Flashcards in L02, L03 Anatomy Of Diaphragm, Resp muscles, Chest Wall, Lungs, Pleural cavities Deck (71):
2 parts of diaphragm?
Arise lateral to LR Crura.
Posterior attachment of diaphragm?
Median, medial, lateral arcuate ligaments
Descent of diaphragm increases what dimension of thorax?
Diaphragm is Main muscle for Passive or active inspiration?
Diaphragm blood supply?
Inferior Phrenic A/V
Three openings in Diaphragm and at which level?
Caval opening transmits what? (2)
At which level?
Terminal branch of phrenic nerve
Inferior Vena Cava
at thoracic artery level
Esophageal opening transmits what? (4）
LR lymphatic vessels from lower third of esophagus
Aortic opening in diaphragm transmits what? (3) AAT
Quadratus lumborum muscle at diaphragm attached to what? Contract during what breathing process?
attach to 12th rib, for active expiration
Nerve supply of diaphragm ? at which level?
Phrenic C3 to C5
2 basic functions of thoracic cage ?
Attachment of muscles
5 structures in the 12 thoracic vertebrae
2 facets on head of rib. Name of facet and what joint each makes?
2 articular facets
Articulate with body of thoracic vertebrae= costovertebral joint
Articulate with transverse process of thoracic vert.=
costotransverse joint (superior and lateral)
Both joints between rib and thoracic vertebrae are what kind? What nature?
Allow free movement
5 parts of ribs?
Classification of Ribs. True ribs=? False Ribs=? Floating ribs=?
True= 1 -7
What is in costal groove?
Why is 1st rib atypical?
Scalene tubercle for attachment of scalene anterior muscle
Subclavian vessels and Brachial plexus lie on subclavian groove
False rib attach to sternum via?
7th costal cartilage
Joints in sternum: 2. Name?
Level of Manubriosternal joint?
T4 T5, sternal angle
Is the attachment site for rib 1 Cartilaginous joint or synovial? Movement?
Attachment site for rib 2-12 synovial or cartilagous ?
Whats special about rib 2 attachment?
Articular DEMIfacet, articulate facet crosses the manubriosternal joint
What is it made of?
Upper 7 ribs CC attach to?
8-10 CC continuous with?
CC of 11-12 location?
Orientation: External Intercostal Muscle?
Ext. = Downward and Inward (towards median)
Internal and Innermost= Downward and Outward (towards flank)
Transverse thoracic muscle name?
Originate from where?
Does it cross intercostal space?
Originate from Posterior Xyphoid Process (anterior thoracic cage)
Subcostal muscle function and location?
Depress lower ribs, Cross floating ribs at posterior wall of thoracic cage
Which three muscles in ICS are short and segmental?
Innermost IM, Transverse thoracic muscle, subcostalis
Costal groove VAN location?
Between Internal and Innermost ICM
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
Terminal branches of Internal Thoracic Artery? (2)
Musculophrenic A/V= Diaphragm, 7-9 ICS
Superior Epigastric A/V= Rectus Abdominis Muscle
Blood Supply of 3-11 ICS?
Thoracic Aorta- Posterior Intercostal Artery- 3-11 ICS
Blood Supply below 12th rib?
Thoracic Aorta- Subcostal Artery
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
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
ANTERIOR Vein drainage for 1-9 ICS?
Anterior intercostal vein- internal thoracic vein- subclavian vein- brachiocephalic vein
Vein below 12th rib?
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
Definition of Pleural Cavity?
Potential Space between parietal and visceral pleura
Parietal Pleura lines?
Visceral Pleura lines?
Inner thoracic cage
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
Pulmonary Plexus Location?
Which Nervous System?
Trachea cartilages type? Location?
Level of trachea bifurcation?
Location= C6- T4
Bifurcation at T4 (Sternal Angle)
Lung Fissure definition?
Fold of visceral pleura that divides the lobes
Name of space between inner thoracic cage wall and parietal pleura?
Name of Lobes? Name of Fissures?
3 Lobes: Upper, Middle, Lower
Name: top fissure is HORIONTAL/MAJOR FISSURE
Bottom fissure is OBLIQUE/ MINOR FISSURE
Name of Lobes and Fissures?
2 Lobes: Upper and Lower
One Fissure: Oblique Major
Has Cardiac Notch
Name of root of lung
2 roles of pulmonary hilum
Attachment of lung in mediastinum
point of entry of blood vessel and airways
5 things that go through pulmonary hilum?
Nerves (pulmonary Plexus)
Loose cuff of pleura name? function?
Extends towards diaphragm
pulmonary ligament, allow free movement during inspiration
Blood Supply of Lungs.
Aorta branch into ? Vein drainage ?
Aorta- bronchial arteries
Bronchial vein- (R) Azygous vein & (L) Hemiazygos vein
Bronchial arteries supply what? (3)
Bronchi, Connective Tissue, Visceral Pleura
Nerve supply of lungs?
Supply consists of?
Parasympathetic fibres from Vagus
Sympathetic fibres from sympathetic trunk T2-T5
Lymphatics of Lungs:
2 systems: name? location?
Superficial plexus- subpleural region of visceral pleura
Deep plexus- along bronchi and pulmonary vessels
Deep plexus pathway?
Pulmonary nodes- bronchopulmonary nodes- superior/ inferior tracheobronchial nodes- L/R paratracheal nodes- bronchomediastinal lymphatic trunk
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
Pericardiophrenic A/V: source? supplies what structure?
from Internal thoracic A/V
supplies pericardium and diaphragm
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
Passive expiration, which muscles involved, pathway?
Diaphragm and External intercostal muscles relax
Internal and Innermost IM contract
Recoil of Lung
increase intrathoracic pressure
Active/ forced inspiration.
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
Active/ forced expiration.
Contract abdominal muscles to increase abdominal pressure
Latissimus dorsi pull down ribs
Quadratus lumborum depress 1-11 ribs
Where is apex of Lung?
2.5cm above clavicle protruding out of thoracic inlet
What is Midsternal Line?
Median plane of sternum
Mid-clavicular line where?
mid-point of clavicle
Midaxillary line where?
between Anterior axillary line and Posterior axillar line (AAL & PAL) (the centre line of flank)
Paravertebral line where?
posterior and lateral line on the edge of vertebral column
Lung/ Visceral Pleura lower border dissects MAL and MCL at?
MCL- 6th rib
Parietal Pleura lower border dissects MAL and MCL at?
MCL- 8th rib
MAL- 10th rib