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Anatomy Year 1 > Part 3: respiratory book > Flashcards

Part 3: respiratory book Flashcards

(94 cards)

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1
Q

What is the level of the inferior margin of the parietal pleura in the midaxillary line?

A

rib 10

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2
Q

What is the level of the inferior margin of the parietal pleura in the midclavicular line?

A

rib 8

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3
Q

What is the level of the inferior margin of the parietal pleura at the vertebrae?

A

T12

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4
Q

root value of the phrenic nerve

A

C3-C5

runs alongside heart /posterior in mediastinum

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5
Q

Pyothorax

A

is pus in the pleural cavity

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6
Q

which nerve is secretomotor to mucous glands of the airways

A

vagus nerve

  • secretomotor refers to the capacity of a structure (often a nerve) to make a gland secrete a substance (usually mucus or serous fluid).
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7
Q

Breast drains into what lymph nodes?

A

axillary
parasternal
abdominal

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8
Q

what dermatome is the belly button (umbilicous) in line with?

A

T10

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9
Q

L1 dermatome is in what region?

A

inguinal region

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10
Q

Intercostal muscles are innervated by ?

A

thoracic spinal nerves

  • the intercostal nerves originate segmentally from the anterior/ventral rami of thoracic spinal nerves T1 to T11.
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11
Q

label 1

A

ligamenta flava

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12
Q

label 2

A

posterior longitudinal ligament

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13
Q

label 3 and 4

A
  1. interspinous ligament
  2. supraspinous ligament
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14
Q

label 5

A

anterior longitudinal ligament

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15
Q

label 6 and 7 and 8

A
  1. spinal cord
  2. spinal nerve
  3. intervertebral foramen (spinal nerve passes laterally)
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16
Q

what layer of intercostal muscles do the intercostal nerve, artery and vein run inbetween?

A

internal intercostal muscle and innermost intercostal muscle

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17
Q

The number of each intercostal space is the same as the rib

a. below - inferior
b. above - superior

A

b. above (superior)

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18
Q

the most superficial intercostal muscle in each space is called?

A

external intercostal muscles (fibres run in pocket direction)

inspiration

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19
Q

the intermediate intercostal muscle

A

internal intercostal muscle (Expiration)

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20
Q

deepest intercosal muscle

A

innermost intercostal muscle

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21
Q

picture to visualise

facet joints sits between what parts of the veretbrae ?

A

the superior/inferior articular process is inbetween the pedicle and the lamina

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22
Q

name the two joints between ribs and vertebrae

A
  • Costovertebral -> head of rib and (demi-facets on vertebral body) – synovial plane joints
  • Costotransverse -> tubercle of rib and transverse process – synovial plane joints
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23
Q

why do the External intercostal muscle fibers and the internal intercostal muscle fibers run at right angles to each?

A

provide strength to the muscle layers.

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24
Q

Between which two intercostal muscles is the neurovascular bundle located?

A

The inner and innermost intercostal muscles - VAN from underneath groove of superior rib

nerve exposed (as last under rib)

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25
In which part of a rib is the neurovascular bundle lodged?Confirm this on the diagram above.
costal groove (undersurface of each rib) -> supplies much of the innervation and vascular supply to the thoracic wall.
26
Which structures comprise the neurovascular bundle? And what is the order from superior to inferior?
Intercostal vein, artery, nerve (superior to inferior)
27
what is liable to damage if a chest drain is inserted into the pleural space to close to the inferior boarder of a rib ????
the intercostal nerve is the LOWEST lying structure in the intercostal space and is therefore liable to damage
28
functions of intercostal muscles
1. contribute to respiratory movements of the chest wall 2. Assist in preventing the lungs and pleura from ballooning out between the ribs during these movements.
29
what does the collateral branch of intercostal nerves supply?
parietal pleura periosteum of the rib intercostal muscles
30
Where in relation to the upper and lower borders of a rib do you think a chest drain needle should be inserted into the pleural cavity to avoid damaging the (main) intercostal nerve ?
The chest drain should be inserted just above the upper (superior) boarder of the rib! To avoid damage to the neurovascular bundle. - nerve most inferior
31
what dermatome underlies the sternal angle?
T2 dermatome (T4-5 vertebrae)
32
dermatome underlies the nipple?
T4
33
dermatome underlies umbilicous
T10 (belly button)
34
dermatome underlies inguinal region
L1
35
what is a dermatome
A dermatome is an area of skin supplied by a single spinal nerve.
36
label a what landmark found here?
T2 sternal angle
37
label b
T5 (count down from T4 - nipples)
38
label c
T10 - umbilicous /belly buttom
39
label d
L1 inguinal region
40
label e and f
e . C4 f. C3
41
label g?
T1
42
label a
****central tendon The phrenic nerve originates from the anterior rami of the C3 through C5 nerve roots and consists of motor, sensory, and sympathetic nerve fibers. It provides complete motor innervation to the diaphragm and **sensation to the central tendon aspect of the diaphragm.**
43
label b , what vertebral level?, what vessels pass through?
inferior vena caval hiatus T8 right phrenic nerve | vena cava has 8 letters
44
why hiatus is in the central tendon?
vena caval hiatus inferior vena cava passes through
45
label c, where is it found (vertebrae level), what passes through
oesophagus hiatus vagus nerve (R/L) also passes through (rest and digest) T10 | oesophagus has 10 letters
46
label d, what vertebrae level>? what passes through
aortic hiatus thoracic duct azygous vein T12 | aortic hiatus (has 12 letter)
47
label e ,
medial arcurate ligament * The medial arcuate ligament crosses the aorta and is continuous with the crus on each side. is shaped like an arch and goes around the aorta to connect diapghragm to the spine attaches to transverse process of L1 and Crus
48
label f
lateral arcurate ligament attaches to transverse process of L1 and medial part of rib 12
49
label g
right crus L1-L3 vertebrae blends with anterior longitudinal ligament
50
label h
left crus L1-L2 vertebrae blends with anterior longitudinal ligament
51
what does the central tendon fuse with?
inferior surface of the pericardium
52
what are the attachments of the diaphragm
1. xiphoid process (anterior) 2. Costal margin (cartilages of ribs 7-10) 3. Lumber vertebrae (L2 left crus, L3 right crus)/to tranverse (L1) process by medial and lateral arcuate ligaments 4. Ribs - lateral arcuate ligaments 5. Inferior surface of pericardium - attached/fuse with central tendon
53
the right dome lies slightly higher than the left – this is thought to be due to ?
the presence of the liver
54
label a and b
a. right dome (higher due to presence of liver) b. left dome
55
label d and e
d.. right crus - (L1-L3) e. left crus - (L1-L2) blend with anterior longitudinal ligament
56
what fibres does the phrenic nerve consist of ?
motor, sensory and sympathetic
57
what innervation does the phrenic nerve provide the diaphragm with
complete motor innervation sensation to the central tendon (sensation of peripheral - 6-11th intervostal nerves) lower intercostal nerves
58
what provides sensory innervation to the periphery of the diaphragm?
lower intercostal muscles (6-11th) *phrenic nerve supplies COMPLETE MOTOR innervation + sensory innvervaiton ONLY to the central tendon.
59
* Which of the left or right dome lies more superior during normal expiration? Why?
- the liver to be tucked up under the bottom edge of the right ribcage,
60
* To which vertebrae are the left and right crura attached?
- Left: L1-L2 - Right: L1-L3
61
describe the central tendon
- insertion of diaphragm - aponeurosis convergence point (of muscular fibres) -lies more anteriorly than posteriorly, meaning the posterior muscle fibres are longer than the anterior fibres - blends with the fibrous pericardium above to maintain it in place (explains depression between the two domes - - Vena caval hiatus pierces the tendon at the junction of the right/central portion
62
which fibres are longer in the diaphragm a. posterior b. anterior
posterior beause the central tendon lies more anteriorly
63
4 origins of the diaphragm
1. Sternal part: The xiphoid process (posterior surface) 2. Costal part: Costal margin (7-10 costal cartilages) 3. Laterally (11/12th ribs) - lateral acruate ligament 4. Posteriorly to lumbar vertebrae (bodies of L1-L3) (+intervertebral discs), anterior longitudinal ligament (left/right crus)
64
label a
a. vena cava hiatus (T8) IVC, right phrenic nerve pass through , located to right side of central tendon
65
label b and e
b. left vagus nerve - passes through Oesophagus hiatus (T10) c. right phrenic nerve ^ same as above remember vagus nerve - rest and digest - goes to GI tract
66
label c
left phrenic nerve
67
label d
d. esophageal hiatus (T10) vagus nerves also pass (L/R)
68
label f
aorta hiatus (T12) azygos vein and thoracic duct pass through
69
insertion of diaphragm
central tendon
70
To which costal cartilages is the diaphragm attached?
costal margin (7-10) (while it attaches directly attachment to 11/12)
71
3. To which part of the sternum is the diaphragm attached?
Xiphoid process
72
To which vertebrae is the diaphragm attached?
L1-L3 (body) – right crus/L1- L2- left crus (transverse process of L1 via medial/lateral arcuate ligaments
73
Vena cava hiatus
T8 through right side of central tendon inferior vena cava right phrenic nerve
74
Oesophagus hiatus
T10 right and left vagus nerves (central)
75
Aortic hiatus
T12 Aorta thoracic duct azygos vein
76
Through which part of the diaphragm does the inferior cava pass
central tendonous part T8 level
77
How does passing through the central tendon (IVC) affect venous return from the lower extremities and low trunk to the heart?
- When the diaphragm contracts -> (during inspiration) -> the diaphragm flattens and the aperture widens!! – stretching the vena cava open, - before it is relaxed in expiration: thus, facilitating blood flow through the inferior vena cava.
78
what is a hiatus hernia and where is it most likely to occur
protrusion of structure abdominal oesophagus and upper part of the stomach -> into the thorax sliding hiatal hernia - stomach and lower part of osephagus slide up into the chest through the diaphragm
79
provides sensory input to the peripheral parts of the diaphragm
* The lower intercostal nerves (6-11)
80
provide motor input to the entire diaphragm + sensory input to the central tendon
the phrenic nerve, C3-C5 – anterior rami
81
1
costo-diaphragmatic recess
82
2
right hilum
83
3
3. tracheal bifurcation
84
4
left main bronchus
85
5
Diaphragm
86
6
humerous
87
7
aortic knuckle
88
8
scapula
89
9
1s rib
90
1.2.3
1. chest xray 2. ches 3. PA view (posterior to anterior)
91
C4
92
pulmonary vein
93
right brachipcephalic vein
94
17
intercostal nerve

Anatomy Year 1 (25 decks)

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