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48 Cards in this Set
- Front
- Back
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Anatomy of the respiratory system is composed of
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Thorax, lungs, extrapulmonary airways
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Relative size of thoracic apertures
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Superior thoracic aperture-narrow, inferior thoracic aperture-wide
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2 important functional characteristics of the thorax
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strength (bones and cartilage) and flexibility (muscle)
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Kyphoscoliosis leads to
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Hypercapnea then hypoxia due to decreased flexibility of the muscles
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Skeletal and cartilagenous components of the thorax
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Thoracic vertebrae, ribs, sternum
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Intervertebral disks are made of?
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Fibrocartilage on the outside (annulus fibrosis), and gel like material on inside (nucleus pulposus)
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How many ribs do we have?
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24 (12 pairs)
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How do we regenerate ribs?
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Expose bone by a periosteum section, remove bone, then replace p-osteum to allow regrowth
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What are the areas of articulation in the posterior attachment of ribs?
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head (two adjacent vertebrae) and tubercle (transverse process of vertebra)
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Area on the vertebra that articulates with ribs?
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Facets: superior costal facet (demifacet), inferior costal facet (demifacet) and transverse CF.
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Anterior attachment and how that changes classification of ribs?
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Either directly with sternum (true ribs), indirectly (false ribs), or not at all (false, 11 & 12)
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What are supernumerary ribs and where can we find them?
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Extra ribs found on either C7 or L1. C7 most common, more likely to be pathos.
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What forms the costal margin/arch?
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Margin formed by fused cartilages of ribs 7-10. Arch formed by both margins.
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Define costal groove.
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Groove located on the inner surface of the rib near its inferior border.
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What is the neurovascular bundle found in the costal groove?
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Structure comprised of a Vein, Artery, and Nerve.
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Thoracocentesis needle is passed where and why?
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The middle of the ICS to avoid the neurovascular bundle on both inferior and superior borders.
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What is the procedure of a intercostal nerve block?
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Needle inserted until a rib is felt then the needle is moved down to inject anesthetic.
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What is the ramification of the rib orientation in adults?
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Oblique orientation allows rib cage to move more allowing larger volumes to be moved.
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What is the ramification of the rib orientation in children?
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Horizontal orientation requires diaphragm to move more air than the rib cage.
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What are the three parts of the sternum?
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Manubrium, body and xiphoid process
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What are the important features of the manubrium?
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Jugular notch, sternal angle, manubriosternal joint
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What is the jugular notch a landmark for?
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Midpoint of the trachea, 2nd thoracic vertebra, ideal place of the tip of the ET tube.
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What is the sternal angle a landmark for?
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2nd rib, T4/5 disk, carina, divides mediastinum.
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What does the manubriosternal joint do during respiration?
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Moves out/forward during inspiration and in/backward during expiration
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How many sternebrae form the sternum and when do they fuse?
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4 and 25.
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In which cavity is the xiphoid process located?
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Abdominal
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Ribs articulate to? (list, anteriorly)
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1: manubrium, 2: manubrium/body, 3-6: body, 7: body/xiphoid
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Intercostal muscle layers and their directions?
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External (down, forward), Internal (down, back), innermost (down back)
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Innervation of intercostal muscles and their spinal cord levels?
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Intercostal nerves (T1-11) and subcostal nerve (T12)
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Diaphragm is shaped like what? Forms the floor of what?
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Dome. Thorax (separates thorax and abdomen)
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Diaphragm is formed by how many subunits? Can they act if one fails?
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2 hemi diaphragms, yes
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Diaphragm is formed of what tissue and innervated by what nerve?
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skeletal muscle, phrenic nerve
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What is the relative location of the right hemidiaphragm?
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Right hemi-diaphragm is slightly higher than left.
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What is the origin of the diaphragm?
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Origin: xiphoid, costal margin, ribs 11 & 12, TP of vertebrae T12 &L1, Body of L1/2.
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What is the insertion of the diaphragm? How many subunits? One is covered by what (sup)?
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Central tendon. 3 (right, middle, left). Pericardium superiorly.
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What are the major diaphragmatic openings and their vertebral levels?
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Caval opening (T8), esophageal hiatus (T10), aortic hiatus (T12)
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Which diaphragmatic openings pass through the diaphragm?
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Caval opening and the esophageal hiatus
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What are two possible congenital defects of the diaphragm and which side predominates?
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Patent posterolateral foramen of bochdalek (left) & patent foramen of Morgagni (right)
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What is a non-congenital defect in the diaphragm, reason, and side?
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Rupture at the lumbocostal triangle caused by trauma. Predominantly on left side (95%)
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What is the motor and sensory innervation of the diaphragm?
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Phrenic x2 (motor: all, sensory: central areas); lower IC Ns (motor: none; sensory: peripheral)
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What are the positions of the diaphragm at end expiration?
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Right: 5th rib, Left: 5th intercostal space
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What are some major factors affecting the position of the diaphragm?
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Lung recoil, Thoracic viscera forces, abd viscera forces, pressure from abd muscles
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How greatly does the diaphram movement change from normal resp to forced resp?
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From 1-2cm change in location to as much as 10cm change during respiration.
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What occupies the thoracic space besides the mediastinum?
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The lungs, doofus!
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What are the names of the uppermost and lowermost portions of the lungs?
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Apex (cupula, cupola) and Base
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What are the external surfaces of the lungs?
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Costal surface, mediastinal surface, diaphragmatic surface.
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What are the borders (edges) associated with the lungs?
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Anterior border, posterior border, inferior border.
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What are the locations of the inf. Border of the lungs at end expiration?
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MCL-rib 6, MAL-rib 8, LVC-rib 10
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