Anatomy of Respiratory System Flashcards
(163 cards)
1
Q
what structures form the upper respiratory tract
A
the right & left nasal cavities
or the oral cavity
the naso- oro- & laryngo- pharynx
larynx
2
Q
what structures form the lower respiratory tract
A
trachea right & left main bronchi lobar bronchi segmental bronchi bronchioles alveoli
3
Q
where does the larynx become the trachea and they pharynx become the oesophagus
A
at C6 vertebra
cricoid cartilage
4
Q
where is the trachea palpated
A
he jugular notch of the manubrium can feel cart igneous right
5
Q
where is the isthmus of the thyroid gland located
A
anterior to tracheal cartilages 2-4
6
Q
what is the only bone that doesn’t articulate with any other bone in the body
A
hyoid
7
Q
bones in neck from superior to inferior
A
hyoid
thyoid
cricoid cartilage
8
Q
where does the thyroid gland sit
A
anterior to trachea
9
Q
where is the thorax located
A
between neck and abdomen
10
Q
what structures make up the thorax
A
chest walls - rib cage
chest cavity - contains viscera, major vessels, nerves, mediastinum, left & right pleural cavities
11
Q
list the chest wall layers from superficial to deep
A
skin fascia (superficial -> deep) skeletal muscle bone (ribs) parietal pleura
12
Q
role of the chest wall
A
protect lungs and heart
movement of breathing
breast tissues - lactation
13
Q
what does the mediastinum contain
A
heart and great vessels
located between pleural cavity
14
Q
role of the pleural cavity
A
to protect lungs
15
Q
define lung lobe
A
are of lung that each of the lobar bronchi supply with air
16
Q
what lobes does the right lung have
A
superior, middle, inferior lobe
17
Q
what are the lung lobes separated by
A
oblique fissures
18
Q
what lobes does the left lung have
A
superior and inferior
19
Q
how does the left lung differ from the right
A
the right lung has a horizontal fissure separating the superior and middle lobes, left lung does not have a middle lobe
20
Q
what lung is higher, why
A
right lung, due to the liver
21
Q
what is lingual
A
appendage of tissue only non left lung as there is no middle lobe on the left lung due to position of heart
22
Q
describe the segments of the lung
A
10 segments can be isolated during surgery, each segment has its own blood/lymph/air/venous supply
23
Q
what is the thoracic skeleton made up of
A
12 rib pairs intercostal spaces 12 thoracic vertebrae clavicle, scapula sternum costal margin
24
Q
what are ribs 1-7 called
A
true ribs, costal cartilage attaches to sternum
25
what are ribs 8-10 called
false ribs as the costal cartilage above to the sternum
26
what are ribs 11 & 12 called
floating ribs
| no sternum attachment
27
what is the sternum made up of
manubrium
body
xiphoid
sternal angle
28
what is the mesosternum
sternum process
29
how does the rib attach to the sternum
via costal cartilage
30
what does the head of the rib articulate with
body of vertebra of the same number thoracic vertebrae but also partly with the vertebrae superiorly
31
what does the rib tubercle articulate with
transverse process of the vertebra of the same number
32
what joint type are the sternocostal joints
synovial
33
what joints in the thoracic skeleton have limited movements
costovertebral
34
what are the costal margins
cartilage edge of the false ribs
35
what type of joint is costovertebral joints
hyaline cartilaginous joints
| no movement
36
3 layers of skeletal muscle located between ribs and within the intercostal spaces
```
external intercostal
internal intercostal
innermost intercostal
(each layer attach between adjacent ribs)
```
37
how do the intercostals move the ribs during breathing
expand chest wall pulling adjacent ribs up and out
38
how many pairs of intercostals is there
11
39
what does each intercostal space between innermost intercostal and internal intercostal carry
neuro-vascular bundle:
| artery, vein and nerve
40
what is the nerve supply of the intercostals
anterior rams of spinal nerve
| intercostal nerve
41
what is the posterior atrial supply to the intercostals
thoracic aorta
42
posterior venous drainage of intercostals
azygous vein
43
anterior atrial supply to intercostals
internal thoracic artery
44
anterior Venous drainage to intercostals
internal thoracic vein
45
what skeletal muscle forms the floor of the chest cavity and the roof of the abdominal cavity
diaphragm - skeletal muscle with a central tendon
46
why does the diaphragm have opening
allows structures to pass through connecting abdominal and chest cavities
47
why is the right dome higher than left dome of the diaphragm
presence of the liver inferiorly
48
what does the diaphragm attach peripherally to
sternum
lower 6 ribs + costal cartilages
L1-L3 vertebral bodies
49
what nerves supply the diaphragm
phrenic nerves C3,4,5
| anteripr rami
50
the diaphragm is supplied by the autonomous/somatic nervous system
somatic
51
where are the phrenic nerves found
neck: anterior surface of scalenus anterior muscle
chest: depend over lateral aspects of heart
52
what does the phrenic nerves supply
somatic sensory & sympathetic axons to diaphragm and fibrous pericardium
somatic motor axons to diaphragm
53
what is the pleural cavity
vacuum containing pleural fluid
54
difference between parietal and visceral pleura
visceral pleura in contact with lungs
55
when the lungs expand how does air move into the lungs
under negative pressure
56
when the intercostals contract how are the ribs elevated
increases A-P and laterally
57
what happens during expiration
elastic recoil so air pushed out
58
where is the trachea palpated
jugular notch of manubrium
59
where is the sternal angle located
rib 2
| T4
60
what is adipose tissues function
insulation
61
function of deep fascia
fibrous tough
| protection
62
what vein is located in the delta-percoral groove
cephalic vein, drains upper limb
63
what is superficial fascia
fat, adipose tissue
64
what causes a winged scapula
paralysis of serrates anterior
dure to injury eg compression of long thoracic nerve which supplies serratus anterior
thoracic wall no longer attached to scapula so sticks out
65
function of the serratus anterior
anchors scapula to thoracic wall
66
muscles of anterolateral chest wall
pectorals major
serratus anterior
ltissimus dorsi
67
were are the subclavian vessels located
lateral to the lateral border of the first rib
| they become axillary vessels then brachia vessels
68
what is the fibrous pericardium covered bilaterally with
parietal pleura
69
what is the only connection of the lungs to the mediastinum
the lung roots
70
areas of the parietal pleura
```
cervical pleura
costal pleura
visceral pleura
diaphragmatic pleura = in contact with parietal
mediastinal parietal pleura
```
71
what is the most dependant part of the pleural cavity (most inferior)
costodiaphragmatic recess
72
where does abnormal fluid in the pleural cavity drain eg pleural effusions/hemothroax
costodiaphragmatic recess - causes blunting of angles
| angles not clear on CXR
73
what is located between diaphragmatic parietal pleura and costal pleura
costodirphragmatic recess
74
what is laterally the most inferior region of the lungs
costophrenic angle
75
what are the structures of the root of lung
```
1 main bronchus
1 pulmonary artery
2 pulmonary veins lymphatics
viscera afferents
sympathetic + parasympathetic nerves
```
76
what is the root of the lung called
the hilum
77
4 features of the hilum
main bronchi (hyalin cartilage in walls)
pulmonary arteries
pulmonary lymph nodes (back)
pulmonary veins
78
on the left lung arteries are located superior/inferior whereas veins are located antrosuperior/antroinferior
```
arteries = superior
veins = antroinferior
```
79
what do normal breathing sounds, sound like
rustling
80
what must be auscultated in the lungs
5 lung lobes
apices (at top of lungs)
bases
81
what do pleurae secrete
pleural fluid into pleural cavity
82
what is the role of pleural fluid
a lubricate
| provides surface tension
83
how do lungs in embryo differ from lungs in adult
lung bud (balloon) in embryo pushes out from the mediastinum into pleural cavity but is not in the cavity whereas in adults theres a vacuum filled with pleural fluid so lung is in the pleural cavity
84
what 4 structures of the resp. have sensory receptors in the mucosa
oropharynx
laryngopharyx
larynx
respiratory tree (trachea to bronchioles)
85
what sensory receptors of nerves are stimulated in sneezing
CN V or CN IX
86
what sensory receptors of nerves are stimulated in coughing
CN IX (glossopharyngeal) - on surface of carotid sheath or CN X (vagus) in carotid sheath
87
what does the carotid sheath contain
vagus nerve
internal carotid artery
common carotid artery
internal jugular vein
88
what is there carotid sheath
bilateral, protective tubes of cervical (neck) deep fascia
| attaches superiorly to the bones of the base of the skull and blends inferiorly with the fascia of the mediastinum
89
how do nerves initiate cough reflex
send sensory impulses to the CNS via carotid sheath
90
how do visceral pleura and respiratory trees visceral afferents (sensory nerve) connect with CNS
via the pulmonary plexus
sympathetic trunk
vagus nerve CNX in the carotid sheath
pulmonary visceral afferents travel from visceral pleura and resp tree to the plexus then follows vagus nerve to the medulla of brain stem
91
what does the pulmonary plexus contain
sympathetic axons
parasympathetic axons
visceral afferens
92
what is the role of motor axons travelling from tracheal bifurcation to branches of the resp tree
supply all mucus glands and all bronchiolar smooth muscle
93
how is a negative pressure in the lungs created
diaphragm contacts + descends
intercostal muscles elevate ribs (increased AP/lateral dimension)
chest wall pull parietal pleura creating vacuum and pulls visceral pleura (lungs)
94
main muscle of quiet inspiration
diaphragm
95
what nerves supply the diaphragm
anterior rami of C3, 4, 5
96
where is the phrenic nerves found in the neck
anterior surface fo scalenus anterior muscle
97
where is the phrenic nerve located in the chest (thorax)
descends over lateral aspects of the fibrous pericardium ANTERIOR TO HYLEM (lung root)
98
role of the phrenic nerve
supplies somatic sensory and sympathetic axons to diaphragm and fibrous pericardium and somatic motor axons to diaphragm
INNERVATES DIAPHRAGM
99
role of phrenic nerve in deep/forced inspiration
greater outflow of action potential of longer duration of phrenic nerve causing diaphragm to flatten + maximally descend
100
what are the intercostal nerves
anterior rami of spinal nerves T1 - T11
101
what does the posterior rami of the nerve supply only supply
the back
102
role of intercostals in deep/forced inspiration
muscle contracts forcefully, raises ribs maximally
103
3 intercostal muscles
external
internal
innermost
104
what are the accessory muscles of deep/forced inspiration
pectoralis major
pectoralis minor
strnocleidomastoid
scalenus anterior, medius + posterior
105
what is recruitment of the accessory muscles a clinical sign of
dyspnoea - breathing difficulty
106
role of pectorals major in deep/forced breathing
if fixed upper limb position ie. hold onto arms of a chair or thigh (hunch over) pectorals major pulls the ribs up and out expanding thoracic cave
107
where does the pectorals major attach between
sternum/ribs + humerus
| adduce and medially rotates humerus
108
role of pectoralis amino in deep inspiration
pulls ribs 3-5 superiorly shards coracoid process of scapula
109
attachments of sternocleidomastoid muscle
sternum/clavicle + mastoid press of temporal bone
| it is the big muscle in neck that can lift thoracic cave superiorly
110
attachment of silenus anterior, medium and posterior
between cervical vertebrae and ribs 1+2
111
where is the sternal angle located
rib 2
112
during cough reflex what is closed to prevent air escaping the lungs
rima glottidis
113
where are the vocal cords found
midline, close the rims glottidis
114
what are the intrinsic muscles of the larynx
all skeletal (voluntary) muscles
attach between cartilages
move the cartilages resulting in vocal cords
115
what are the intrinsic muscles of the larynx supplied by
somatic motor branches of CNX
116
role of intrinsic muscles of the larynx during cough reflex
adduct vocal cords
117
what are the 3 laryngeal cartilages
```
thyroid cartilage (large cartilage superior)
cricoid cartilage
aretanoid cartilage (posterior 2 little cartilages)
```
118
what separates the upper and lower resp trac
rima glottidis
119
what nerve are the vocal cords supplied by
vagus nerve
120
where do the vocal cords sit
C6
121
where does the right and left mixed cranial nerves connect with the CNS
at medulla (obligate) of brainstem
122
how does the vagus nerve enter brain
at base of skull via jugular foramen with internal jugular vein
123
how does the vagus nerve descend from brain to neck
within carotid sheath
124
where does the vagus nerve descend over in the chest
POSTERIOR TO HYLEM (lung root)
125
what does CNX supply to the chest organs inc. pulmonary plexus
parasympathetic axons
126
how does CNX pass through the diaphragm
on the oesophagus
| on surface of stomach divide into parasympathetic branches fro foregut + midgut organs
127
what is the function of the vagus nerve in cough reflex
supplies sensory axons to the mucosa lining larynx
| supplies motor axons to intrinsic muscles of larynx
128
how is air pushed out during expiration
diaphragm relaxes and rises
intercostals lower ribs
elastic tissue of lungs recoils
129
what are the accessory muscles of deep (forced) inspiration
right/left anterolateral abdominal wall muscles contract increasing abdominal pressure, forces diaphragm up increasing intra-thoracic pressure
130
what are the anterolateral abdominal wall muscles
right/left transverses abdominus
right/left internal oblique
right/left external oblique
right/left rectus abdominis (6 pack muscles)
131
where does the aponeurosis of the right and left external oblique meet
midline - linea alba
132
why are abdominal muscles unique
50/50 muscle/tendon (aponeurosis)
133
what forms the transition between muscle and aponeurosis
linea semilunaris (right and left)
134
where does the right external oblique attach
superiorly: lower ribs
inferiorly: anterior iliac crest and pubic tubercle
135
what is the attachments of the internal oblique muscles (deep to external oblique)
superior: inferior border of lower ribs
inferior: ileac crew and thoracolumbar fascia of lower back
136
muscle fibre direction of external oblique
anterior downwards
137
muscle fibre direction of internal oblique
posterior downwards
138
where is the transverses abdominus located
deep to internal oblique
139
direction of fibres of transverses abdominus
posterior to anterior
| horizontal
140
attachments of transverse abdominus
superiorly: deep aspects of the lower ribs
inferiorly: iliac crest + thoracolumbar fascia of lower back
141
what nerves (somatic motor, sensory and sympathetic fibres) supply the abdomen muscles
thoracoabdominal nerves:
7TH-11TH Intercostal travel anteriorly to plane between internal oblique & transverses abdominus
subcostal nerve T12 anterior ramus
iliohypogastic nerve half L1 anterior rami
ilioinguinal nerve other half L1
142
function of the 4 abdominal muscles
```
maintain posture
suport vertebral column
movements of spine
guarding (protect) abdominal viscera
contract to increase intra-abdominal pressure + forced expiration
```
143
in the cough reflex the CNS responds rapidly to coordinate what responses
1) deep inspiration: diaphragm (phrenic nerves), intercostal muscles (intercostal nerves) & accessory muscles
2) adduction vocal cords, close rima glottidis (vagus)
3) anterolateral abdominal wall muscles contract (intercostal nerves) builds intra-abdominal pressure (vocal cords closed)
4) vocal cords suddenly abduct opening rims glottides
5) soft palate tenses (CNV) and elevates (vagus) closes nasopharynx and directs stream of air (100mph) through oral cavity as cough
144
what is the main nerve of the diaphragm
phrenic nerve
145
what nerve adducts then abducts vocal cords closing rim glottidis
vagus nerve
146
what nerves cause contraction of the anterolateral abdominal wall muscles
intercostal nerves
147
what causes the soft palate to tense
CNV (trigeminal nerve)
148
what causes soft palate to elevate
vagus nerve
149
4 parts of the mediastinum
middle mediastinum
anterior mediastinum
superior mediastinum
posterior mediastinum
150
what does the middle mediastinum contain
the heart and commencement of great vessels
151
what does the anterior mediastinum contain
adults - fat
| children - thymus gland for immune response, produces mature T cells
152
what does the posterior mediastinum contain
thoracic aorta
thoracic duct
azygous vein (drains intercostals)
153
what does the superior mediastinum contain
aorta and veins draining from head + neck
154
what is the level of the sternal angle
T4
| rib 2
155
what is the level of the mid mediastinum
T7
156
what is the consequences of a mediastinal shift
tracheal deviation away from the side of a unilateral tension pneumothorax - palpated in jugular notch
SVC compression - reduces venous return to heart = hypotension (low arterial bp)
157
where does the aorta, thoracic duct and azygous vein perforate the diaphragm
T12
158
where does the trachea bifurcate
carina
| T5, rib 2
159
where can the sternal angle be palpated
Rib 2
160
where is the right middle lob located
between ribs 4-6
| mid clavicular and midaxillary lines
161
where is the horizontal fissure
right rib 4
162
where can the base of the lungs be auscultated
T12
163
where are the oblique fissures
Rib 6 (rising to T3)
