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Flashcards in Respiratory anatomy Deck (78)
1

location of the left recurrent laryngeal nerve

between the trachea and oesophagus

2

right vagus nerve

lies on the trachea

3

right phrenic

lies on SVC

4

left vagus

lies on the aortic arch

5

phrenic nerve

lies anterior to lung roots

6

vagus

posterior to lung roots

7

blood supply to trachea

inferior thyroid arteries and bronchial arteries
inferior thyroid vein

8

lymph drainage from trachea

pre and para tracheal nodes

9

nerve supply of trachea

vagi, reccurent laryngeal and sympathetic trunk

10

describe the numbers of lung segments

10 in total
3 superior lobe
2 middle or lingual
5 lower lobe

11

oblique fissure

spine of T4 to rib 6

12

horizontal fissure

4th intercostal space until it meets the oblique fissure at the mid axillary line

13

describe the parts of the hilum

bronchi- posterior
pulmonary arteries- anterior superior
pulmonary veins- anterior inferior

14

pulmonary ligament

allows hilar movement

15

origin of the right bronchial artery

3rd posterior intercostal artery from the descending aorta

16

origin of two left bronchial arteries

direct branch from the descending aorta

17

drainage of bronchial arteries

may anastomose with pulmonary arteries
drains to azygous system

18

where does the deep lymphatic plexus drain to?

pulmonary nodes, located in the hila

19

where do the pulmonary nodes drain to?

bronchopulmonary nodes (around the main bronchi)

20

where do the bronchopulmonary nodes drain to?

inferior and superior tracheobronchial nodes ( around the carina)

21

where do the tracheabronchial and posterior mediastinal nodes drain to?

paratracheal nodes and bronchomediastinal lymph trunks

22

where would a chest drain be inserted

just above the rib to avoid damage to NV bundle

23

what nerve supplies the axilla wall and upper medial part of UL and is at risk in breast surgery

Intercostobrachial Nerve

24

what dermatomes supple the skin and muscles of the abdo wall

T7- 12

25

what does the ventral rami of t2-11 make

the intercostal nerves

26

what is the subcostal nerve made of

T12

runs along the border of the twelfth rib

27

where may a breast tumour spread to

anterior grp, central grp, apical grp mostly


but also to internal mammary nodes

28

where does the breast receive its blood supply from

internal thoracic artery
anterior intercostal branches

superior thoracic
thoraco acromonial and lateral thoracic branches of the axillary artery

so most lymph drains to apical nodes

29

where does thoracic wall lymph drain to

parasternal nodes
intercostal nodes

30

what veins drain the intercostal spaces

anterior intercostal veins
posterior intercostal veins
(both venae comitantes- int thoracic art and post intercostal art)

31

what muscles are described here:
lower ribs
posterior
internal surface

subcostales

32

what muscles are described here:
internal aspect of ribs and costal cartilages 3-6
downwards and medially to the sternum and costal margin
anterior ribs, internal surface

transversus thoracis

33

in what direction do the external intercostal muscles go

downwards and medially

34

what direction do the internal intercostal muscles go

downwards and laterally

35

what lies on top of the parietal pleura

endothoracic fascia

36

what type of joint is between a rib and costal cartilage

primary cartilaginous joint (hyaline)

37

what features can be seen on the first rib

scalene tubercle of scalenus anterior
groove for subclavian vein
groove for subclavian artery and lower trunk of the brachial plexus

38

where does the diaphragm attach

anterior to xiphoid process - T8/9
deep surfaces of ribs and costal cartilages 7-12

39

where is the median arcuate ligament

T12

sympathetic trunk goes behind

40

where is the medial arcuate ligament

body of L1 to transverse process L1

41

where is the lateral arcuate ligament

tip of L1 to transverse process t12 rib
subcostal vessels and nerve go behind

42

where is the left crus

L1 and 2 bodies

43

where is the right crus

L1, 2, 3 bodies

44

what comes through the diaphragm at t8

IVC
right phrenic nerve

45

what comes through the diaphragm at t10

oesophagus
vagus nerves
left gastric vessels

46

what comes through the diaphragm at t12

aorta
thoracic duct
azygous veins

47

what goes through the crura

splanchnic nerves

48

what is the arterial supply of the diaphragm

internal thoracic => pericardiophrenic
musculophrenic
sup phrenic arteries from aorta
lower internal intercostal arteries

49

where does bucket handle inspiration occur

ribs 8 -10 due to flat costo transverse joints that allow gliding

50

describe the pleural surface markings of reflections

Rise to level of neck of 1st rib, 2 cms above clavicle
•2nd cc lie adjacent in the mid line
•4th Lcc notch for the heart
•6th cc deviate laterally
•8th rib lie in the midclavicular line
•10th rib lie in the mid axillary line
•12th rib lie in the mid scapular line
•Mid line level with T12 (just below the 12th rib)

51

what is the costomediastinal recess

anteriorly where pleura wraps around the mediastinum but lungs does not fill the recess

52

describe the surface markings of the lungs

Rise to level of neck of 1st rib, 2 cms above clavicle
•2nd cc lie adjacent in the mid line
•4th Lcc cardiac notch
•6th cc deviate laterally
•6th rib lie in the midclavicular line
•8th rib lie in the mid axillary line
•10th rib lie in the mid scapular line and mid line


2 spaces higher than the pleura

53

what segment is particularly prone to pneumonia

apical segment of the inferior lobe- inferolateral to the upper posterior position of the oblique fissure

listen below and lateral to the spine of T4

54

what is extension

a superimposed acute MI following a large MI

55

what nerves supply the intercostal spaces

intercostal nerves t1-11
ventral rami of t2 - 11 are the intercostal nerves

t12 is the subcostal nerve

56

in what direction do external intercostals go

downwards and medially

57

what direction do internal intercostals go

downwards and laterally

58

where are subcostales found

lower ribs, internal surfaces, posterior

59

where is transversus thoracis

anterior

60

what does the supreme intercostal artery supply

1st two ic spaces

from costocervical trunk

61

what does the intercostobrachial nerve supply

t2- supplies the thorax wall in the axilla and upper medial UL

62

what are the 3 segments of the upper lobe

post, ant, apical

63

what are the 2 segments of the middle lobe of the right lung

medial and lateral

64

what are the 2 segments of the lingual of the left lung

sup and inf

65

what are the 5 segments of the lower lobe

apical
med lat ant post

66

where does the single right bronchial artery arise

3rd posterior intercostal artery

67

where do the two left bronchial arteries arise

directly from the aorta

68

where do the bronchial arteries drain

azygous or pulmonary veins

69

describe lung lymph drainage

pulmonary
bronchopulmonary
tracheobronchial
paratracheal
bronchomediastinal
thoracic duct
or right lymphatic trunk

70

what is the nerve supply of the lung

pulmonary plexus
visceral pleura has no sensory supply
parietal pleura has sensory from intercostal and phrenic

71

what could lung tumours impinging on nerves cause

phrenic nerve- diaphragm paralysis
cervical sympathetic trunk - horners

left side only- LRLN -horseness

72

describe the int mammary

branch of first part of the subclavian
lies along the margins of the septum
terminates as the superior epigastric and musculophrenic arteries
supplies medial 1/2 breast

73

how many anterior intercostal arteries are there per space

2 per space in space 1-6

7-10 supplied by musculophrenic

11 and 12 have no anterior supply

74

what is the blood supply to the intercostal spaces

supreme intercostal
ant intercostals
post intercostals
musculophrenic
subcostal arteries

75

what is the venous drainage of the intercostal spaces

BCV
superior intercostal vein (2nd and 3rd spaces)
azygos venae comitantes

76

lymph drainage of the IC spaces

parasternal nodes
intercostal nodes on the rib heads

77

where would you listen for pneumonia

below and lateral to t4 spinous process- apical segment of inferior lobe

78

where does the horizontal fissure meet the oblique fissure

mid axillary line