lung Development

Answer 5

1. Lung Bud
2. Pushes from mediastinum
3. Covered in pleura
4. Parietal pleura on wall
5. Visceral pleura on lungs
6. Reflect on lung roots

Question 6

Lung lobe

Answer 6

Area of lung that each of the lobar bronchi supply with air
Right - upper, lower, middle
Left - Upper, lower
Lobes separated by fissures

Question 7

Bronchopulmonary segment

Answer 7

Area of lung lobe that each of the segmental bronchi supply with air
Each lung has 10 segments

Question 8

Costovertebral joints

Answer 8

Limited movement

Question 9

Muscles of breathing

Answer 9

External intercostal muscles
Internal intercostal muscles
Innermost intercostal muscles

Question 10

Intercostal spaces

Answer 10

11 pairs

Each contains a neurovascular bundle between internal and innermost intercostal muscle

Question 11

Nerve supply of intercostal space

Answer 11

anterior ramus of spinal nerve

Question 12

Posterior blood supply of intercostal spaces

Answer 12

Arterial = thoracic aorta
Venous = azygous vein

Question 13

Anterior blood supply of intercostal spaces

Answer 13

Arterial = internal thoracic artery
Venous = internal thoracic vein

Question 14

Phrenic nerves that keep diaphragm alive

Answer 14

C3,4,5

Question 15

Where is the middle lobe auscultated

Answer 15

Between right ribs 4 and 6

Question 16

Site of lung apex

Answer 16

Superior to the clavicle

Question 17

Where is the lung base auscultated

Answer 17

T11 vertebrae

Question 18

Contains hyaline cartilage and is surrounded by the arch of the azygous vein

Answer 18

Right main bronchus

Question 19

Anatomy of coughing

Answer 19

1. Sensors throughout resp tract
2. CNS responds rapidly
3. Deep inspiration
4. Adduction of vocal cords to close rima glottis
5. Contraction of abdominal wall muscles
6. Build up of pressure
7. Vocal cords abduct to open rima glottides
8. Soft palette tenses and elevates to close off entrance to nasopharynx (cough not sneeze)

Question 20

Cranial nerves involved in sneezing

Answer 20

CN V, CN IV

Question 21

Cranial nerves involved in coughing

Answer 21

CN IX, CN X

Question 22

Carotid sheaths

Answer 22

Protective tubes of cervical deep fascia
Contain:
vagus nerve
internal carotid artery
common carotid artery
internal jugular vein

Question 23

Motor axons travel from

Answer 23

Tracheal bifurcation
Along branches of resp tress
Supply mucous glands and all bronchiolar smooth muscles

Question 24

Pulmonary visceral afferents travel from

Answer 24

Visceral pleura
Resp tree
To plexus
Follow vagus nerve to medulla of brainstem

Question 25

Pectoralis major

Answer 25

Attaches between sternum/ribs and humerus

Question 26

Pectoralis minor

Answer 26

Can pull ribs 3-5 superiorly towards scapula

Question 27

Sternocleidomastoid

Answer 27

Attaches between sternum and mastoid process of temporal bone

Question 28

Scalenus anterior, medis, posterior

Answer 28

Attach between cervical vertebrae and ribs 1 and 2

Question 29

Recruitment of accessory muscle suggests

Answer 29

Dyspnoea | difficulty breathing

Question 30

Intrinsic muscles of larynx

Answer 30

Skeletal Between cartilages Supplied by motor

Question 31

Left and right vagus nerves

Answer 31

``` Connect with CNS at medulla Pass through jugular foramen Descend through neck within carotid sheath Descend posterior to lung root Pass through diaphragm on the oesphagus Divide on surface of stomach ```

Question 32

Subcostal nerve

Answer 32

T12 anterior ramus

Question 33

Iliohypogastric nerve

Answer 33

half of L1 anterior ramus

Question 34

Ilioinguinal nerve

Answer 34

Other half of L1 anterior ramus

Question 35

Asthma dynamic airway compression can lead to

Answer 35

Rupture of lung and visceral pleura | Causing Pneumothorax

Question 36

Pneumothorax Examination

Answer 36

Reduced ipsilateral chest expansion Reduced ipsilateral breath sounds Hyper-resonance

Question 37

Pneumothorax investigations

Answer 37

Absent lung markings peripherally | Lung edge visible

Question 38

Tension Pneumothorax

Answer 38

Torn pleura creates a one way valve that permits air to enter pleural cavity but prevents it from leaving With each inspiration more air enters Pneumothorax expands and lung collapses towards root Eventually build up of air in pleural cavity applies tension to mediastinal structures

Question 39

What may cause mediastinal shift

Answer 39

Tension pneumothorax

Question 40

Consequences of mediastinal shift

Answer 40

Tracheal deviation away from side affected

Question 41

How does tension pneumothorax cause hypertension

Answer 41

SVC compression | Reduces venous return to heart

Question 42

Management of pneumothorax

Answer 42

1. Needle aspiration 2. Chest drain BOTH 4th of 5th INTERCOSTAL SPACE MIDAXILLARY LINE

Question 43

Management of tension pneumothorax

Answer 43

Insertion of IV cannula, 2nd intercostal space, midclavicular line

Question 44

2 factors required for hernia formation

Answer 44

1. weakness of one structure | 2. increased pressure on one side of wall

Question 45

Paraoesophageal hiatus hernia

Answer 45

herniated part of stomach passes through oesophageal hiatus to become parallel to oesophagus and and in chest

Question 46

Sliding hiatus hernia

Answer 46

Herniated part of stomach slides through oesophageal hiatus into chest WITH gastro-oesophageal junction

Question 47

Inguinal hernia

Answer 47

Form in medial half of inguinal region Weakness in inguinal canal Pressure in antra-abdomen

Question 48

Direct inguinal hernia

Answer 48

'Finger' of peritoneum forced through inguinal canal into scrotum 'Finger' of peritoneum forced through deep ring and out of superficial ring into scrotum

Question 49

Differentiate between inguinal hernias

Answer 49

1. Reduce hernia 2. Occlude the deep ring with fingertip pressure 3. Ask patient to cough 4. If hernia is direct = lump reappears