Part 4: respiratory book Flashcards
(91 cards)
1
Q
How many boarders does the lung have?
A
3 (margins)
Anterior, Posterior , Inferior
2
Q
How many surfaces does the lung have?
A
3
costal (anterolateral)
inferior (diaphragmatic = base)
medial (mediastinal)
3
Q
which surface of lung is the hilum found
A
medial - mediastinal
4
Q
a.
A
apex
5
Q
b
A
anterior boarder
6
Q
c
A
posterior boarder
7
Q
d
A
medial surface/mediastinal
8
Q
e
A
BASE
9
Q
f
A
diaphragmatic surface
10
Q
h
A
costal surface
11
Q
i and j
A
i. Cardiac notch
j. lingula
12
Q
k
A
inferior boarder
13
Q
what does the left lung pocess which the right lung does not
A
Cardiac notch
Lingula
Cardiac and aortic impression -> medial surface – aortic arch, thoracic aorta, oesophagus
2 lobes – 1 oblique fissure
ABV – root of hilum (pulmonary artery is the most superior
Smaller, longer/narrower
Root of hilum ABV
14
Q
what does the right lung pocess that the left doesnt
A
3 lobes – 2 fissures
Main bronchi split into two branches at the root (before entering lung)
Superior – eparterial
Inferior – hyparterial
Shorter but wider – position of the liver
Arrangement of root of hilum (Artery not as superior), superior bronchi.
15
Q
a.
A
a. grooe for right brachiocephalic vein
16
Q
b
A
b. groove for SVC
17
Q
c
A
Azygos vein
18
Q
d
A
d. Cardiac impression
19
Q
e
A
IVC
20
Q
g
A
oesophagus
21
Q
h, f
A
h. left brachiocephalic vein
f: subclavian artery (left/right)
22
Q
i, j, k,
A
i. aortic arch
j . cardiac impression
k . descending aorta
23
Q
what is the hilum
A
the area on the medial surface of the lung through which structures enter or leave the lung
24
Q
what is the root of the lung
A
The structures which enter and leave the lung at the hilum are known collectively as the root of the lung.
25
Which 4 structures make up the root of the lung?
* - A main bronchus
* - *Two* pulmonary veins
*.. - Pulmonary artery
also
- bronchial arteries and veins
- lympathtic vessels
26
Fixtures on the medial surface of the left lung:
* heart (left ventricle)
* aortic arch
* thoracic aorta
* esophagus
27
The lymphatics of the lungs and visceral pleura drain into the
**bronchopulmonary lymph node**s at the bifurcations of the larger bronchi at the lung hila.
bronchopulmonary ->** tracheobronchial **(bifurcation of trachea) -> **thoracic duct/right lympathatic duct**
28
advantage of bronchopulmonary segments?
each lung segment has its own individual blood and air supply from branches of the pulmonary artery and the bronchi
allows a surgeon to remove a particular segment without adversely affecting any neighboring segments.
29
how many bronchopulmonary seegments in each lung
right lung - 10
left lung - 8/9
30
what surface is the hilum found on?
medial/mediastinal
31
which lung is this the hilum of?
LEFT LUNG
32
a.
LEFT pulmonary artery
33
b
LEFT main bronchus
34
c.
LEFT pulmonary veins
35
d
LEFT bronchopulmonary lymph node
36
e
pulmonary ligament (left)
37
what lung is this
hilum of right lung
- bronchus is divided (splits into superior lobe) before entering lungs
- superior lobes more even with arteries compared to left side
38
a
Right pulmonary artery
39
b
right main bronchus
(divides into superior in right lobe - eparterial lobe of bronchus)
40
c
pulmonary veins
41
d
bronchopulmonary lymph nodes - right lung
42
e
pulmonary ligament - right lobe
43
Which layer of the pleura enters and lines the fissures of the lungs?
Visceral pleura
44
Which layer of the pleura is sensitive to pain?
The Parietal pleura (visceral pleura lack sensory innervation)
45
Which nerve(s) supplies pain sensation to the pleura?
Phrenic nerve: provides both touch and pain sensory innervation to the mediastinal pleura/pericardium
- in addition to the intercostal nerves
46
label the parietal pleura according to its location within the thorax
a. Cervical (apical)
b. Costal
c. Mediastinal
d. Diaphragmatic
47
what membrane lies immediately above cervical plerua
fascial membrane known as the
suprapleural membrane
48
The presence of blood within the pleural space
haemothorax.
49
A pleural reflection occurs where
the parietal pleura lining one surface of the chest wall changes its direction to line another surface
, e.g., from the inner surface of the ribs onto the superior surface of the diaphragm
50
label 1 + 2
1= Costo-diaphragmatic reflection + recess
2= Costo-mediastinal reflection + recess
51
what are pleural recesses
* At the location of reflections, the parietal pleura is more widely separated from the visceral pleura during expiration thus forming a pleural recess (= space).
* Each reflection shares the name of its corresponding recess. So, the recesses formed in the above examples are known as the costodiaphragmatic recess (costophrenic recess or angle) and the costomediastinal recess, respectively.
* The recesses are clinically useful for needle aspiration of excessive accumulation of fluid in the pleural space – known as a pleural effusion.
52
label a + b
a. costomediastinal recess
b. costodiaphragmatic recess
53
innvervation of the parietal pleura
The phrenic nerve -> mediastinal and diaphragmatic parietal pleura
the lower 6 intercostal nerves -> cervical (apical) and costal parietal pleura
* The parietal pleura is sensitive to pain, pressure, temperature, and touch.
54
Innvervation of visceral pleura
only autonomic innervation for stretch and is insensitive to pain.
It is supplied autonomically through the pulmonary plexus (sympathetic and parasympathetic (vagus) supply).
55
what is different about female chest x-rays
breast shadow
56
The inferior margin of the parietal pleura in
1. mid-clavicular line
2. mid-axillary line
3. the vertebral column
1. rib 8
2. rib 10
3. T12
57
pus in the pleural cavity
Pyothorax
58
Vagus nerve is secretomotor to
mucous glands of the airways
59
Intercostal muscles are innervated by
the intercostal nerves
ventral rami of thoracic spinal nerves
T1-T11
60
inferior margin of the lung at the mid-clavicular line
rib 6
61
inferior margin of the lung at the mid-axillary line
rib 8
62
inferior margin of the lung at the paravertebral line
rib 10
63
inferior margin of the parietal pleura at the mid-clavicular line
rib 8
64
inferior margin of the parietal pleura at the mid-axillary line
rib 10
65
inferior margin of the parietal pleura at the paravertebral
rib 12
66
horizontal fissue is at which rib
4th rib
(right lung only)
67
oblique fissue cross what rib
6th rib
right and left lung
(starts at t3)
68
Arterial supply of the thoracic wall
1. posterior intercostal artery (branch off descending aorta)
2. anterior intercostal artery (branches off internal thoracic artery - which branches off subclavian arteries)
69
what does the posterior intercostal artery branch off?
the descending aorta
70
what does the anterior intercostal artery branch off?
the internal thoracic artery -> subclavian
71
venous drainage of the thoracic wall
* azygos
* hemiaygos
* accessory hemizaygos veins
*
- internal thoracic veins
72
motor innervation of entire diaphragm is supplied by
The phrenic nerves
anterior rami - C3-C5
73
Innervation of diaphragm
motor -> phrenic nerve (c3-c5)
sensory -> phrenic nerve and lower intercostal nerves (T7-T11)
74
vena cava hiatus opening is at which vertebrae level
- T8
- right phrenic nerve
- (in central tendon)
75
oesophageal hiatus opening
t10
osephagus
and both vagus nerves
76
aortic hiatus
t12
between left and right crus
(aorta) + azygos, hemiazygos vein, thoracic duct
77
where can you palpate the apex beat of the heart
5th intercostal space
mid-clavicular line
78
Name the lobe of the lung situated between the oblique and horizontal fissures on the right?
Middle Lobe
79
To what vertebral levels do the pleura extend inferiorly?
anteriorly
laterally
posteriorly
T8 anteriorly
T10 laterally
T12 posteriorly
80
At what vertebral level does the aorta pass through the diaphragm?
T12
81
What intercostal muscle lies most deep? What is its nerve supply?
Innermost intercostal muscle
- intercostal nerves (T1-T11) of anterior rami of spinal nerve
82
Which bronchus is shorter, wider and more vertical? What is the clinical importance of this?
Right bronchi
- foreign bodies/objects - inhaled items are more likely to enter
83
What type of epithelium is present in the trachea and primary bronchi?
cilliated pseudostratified columnar epithelium
with goblet cells
84
What type of epithelium is present in the trachea and primary bronchi?
cilliated pseudostratified columnar epithelium
with goblet cells
85
Concerning the costovertebral joints. The head of rib 5 articulates with the body of which vertebra(e)?
T4 and T5
86
oncerning the intercostal spaces. The intercostal neurovascular bundle is situated between which of the following layers?
internal and innermost intercostal muscles
87
**** Concerning the diaphragm. The inferior vena cava, oesophagus and thoracic aorta pass through the diaphragm at which vertebral levels respectively?
infererior vena cava - T8
Oesophagus - T10
Aortic - T12
88
Concerning the surface markings of the parietal pleura. The inferior reflection of parietal pleura crosses which rib in the midclavicular line?
8th rib
89
which rib is located to the horizontal fissure?
4th rib
90
the internal thoracic artery originates off of??
the subclavian artery
91
internal thoracic arteries give off what arteries?
| come from sublcavian
antrior intercostal arteries
