S&d Test 2: Lungs & Post. Mediastinum

Front 1

Innervation of phrenic nerve.

Back 1

General sensory from central diaphragm, pleura, pericardium (lower intercostal nerves innervate peripheral diaphragm)

Front 2

2 principal muscles of inspiration (& 2 accessory)

Back 2

external intercostals, diaphragm (accessory-sternocleidomastoid, scalenes)

Front 3

2 principal muscles of active expiration (mechanism of quiet breathing)

Back 3

Internal intercostals, abdominal muscles (quiet is passive recoil of lungs and ribs)

Front 4

Innervation of parietal pleura

Back 4

General sensory nerves, so very sensitive to pain

Front 5

Innervation of visceral pleura

Back 5

Visceral sensory, so insensitive to pain

Front 6

The potential space enclosed between the visceral and parietal pleura.

Back 6

pleural cavity

Front 7

What are the 4 parts of the parietal pleura?

Back 7

Costal, diaphragmatic, mediastinal, cervical

Front 8

What does the parietal pleura do at the hilum of the lung?

Back 8

Reflects and forms the visceral pleura against the lung

Front 9

Where are the two pleural recesses? When are they filled, if ever?

Back 9

costomediastinal, costodiaphragmatic; filled only on forced inspiration

Front 10

Differentiate between an open and closed pneumothorax.

Back 10

An open PT comes from outside air, a closed PT enters the pleural cavity from the lung itself

Front 11

What happens with a tension pneumothorax? Treatment?

Back 11

air enters pleural cavity but can't leave, so lung collapses on itself. Needs needle decompression to allow air to escape the pleural cavity.

Front 12

Which lung has three lobes?

Back 12

Right

Front 13

Purpose of root of lung

Back 13

Attach lung to mediastinum

Front 14

On the right lung, describe the lobes and fissures.

Back 14

3 lobes: superior, middle, inferior; 2 fissures, oblique and horizontal (which is in front)

Front 15

In the root, describe the layout of the vein, artery, and bronchus.

Back 15

From anterior to posterior: vein, artery, bronchus

Front 16

Where does an inhaled foreign body most frequently lodge itself?

Back 16

right main bronchus

Front 17

Which lung and lobe has the lingula?

Back 17

Left lung, superior lobe (at bottom)

Front 18

On left lung, describe lobes and fissure(s).

Back 18

2 lobes: superior and inferior, 1 fissure: oblique

Front 19

In the root, describe the layout of the vein, artery, and bronchus.

Back 19

vein most anteriorly, then artery in superior position and bronchus in posterior position (think upside down V)

Front 20

Describe presentation of TB.

Back 20

Inhalation of m. tuberculosis; localized lesions or tubercules which rupture into bronchi

Front 21

Describe presenation of coal miner's lung.

Back 21

Extensive black carbon pigment and fibrotic central region of lung

Front 22

Three main COPD (chronic obstructive pulmonary disease)

Back 22

chronic bronchitis, asthma, emphysema

Front 23

Presentation of emphysema

Back 23

permanent enlargement of air spaces, airways collapse during expiration, hypertrophy of intercostal muscles leads to barrel-chested appearance

Front 24

2 main origins of lung cancer

Back 24

alveolar lining cells of lung parenchyma or epithelium of tracheobronchial tree

Front 25

Most common types of lung cancer

Back 25

squamous cell (bronchogenic) carcinoma and adenocarcinoma

Front 26

What type of lung disease is idiopathic pulmonary fibrosis? What happens?

Back 26

chronic restrictive; causes chronic inflammation, fibrosis, and more pressure to inflate stiffened lungs

Front 27

Population affected by idiopathic PF

Back 27

men more often, diagnosed between 30-50 yo

Front 28

Cause of idiopathic PF:

Back 28

Possibly by environmental or occupational agents, leading to hypoxemia and cyanosis

Front 29

Name flow of air in the bronchial tree, starting in the trachea.

Back 29

Trachea, main bronchus (1), lobar bronchus (2), segmental bronchus (3), bronchioles

Front 30

What does each lung segment receive? What does it share?

Back 30

Each has bronchus and pulmonary artery, shares veins between segments

Front 31

On the right lung, name the 3 segments that make up the superior lobe.

Back 31

Apical, Posterior, and Anterior (I, II, III) (apes, possums, and ants)

Front 32

On the right lung, name the 2 segments that make up the middle lobe.

Back 32

Lateral and medial (IV, V)

Front 33

On the right lung, name the 5 segments that make up the inferior lobe.

Back 33

Superior, Medial basal, Anterior basal, Lateral basal, posterior basal (VI, VII, VIII, IX, X)

Front 34

On left lung, name the superior segments.

Back 34

Apicoposterior, anterior, superior lingular, inferior lingular

Front 35

On left lung, name the inferior segments.

Back 35

Superior, medial basal, anterior basal, lateral basal, posterior basal

Front 36

Causes of pulmonary embolism

Back 36

Venous stasis, trauma, coagulation disorders

Front 37

% of PEs that are silent? What % cause of death in hospital pts?

Back 37

60% are silent, Causes 10-15% of deaths in hospitals

Front 38

Massive pulmonary embolisms can lead to?

Back 38

infarction

Front 39

What do bronchial arteries run with?

Back 39

Bronchi

Front 40

Job and action of bronchial veins.

Back 40

Drain the parenchyma, primarily into azygos system of veins

Front 41

Where is the pulmonary plexus and what does it do?

Back 41

Distributed along branches of airway and vessels, controls breathing rate (parasympathetic from vagus)

Front 42

Where does lung lymph drain to?

Back 42

Tracheobronchial lymph nodes, which drain into bronchomediastinal trunks

Front 43

What's in the posterior mediastinum?

Back 43

descending aorta, sympathetic trunks, azygos veins, thoracic duct, esophagus and plexus

Front 44

How do posterior mediastinal masses present?

Back 44

pain, neuro symptoms, trouble swallowing

Front 45

Location and innervation of esophagus

Back 45

descends on anterior bodies of vertebrae, innervation by sympathetic and parasympathetic nerves

Front 46

Blood supply for esophagus

Back 46

esophageal arteries from aorta, bronchial arteries, and left gastric artery; vein drainage to azygos system

Front 47

Location of azygos system

Back 47

right side, hemiazygos on left side

Front 48

Distribution of hemiazygos and accessory hemiazygos veins.

Back 48

accessory drains left middle 4 posterior intercostal, hemiazygos drains lower 4 post. IC veins

Front 49

Location of thoracic duct.

Back 49

Between aorta and azygos vein

Front 50

Emptying of thoracic duct

Back 50

Empties lymph into junction of left internal jugular vein and subclavian vein

Front 51

Site of action of thoracic splanchnic nerves

Back 51

abdomen, but arise in thorax (greater, lesser, least)