Spring A&p Unit 1

Front 1

Structures of the Respiratory system

Back 1

Thorax
Lungs
Extrapulmonary airways

Front 2

Functional characteristics of the Thorax

Back 2

Strength
Flexibility

Front 3

Two openings of the Thorax

Back 3

Superior thoracic aperture- narrow
Inferior thoracic aperture- wide/broad

Front 4

Structures entering the thorax

Back 4

Trachea,
Vagus nerve
esophagus
phrenic nerve

Front 5

Three types of bones associated with the thorax

Back 5

Ribs
Thoracic vertebra
Sternum

Front 6

Types of cartilage in respiratory system

Back 6

fibrocartilage- strongest type found in intervetebral disc
Hyalin cartilage- primary on
Elastic cartilage- epiglottis

Front 7

How many ribs do we have

Back 7

12 pairs

Front 8

only bone capable of regenerating itself

Back 8

rib
covered by periosteum

Front 9

Posterior attachment of rib

Back 9

Head- body of corresponding vertebra and vertebra above
Tubercle- transverse process of corresponding vertebra

Front 10

Facets

Back 10

smooth area on vertebrae where rib articulates
superior,inferior and transvers costal facet

Front 11

Anterior attachment of rib

Back 11

either directly or indirectly with sternum via their costal cartilage
Except ribs 11 &12

Front 12

Classification of ribs

Back 12

True ribs 1-7
False ribs 8-12
8-10 indirectly ariticulate with costal cartilage of rib above it
11-12 Floating - do not connect to sternum

Front 13

Supernumerary ribs

Back 13

Extra ribs
Cervical(c7)can compress sc artery or brachial plexus
Lumbar- less common

Front 14

costal margin

Back 14

formed by fused costal cartilages of ribs 7-10

Front 15

costal arch

Back 15

formed by the two coastal margins put together

Front 16

costal margin

Back 16

structure formed by fused costal cartilages fo ribs 7-10

Front 17

Costal arch

Back 17

formed by the two costal margins

Front 18

Costal Groove

Back 18

located on inner surface of the rib near its inferior border- contains neurovascular bundle

Front 19

Neurovascular bundle

Back 19

Intercostal vein-Superior
Intercostal artery-Middle
Intercostal nerve- inferior

Front 20

Thoracentesis- where is needle passed

Back 20

through the middle of the ICS to avoid the neurovascular bundle

Front 21

Where is needle inserted in a Intercostal nerve block

Back 21

adjacent to the rib to infiltrate the intercostal nerve

Front 22

Rib orientation of the adult

Back 22

Oblique- sternal attachment is lower than the vertebral attachment. Allows of elevation of rib cage during inspiration

Front 23

rib orientation of the infant and young child

Back 23

Horizontal. attachment at the same level. become more oblique around age 2

Front 24

what is responsible for enlargement of lungs in the infant

Back 24

diaphragm-ascends during expiration and descends during inspiration

Front 25

Intercostal space

Back 25

area between adjacent ribs- 11 pairs of ICS

Front 26

3 parts of the sternum

Back 26

Manubrium
Body
Xiphoid Process

Front 27

3 features of the manubrium

Back 27

Jugular Notch (Suprasternal Notch)
Sternal Angle (Angle of Louis)
Manubriosternal Joint

Front 28

Jugular Notch

Back 28

concave area located along superior border of the manubruim. Horizontal line intersects through jugular notch will intersect 2nd thoracic vertebra. T2 is mid-point of trachea- ideal for tip of ETT

Front 29

Sternal Angle

Back 29

area where manubrium articulates with the body of sternum. Landmark for:
2nd rib articulates to sternum
Horizontal line intersects posteriorly with intervertebral disc of t4 and t5
bifurcation of trachea
divides mediastinum into superior and inferior

Front 30

Manubriosternal joint

Back 30

articualtion of the manubrium and body of sternum-functions like a hinge that allows for movement of the body of the sternum to enlarge the thorax during inspiration

Front 31

Body of the sternum

Back 31

fusion of 4 sternabrae. the middle largest portion of the sternum. fusion complete around 25 years

Front 32

Xiphoid Process

Back 32

lowermost smallest portion of the sternum. Lies anterior to abdominal cavity

Front 33

Rib 1 articulates to

Back 33

manubrium

Front 34

rib 2 articulates to

Back 34

manubrium and body (sternal angle)

Front 35

Rib 3,4,5,6 articualtes to

Back 35

body

Front 36

Rib 7 articulates to

Back 36

Body and Xiphoid process

Front 37

3 layers of intercostal muscles

Back 37

External Intercostal Layer-downward forward
Inernal Intercostal Layer-downward backward
Innermost Intercostal Layer- sparse- primarily in lower intercostals spaces- downward and backward

Front 38

Intercostal Nerves

Back 38

11 pair- innervated intercostal muscles. They originate from SC segments T1-T11

Front 39

Subcostal Nerve

Back 39

t12 spinal nerve- located in the costal groove of rib 12 and innervates the muscle and skin below the rib cage

Front 40

Diaphragm

Back 40

dome shaped muscle that forms the floor of the thorax. seperates abdominal from thoracic cavity. composed fo 2 halves

Front 41

how do you determine if both hemidiaphragms are working

Back 41

Fluoroscopy by sniff test- non functioning hemi will ascend into the thorax with inspiration

Front 42

what innervates the diaphragm

Back 42

phrenic nerves c3-C5

Front 43

Shape of the diaphragm

Back 43

right sits higher than left because of weight of heart pushing down on left- possibly because liver pushing up on left

Front 44

Origin of skeletal muscle fibers comprising the diaphragm

Back 44

Internal suface of the xiphoid process
Internal suface of the costal margin
Internal suface of ribs 11 and 12
Transverse process of vertebrea T12 and L1
body of vertebrae L1 and L2

Front 45

central tendon

Back 45

Area of connective tissue that is the insertion point of the muscle tissue of the diaphragm. muscle fibers project upward and inward. there are right middle and left leaflets

Front 46

What leaflet of the central tendon is covered by pericardium

Back 46

Middle leaflet. as diaphragm descends it also pulls on the pericardium

Front 47

where is the contraction of the diaphragm

Back 47

at the central tendon- during contraction the central tendon moves downward and the diaphragm descends during inspiration

Front 48

3 major diaphragmatic openings

Back 48

vena cava foramen (caval opening)- T8
Esophageal hiatus- T10
Aortic hiatus- T12

Front 49

what passes through the vena cava foramen

Back 49

inferior vena cava

Front 50

what passes through the esophageal hiatus

Back 50

Esophagus and portions of the Vagus Nerve. Hiatal Hernias occur here

Front 51

What passes through the aortic hiatus

Back 51

retrodiaphragmatic opening aorta passes through. Aorta lies behind fibers that originate from L1 and L2 and project upward to help the form the diaphragm

Front 52

Congenital defects of the diaphragm

Back 52

patent posteriolateral foramen of bochdalek (Posterior Pleuralperitoneal hiatus)
Patent foramen of morgagni (Anterior Pleuralperitoneal hiatus)

Front 53

patent posteriolateral foramen of bochdalek (Posterior Pleuralperitoneal hiatus)

Back 53

failure of closing this paired opening on fetal diaphragm leads to hernia. Most common. more frequent on left side. not enough room for lung development

Front 54

Lumbocostal (vertebralcostal)Triangle

Back 54

connective tissue in adult where bochdalek had been in fetus. extends from transverse process of L1- rib 12

Front 55

Patent foramen of morgagni

Back 55

located along lateral aspects of sternum between sternal and costal fibers. rare, more common on right side

Front 56

Sternocostal Triangle

Back 56

Area of connective tissue present in adult where morgagni had been in fetus

Front 57

Non congenital defects- rupture and herniation of the diaphragm

Back 57

Vertebrocostal Foramen/Hiatus- sudden large increase in intathoracic pressure leads to rupture of the diaphragm

Front 58

Innervation of the diaphragm

Back 58

Phrenic Nerves
Lower intercostal nerves

Front 59

Phrenic Nerves

Back 59

Pair. Right innervates right hemi and left - left hemi.
both motor and sensory. come from neck area and pass down along outer suface of pericardium then brach out to supply the diaphragm

Front 60

What provides motor innervation to the entire diaphragm

Back 60

Phrenic nerve

Front 61

Sensory component of phrenic nerve

Back 61

all but most peripheral areas of the diaphragm. sensations from actual diphragm muscle, parietal pleura lining upper suface of the diaphragm and parietal peritoneum lining under surface of the diaphragm

Front 62

Lower intercostal nerves

Back 62

supply sensory information to most peripheral areas of the diaphragm & lower intercostal spaces. pain here felt directly over area. supplies no motor function.

Front 63

The Upper most portion of the diaphragm

Back 63

dome -cupula cupola & apex.

Front 64

Location of right hemidiaphragm

Back 64

fifth rib

Front 65

Location of left hemidiaphragm

Back 65

5th intercostal space

Front 66

Major factors affecting the position of the diaphragm

Back 66

recoil of the lungs
forces exerted on upper surface of the diaphragm
forces acting on undersurface of the diaphragm
Intraabdominal pressure r/t abdominal muscle activity

Front 67

recoil of the lungs

Back 67

Lungs are attached to upper surface of the diaphragm so greater recoil= higher diaphragm position.

Front 68

Disorder that causes lungs to have greater recoil

Back 68

Fibrotic Lung Disorder- increased connective tissue fibers

Front 69

Disorder that causes lungs to have less recoil

Back 69

Emphysema- loss of elastic and collagen tissue that leads to much less recoil

Front 70

what exerts forces on upper surface of the diaphragm

Back 70

CHF- heart is distended with blood and the extra weight pushes left hemi lower
Pulmonary Edema- lungs fill up with excess fluid

Front 71

What forces act on undersurface of the diaphragm

Back 71

pregnancy
recumbancy- abdominal viscera falls up against under suface of the diaphragm and pushes to higher level

Front 72

What increases intraabdominal pressure

Back 72

contraction of abdominal muscles. greater degree of abdominal muscle tone when standing. diaphragm is at higher level when standing

Front 73

range of movement of the diaphragm during breathing

Back 73

during rest 1-2 cm
strong inspiratory effort-can descend as much as 10 cm