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Flashcards in Resp 3 - Anatomy 3 Deck (44):
1

Name the intercostal muscles from superficial to deep:

External
Internal
Innermost

2

In what direction do the fibres of the External Intercostal muscles run? What is their role?

Down and anteriorly
Pull ribs up and out = 30% chest expansion during quiet respiration

3

In which direction do the fibres of the Internal and Innermost Intercostal muscles run? What is their role?

Down and posteriorly
Pull ribs down during forced expiration

4

What do the intercostal nerves supply?

- Intercostal muscles
- Parietal pleura
- Overlying skin

5

Define the origins of the diaphragm:

- Xiphoid process
- Interior 7-12 costal cartilages
- Arcuate ligament
- Crura of diaghragm

6

What is the insertion of the diaphragm?

Central tendon of the diaphragm

7

Which 2 muscles are responsible for chest expansion in quiet respiration?

1) External Intercostal muscles ~ 30%
2) Diaphragm ~ 70%

8

Which nerve supplies the diaphragm? What are its roots?

Phrenic nerve
C3, C4, C5 keeps the diaphragm alive

9

How many openings does the diaphragm have, what structures pass through them?

3:
@ T8 = Inferior Vena Cava
@ T10 = Oesophagus
@ T12 = Abdominal Aorta

10

At which spinal level does the Aorta pass through the diaphragm?

T12

11

At which spinal level does the IVC pass through the diaphragm?

T8

12

At which spinal level does the oesophagus pass through the diaphragm?

T10

13

In what order do the intercostal nerves, arteries and veins run along the ribs from superior to inferior?

Vein, Artery, Nerve (VAN)

14

Where should a needle be inserted for pleural aspiration/chest drain, and why?

Upper border of rib, to avoid intercostal neurovascular supply

15

Which arteries supply the parietal pleura?

Intercostal arteries

16

Where do the Intercostal arteries arise from?

Anterior segment = Internal Thoracic artery
Posterior segment = Superior Intercostal artery

17

Where do the intercostal veins drain into?

Anterior segment = Internal Thoracic vein
Posterior segment: RHS = Azygos, LHS = Hemiazygous

18

How much pleural fluid is usually present?

~ 10-20 ml

19

Name the 3 reflections of the pleura:

Anterior = Sternal
Posterior = Vertebral
Inferior = Costal

20

What is responsible for producing and absorbing pleural fluid?

Capillaries of parietal surface = Produce pleural fluid
Parietal lymph nodes = Absorb pleural fluid

21

What are the main functions of the pleural fluid?

- Reduce friction
- Create surface tension = cohesion (when chest expands, so does lungs)

22

What is the blood supply to and from the visceral pleura?

Bronchial arteries
Bronchial veins

23

What is the main difference between the nerve supply to the parietal and visceral pleura?

Parietal = Somatic and Autonomic
Visceral = Autonomic only (no pain)

24

What is the Carina?

Ridge at the base of the trachea which separates the L and R bronchi

25

What is the name of the ridge separating the entrances to the R and L bronchi?

Carina

26

How many lobar bronchi are there in each lung?

Right lung = 3
Left lung = 2

27

What is the name of the airway supplying each bronchpulmoanry segment?

Segmental bronchi

28

What is a bronchopulmonary segment?

Pyramidal area of lung, each supplied by a segmental bronchus, artery and vein. (Branches of pulmonary and bronchial)

29

How are bronchopulmonary segments useful in surgery?

Can be isolated and removed with minimal bleeding, air leakage or interference with other segments

30

Where do the Bronchial arteries arise from?

Right = 3rd Intercostal artery
Left = Aorta

31

How is the blood supply to the lungs maintained after a pulmonary embolus?

Anastamoses are present between the pulmonary and bronchial arteries (dual blood supply)

32

Which veins drain most of the blood supplied by the Bronchial arteries?

Pulmonary veins

33

Name the parasympathetic nerve which has afferent and efferent fibres in the lungs:

Vagus nerve

34

Name the 2 lymphatic plexuses in the lungs, and the lymph node they drain to:

1) Superficial sub-pleural lymphatic plexus (deep to visceral pleura)
2) Deep bronchopulmonary lymphatic plexus (in submucosa of bronchi and peribronchial tissue)

Hilar lymph nodes

35

Define the mediastinum:

Central compartment of thoracic cavity, between the 2 pleural sacs

36

Name the 4 divisions of the mediastinum:

1) Superior
2) Anterior
3) Middle
4) Posterior

37

Name the borders of the superior mediastinum:

Superior = Thoracic inlet
Inferior = Sternal angle line
Anterior = Manubrium
Lateral = Pleural sacs
Posterior Vertebral bodies T1-4

38

Name the contents of the superior mediastinum:

- Great vessels
- Nerves (Vagus, Phrenic, Cardiac and sympathetic trunk)
- Oesophagus
- Trachea
- Thymus
- Thoracic duct

39

Name the borders of the anterior mediastinum:

Superior = Sternal angle line
Inferior = Diaphragm
Anterior = Body of sternum and Transverse Thoracis muscles
Lateral = Mediastinal pleura (part of parietal pleura)
Posterior = Pericardium

40

Name the contents of the anterior mediastinum:

Nothing
Except Thymus in childhood - receeds in adulthood

41

Name the borders of the middle mediastinum:

Superior = Sternal angle line
Inferior = Diaphragm
Anterior = Anterior margin of Pericardium
Lateral = Mediastinal pleura
Posterior = Posterior margin of Pericardium

42

Name the contents of the Middle Mediastinum:

- Heart + Pericardium
- Tracheal bifurcation + L/R bronchi
- Great vessels
- Nerves (cardiac plexus + phrenic)
- Tracheobronchial lymph nodes

43

Name the borders of the Posterior Mediastinum:

Superior = Sternal angle line
Inferior = Diaphragm
Anterior = Posterior margin of the Pericardium
Lateral = Mediastinal pleura
Posterior = Vertebral bodies T5-12

44

Name the contents of the Posterior Mediastinum:

- Thoracic Aorta
- Thoracic duct
- Oesophagus
- Azygos vein system
- Sympathetic trunk