Anatomy Exam 4: Lungs

Front 1

superior thoracic aperture is also called _____

inferior thoracic aperture is also called _______

Back 1

thoracic inlet

thoracic outlet

Front 2

Thoracic cavity consists of R and L pleural cavities, each surrounding a lung, and the mediastinum, which separates ___________

Back 2

separates the R and L pleural cavities

Front 3

Penetrating wounds to the neck or poor technique in attempting to access the subclavian vein can lead to what?

Back 3

collapsed lung

(copula of lung extends into root of neck)

Front 4

The pleurae are closed sacs of serous membrane that enclose each lung. What are the two parts?

Back 4

parietal & visceral pleura

Front 5

The Visceral pleura surrounds the lung and the parietal pluera surrounds ........

Back 5

everything else!

encloses entire pleural area & separates it from the other regions of the thorax

Front 6

The Parietal pleura is divided into regions based on the structures that they contact. What are the 4 regions?

Back 6

costal
diaphragmatic
mediastinal
cervical (cupola)

Front 7

The ___________ is the potential space between the parietal and visceral pleura.

Back 7

pleural cavity

Front 8

T/F
Normally the two pleural layers are separated by a thin layer of serous fluid, not an actual space or cavity.

Back 8

TRUE

Front 9

What does the serous fluid allow?

Back 9

the parietal and visceral pleura to slide across each other easily

Front 10

Where do some actual spaces btwn the parietal and visceral plueras' exist?

why do these spaces exist?

Back 10

costomediastinal recess & costodiaphragmatic recess


the lungs typically do not expand into these spaces

Front 11

Where does the costodiaphragmatic recess occur?

Back 11

btwn the costal & diaphragmatic parts of the parietal plueral

Front 12

where does the costomediastinal recess occur?

Back 12

anteriorly btwn the costal & mediastinal parts
*larger on left side due to cardiac notch

Front 13

Fluids may collect in these spaces, know as ?

What fluids may accumulate?

Back 13

pleural effusion

serous fluid = hydrothorax
blood = hemothorax
chyle = chylothorax
(can be seen on X-ray bc space is white instead of black)

Front 14

Clinical significance of the pleurae

Back 14

-each cavity is separate compartment--> isolation of infection
-fluid accumulation can occur
-inflammation = pleuritis

Front 15

The trachea descends into the thorax and splits into left and right __(a)____.
_(a)___ divide into __(b)___, which divide into __(c)__

Back 15

(a) main (primary) bronchi
(b) lobar (secondary) bronchi
(c) segmental (tertiary) bronchi

Front 16

Each segmental (tertiary) bronchi supplies a ______________, the functional unit of the lung

Back 16

bronco-pulmonary segment

Front 17

The right inferior (lower) lobar bronchus is in line with the _________, and foreign objects often lodge here

Back 17

right main bronchus

Front 18

O2 & nutrients are provided to lungs via __________

Back 18

bronchial arteries

Front 19

The left side has a superior & inferior left bronchial artery that arise directly from what?

Back 19

the anterior surface of the thoracic aorta

Front 20

The right side has a SINGLE right bronchial artery which typically arises from _____________________
or from ________________________

Back 20

the proximal part of one of the posterior intercostal arteries (usually the 3rd)
or from a common trunk w/ the left superior bronchial artery

Front 21

Air enter/leaves the lung via _______
Deoxygenated blood enters via ______
Oxygenetated blood leave via _______

Back 21

(air) primary bronchi
(deoxygenated blood) pulmonary artery
(oxygenated blood) pulmonary veins

Front 22

The collection of tubular structures connecting the lung to structures in the mediastinum is referred to as what?

Back 22

the root of the lung

Front 23

The root of the lung contains what?

Back 23

primary bronchus
pulmonary artery & vein
bronchial vessels
nerves
lymphatics

Front 24

The _______ nerve runs anterior to the root of the lung & the _____ nerve runs posterior to it

Back 24

anterior - phrenic nerve
posterior- vagus nerve

Front 25

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?

Back 25

hilum of lung

(hilum & root are NOT the same, hilum = where structures enter, root = structures)

Front 26

What is the pulmonary ligament?

Back 26

a thin reflection of pleura connecting the lung hilum to the mediastinum

Front 27

The right lung has (2/3) lobes and (1/2) fissures

What runs along the sulcus?

Back 27

3 lobes - superior, middle, inferior
2 fissures- horizontal, oblique

sulcus- Azygos v, esophagus, R Subclavian a, vena cava, 1st rib

Front 28

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?

Back 28

2 lobes- superior, inferior
1 fissure- oblique

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

unique features- lingula & cardiac impression

Front 29

What are 3 signs that would indicate lung disease?

Back 29

enlarged air spaces (emphysema)
carbon deposits (black)
enlarged/blackened lymph nodes

Front 30

What is significant about bronchopulmonary segments?

Back 30

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

Front 31

During normal inhalation, what muscle is responsible?

during forced?

Back 31

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

forced- anything attached to rib is involved

Front 32

During normal exhalation, what muscle is responsible?

during forced?

Back 32

normal- none

forced- anterior abdominal wall muscles

Front 33

The _______ is the main muscle involved in breathing. It also separates the thoracic and abdominal cavitites

Back 33

diaphram

Front 34

What arteries supply the diaphram?

Back 34

-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)

Front 35

What are the 3 openings in the diaphragm?
what spinal level are they at, and what passes through?

Back 35

Caval opening: T8, inferior vena cava

Esophageal hiatus: T10, esophagus & vagal trunks

Aortic hiatus: T12, aorta & thoracic duct

Front 36

Increaseing intrathoracic voume requires what movements?

Back 36

-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)

Front 37

Normal breathing diaphram & abdominal movement, pressure change:
Inspiration-
Exhalation-

Back 37

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)

Front 38

Lung examination involves what?

Back 38

observation
palpation
ausculation
*need to know surface anatomy*
(also percussion & fremitus)

Front 39

Where is the superior border of the lung?

Back 39

pleura and lung project above 1st rib

Front 40

Where is the anterior border ?

Back 40

pleura approaches midline on R but not as far on L

costomediastinal recess

Front 41

Where is the inferior & posterior border?

Back 41

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

Front 42

What lung points do you check with a stethoscope?

Back 42

Apex
middle lobe (right lung only)
superior lobe
inferior lobe

Front 43

What can be found using lung palpation?

Back 43

-thoracic expansion during respiration
-pleural friction rub
-crepitus due to trapped air

Front 44

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.

Back 44

costodiaphragmatic recess

intercostal nerve