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104 Cards in this Set

  • Front
  • Back
what is the superior limit of the thoracic cavity?
thoracic inlet
at what level do the domes of the diaphragm lie?
approx the 5th intercostal space during expiration
where do the intercostal veins drain?
azygos vein
t/f... the intercostal nerves branch off the thoracic spinal cord and pass through the sympathetic trunk
true
where does the trachea begin?
inferior border of larynx (C6)
what holds the trachea patent?
C-shaped rings of cartilage
where are the cartilage rings deficient in the trachea?
posteriorly
why are the cartilage rings in the trachea deficient posteriorly?
to permit expansion of the oesophagus during swallowing
where does the trachea bifurcate?
behind the manubriosternal joint
how is the right primary bronchus different to the left?
the right primary bronchus is shorter, wider and more vertically oriented than the left
how mnay lobes does the left lung have?
2 - upper and lower
t/f... the left lung has a transverse fissure only
false, the left lung has an oblique fissure only
what is the space between the lungs called?
mediastinum
which layer of pleura lines the thoracic cavity?
parietal pleura
where is the visceral pleura?
lining the lungs and between the lobes
what holds the two layers of pleura together?
surface tension of the pleural fluid
what is the nerve supply to the lungs and visceral pleura?
autonomic from the vagus nerve and sympathetic trunk
t/f... the visceral pleura is pain sensitive
false, the parietal pleura is innervated for pain but not the visceral pleura
what is the nerve supply to the parietal pleura?
intercostal nerves and phrenic nerve
describe the lymphatic drainage of the lung
subpleural lymphatic plexus drains to the hilar lymph nodes
what innervates the diaphragm?
phrenic nerve (C3,4,5)
what are the accessory muscles?
pec minor, scalenes, SCM, intercostals
t/f... the intercostal vessels lie between the internal and innermost intercostal muscles
true
t/f... the pulmonary arteries lie posterior to the principal bronchi
false, the pulmonary arteries lie anterior to the bronchi
t/f... the pulmonary veins lie inferior to the pumonary artery and bronchus
true
what percentage of patients with thoracic trauma die?
10%
what fraction of trauma deaths is due to chest injury?
1/4
what percentage of blunt injurites require thoracotomy?
less than 10%
what percentage of penetrating injuries require thoracotomy?
10-30%
how many mls of pleural fluid surrounds both lungs?
2 ml
what is the thickness of the layer of pleural fluid?
10-30 microns
which layer of pleura has a higher density of microvilli?
visceral
what provides lubrication for the movement between lungs and chest wall?
glycoproteins trapped in microvilli
t/f... the right and left pleural spaces commmunicate
false
what is the pressure in the plaural space at the top of the lung?
about -8.5 cm H2O (below atmospheric)
what is the pressure in the pleural space at the bottom of the lungs?
about -2.5 cm H2O
why is there usually no gas in the pleural space?
the venous blood perfusing capillaries around the pleural surfaces is 60 cm H2O below atmospheric so any gas introduced tends to resorb
why is the pleural pressure subatmospheric?
due to the elastic recoil of the lung acting against the chest wall
at total lung capacity, is the pleural pressure more or less negative than at functional residual capacity?
more negative
which parts of the lung expand more during inspiration?
lower parts
what is compliance?
change in volume for a given change in pressure
what are the core features of post traumatic stress disorder?
reliving the event, avoiding associated stimuli, heightened anxiety and arousal and emotional numbing
which spinal regions contribute to the sympathetic trunk?
thoracic and upper lumbar
where are the preganglionic cell bodies of sympathetic nerves?
lateral horn of the spinal cord grey matter
where does the peripheral part of the parasympathetic system arise from?
brain stem or sacral spinal cord segments
which cranial nerves have a parasympathetic component?
occulomotor, facial, glossopharyngeal, vagus
where are the cranial preganglionic nerve cell bodies located?
cranial nerve nuclei
where are the sacral preganglionic cell bodies located?
intermediate region of the sacral spinal cord grey matter segments 2 to 4
t/f... postganglionic parasympathetic neurons are usually long
false, they are usually short
what is the peripheral neurotransmitter for the sympathetic system?
noradrenaline
what is the peripheral neurotransmitter for the parasympathetic system?
acetylcholine
which structures in the thorax receive an autonomic supply?
oesophagus, lungs, heart, blood vessels
t/f... the walls of the thorax (including the skin) receive only a sympathetic supply via the sympathetic trunk and the intercostal nerves
true
which spinal cord segments contribute to the sympathetic supply to the heart and lungs?
T1 to T5
where does the preganglionic parasympathetic supply to the oesophagus, lungs and heart originate?
cranial nerve nuclei (dorsal motor nucleus of the vagus, nucleus ambiguous)
with a pneumothorax, which side will the mediastinum shift to?
the side of the unaffected lung
what is the most common cause of pneumothorax in young people?
spontaneous due to the rupture of small blebs on the surface of visceral pleura
what are the common symptoms of pneumothorax?
pleuritic chest pain and dyspnoea
what is the posterior boundary of the thoracic inlet?
T1
what is the lateral boundary of the thoracic inlet?
rib 1 and its costal cartilage
what is the anterior boundary of the thoracic inlet?
manubrium
what is the posterior boundary of the thoracic outlet?
T12
what is the lateral boundary of the thoracic outlet?
rib 12 and the costal margin
what is the anterior boundary of the thoracic outlet?
xiphisternal joint
what is the lowest rib to articulate with the sternum?
R7
which are the true ribs?
ribs 1 to 7
which rib does not have an angle?
R12
at what level does the aorta pierce the diaphragm?
T12
what structure pierces the diaphragm at T8?
IVC
which muscles participate in forced inspiration?
scalenes, sternocleidomastoid, pec major, pec minor
which intercostal muscles contribute to inspiration?
external intercostals
which intercostal muscles are involved in forced expiration?
internal intercostals
how many white cells are present in the pleura?
1.7 x 10^6
what secretes the pleural fluid?
parietal pleura
what resorbs the pleural fluid?
parietal pleural lymphatics
what effect does age have on airway closure?
airway closure increases with age
how does airways resistance relate to the radius?
resistance is inversely proportional to the radius^4
what is dyspnoea?
an individual's subjective awareness of discomfort related to the act of breathing
t/f... cough receptor fibres are unmyelinated
false, they are myelinated
what is the normal inspiration to expiration ratio?
I:E - 3:1
what produces stridor?
tracheal or laryngeal obstruction
what sound is produced by air flowing through fluid in large airways?
coarse crackles
what is responsible for the noise of fine crackles?
small airways popping open
what are the features of post traumatic stress disorder?
re-experiencing the event, avoidance of stimuli associated with the trauma, increased arousal, emotional numbing
what is the typical onset of PTSD?
weeks or months after the event
how long do symptoms of PTSD have to last to meet criteria?
one month
what percentage of concentration camp survivors have PTSD?
85%
what structure does the IVC pass through as it goes through the diaphragm?
vena caval foramen
what innervates the diaphragm?
phrenic nerve
which phrenic nerve pierces the muscular part of the diaphragm?
left phrenic nerve
which part of the diaphragm does the right phrenic nerve pierce?
central tendon
what are the three cells in respiratory epithelium?
principal cell - columnar with apical cilia, goblet cell, basal cell - divides to replace goblet and principal cells
t/f... respiratory epithelium is classified as pseudostratified epithelium
true
what do respiratory glands secrete?
mucous
at what speed do the cilia propel trapped particles towards the pharynx?
1 cm/minute
t/f... clara cells are present in terminal bronchioles
true
t/f... bronchioles contain cartilage
false
t/f... there are no goblet cells in terminal bronchioles
true
which age group have more crashes, over 65 or under 65?
over 65
what percentage of crashes on expressways are due to fatigue?
20%
what percentage of crashes on major roads are due to fatigue?
16%
what is the increased risk of crash while using a mobile phone?
4x increased risk
what is the rate of seatbelt wearing in Australia?
95%
what percentage of cars in Australia have air bags?
50%