respiratory anatomy

Question 1

superior thoracic aperture

Answer 1

the opening at the top of the thoracic cavity
anatomically - thoracic inlet
clinically - thoracic outlet

Question 2

what is the superior thoracic aperture bounded by

Answer 2

1. T1 posteriorly
2. 1st pair of ribs laterally
3. costal cartilage of the 1st rib and the superior border of the manubrium anteriorly

Question 3

what is the inferior thoracic aperture bounded by

Answer 3

1. T12 posteriorly
2. 11th and 12th pair of ribs laterally
3. costal cartilage of ribs 7-10 and the xiphisternal joint anteriorly

Question 4

how it the rib cage separated from the peritoneal cavity

Answer 4

the thoraco-abdominal cavity

Question 5

define diaphragm

Answer 5

fibromuscular membrane stretched across the midline of the body

Question 6

the head of the rib articulates with …

Answer 6

the body of the thoracic vertebra of the same number AND the body of the vertebra above at the costovertebral joints (synovial plane)

Question 7

the tubercle of the rib articulates with …

Answer 7

the transverse process of the thoracic vertebra of the same number at the costotransverse joint (synovial plane)

Question 8

describe the shape of the 1st rib

Answer 8

broad and flat

surfaces look up and downward

Question 9

describe the head of the 1st rib

Answer 9

possesses only a single articular facet (most have 2) for articulation with the body of T1

Question 10

describe the upper surface of the body of the 1st rib

Answer 10

marked by 2 shallow grooves
separated by the scalene tubercle (attachment of the anterior scalene muscle)
anterior groove lodges the subclavian vein and the posterior groove for the subclavian artery and the lowest trunk of the brachial plexus

Question 11

what are the 3 peripheral attachments of the diaphragm

Answer 11

1. lumbar vertebrae and arcuate ligaments
2. costal cartilages of ribs 7-12
3. xiphoid process of the sternum

Question 12

what is the central attachment of the diaphragm

Answer 12

central tendon

Question 13

describe the parts of the diaphragm that arise from the vertebrae

Answer 13

they are tendinous in structure and are known as the R and L crura

Question 14

right crus

Answer 14

arises from L1-L3
some fibres of the right crus surround the oesophageal opening and help prevent reflux of gastric contents back into the oesophagus

Question 15

left crus

Answer 15

arises from L1-L2 and their intervertebral discs

Question 16

what happens during inspiration to the diaphragm

Answer 16

insp: contracts and descends, domes flatten, increases the vertical diameter of the thoracic cavity

Question 17

how many openings are there in the diaphragm and what are these known as

Answer 17

3 hiatuses

Question 18

where are the diaphragm hiatuses located

Answer 18

T8, T10, T12

Question 19

T8 diaphragm hiatus

Answer 19

caval opening passes through the central tendon of the diaphragm
transmits the IVC and the R phrenic nerve from the abdomen into the thorax (tendon can’t contract and impede blood flow)

Question 20

T10 diaphragm hiatus

Answer 20

oesophageal hiatus
located through the muscular sling of the R crus
transmits the oesophagus and both vagus nerves

Question 21

T12 diaphragm hiatus

Answer 21

aortic hiatus
between the R and L crus
transmits the aorta, azygos veins, hemiazygos vein and thoracic duct

Question 22

phrenic nerve roots

Answer 22

anterior rami of C3,4 (mainly) and C5

it is both motor and sensory

Question 23

what are the motor functions of the phrenic nerve

Answer 23

pierces and innervates the diaphragm from its anterior surface

Question 24

what are the sensory functions of the phrenic nerve

Answer 24

supplies the central part of the diaphragm

peripheral portions are also innervated by sensory fibres of the intercostal nerves T7-12

Question 25

lymphatic drainage of the chest wall

Answer 25

L side drains to thoracic duct (--> L brachiocephalic vein) | R side drains to R lymphatic duct (--> R brachiocephalic vein)

Question 26

upper respiratory tract

Answer 26

part of the respiratory system lying above the sternal angle or above the cricoid cartilage the larynx is sometimes included in the upper and lower airway

Question 27

lower respiratory tract

Answer 27

trachea, bronchi, bronchioles, lungs (including alveoli) | also sometimes includes the larynx

Question 28

what is the respiratory/tracheobronchial tree refering to

Answer 28

the branching structure of airways supplying air to the lungs includes the trachea, bronchi and bronchioles

Question 29

what is included in the conducting portion

Answer 29

no gas exchange 1. trachea 2. main bronchus 3. lobar bronchus 4. segmental bronchus 5. conducting bronchiole 6. terminal bronchiole

Question 30

what is included in the respiratory portion

Answer 30

gas exchange occurs 7. respiratory bronchiole 8. alveolar duct 9. alveolar sac 10. alveolus

Question 31

where is the larynx found

Answer 31

in the anterior neck between C3-6 | extends from the tip of the epiglottis to the inferior border of the cricoid cartilage

Question 32

what innervates the larynx

Answer 32

branches of the vagus nerve

Question 33

what are the 3 borders of the lungs

Answer 33

anterior, posterior, inferior

Question 34

what are the 4 lobes of the lungs

Answer 34

superior inferior middle (R only) lingula (L only)

Question 35

what are the 3 surfaces of the lungs

Answer 35

costal mediastinal diaphragmatic

Question 36

what is in the lung hilum

Answer 36

1. bronchi 2. pulmonary artery (in front of bronchus) 3. superior pulmonary vein (most anterior) 4. inferior pulmonary vein (most inferior) (includes the group of structures that enter/leave the lung hilum)

Question 37

where is the lung hilum located

Answer 37

on the mediastinal surface of the lung

Question 38

what is different about the R lung hilum

Answer 38

it has an additional bronchus called eparterial bronchus (above the artery) R main bronchus is also referred to as the hyparterial bronchus

Question 39

parts of the pleura

Answer 39

``` visceral - against the lungs parietal - against the rib cage cupular - covers the apex costal - covers rib surface diaphragmatic mediastinal ```

Question 40

nerve supply of pleura

Answer 40

parietal: somatic nerves (IC nerves, phrenic nerves - PAIN SENSITIVE) visceral: autonomic nerves (T2-5) PAIN INSENSITIVE

Question 41

where are the pleural reflections and recessess

Answer 41

costomediastinal costodiaphragmatic (clinically referred to as the costophrenic angle) when we breathe in the recesses are filled

Question 42

define pleural reflection

Answer 42

place at which the parietal pleura changes its direction of travel

Question 43

define pleural recess

Answer 43

the increased space between the layers of pleura occurring at the pleural reflections

Question 44

surface anatomy of the lungs and pleura

Answer 44

2 IC spaces between bottom of lung and pleura during expiration e.g. inferior margins of the lung (midclavicular line - rib 6, midaxillary line - rib 8, midscapular line - rib 10) inferior margins of parietal pleura (rib 8, 10 and 12) horizontal fissure of R lung follows line of 4th rib anteriorly oblique fissure begins at T3 spine and follows line of 6th rib anteriorly

Question 45

what type of epithelium and cartilage is in the trachea

Answer 45

stratified columnar epithelium hyaline cartilage the large bronchi is histologically similar to the trachea

Question 46

compare the wall of the bronchioles to the trachea and bronchi

Answer 46

no cartilage, glands or goblet cells in the walls of the bronchioles compared to the trachea and larger bronchi epithelium is either columnar or cuboidal

Question 47

what happens as the tubes become smaller in the lung:

Answer 47

1. epithelium becomes flatter (columnar --> cuboidal --> squamous) 2. cartilage reduces (rings --> small plates --> complete abscence in bronchioles) 3. mucous secreting glands and goblet cells decrease (complete abscence in bronchioles)