ribs/thoracic cage/movements/lymph
which space in completely enclosed by the diaphragm?
inferior thoracic aperture
which muscle fiber is most active in expiration
where does the right bronchial vein drain into? left bronchial vein drain into?
right --> azygous vein
left --> accessory hemiazygous vein
what is the fluid between parietal pleura and visceral pleura? what is its purpose?
serous fluid
reduce friction, maintains negative pressure, and the surface tension keeps the layers together to allow for sliding during respiration
Name for the area where the visceral and parietal layers are continous?
what passes through there? (what does the thing that passes through there consist of)
what attaches the mediastinum to the pleura?
- hilum of the lung
- root of the lung (primary main broncus, pulmonary artery, 2 pulmonary veins, bronchial vessels, lympatics, nerves)
- pulmonary ligament
What are the true ribs? false ribs? floating ribs?
and tell me where and how they attach to the sternum
true ribs- 1-7 (directly attach)
false ribs- 8-10 (indirectly attach via costal cartilage to rib 7)
floating ribs - 11-12 (do not attach)
what muscle plays a small role in forced expiration (cough or sneeze) and in proprioception?
transversus thoracic m.
musculophernic a. and superior epigastric a.
name the 4 parietal pleura and around where they "sit"/are located?
cervical pleura- superiour along 1st rib
diaphragmatic pleura = inferior along the diaphragm
mediastinal pleura = medial along the mediastinum
costal pluera = most lateral
which bronchus is shorter, wider, and more vertical than the other?
what risks does this pose? (think in class example)
right primary bronchus
- food is most likely to get stuck here and obstruct airway
What vertebrae would rib 6 articulate with? be specific with where, name all the important landmarks
head of rib 6 -
- superior costal facets of T6
- inferior costal facets of T5
tubercle of the rib 6 -
- costal facet on the transverse processes of T6
which muscle is the deepest of the intercostal muscles? what direction do the fibers run?
innermost intercostal m.
same direction as internal intercostal m (like covering hands over heart)
which nerve is responsible or innervating the diaphragm? where does it originate?
injury to this nerve will result in what?
give me details on what will happen during inspiration and expiration
phrenic nerves, C3,4,5
unilateral diaphragmatic paralysis
inspiration - diaphragm ascents
expiration - diaphragm descends
what are the two recesses that may be found in the plerual cavities? During what kind of breathing can these recesses be found?
- costodiaphragmatic recess
- costomediastnial recess
- shallow breathing
how many lobes and fissures are in the right lung and the left lung?(name them)
right :
3 lobes (superior, middle, inferior)
2 fissures
1. horizontal (separates superior and middle lung)
2. oblique (separates inferior lobes from superior and middle lobes)
left:
- 2 lobes (superior and inferior)
- 1 fissure (oblique)
what are the boarders of the superior thoracic aperture?
inferior thoracic aperature?
superior - T1, rib 1, manubrium
inferior - T12, rib 11, rib 12, costal margin and xiphoid process
which muscle fiber runs inferior and medial, like hands in your pocket? During what action is this muscle most active? What does it do to the ribs?
external intercostal m.
most active in inspiration
elevate the ribs
which artery is responsible for supplying bronchial tree, root of lung, supporting tissue, and visceral pleura with oxygenated blood?
bronchial artery
where should you "aim" for when preforming a thoracentesis? why?
9th intercostal space
to avoid the inferior border of the lung, ribs 8-10 are approximately where the costodiaphragmatic recess can be found
what is the tounge-like extension found on the left lung? which lobe is it found on?
lingula, superior
pulmonary nodes --> bronchopulmonary lymphnodes --> tracheobronchial lymph nodes (located at the bifurcation of the trachea) --> right and left bronchomediastinal trunk --> venous angle (junction of subclavian vein and internal juglar)
what direction do the fibers of the tranversus thoracis m. run? where does it insert? what other muscle is it continuous inferiorly with?
-superolaterally
-lower borders of ribs 2-6
- transversus abdominis
a pt presents with a recent diagnosis of lung cancer. pt reports shortness of breath and feels like he "can't get enough air". Upon examination his right sided thorax ascents during inspiration. which nerve is most likely affected and where does it originate in the spinal cord?
- right phrenic nerve
C3,4,5 keep the diaphragm alive
what cavity/recess is thoracentesis attempting to retrieve fluid from?
costodiaphragmatic recess
take me thorugh the pathway of air through the tracheobroncial tree.
larynx --> trachea (around C6) --> divides into left and right primary bronchi (at T4/5 or the sternal angle) --> each bronchi divides into lobar (secondary) bronchi (right has 3, left has 2) --> each lobar bronchus divides into segmental (tertiary) bronchi ( vary in number but right = 10 left = 8-10)