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

MBBS I CPRS > L02, L03 Anatomy Of Diaphragm, Resp muscles, Chest Wall, Lungs, Pleural cavities > Flashcards

Flashcards in L02, L03 Anatomy Of Diaphragm, Resp muscles, Chest Wall, Lungs, Pleural cavities Deck (71):
1

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

Peripheral muscular
Central tendinous

Median, medial, lateral arcuate ligaments

2

Descent of diaphragm increases what dimension of thorax?
Diaphragm is Main muscle for Passive or active inspiration?

Vertical diameter
Passive

3

Diaphragm blood supply?

Musculophrenic A/V
Inferior Phrenic A/V

4

Three openings in Diaphragm and at which level?

Caval T8
Esophageal T10
Aortic T12

5

Caval opening transmits what? (2)
At which level?

Terminal branch of phrenic nerve
Inferior Vena Cava

at thoracic artery level

6

Esophageal opening transmits what? (4)

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

7

Aortic opening in diaphragm transmits what? (3) AAT

Aorta
Azygous vein
Thoracic duct

8

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

attach to 12th rib, for active expiration

9

Nerve supply of diaphragm ? at which level?

Phrenic C3 to C5

10

2 basic functions of thoracic cage ?

Protect organs
Attachment of muscles

11

5 structures in the 12 thoracic vertebrae

Lamina
Pedicle
Spinous Process
Transverse process
Body

12

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)

13

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

Synovial
Allow free movement

14

5 parts of ribs?
HNTSA

Head
Neck
Tubercle
Shaft
Angle

15

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

True= 1 -7
False= 8-10
Floating= 11-12

16

What is in costal groove?

VAN

17

Why is 1st rib atypical?

Scalene tubercle for attachment of scalene anterior muscle
Subclavian vessels and Brachial plexus lie on subclavian groove

18

False rib attach to sternum via?

7th costal cartilage

19

Sternum Anatomy.
3 parts?

Manubrium
Body
Xiphoid process

20

Joints in sternum: 2. Name?

Manubriosternal joint
Xiphisternal joint

21

Level of Manubriosternal joint?

T4 T5, sternal angle

22

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

Cartilaginous
Limited

23

Attachment site for rib 2-12 synovial or cartilagous ?

Synovial
Free Movement

24

Whats special about rib 2 attachment?

Articular DEMIfacet, articulate facet crosses the manubriosternal joint

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

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