L02, L03 Anatomy Of Diaphragm, Resp muscles, Chest Wall, Lungs, Pleural cavities Flashcards

(71 cards)

1
Q

2 parts of diaphragm?
Arise lateral to LR Crura.
Posterior attachment of diaphragm?

A

Peripheral muscular
Central tendinous

Median, medial, lateral arcuate ligaments

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2
Q

Descent of diaphragm increases what dimension of thorax?

Diaphragm is Main muscle for Passive or active inspiration?

A

Vertical diameter

Passive

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3
Q

Diaphragm blood supply?

A

Musculophrenic A/V

Inferior Phrenic A/V

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4
Q

Three openings in Diaphragm and at which level?

A

Caval T8
Esophageal T10
Aortic T12

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5
Q

Caval opening transmits what? (2)

At which level?

A

Terminal branch of phrenic nerve
Inferior Vena Cava

at thoracic artery level

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6
Q

Esophageal opening transmits what? (4)

A

Esophagus
Vagus
LR lymphatic vessels from lower third of esophagus
Epigastric vessels

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7
Q

Aortic opening in diaphragm transmits what? (3) AAT

A

Aorta
Azygous vein
Thoracic duct

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8
Q

Quadratus lumborum muscle at diaphragm attached to what? Contract during what breathing process?

A

attach to 12th rib, for active expiration

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9
Q

Nerve supply of diaphragm ? at which level?

A

Phrenic C3 to C5

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10
Q

2 basic functions of thoracic cage ?

A

Protect organs

Attachment of muscles

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11
Q

5 structures in the 12 thoracic vertebrae

A
Lamina
Pedicle
Spinous Process 
Transverse process
Body
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12
Q

2 facets on head of rib. Name of facet and what joint each makes?

A

2 articular facets
Articulate with body of thoracic vertebrae= costovertebral joint
Articulate with transverse process of thoracic vert.=
costotransverse joint (superior and lateral)

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13
Q

Both joints between rib and thoracic vertebrae are what kind? What nature?

A

Synovial

Allow free movement

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14
Q

5 parts of ribs?

HNTSA

A
Head 
Neck 
Tubercle 
Shaft 
Angle
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15
Q

Classification of Ribs. True ribs=? False Ribs=? Floating ribs=?

A
True= 1 -7
False= 8-10
Floating= 11-12
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16
Q

What is in costal groove?

A

VAN

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17
Q

Why is 1st rib atypical?

A

Scalene tubercle for attachment of scalene anterior muscle

Subclavian vessels and Brachial plexus lie on subclavian groove

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18
Q

False rib attach to sternum via?

A

7th costal cartilage

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19
Q

Sternum Anatomy.

3 parts?

A

Manubrium
Body
Xiphoid process

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20
Q

Joints in sternum: 2. Name?

A

Manubriosternal joint

Xiphisternal joint

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21
Q

Level of Manubriosternal joint?

A

T4 T5, sternal angle

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22
Q

Is the attachment site for rib 1 Cartilaginous joint or synovial? Movement?

A

Cartilaginous

Limited

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23
Q

Attachment site for rib 2-12 synovial or cartilagous ?

A

Synovial

Free Movement

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24
Q

Whats special about rib 2 attachment?

A

Articular DEMIfacet, articulate facet crosses the manubriosternal joint

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25
``` Costal Cartilage: What is it made of? Upper 7 ribs CC attach to? 8-10 CC continuous with? CC of 11-12 location? ```
Hyaline cartilage Sternum 7th CC Abdominal Structure
26
Intercostal spaces. Orientation: External Intercostal Muscle? Internal IM? Innermost IM?
Ext. = Downward and Inward (towards median) | Internal and Innermost= Downward and Outward (towards flank)
27
Transverse thoracic muscle name? Originate from where? Does it cross intercostal space?
Sternocostalis Originate from Posterior Xyphoid Process (anterior thoracic cage) No
28
Subcostal muscle function and location?
Depress lower ribs, Cross floating ribs at posterior wall of thoracic cage
29
Which three muscles in ICS are short and segmental?
Innermost IM, Transverse thoracic muscle, subcostalis
30
Costal groove VAN location?
Between Internal and Innermost ICM
31
Blood Supply of Thoracic Cage. 1-6 ICS supply? Special Case of 1-2 ICS?
Subclavian Artery- Internal Thoracic Artery- Anterior intercostal arteries- 1-6 ICS Subclavian Artery- Costocervical trunk- Superior Intercostal Artery- 1-2 ICS
32
Terminal branches of Internal Thoracic Artery? (2)
Musculophrenic A/V= Diaphragm, 7-9 ICS | Superior Epigastric A/V= Rectus Abdominis Muscle
33
Blood Supply of 3-11 ICS?
Thoracic Aorta- Posterior Intercostal Artery- 3-11 ICS
34
Blood Supply below 12th rib?
Thoracic Aorta- Subcostal Artery
35
POSTERIOR Vein drainage of thoracic cage. Right side sequence for 1-2 ICS? Left side sequence for 1-2 ICS?
Right: 1-2 ICS- Right superior intercostal vein- azygous vein- superior vena cava Left: 1-2 ICS- Left superior intercostal vein- Left brachiocephalic vein/ accessory hemizygous vein
36
POSTERIOR Vein Drainage of 3-11 ICS? L and R.
Right: 3-11 ICS- posterior intercostal vein- azygous vein- superior vena cava Left: 3-11 ICS- accessory hemiazygous and hemiazygous vein- superior vena cava
37
ANTERIOR Vein drainage for 1-9 ICS?
Anterior intercostal vein- internal thoracic vein- subclavian vein- brachiocephalic vein
38
Vein below 12th rib?
Subcostal Vein
39
Nerve Supply of Thoracic Cage branching to Spinal cord? (5) Anterior to Posterior: L,C,A,P,PR,SC
(Anterior to Posterior) | Lateral- Collateral- Anterior and Posterior branch- Posterior Ramus- Spinal cord
40
Definition of Pleural Cavity?
Potential Space between parietal and visceral pleura
41
Parietal Pleura lines? | Visceral Pleura lines?
Inner thoracic cage | lungs
42
Nerve supply for Parietal Pleura? EXCEPTION? (Diaphragmatic Pleura) ' ' for Visceral Pleura?
Parietal= supplied by intercostal nerves EXCEPT Diaphragmatic pleura: Costal and peripheral parts supplied by Intercostal Nerves. CENTRAL (sensory portion) supplied by Phrenic Nerve C3-C5 Visceral Pleura= Supplied by Pulmonary Plexus
43
Pulmonary Plexus Location? Which Nervous System?
T2-T5 | Autonomic NS
44
Trachea cartilages type? Location? | Level of trachea bifurcation?
Cartilage= hyaline Location= C6- T4 Bifurcation at T4 (Sternal Angle)
45
Lung Fissure definition?
Fold of visceral pleura that divides the lobes
46
Name of space between inner thoracic cage wall and parietal pleura?
endothoracic fascia
47
Right Lung. | Name of Lobes? Name of Fissures?
3 Lobes: Upper, Middle, Lower Name: top fissure is HORIONTAL/MAJOR FISSURE Bottom fissure is OBLIQUE/ MINOR FISSURE
48
Left Lung. | Name of Lobes and Fissures?
2 Lobes: Upper and Lower One Fissure: Oblique Major Has Cardiac Notch
49
Name of root of lung
Hilum
50
2 roles of pulmonary hilum
Attachment of lung in mediastinum | point of entry of blood vessel and airways
51
5 things that go through pulmonary hilum? | BNLBP
``` Bronchus Nerves (pulmonary Plexus) Lymph nodes Bronchial vessels Pulmonary A/V ```
52
Loose cuff of pleura name? function? | Extends towards diaphragm
pulmonary ligament, allow free movement during inspiration
53
Blood Supply of Lungs. | Aorta branch into ? Vein drainage ?
Aorta- bronchial arteries | Bronchial vein- (R) Azygous vein & (L) Hemiazygos vein
54
Bronchial arteries supply what? (3)
Bronchi, Connective Tissue, Visceral Pleura
55
Nerve supply of lungs? | Supply consists of?
Pulmonary Plexus Parasympathetic fibres from Vagus Sympathetic fibres from sympathetic trunk T2-T5
56
Lymphatics of Lungs: | 2 systems: name? location?
Superficial plexus- subpleural region of visceral pleura | Deep plexus- along bronchi and pulmonary vessels
57
Deep plexus pathway?
Pulmonary nodes- bronchopulmonary nodes- superior/ inferior tracheobronchial nodes- L/R paratracheal nodes- bronchomediastinal lymphatic trunk
58
Bronchomediastinal lymphatic trunk drains into what?
Left- Thoracic duct & Right- Right Lymphatic Duct | Both drain into subclavian vein- brachiocephalic vein- superior vena cava- right atrium
59
Pericardiophrenic A/V: source? supplies what structure?
from Internal thoracic A/V | supplies pericardium and diaphragm
60
Mechanism of Breathing relating to anatomy. | Action: Which muscle is responsible for passive normal respiration? Which dimensions increase during inspiration?
Diaphragm and External intercostal muscle contract- increase Anterior- Posterior diameter(AP)- Transverse diameter (TD)- Vertical height- Negative intrathoracic pressure
61
Passive expiration, which muscles involved, pathway?
Diaphragm and External intercostal muscles relax Internal and Innermost IM contract Recoil of Lung increase intrathoracic pressure
62
Active/ forced inspiration. | Muscles, dimensions.?
Contraction of diaphragm, intercostal muscles raise ribs 2-12 upwards increasing TD, Sternum moves anterior and superior, Vertical height, TD and AP increase. Further expansion involves: Scalene anterior, serratus posterior superior, pectoralis major and minor= raise ribs Sternocleidomastoid muscle
63
Active/ forced expiration. | Muscles, dimensions?
Relax diaphragm Contract abdominal muscles to increase abdominal pressure Latissimus dorsi pull down ribs Quadratus lumborum depress 1-11 ribs
64
Where is apex of Lung?
2.5cm above clavicle protruding out of thoracic inlet
65
What is Midsternal Line?
Median plane of sternum
66
Mid-clavicular line where?
mid-point of clavicle
67
Midaxillary line where?
between Anterior axillary line and Posterior axillar line (AAL & PAL) (the centre line of flank)
68
Paravertebral line where?
posterior and lateral line on the edge of vertebral column
69
Lung/ Visceral Pleura lower border dissects MAL and MCL at?
MCL- 6th rib | MAL-8th rib
70
Parietal Pleura lower border dissects MAL and MCL at?
MCL- 8th rib | MAL- 10th rib
71
Lungs and VP lower border intersect with Posterior Paravertebral line (PPL one inch later to PML) at which rib? Parietal Pleura?
Lungs/ VP= 10th Rib | PP= 12th rib