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