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44 Cards in this Set

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superior thoracic aperture is also called _____

inferior thoracic aperture is also called _______
thoracic inlet

thoracic outlet
Thoracic cavity consists of R and L pleural cavities, each surrounding a lung, and the mediastinum, which separates ___________
separates the R and L pleural cavities
Penetrating wounds to the neck or poor technique in attempting to access the subclavian vein can lead to what?
collapsed lung

(copula of lung extends into root of neck)
collapsed lung

(copula of lung extends into root of neck)
The pleurae are closed sacs of serous membrane that enclose each lung. What are the two parts?
parietal & visceral pleura
The Visceral pleura surrounds the lung and the parietal pluera surrounds ........
everything else!

encloses entire pleural area & separates it from the other regions of the thorax
The Parietal pleura is divided into regions based on the structures that they contact. What are the 4 regions?
costal
diaphragmatic
mediastinal
cervical (cupola)
costal
diaphragmatic
mediastinal
cervical (cupola)
The ___________ is the potential space between the parietal and visceral pleura.
pleural cavity
T/F
Normally the two pleural layers are separated by a thin layer of serous fluid, not an actual space or cavity.
TRUE
What does the serous fluid allow?
the parietal and visceral pleura to slide across each other easily
Where do some actual spaces btwn the parietal and visceral plueras' exist?

why do these spaces exist?
costomediastinal recess & costodiaphragmatic recess


the lungs typically do not expand into these spaces
costomediastinal recess & costodiaphragmatic recess


the lungs typically do not expand into these spaces
Where does the costodiaphragmatic recess occur?
btwn the costal & diaphragmatic parts of the parietal plueral
where does the costomediastinal recess occur?
anteriorly btwn the costal & mediastinal parts
*larger on left side due to cardiac notch
Fluids may collect in these spaces, know as ?

What fluids may accumulate?
pleural effusion

serous fluid = hydrothorax
blood = hemothorax
chyle = chylothorax
(can be seen on X-ray bc space is white instead of black)
Clinical significance of the pleurae
-each cavity is separate compartment--> isolation of infection
-fluid accumulation can occur
-inflammation = pleuritis
The trachea descends into the thorax and splits into left and right __(a)____.
_(a)___ divide into __(b)___, which divide into __(c)__
(a) main (primary) bronchi
(b) lobar (secondary) bronchi
(c) segmental (tertiary) bronchi
Each segmental (tertiary) bronchi supplies a ______________, the functional unit of the lung
bronco-pulmonary segment
The right inferior (lower) lobar bronchus is in line with the _________, and foreign objects often lodge here
right main bronchus
O2 & nutrients are provided to lungs via __________
bronchial arteries
bronchial arteries
The left side has a superior & inferior left bronchial artery that arise directly from what?
the anterior surface of the thoracic aorta
the anterior surface of the thoracic aorta
The right side has a SINGLE right bronchial artery which typically arises from _____________________
or from ________________________
the proximal part of one of the posterior intercostal arteries (usually the 3rd)
or from a common trunk w/ the left superior bronchial artery
the proximal part of one of the posterior intercostal arteries (usually the 3rd)
or from a common trunk w/ the left superior bronchial artery
Air enter/leaves the lung via _______
Deoxygenated blood enters via ______
Oxygenetated blood leave via _______
(air) primary bronchi
(deoxygenated blood) pulmonary artery
(oxygenated blood) pulmonary veins
The collection of tubular structures connecting the lung to structures in the mediastinum is referred to as what?
the root of the lung
the root of the lung
The root of the lung contains what?
primary bronchus
pulmonary artery & vein
bronchial vessels
nerves
lymphatics
primary bronchus
pulmonary artery & vein
bronchial vessels
nerves
lymphatics
The _______ nerve runs anterior to the root of the lung & the _____ nerve runs posterior to it
anterior - phrenic nerve
posterior- vagus nerve
The region on the medial surface of the lung outlined by plueral reflection, where the structures that make up the root of the lung enter, is the what?
hilum of lung

(hilum & root are NOT the same, hilum = where structures enter, root = structures)
What is the pulmonary ligament?
a thin reflection of pleura connecting the lung hilum to the mediastinum
The right lung has (2/3) lobes and (1/2) fissures

What runs along the sulcus?
3 lobes - superior, middle, inferior
2 fissures- horizontal, oblique

sulcus- Azygos v, esophagus, R Subclavian a, vena cava, 1st rib
3 lobes - superior, middle, inferior
2 fissures- horizontal, oblique

sulcus- Azygos v, esophagus, R Subclavian a, vena cava, 1st rib
The left lung has (2/3) lobes and (1/2) fissures

What runs along the sulcus?

What 2 other features are unique to the left lung?
2 lobes- superior, inferior
1 fissure- oblique

sulcus- aorta, esophagus, L Subclavian a, L brachiocephalic v, 1st rib

unique features- lingula & cardiac impression
2 lobes- superior, inferior
1 fissure- oblique

sulcus- aorta, esophagus, L Subclavian a, L brachiocephalic v, 1st rib

unique features- lingula & cardiac impression
What are 3 signs that would indicate lung disease?
enlarged air spaces (emphysema)
carbon deposits (black)
enlarged/blackened lymph nodes
What is significant about bronchopulmonary segments?
Each segment has its own artery and can function independently, allows individual segments to be removed if diseased, leaves rest of lung intact & function remains
During normal inhalation, what muscle is responsible?

during forced?
normal- mainly diaphram (phrenic n) & some intercostal muscles

forced- anything attached to rib is involved
During normal exhalation, what muscle is responsible?

during forced?
normal- none

forced- anterior abdominal wall muscles
The _______ is the main muscle involved in breathing. It also separates the thoracic and abdominal cavitites
diaphram
What arteries supply the diaphram?
-paricardiacophrenic (from internal thoracic)
-musculophrenic (terminal branch of internal thoracic along w/ superior epigastric)
-superior phrenic (from thoracic aorta)
-inferior phrenic arteries (often from abdominal aorta)
-paricardiacophrenic (from internal thoracic)
-musculophrenic (terminal branch of internal thoracic along w/ superior epigastric)
-superior phrenic (from thoracic aorta)
-inferior phrenic arteries (often from abdominal aorta)
What are the 3 openings in the diaphragm?
what spinal level are they at, and what passes through?
Caval opening: T8, inferior vena cava

Esophageal hiatus: T10, esophagus & vagal trunks

Aortic hiatus: T12, aorta & thoracic duct
Caval opening: T8, inferior vena cava

Esophageal hiatus: T10, esophagus & vagal trunks

Aortic hiatus: T12, aorta & thoracic duct
Increaseing intrathoracic voume requires what movements?
-descent of the diaphram (piston)
-anterior movement of the sternum (pump handle movement)
-elevation of the lateral aspect of the ribs (widening region of ribs)(bucket handle movement)
Normal breathing diaphram & abdominal movement, pressure change:
Inspiration-
Exhalation-
Inhalation-
contraction of diaphram
relaxation of abdominal muscles
decrease intrathoracic pressure (increase vertical dimension)

Exhalation-
relaxation of diaphram
NO abdominal movement
increases intrathoracic pressure (decrease vertical...
Inhalation-
contraction of diaphram
relaxation of abdominal muscles
decrease intrathoracic pressure (increase vertical dimension)

Exhalation-
relaxation of diaphram
NO abdominal movement
increases intrathoracic pressure (decrease vertical dimension)
Lung examination involves what?
observation
palpation
ausculation
*need to know surface anatomy*
(also percussion & fremitus)
Where is the superior border of the lung?
pleura and lung project above 1st rib
pleura and lung project above 1st rib
Where is the anterior border ?
pleura approaches midline on R but not as far on L

costomediastinal recess
pleura approaches midline on R but not as far on L

costomediastinal recess
Where is the inferior & posterior border?
lower border of lung high anteriorly

6th Rib level at mi-clavicular line, 8th rib level at mid-axillary line, and 10th rib level at scapular level (pleural border is at 2 ribs lower at each point)

costodiaphragmatic recess
What lung points do you check with a stethoscope?
Apex
middle lobe (right lung only)
superior lobe
inferior lobe
Apex
middle lobe (right lung only)
superior lobe
inferior lobe
What can be found using lung palpation?
-thoracic expansion during respiration
-pleural friction rub
-crepitus due to trapped air
Thoracocentesis (chest tube placement) is done at the ______________ recess.
Procedurally start at inferior rib and go up slightly, making sure to avoid the intercostal___________, which is unprotected directly below the superior rib.
costodiaphragmatic recess

intercostal nerve
costodiaphragmatic recess

intercostal nerve