Lecture 35 - Diaphragm and accessory muscles/pleurae/lungs

Question 1

3 portions of the diaphragm

Answer 1

costal portion, sternal portion, vertebral portion

Question 2

the main vertebral attachments are formed by the

Answer 2

left and right diaphragmatic crus

Question 3

the right crus is __ and arises from __

Answer 3

long, L4

Question 4

the left crus is __ and arises from __

Answer 4

short, L3

Question 5

attachments from vertebral body of L2 and transverse process of L1

Answer 5

medial arcuate ligaments (psoas major)

Question 6

attachments from transverse process of L1 to the 12th rib

Answer 6

lateral arcuate ligaments (quadrates lumborum)

Question 7

the right hemidiaphragm reaches as high as the

Answer 7

4th interspace

Question 8

the left hemidiaphragm reaches as high as the

Answer 8

5th rib

Question 9

3 openings that pierce the diaphragm

Answer 9

aortic hiatus, esophageal hiatus, caval hiatus

Question 10

opening formed by the right crus as it arches to meet the left crus (at 12th thoracic vertebral level)

Answer 10

aortic hiatus

Question 11

opening formed by the muscle fibers of the right crus as they recur around the esophagus (10th thoracic vertebral level)

Answer 11

esophageal hiatus

Question 12

perforation through the diaphragm lying in the right portion of the central tendon (between 8th and 9th thoracic vertebral levels)

Answer 12

caval hiatus

Question 13

occurs through the esophageal hiatus

Answer 13

hiatal hernia

Question 14

the diaphragm is innervated bilaterally by the

Answer 14

phrenic nerves (C3-5)

Question 15

the phrenic nerve lies

Answer 15

on the belly of the anterior scalene

Question 16

inspiration is an ___ process and requires ___ of muscles

Answer 16

active, contraction

Question 17

quiet expiration is a ___ process and requires ___ of muscles along with ___ of lung tissue

Answer 17

passive, relaxation, recoil

Question 18

created by the mucous membranes of the airways in the lungs, plays an important role in expiration, causes a partial collapse

Answer 18

surface tension

Question 19

shiny serous layer, which tightly adheres to the lungs

Answer 19

visceral pleura

Question 20

fibrous connective tissue layer that is attached to the bony thorax and diaphragm, and lies next to the fibrous layer of the pericardium

Answer 20

parietal pleura

Question 21

4 parts of the parietal pleura

Answer 21

costal pleura (contact w/ thoracic wall), diaphragmatic pleura (contact w/ diaphragm), cervical pleura (apex of lungs), mediastinal pleura (inside lungs where heart lies)

Question 22

the area between the visceral and parietal pleural layers that is formed by the pleural membrane as they reflect upon themselves

Answer 22

pleural space

Question 23

the extension of the pleural space into the area formed between the posterior body wall and the posterior dome of the diaphragm

Answer 23

costodiaphragmatic recess

Question 24

the fluid that accumulates in the pleural space and settles into the costodiaphragmatic recess

Answer 24

pleural effusion

Question 25

the superior aspect of each lung is called the

Answer 25

apex

Question 26

the inferior aspect of each lung is called the

Answer 26

base

Question 27

part of the lung where vessels and airways enter

Answer 27

hilum (root)

Question 28

the left lung has __ lobes and a ___

Answer 28

2, lingula

Question 29

the right lung has __ bronchopulmonary segments and the left lung has __

Answer 29

10, 8

Question 30

represent subdivisions of the pulmonary lobes

Answer 30

bronchopulmonary segments

Question 31

the right bronchial artery arises from the

Answer 31

right 3rd posterior intercostal artery

Question 32

the superior left bronchial artery arises from the

Answer 32

aortic arch

Question 33

the inferior left bronchial artery arises from the

Answer 33

thoracic aorta

Question 34

what lies in the pleural space

Answer 34

nothing! it's a potential space

Question 35

boundaries of parietal pleura

Answer 35

2 rib spaces below the lung base (midclavicular line, lung base ends at 6th rib so parietal pleura ends at 8th rib) *different ribs at the different lines

Question 36

which hilum is hypoarterial (below pulmonary a)

Answer 36

left

Question 37

which hilum is epiarterial (above and around pulmonary a)

Answer 37

right

Question 38

"keel-like" projection of the last trachial ring up to the lumen of the trachea

Answer 38

carina

Question 39

used as a landmark for visualizing the branching from the trachea of the two mainstem bronchi during fiber optic bronchoscopy

Answer 39

carina

Question 40

characteristics of mainstream bronchi

Answer 40

the bifurcation creates a 62 degree angle, the left is longer/horizontal/smaller diameter; right is shorter/vertical/larger diameter

Question 41

bronchial veins empty into

Answer 41

superior vena cava | they run with bronchial arteries

Question 42

the right mainstream bronchi has ___ lobar bronchi and the left has ___ lobar bronchi

Answer 42

3, 2

Question 43

the lobar bronchi divide into the

Answer 43

segmental bronchi

Question 44

the right lung has __ segmental bronchi and __ on the left

Answer 44

10, 8 (one for each bronchopulmonary segment)

Question 45

the segmental bronchi subdivide into __

Answer 45

20-25 subsegmental bronchi

Question 46

the last sub segmental bronchus divides into the

Answer 46

bronchioles

Question 47

the bronchioles have no

Answer 47

cartilage

Question 48

bronchioles terminate in the

Answer 48

alveoli

Question 49

the alveoli are surrounded by ______, thus creating an _______

Answer 49

pulmonary capillaries, alveolar-capillary membrane

Question 50

what occurs at the alveoli

Answer 50

exchange of respiratory gasses (O2 and CO2)

Question 51

derived from 3rd posterior intercostal artery, follows the right mainstream bronchis and its branches to the lung

Answer 51

the right bronchial artery

Question 52

comes from descending portion of aortic arch; follow left mainstream bronchus and its branches to the left lung

Answer 52

the 2 left bronchial arteries

Question 53

venous blood is returned via the

Answer 53

right/left bronchial veins to the azygous vein and accessory hemiazygous vein

Question 54

left lung upper lobe bronchopulmonary segment names

Answer 54

anterior, apico-posterior

Question 55

left lung lingula bronchopulmonary segment names

Answer 55

superior, inferior

Question 56

left lung lower lobe bronchopulmonary segment names

Answer 56

superior, posterior basal, lateral basal, antero-medial basal

Question 57

right lung upper lobe bronchopulmonary segment names

Answer 57

apical, anterior, posterior

Question 58

right lung middle lobe bronchopulmonary segment names

Answer 58

medial, lateral

Question 59

right lung lower lobe bronchopulmonary segment names

Answer 59

superior, medial & lateral basal, anterior & posterior basal