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PAS 501 > Pulmonary > Flashcards

Pulmonary Flashcards

(88 cards)

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1
Q

Parts of sternum

A

Manubrium
Body
Xiphoid process

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2
Q

What does the superior articular process articulate with

A

Vertebra above

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3
Q

What does the inferior articular process articulate with

A

Vertebra below

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4
Q

What does the transverse facet articulate with

A

Tubercle (costotransverse joint)

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5
Q

What do the demifacets articulate with

A

Head of rib on vertebra (costovertebral joint)

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6
Q

Atypical ribs

A

1 (flat and wide)
2 (flat)
10 (only articulates with T10)
11 (floating)
12 (floating)

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7
Q

True ribs

A

1-7
Directly articulate with sternum

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8
Q

False ribs

A

8-10
Indirectly attach to sternum through interchondral joints

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9
Q

Floating ribs

A

11-12
Do not articulate with sternum

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10
Q

Costochondral joints

A

Anterior portion of ribs meet costal cartilage

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11
Q

Interchondral joints

A

Indirect anchorage to sternum seen in ribs 8-10

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12
Q

Costal margin

A

Inferior margin of thoracic wall

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13
Q

Rib motions

A

1-7 pump up and down
8-10 swing up like bucket handle
11-12 move lateral-medially

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14
Q

Pectoralis minor

A

Ribs 3-5–> coracoid process of scapula
I: medial pectoral nerve
Protracts scapula

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15
Q

Deltoid

A

Cavicle, acromion, and spine–> deltoid tuberosity of humerus
I: axillary nerve
Abduct upper limb

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16
Q

Pectoralis major

A

Sternum and calvicle–> proximal humerus
I: lateral and medial pectoral nerve
Adduct, medialy rotate, and flex humerus at shoulder joint

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17
Q

Anterior scalene

A

TP of cervical vertebrae–> rib1
I: Anterior rami of cervival spinal nerves
Cervical rotation and elevation of rib1

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18
Q

Middle scalene

A

TP of cervical vertebrae–> rib 1
I: anterior rabmi of cervical spinal nerves
Cervical rotation and elevation of rib 1

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19
Q

Posterior scalene

A

TP of cervical vertebrae–> rib 2
I: anterior rami of cervical spinal nerves
Cervical rotation and elevation of rib 2

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20
Q

External intercostal membrane

A

Replace external intercostal muscles anteriorly and connect to sternum

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21
Q

External intercostal muscle

A

A primary muscel of inspiration
Elevates ribs.
Fibers run anteroinferiorly
I: intercostal nerves
Don’t go all the way to sternum

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22
Q

Internal intercostal muscles

A

Go from sternum to angle of ribs
Most active during expiration
Depress ribs
Fibers run inferoposteriorly

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23
Q

Internal intercostal membranes

A

Replace internal intercostal muscle to connect it to vertebrae

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24
Q

Innermost intercostal muscle

A

Fibers run inferoposteriorly
Acts with internal intercostal during inspiration
Occupy lateral-most parts of intercostal spaces (don’t go to sternum or vertebrae)

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25
Fascia layers of thorax superficial to deep
Skin Superficial fascia Adipose tissue Intercostals Endothoracic fascia Parietal pleura Pleural cavity Visceral pleura
26
Primary muscles of inspiration
Diaphragm External intercostals
27
Accessory muscles of inspiration
Scalenes Sternocleidomastoid
28
Accessory muscles of expiration
Rectus abdominis Internal oblique Transversus abdominis External oblique
29
Airway order
Nasopharynx Oropharynx Laryngopharynx Trachea Mainstem (primary) bronchi Lobar (secondary) bronchi Segmental (tertiary) bronchi Bronchioles Alveoli
30
What levels does the trachea span
C6-T4/5 (bifurcates here into L and R mainstem bronchi)
31
What makes up posterior trachea
Trachealis muscle
32
What makes the anterior part of trachea
C shaped cartilaginous rings open posteriorly
33
How many lobar bronchi in right lung
3 one for each lobe Middle and lower come off of bronchus intermedius
34
How many lobar bronchi in left lung
2 one for each lobe
35
Bronchioles
Lose hyaline cartilage Elastic fibers of lung keep them open. Subdivide to formm terminate alveoli
36
Where does the internal thoracic artery come from
Subclavian
37
What does the internal thoracic artery bifurcate into
Musculophrenic and epigastric
38
Parietal pleura
Around cavity
39
Visceral pleura
On organ
40
Intercostal nerve sensory to pleura
T1-11 Cervical costal Diaphragmatic Carry motor, sensory, and autonomic fibers
41
Phrenic nerve
C3, C4, C5 Sensory to pleura at cervical, mediastinal, and diaphragmatic Sensory to pericardium Motor to diaphragm
42
What gives atonomic innervation to cisceral plerua
Vagus nerve
43
Pneumothorax
Air in pleural cavity
44
Pleural effusion
Any fluid in pleural cavity
45
Hydropneumothorax
Serous fluid with pneumothorax
46
Hemothorax
Blood in pleural cavity
47
Chylothorax
Lymph in pleural cavity
48
Empyema (pyothorax)
Purulent fluid (pus)
49
Costal lung surface
Faces ribs and costal parietal pleura
50
Mediastinal lung surface
Faces mediastinum and mediastinal parietal pleura Hilum of lung Roots of lung
51
What surface of lung is the hilum on
Mediastinal
52
Diaphragmatic surface of lungs
Faces diaphragm and diaphragmatic parietal pleura Base of lung
53
What all is at the superor thoracic apeture
Trachea Esophagus Vessels Nerves R/L pleural cavities
54
Inferior thoracic apeture
Enclosed by diaphragm
55
Where does the IVC pass through diaphragm
T8
56
Where does the esophagus pass through the diaphragm
T10
57
Where does the thoracic aorta pass through the diaphragm
T12
58
Diaphragmatic apetures
Caval Aortic Esophageal
59
Where is and what goes through caval hiatus
T8 IVC goes through diaphragm Right phrenic nerve Lymphatic vessels
60
Where is and what goes through esophageal hiatus
T10 Esophagus Anterior vagal trunk Posterior vagal trunk Esophageal branches of left gastric vessels Lymphatic vessels
61
Where is and what goes through aortic hiatus
T12 Descending aorta Azygos vein Thoracic duct
62
Central tendon
Central aponeurosis Fused to inferior surface of fibrous pericardium
63
Right lung fissures
Oblique separates RUL and RML from RLL Horizontal separates RUL from RML
64
Left lung fissures
Oblique separates LUL and LLL
65
Mediastinal structures on surface of right lung
Heart IVC SVC Azygos vein Esohagus Subclavian arteries and veins
66
Mediastinal structures on surface of left lung
Heart Aortic arch Thoracic aorta Esophagus Subcalvian arteries and veins
67
How to tell which lung you're looking at
Position of pulmonary artery compared to bronchiole Right Anterior Left Superior
68
Bronchial arteries
Come from thoracic aorta and give blood supply to lung tissue, visceral pleura, and root structures. Much smaller than pulmonary arteries but sometimes seen in hilum
69
Where do the bronchial veins drain
Azygos vein
70
Indications for intercostal nerve blocks
Thoracic surgery Upper abdominal surgery Breast surgeryy Rib fractures Chest tube placement
71
Absolute contraindication of intercostal nerve block
Local infection
72
Relative contrainidications of intercostal nerve block
Coagulation disorders
73
Where to do intercostal nerve block
Posterior to midaxillary line
74
Complications of intercostal nerve block
Pneumothorax (not much room for error) Bleeding (hitting vessel)
75
Where does the lateral cutaneous branch come off intercostal
Midaxillary line
76
Transudative pleural effusion
Pleural effusion with increased hydrostatic pressure or decreased oncotic pressure. CHF Hypoproteinemia
77
Exudative pleural effusion
Pleural effusion with thick stuff with cells. Parapneumonic Infectious Malignant Connective tissue disease Chylothorax
78
Thoracentesis/pleural effusion signs and symtpms
Dyspnea Cough Respirophasic chest pain Dullness to percussion Absent or decreased breath sounds Pleural fiction rubs
79
Chest tube procedure
Local anesthesia, intercostal nerve block, or IV sedation Inserted at 4th or 5th intercostal space mid-axillary line
80
Emergent needle decompession
Done at second intercostal space midcalvicular line for tension pneumothorax.
81
Tension pneumothorax signs
Absence of breath sounds Tracheal deviation to contralateral side JVD Give emergent needle decompression
82
land mark for 4/5th intercostal space midclavicular line
Nipple
83
When does the patient feel the most pain in thoracic procedure
Breaking through the parietal pleura
84
Should the patient inhlale or exhale for most radiographs
Inhale
85
Should the patient inhale or exhale for pneumothorax radiograph
Exhale
86
Best test to diagnose PE
CTPA/CTPE
86
When is D dimer not reliable for PE test
Hospital setting
87
What does a clot look like on CT
Hypodensity within vessel

PAS 501 (3 decks)

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