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44 Cards in this Set
- Front
- Back
superior thoracic aperture is also called _____
inferior thoracic aperture is also called _______ |
thoracic inlet
thoracic outlet |
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Thoracic cavity consists of R and L pleural cavities, each surrounding a lung, and the mediastinum, which separates ___________
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separates the R and L pleural cavities
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Penetrating wounds to the neck or poor technique in attempting to access the subclavian vein can lead to what?
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collapsed lung
(copula of lung extends into root of neck) |
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The pleurae are closed sacs of serous membrane that enclose each lung. What are the two parts?
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parietal & visceral pleura
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The Visceral pleura surrounds the lung and the parietal pluera surrounds ........
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everything else!
encloses entire pleural area & separates it from the other regions of the thorax |
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The Parietal pleura is divided into regions based on the structures that they contact. What are the 4 regions?
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costal
diaphragmatic mediastinal cervical (cupola) |
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The ___________ is the potential space between the parietal and visceral pleura.
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pleural cavity
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T/F
Normally the two pleural layers are separated by a thin layer of serous fluid, not an actual space or cavity. |
TRUE
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What does the serous fluid allow?
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the parietal and visceral pleura to slide across each other easily
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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 |
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Where does the costodiaphragmatic recess occur?
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btwn the costal & diaphragmatic parts of the parietal plueral
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where does the costomediastinal recess occur?
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anteriorly btwn the costal & mediastinal parts
*larger on left side due to cardiac notch |
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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) |
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Clinical significance of the pleurae
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-each cavity is separate compartment--> isolation of infection
-fluid accumulation can occur -inflammation = pleuritis |
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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 |
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Each segmental (tertiary) bronchi supplies a ______________, the functional unit of the lung
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bronco-pulmonary segment
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The right inferior (lower) lobar bronchus is in line with the _________, and foreign objects often lodge here
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right main bronchus
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O2 & nutrients are provided to lungs via __________
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bronchial arteries
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The left side has a superior & inferior left bronchial artery that arise directly from what?
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the anterior surface of the thoracic aorta
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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 |
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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 |
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The collection of tubular structures connecting the lung to structures in the mediastinum is referred to as what?
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the root of the lung
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The root of the lung contains what?
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primary bronchus
pulmonary artery & vein bronchial vessels nerves lymphatics |
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The _______ nerve runs anterior to the root of the lung & the _____ nerve runs posterior to it
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anterior - phrenic nerve
posterior- vagus nerve |
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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?
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hilum of lung
(hilum & root are NOT the same, hilum = where structures enter, root = structures) |
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What is the pulmonary ligament?
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a thin reflection of pleura connecting the lung hilum to the mediastinum
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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 |
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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 |
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What are 3 signs that would indicate lung disease?
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enlarged air spaces (emphysema)
carbon deposits (black) enlarged/blackened lymph nodes |
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What is significant about bronchopulmonary segments?
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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
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During normal inhalation, what muscle is responsible?
during forced? |
normal- mainly diaphram (phrenic n) & some intercostal muscles
forced- anything attached to rib is involved |
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During normal exhalation, what muscle is responsible?
during forced? |
normal- none
forced- anterior abdominal wall muscles |
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The _______ is the main muscle involved in breathing. It also separates the thoracic and abdominal cavitites
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diaphram
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What arteries supply the diaphram?
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-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) |
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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 |
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Increaseing intrathoracic voume requires what movements?
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-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) |
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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 dimension) |
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Lung examination involves what?
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observation
palpation ausculation *need to know surface anatomy* (also percussion & fremitus) |
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Where is the superior border of the lung?
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pleura and lung project above 1st rib
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Where is the anterior border ?
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pleura approaches midline on R but not as far on L
costomediastinal recess |
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Where is the inferior & posterior border?
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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 |
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What lung points do you check with a stethoscope?
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Apex
middle lobe (right lung only) superior lobe inferior lobe |
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What can be found using lung palpation?
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-thoracic expansion during respiration
-pleural friction rub -crepitus due to trapped air |
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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 |