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Flashcards in Resp Deck (66)
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1

How do the external intercostal muscles run?

Obliquely anteriorly and inferiorly in the intercostal spaces

2

How do the internal intercostal muscles run?

Obliquely posteriorly and inferiorly in the intercostal spaces deep to, and at right angles, to the external intercostals

3

What are the disease processes involving the pleural lining?

Pleuritis
Pleural adhesion
Pneumothorax
Hemothorax
Pleural exudates/effusion
Empeyma (pyothorax)
Chylothorax

4

What is the complication with hemo or pneumothorax?

Compression of the parenchyma tissues of the lung resulting in respiratory distress

5

What are the lower borders of the costal pleura?

8th rib - MCL
10th rib - MAL
12th rib - neck

6

How can you safely access the pericaridal sac?

At the left parasternal area, between costal cartilages 4 and 6
Can be entered without piercing the pleural space and lungs

7

Where are the three places the pleura extends below the costal margins

Right xiphisternal angerl
Right and left costovertebral angles

8

Anteriorly, what is the upper border of the lung?

Apex rises about 2-4cm above the inner (medial) third of the clavicle

9

The slow of the lower borders of the lung run....?

2 ribs above the plerual reflection
Lower border crosses the 6th rib at the MCL and T10 in MSL

10

Where do you find the oblique fissure?

Begins on the anterior chest at the level of the 6th rib MCL and extends laterally upward
Crosses the 5th rib in the MAL
Crosses the 4th rib and 4th interspace
Ends at the spinous process of T4

11

Where do you find the horizontal fissure?

Extends form the fourth rib at the sternal border
Follows the contour of the costal cartilage of the 4th rib
Crosses the foruth interspace and ends at the oblique fissue, after crossing the 5th rib in the MAL

12

Where does the trachea bifurcate?

Anteriorly - level of the sternal angle
Posteriorly - T4 spinous process

13

Where is the right hemidiaphragm located?

At the level of the 5th rib anteriorly
T9 posteriorly

14

Describe the vena caval hiatus

T8/9 disc
Inferior vena cava and branches of the right phrenic nerve

15

Describe the esophageal hiatus

10th rib
Esophagus, anterior and posterior vagus nerve, esophageal branches of the left gastric vessels

16

Describe the aortic hiatus

T12
Azygos vein, thoracic duct, lymph vessels
NOT the aorta - it runs posterior the the median arcuate ligament and anterior to the 12th rib

17

Describe the steronocostal hiatuses?

T10
Superior epigastric vessels

18

What are the structures that pass through the diaphragm without a specific hiatus?

Sympathetic trunk
Thoracic splanhnic nerves
Hemiazygos vein
Branches of the phrenic nerves

19

That thoracic landmark is at level: T2?

Jugular notch

20

That thoracic landmark is at level: T3?

Base of scapular spine
Top of aortic arch

21

That thoracic landmark is at level: T4?

Sternal angle (manubriosternal junction)
Second costal cartilage
Tracheal bifurcation
Upper end of the ascending aorta
Beginning of descending aorta
Arch of azygos vein and its entrance into the superior VC
Fusion of right and left mediastinal pleura in anterior midline

22

That thoracic landmark is at level: T7?

Inferior angle of scapula

23

That thoracic landmark is at level: T8/9 disc?

Vena caval hiatus

24

That thoracic landmark is at level: T9?

Xiphoid process

25

That thoracic landmark is at level: T10?

Esophageal hiatus

26

That thoracic landmark is at level: T12?

Aortic hiatus

27

What are the boundaries of the triangle of auscultation? What is it over?

Bounded by the trapezius, latissimus dorsi and medial border of the scapula
Found over the inferior lobe of the corresponding lung

28

What is the normal ratio of AP diameter/transverse diameter?

1:2 5:7
From PAL to AAL
From AAL to AAL

29

Define a Barrel chest

Increase in the AP diameter of the chest with teh AP diameter approximating that of the transverse diameter
Caused by COPD

30

Define kyphosis

Abnormal curvature that is convex posteriorly (thoracic)
Causes: osteoporosis, compression fractures, hunch back
Slows up as a restrictive pattern on pulmonary function tests