What are vertebrosternal or true ribs?
What are vertebrobronchal ribs or false ribs?
What are floating ribs?
1-7, directly attached to sternum
8-10, not directly attached to sternum - attached via 7th rib
11-12, not attached to sternum, only to vertebrae
How high do the R and L diaphragm reach?
What 3 main structures pass through the diaphragm, and at what spinal levels?
Describe the thoracic pleurae.
R: upper border of 5th rib, L: lower border of 5th rib
IVC (T8), Oesophagus (T10), Aorta (T12)
Visceral pleura covers surface of each lung.
Parietal pleura is the outer layer that lines the thoracic cavity:
- Cervical pleura above 1st rib
- Diaphragmatic pleura covers superior diaphragm surface
- Mediastinal pleura covers lateral surface of mediastinum
- Costal pleura covers thoracic wall
NB: deep inspiration seperates costal and diaphragmatic pleura, producing the costophrenic recess
What is the nerve supply to the visceral pleura? Is it conscious?
What is the nerve supply to the costal parietal pleura? Is it conscious?
What is the nerve supply to the mediastinal and diaphragmatic parietal pleura? Where is the pain referred to?
Vagus nerve and sympathetic fibres, insensitive to pain stimuli, only detects stretch
Intercostal nerves, sensitive, thoracoabdominal pain
Phrenic nerve, radiates to root of neck/shoulder
What are the functions of the diaphragm?
What is the extent of the parietal pleura in the neck?
- Seperate thoracic cavity from abdominal cavity
- Contracts/relaxes allowing inspiration and expiration
- Helps posture and acts as oesophageal sphincter
2-3cm above level of medial 1/3 of clavicle
A: maxillary sinuses
B: ethmoid sinuses
C: Inferior concha/turbinate
D: Superior concha
F: Middle meatus
What makes up the floor of the nasal cavity?
A: Perpendicular plate of ethmoid bone
C: Septal cartilage
The palatine process of the maxilla (anterior) and the horizontal process of the palatine bone (posterior)
Where does the maxillary air sinus drain to?
How are the orbits connected to the nose?
How are the ears connected to the pharaynx?
What is the seonsory supply to the mucous membranes of the nose?
Nasolacrimeal duct -> inerior nasal meatus
What are the 2 functions of the larynx?
What do the intrinsic laryngeal muscles do?
Act as a sphincter protecting the lower respiratory tract; To produce phonation
Alter the position and tension of the vocal cords, thus modifying the sound (also active during coughing, swallowing and deep inspiration).
B: Thyroid membrane
C: Thyroid cartilage
D: Laryngeal prominance (adam's apple)
E: Cricothyroid ligament
F: Arytenoid cartilage
G: Cricoid cartilage
What is the larynx's nervous supply?
What is the larynx's blood supply?
Superior laryngeal nerves, L and R recurrent laryngeal nerves (motor to all intrinsic muscles except cricothyroid which is the external laryngeal), branches of the vagus nerve
Superior and inferior thyroid arteries, and venous drainage via thyroid veins
What vertebra does the trachea arise from?
Where does it end?
What is the difference between the R bronchi and the L bronchi?
What do the main bronchi branch into?
How many bronchopulmonary segments are there?
Sternal angle (T4/5)
R main bronchi is wider and shorter (and more vertical) and pases directly to the hilum of the lung.
Lobar bronchi (L: 2 and R:3) -> several segmental bronchi
10 in R lung (3 superior, 2 middle, 5 inferior), 8-10 in L (4-5 in upper and lower)
What is the nerve supply to the lungs?
Are the cartilaginous rings complete around the trachea, bronchi and bronchioles?
If a lung tumour causes pain initially it is diffuse. An individual with pleurisy (pleural inflammation) will have sharp localised pain. Explain this difference.
Vagus (from pulmonary plexus)
Only cricord cartilage in trachea complete. In rest of trachea and bronchi = incomplete. No cartilage in bronchioles.
When disese affects the organ, it spreads to the parietal pleura which is innervated by non-visceral spinal nerves, causing pain in the area overlying the organ and is sharp (pain located to cutaneous distribution of the intercostal nerves). True visceral pain is carried by the autonomic NS and is referred to areas of the body often far from the painful organ.