Respiratory Anatomy Flashcards
(146 cards)
1
Q
what is the thoracic inlet bound by
A
The first thoracic vertebra (T1) posteriorly
The first pair of ribs laterally.
The costal cartilage of the first rib and the superior border of the manubrium anteriorly
2
Q
what is the thoracic outlet bound by
A
12th thoracic vertebra posteriorly.
11th and 12th pairs of ribs laterally.
Costal cartilages of ribs 7 through 10 and xiphisternal joint anteriorly.
3
Q
what is the sternal angle and where
A
between manubrium and body of sternum
T4/5 vertebrae
4th intervertebral disc
4
Q
what is in between ribs
A
intercostal muscles
5
Q
what parts are in the sternum
A
manubrium - jugular notch
- body
- xiphoid, T10 vertebrae, rib 7
6
Q
at what vertebral level is the xiphoid
A
T10 vertebrae, rib 7
7
Q
what joint is between the clavicle and clavicle notch on sternum
A
saddle joint
8
Q
what ribs are true ribs
A
1-7 rib - true ribs, connected to sternum
9
Q
what type of ribs are ribs 8-10
A
false ribs, indirectly connected
10
Q
what type of ribs are ribs 11 and 12
A
floating ribs, not connected to sternum
11
Q
what joint is between the costal cartilage of ribs and sternum
A
synovial joint
12
Q
what joint is between the ribs and vertebrae
A
plain synovial joint
13
Q
describe the 1st rib and how many facets does it have
A
broad and flat
has 1 articular facet to attach w vertebral bodies
grooves for subclavian artery and vein
14
Q
what does the head of the rib bind to
A
Head binds to body of vertebrae - synovial plane joint
15
Q
what does the tubercle of the rib bind to
A
Tubercle binds w transverse process of vertebrae
16
Q
how many articular facets do the ribs have (apart from 1st)
A
2 articular facets
17
Q
what happens to the thoracic cavity on inspiration
A
transverse diameter increases ‘pump handle’ ‘bucket handle’ upwards and outwards
- diaphragm contracts + inc size of lung
- on forceful - need external intercostals and accessory muscles
18
Q
what muscles are used on forceful expiration
A
internal intercostal muscles + abdominal muscles used
19
Q
what are the intercostal muscles innervated by
A
innervated by ventral rami of thoracic spinal nerve
20
Q
what are the layers of intercostal muscle and their orientation
A
1) superficial layer, external intercostal muscle. Inferior anterior
2) internal intercostal - inferior posterior orientated
3) innermost intercostal, orientated ^^
21
Q
whats in the costal groove
A
neuromuscular bundles, intercostal vein + artery + nerve (VAN) between internal and innermost muscles
collateral branches
22
Q
where is costal groove
A
between internal and innermost intercostal muscles
23
Q
what is the intercostal muscles drained by
A
Drained by azygous vein into SVC
24
Q
what supplies the thoracic wall
A
posterior and anterior intercostal arteries (branch from internal thoracic artery - subclavian artery) and branches from axillary arteries
25
what drains the thoracic wall
azygous vein
hemiazygous accessory
internal thoracic veins
26
what is the lymphatic drainage of the right side of the thoracic wall
Right lymphatic duct -> internal jugular vein and right subclavian vein
27
what is the lymphatic drainage of the left side of the thoracic wall
thoracic duct -> internal jugular vein and left subclavian vein
28
what is the lymphatic drainage of the left side of the breast
Breast -> axillary lymph node -> parasternal LN -> abdominal LN
29
how is the mediastinum divided
superior
inferior: anterior, middle, posterior
divides at sternal angle
30
what are the peripheral attachments of the diaphragm
to lumber vertebrae
Costal cartilage on ribs 7-12
xiphoid process of sternum
31
what is the central attachment of the diaphragm
to central tendon
32
what innervates the diaphragm
Phrenic nerve supply C3-5,
motor (from inferior surface)
sensory (supplies central part
peripheral part of diaphragm innervated by sensory fibres of intercostal nerves, T7-T12
33
what are crus and where does right crus come from
tendons at bottom of diaphragm
| right L1-3
34
where does left crus come from
L1-2 + intervertebral discs
35
where are the diaphragm hiatuses (openings)
T8 - caval, vena cava through central tendon, phrenic nerve
T10 - oesophageal hiatus in muscle, vagus nerve
T12 - aortic hiatus, btwn right and left crust
36
where does the trachea bifurcate
at sternal angle level
| 2 primary bronchi at T4/5
37
what borders does the lung have
anterior, posterior, inferior
38
what surfaces does the lung have
costal, mediastinal, diaphragmatic
39
what is the peripheral part of the diaphragm innervated by
by sensory fibres of intercostal nerves, T7-T12).
40
where does the conducting zone and respiratory zone start
end - terminal bronchioles
| start - respiratory bronchioles
41
where is the cardiac notch
cardiac notch at rib 4-6, lingula
42
what is the hilum
on mediastinal surface of lung
43
what is the root of the lung
group of structures that enter/leave lung through hilum - bronchus, artery, vein, lymph
44
what impressions are on the left lung
Aortic arch and heart + oesophagus impression on left lung
| descending aorta
45
what impressions are on the right lung
Heart impression
| inferior and superior vena cava
46
how many bronchopulmonary segments are there
10
47
what is the parasympathetic innervation of the lungs, pulmoary plexus
Parasympathetic - vagus nerve
48
what is the sympathetic innervation of the lungs
T2-5, bronchodilator
49
what arteries supply lung
2 thoracic aorta on left
| 1 posterior intercostal artery on right
50
what veins drain the lungs
azygous + accessory hemiazygous
51
what is the lymphatic drainage of the lungs
superficial and deep LNs - bronchomediastinal lymph trunk
52
what is the pleura what are the components
Outer lungs and internal thorax covered
Visceral and parietal pleura
53
what is in the pleural cavity, whats its purpose
Cavity filled w intrapleural fluid allows movement of lung and sticks them together
54
what innervates visceral pleura
autonomic NS
55
what innervates parietal pleura
somatic neurones, pain sensitive
| Intercostal nerves, phrenic nerves
56
what is a recess
increased space between layers of pleura at reflection
57
what is reflection
where parietal pleura becomes visceral
58
what are some reflections in the lung
Costodiaphragmatic reflection + recess on bottom
| Costomediastinal
59
what are the margins of the lungs
mid clavicular rib 6
mid axillary line rib 8
paravertebral line 10
60
what are the margins of the parietal pleura
mid clavicular rib 8
mid axillary line rib 10
paravertebral line 12
61
what rib does the horizontal fissure follow (right lung)
4th rib
62
what rib does the oblique fissure follow
begins at spine T2/3, follows 6th rib
63
what are the layers in the histology of the respiratory systen
mucosa (epithelium and lamina propia)
Submucosa
Cartilage
Adventitia
64
what are the histological features of the trachea
20 C shaped hyaline cartilage, gaps filled by trachealis muscle and fibroelastic tissue
65
what is the purpose of the mucosa and submucosa
warm + moisten air, trap foreign particles in mucous
66
describe the tracheas epithelium
pseudostratified ciliated columnar epithelium w goblet cells
Basement membrane in between
Lamina propia - contains elastin n bv
67
describe the sub mucosa
Mixed sero-mucous glands
68
where is the perichondrium
between submucosa and cartilage
69
what is the adventitia
connects n supports trachea to surrounding tissue
70
what is the extra pulmonary bronchi and its histology
2 primary bronchi
| same as trachea
71
what is the histology of intra pulmonary bronchi
less cartilage, does not completely encircle the lumen.
| layers of smooth muscle between the mucosa and submucosa
72
what is the diameter of bronchioles
<1mm
73
what is the histology of bronchioles
Ciliated columnar epithelium (non-ciliated in smaller bronchioles - terminal)
Smooth muscles inc
Clara cells - secrete surfactant
No goblet cells, no cartilage, no submucosal glands
74
what is the histology of respiratory bronchioles
ciliated cuboidal epithelium
75
what are alveolar ducts surrounded by
surrounded by smooth muscle, elastin and collagen
76
what are type 1 pneumocytes
alveoli cells
| large flattened, v thin, diffusion take place
77
what are type 2 pneumocytes
secrete surfactant, decrease surface tension and stop alveoli collapsing
78
what cells are there in alveoli
type 1 pneumocytes, type 2 and macrophages (dust cells) - brownish
79
what do goblet cells do
secrete mucous
80
spermatogenesis
| oogenesis
ff
81
what cell is formed when the nucelus of sperm fuses nucleus of ovum
diploid cell called the ZYGOTE
82
what is formed after the zygote divides a couple times
Morula
| solid ball of cells
83
are the children affected if the mother has a mitochondrial disease
yes, all affected
84
what does the morula divide into and why
blastocyst
| getting nutrition to central core becomes difficult
85
describe blastocyst
has blastocystic cavity
Cells accumulate at one end to form an inner cell mass.
outer lining of cells is trophoblast.
86
where does fertilisation happen
in fallopian tube
87
zygote to blastocyst
| happens while moving from fallopian tube to uterus
ff
88
where does implantation occur
in the uterine endometrial layer and placenta begins to develop
89
how is chorion formed
cells that are outer mass of blastocyst - trophoblast
divide to form 2 layers
develop finger like processes (chorionic villi)
90
what does chorion do
```
Implantation process (chorionic villi)
Forms part of the placenta in due course
Secretes human Chorionic gonadotropin (HCG) (used to detect pregnancy)
```
91
at what day does implantation occur
day 7
92
what are fimbrae
are next to ovary
| capture ovum then release into tube
93
what is the Decidua basalis
part of the endometrium deep to the implanted conceptus.
94
what does HCG do
secreted by the chorion is going to help maintain the decidua (endometrium)
95
what happens to the inner cell mass of the blastocyst
cells of the inner cell mass form a 2–layered flat disc called the BILAMINAR DISC
epiblast
hypoblast
2 cavities - amniotic and yolk sac
96
what are the 2 layers of the bilaminar disc
epiblast
| hypoblast
97
what 2 cavities are formed with the bilaminar disc
```
Amniotic cavity (A)
Yolk sac (Y)
```
98
when is placenta formed and matured
after 12 weeks
| matured 18-20weeks
99
what is the function of the placenta
Foetal nutrition
Transport of waste and gases
Immune etc
100
describe placenta
Foetal part and surface: smooth with foetal blood vessels and end of umbilical cord
Maternal part: Decidua basalis of endometrium
Rough and has maternal blood vessels
101
what cavities are there in the embryo at week 2
Amniotic cavity
Chorionic cavity
Allantoic cavity
Yolk sac
102
what is the midline of the embryo
top of amniotic cavity
103
what is the Primitive streak
formed in the midline of the epiblast by the dipping in of cells (invagination)
forms axis for embryo
104
what is gastrulation, describe the process
Epiblast cells migrate to lie inbetween epiblast and hypoblast layers
form 3 germ layers
ectoderm
mesoderm
endoderm - trilaminar disc
cells are now specialised
105
what are the specialities of each layer in trilaminar disc
ectoderm - skin, NS
mesoderm - muscle, reproductive
endoderm - gut tube, resp tube
106
how is the notochord formed and what does it do
primitive streak keeps dividing
form cluster of cells in mesoderm, disconnect
secretes protein to induce neural tube
107
how is neural tube formed whats this process called
ectoderm thickens, makes crest until comes together and makes tube
neuralation
108
what induces the mesoderm to thicken
neural tube
109
what does the mesoderm seperate into
3 parts
paraxial
intermediate plate
lateral plate mesoderm
110
what happens to the lateral plate mesoderm, what are the sections called
it splits
| somatic and splanchnic mesoderm
111
what does the paraxial mesoderm divide into
into 3
- dermatome
- myotome
- sclerotome (bones)
112
what does intermediate plate mesoderm become
urogenital system (kidneys + repro)
113
what does lateral plate mesoderm become
body cavity and coverings
114
what is teratology
congenital abnormalities and abnormal formations.
115
whats and (R) enantiomer
isomer
| effective drug for morning sickness, positive
116
whats and (S) enantiomer
can cause birth defects
117
what are teratogens
environmental factors that cause abnormal development.
118
what are causes of abnormal foetus development
environmental
genetic
multifactorial
unknown
119
what is the risk of teratogenesis in weeks 1-2
High risk of death, low risk from teratogens
120
what is the risk of teratogenesis in weeks 3-8
Period of greatest sensitivity to teratogens
121
what is the risk of teratogenesis in weeks 9-38
Decreasing sensitivity to teratogens
122
what does the risk posed by teratogens depend on
Exposure during critical periods of development
Dosage of drug
Genetic constitution of embryo ie some more susceptible than others at equivalent doses etc
123
how can you diagnose malformations prenatally
Blood - AFP
Ultrasound scan – 12 week anomaly scan
Invasive tests: chorionic villus sampling and amniocentesis
124
how can you diagnose malformations postnatally
Hip stability
Testes (descent)
Fingers and toes
Hearing
125
what 4 structures are developed in the respiratory system
trachea
lungs
pleura
diaphragm
126
where does the repsiratory system develop from
foregut part of primitive gut tube
127
what is the gut tube formed from
endoderm
128
where do the trachea and lung buds bud out from and when
out from the ventral wall of the foregut
| at week 4
129
what is the position of the trachea to the oesophagus
trachea anterior to
| oesophagus
130
what seperates the trachea and lung buds from oesophagus
oesophagotracheal septum
131
what happens if the trachea and oesophagus don’t separate
```
Tracheoesophageal fistula (abnormal passage)
Oesophageal Atresia (passage is closed/absent)
```
132
what does the splanchnic layer form
forms visceral pleura
133
what does the somatic layer form
forms parietal pleura
134
what is the pericardioperitoneal canal
space between these two layers of mesoderm around the lungs is continuous with the heart in front and the peritoneal cavity below
pleura still open to heart and abdomen
135
what is it called once the pericardioperitoneal canal is closed off
pleural cavity
136
How do the pleural cavities get closed off from the heart
fold of lateral plate somatic mesoderm will grow in from the periphery and close off pleural cavity
pleuropericardial fold
137
what does the pleuropericardial fold become
become the pericardium of the heart
138
what seperates the pleural cavity from peritoneal cavity
diaphragm
139
what are the stages of lung development
```
embryonic
pseudoglandular
canalicular
saccular
alveolar (post natal after 40weeks)
```
140
what happens in the canalicular stage
alveolar ducts form
| Type 1 and 2 pneumocytes
141
when can gas exchange take place in the lung development stages
saccular stage
| alveoli develop, surfactant
142
what happens in pseudoglandular stage
). Development of all lung structures except respiratory part (no gas exchange)
143
what structures form the diaphragm
Septum transversum
Pleuroperitoneal folds
Skeletal muscle ingrowth from the peripheral body wall (muscular part of diaphragm)
dorsal mesentery of the oesophagus
look at diagram
144
what is a major defect of the diaphragm
Failure of the diaphragm to completely close during development -> hernias
hernia - protrusion of an organ through the structure or muscle that usually contains it
Pulmonary hypoplasia
145
what does the septum transversum become
forms the central tendon of the diaphragm
146
what forms the diaphragmatic crura
Skeletal muscle from the periphery covers the dorsal mesentery to form the diaphragmatic crura.
