Lungs & Diaphragm

Question 1

What lines of separation does the right lung possess?

Answer 1

Oblique fissure and horizontal fissure

Question 2

What is the location of the superior lobe of the right lung?

Answer 2

Above the horizontal fissure

Question 3

What is the location of the middle lobe of the right lung?

Answer 3

Between the horizontal and oblique fissures

Question 4

What is the location of the inferior lobe of the right lung?

Answer 4

Below the oblique fissure

Question 5

Why are the grooves and impressions of the lungs not typically present in the living?

Answer 5

Due to the perfusion/inflation of the lungs

Question 6

What are the grooves/impressions found in the right lung?

Answer 6

Grooves for the azygos vein, esophagus, superior vena cava, and right brachiocephalic vein, as well as the cardia impression (shallow)

Question 7

What are the lines of separation found with the left lung?

Answer 7

Only the oblique fissure

Question 8

What is the location of the superior lobe of the left lung?

Answer 8

Above the oblique fissure

Question 9

What is the location of the inferior lobe of the left lung?

Answer 9

Below the oblique fissure

Question 10

What are characteristic features of the left lung?

Answer 10

Lingula, grooves for the aorta and left subclavian artery, cardiac notch, and a deep cardiac impression

Question 11

What is significant about the cardiac notch of the left lung?

Answer 11

Important for auscultation of the heart

Question 12

Why does the esophagus typically not lie against the left lung?

Answer 12

It rests on the aorta

Question 13

What are the functional units of the lung?

Answer 13

Bronchopulmonary segments

Question 14

Each bronchopulmonary segment consists of what four things?

Answer 14

Segmental bronchus, branch of the pulmonary artery, segment of lung tissue, and surrounding septum

Question 15

Why are bronchopulmonary segments clinically important?

Answer 15

Can be surgically removed without affecting the functioning of adjacent segments

Question 16

What is the blood supply of the lungs?

Answer 16

Bronchial arteries and bronchial veins

Question 17

From where do the bronchial arteries arise?

Answer 17

Thoracic aorta

Question 18

Where do the bronchial veins drain?

Answer 18

Azygos and accessory hemiazygos veins

Question 19

What is the primary tissue of the trachea, main bronchi, and lobar bronchi?

Answer 19

Cartilaginous rings

Question 20

What is the primary tissue of segmental bronchi?

Answer 20

Smooth muscle

Question 21

What is the primary tissue of bronchioles?

Answer 21

Smooth muscle

Question 22

What is the primary tissue of alveoli?

Answer 22

Membrane

Question 23

What is bronchitis?

Answer 23

Inflammation of the segmental bronchi

Question 24

What is bronchiolitis?

Answer 24

Inflammation of the bronchioles

Question 25

What is pneumonia?

Answer 25

Inflammation of the alveoli

Question 26

What fibers form the anterior and posterior pulmonary plexuses?

Answer 26

Vagus and sympathetic trunk

Question 27

The sympathetic trunk is made up from which cord levels?

Answer 27

T2-T5

Question 28

What effect does sympathetic activation have on the lungs?

Answer 28

Bronchial dilation, vasoconstriction, and decreased glandular secretion

Question 29

What effect does parasympathetic activation have on the lungs?

Answer 29

Bronchial constriction, vasodilation, and increased glandular secretion

Question 30

What is asthma?

Answer 30

An obstructive airway disease characterized by coughing, wheezing, and difficulty breathing

Question 31

What causes asthma?

Answer 31

Spasms of the smooth muscle which lies in the segmental bronchi and bronchioles

Question 32

What also tends to accompany asthma?

Answer 32

Excessive secretion of mucus

Question 33

What triggers extrinsic asthma?

Answer 33

Allergies

Question 34

What triggers intrinsic asthma?

Answer 34

Stimuli such as stress, cold, or exercise

Question 35

Subluxation of what area tend to accompany asthma?

Answer 35

Upper thoracic region

Question 36

What part of the autonomic nervous system would dominate in asthma if there was a subluxation in the upper thoracics (T2-T5)?

Answer 36

Parasympathetics

Question 37

What effect does the release of epinephrine have on the lungs that is released from the adrenal medulla that is supplied by the lower thoracics (T9-T11)?

Answer 37

Bronchodilation

Question 38

What is the pathway of lymph drainage in the lungs?

Answer 38

Lungs to pulmonary and bronchopulmonary nodes in hilum to tracheobronchial nodes

Question 39

Are the lungs rich or poor in lymphatics?

Answer 39

Rich

Question 40

Why do the lungs have so many lymphatics?

Answer 40

Breathing accumulates toxins and pathogens and the lungs are an interface with the external world

Question 41

What is a bronchogenic carcinoma?

Answer 41

Primary tumor of the bronchus

Question 42

What is a bronchogenic carcinoma directly related to?

Answer 42

Cigarette smoking and air pollution

Question 43

How does a bronchogenic carcinoma quickly spread to lymph nodes and the bloodstream?

Answer 43

By eroding a venue and traveling via the pulmonary veins to the heart and systemic circulation

Question 44

A bronchogenic carcinoma often causes an enlargement of which type of lymph node?

Answer 44

Sentinel

Question 45

How may a bronchogenic carcinoma result in paralysis of half of the diaphragm?

Answer 45

Damage to phrenic nerve

Question 46

How may a bronchogenic carcinoma result in paralysis of half of the larynx?

Answer 46

Damage to recurrent laryngeal nerve

Question 47

Where can referred pain be found with a bronchogenic carcinoma?

Answer 47

Upper or middle thoracic cord segments

Question 48

Which innervation of the lungs contain sensory fibers?

Answer 48

BOTH the vagal and sympathetic fibers

Question 49

What two things does the diaphragm separate?

Answer 49

Thorax from abdomen

Question 50

Why is the right dome of the diaphragm slightly higher than the left?

Answer 50

It overlies the liver

Question 51

What are the two parts of the diaphragm?

Answer 51

Muscular part and central tendon

Question 52

What is the origin of the sternal part of the diaphragm?

Answer 52

Xiphoid process

Question 53

What is the origin of the costal part of the diaphragm?

Answer 53

Lower 6 costal cartilages

Question 54

What is the origin of the lumbar part of the diaphragm?

Answer 54

Lumber vertebrae 1-3 and the medial and lateral arcuate ligaments

Question 55

At which vertebral level is the caval opening of the diaphragm located?

Answer 55

T8

Question 56

What does the caval opening of the diaphragm transmit?

Answer 56

Inferior vena cava and right phrenic nerve

Question 57

At which vertebral level is the esophageal hiatus of the diaphragm located?

Answer 57

T10

Question 58

What does the esophageal hiatus of the diaphragm transmit?

Answer 58

Esophagus and the anterior and posterior vagal trunks

Question 59

What is significant about the placement of the esophagus?

Answer 59

It is not firmly attached meaning it can slide

Question 60

At which vertebral level is the aortic hiatus of the diaphragm located?

Answer 60

T12

Question 61

What does the aortic hiatus of the diaphragm transmit?

Answer 61

Aorta, thoracic duct, and azygos vein

Question 62

What is the blood supply of the muscular part of the diaphragm?

Answer 62

Musculophrenic artery

Question 63

What is the blood supply of the central tendon of the diaphragm?

Answer 63

Pericardiacophrenic artery

Question 64

What is the blood supply of the upper surface of the diaphragm?

Answer 64

Superior phrenic artery

Question 65

What is the blood supply of the lower surfaces of the diaphragm?

Answer 65

Inferior phrenic artery

Question 66

From where do the superior and inferior phrenic arteries arise?

Answer 66

Aorta

Question 67

From where do the musculophrenic and pericardiacophrenic arteries arise?

Answer 67

Internal thoracic artery

Question 68

What nerve is motor to the diaphragm and sensory to its central part?

Answer 68

Phrenic nerve (C3-C5)

Question 69

What nerves are sensory to the peripheral part of the diaphragm?

Answer 69

Intercostal nerves

Question 70

Why does the inferior vena cava attach to the caval opening?

Answer 70

To facilitate greater venous return

Question 71

What is a hiatal hernia?

Answer 71

When the upper part of the stomach slides up into the thoracic cavity through the opening

Question 72

What is the cause of a hiatal hernia?

Answer 72

Weakness in the diaphragmatic wall around the esophageal hiatus

Question 73

A hiatal hernia typically occurs at what age?

Answer 73

After 50 years old

Question 74

What technique is specifically effective for a hiatal hernia?

Answer 74

S.O.T.

Question 75

Hiatal hernias are a major cause of what GI tract disease?

Answer 75

Gastroesophageal reflux

Question 76

What are the three movements of respiration that result in an increase in intrathoracic volume and a decrease in intrathoracic pressure?

Answer 76

Piston, bucket handle, and pump hande movements

Question 77

What is the piston movement of respiration?

Answer 77

Diaphragm contracts, pulling the domes inferiorly into the abdomen

Question 78

What is the bucket handle movement of respiration?

Answer 78

Elevation of the lower ribs (7th-10th) about an anteroposterior axis

Question 79

What is the pump handle movement of respiration?

Answer 79

Elevation of the upper ribs (2nd-6th) about a transverse axis

Question 80

The piston movement of respiration results in an increase in what diameter of the thorax?

Answer 80

Vertical

Question 81

The bucket handle movement of respiration results in an increase in what diameter of the thorax?

Answer 81

Transverse

Question 82

The pump handle movement of respiration results in an increase in what diameter of the thorax?

Answer 82

Antero-posterior

Question 83

Which movement of respiration is best seen from the side view as the chest rises?

Answer 83

Pump handle movement

Question 84

What muscles are responsible for both the bucket handle and pump handle movements of respiration?

Answer 84

External intercostal

Question 85

What is the second most important muscle of respiration?

Answer 85

External intercostal

Question 86

What muscles contract during forced expiration?

Answer 86

Internal intercostals, innermost intercostals, and the anterior abdominal wall muscles

Question 87

Which muscles are important for coughing, sneezing, and general clearing of the airway?

Answer 87

Internal intercostals

Question 88

During inspiration, what happens to the intrathoracic volume and pressure?

Answer 88

Increase, decrease

Question 89

During expiration, what happens to the intrathoracic volume and pressure?

Answer 89

Decrease, increase

Question 90

When abdominal volume is decreased, what happens to the intra-abdominal pressure?

Answer 90

Increased

Question 91

What are hiccups?

Answer 91

Results of spasmodic contractions of the diaphragm

Question 92

What are the distinguishing factors of serious hiccups that could be signs of pericarditis, pleuritic, or peritonitis?

Answer 92

Painful abdomen, fever, or hiccups lasting more than two days.