Flashcards
tuesday jan 28
Cards in this deck (50)
- 1Each lung hasan apex (or cupula = dome) that reaches
the thoracic inlet,
base that sits upon the diaphragm - 2Apex of lungascends above clavicle
- 3Horizontal fissurefollows rib 4
on the right lung - 4Oblique fissurefound laterally at rib 4, descends medially to meet rib 6 at midclavicular line
identify superior and inferior lobe - 5Base of lungat level of rib 6 anteriorly (midclavicular
line) - 6Pleural cavitycontinues to rib 8 anteriorly
(midclavicular line) - 7From midline there is a cardiac notchstarting at costal cartilage 4 and arching over not quite to midclavicular line
- 8Lower limit of lungat rib 6 anteriorly (midclavicular
line) - 9Pleural cavity continues torib 8 anteriorly at the
midclavicular line - 10Pleural cavitiesare spaces filled with fluid
- 11The pleural cavities are primarily formed bythe parietal (outer) and visceral (inner) pleura (which are continuous)
- 12Endothoracic fascia(a form of loose CT) connects parietal
layer to chest wall - 13The pleural cavities contain several prominent recesses:costodiaphragmatic and costomediastinal
- 14Left and Right HilaThe regions where structures
enter and leave the lungs
Formed by reflection of parietal
and visceral pleurae - 15Parietal Pleura – Innervated byintercostal and phrenic nn., very
sensitive to painful stimuli: - 16Intercostal nn.to diaphragmatic and costal
portions - 17Phrenic nn.central diaphragmatic and
mediastinal portions - 18Visceral Pleura and Lung Structures –visceral pleurae are innervated byvisceral afferents from the autonomics fibers that follow bronchial vessels.
- 19Lymph drainage follows course of nodes:Pulmonary nodes—>bronchopulmonary
nodes —> tracheobronchial nodes —> Tracheal (paratracheal) nodes - 20The Mediastinumis the thoracic region between the two lungs, between sternum and vertebrae, housing the heart and great vessels
- 21Superior Mediastinum: above sternal angle Inferior mediastinum: below sternal angle.
- 22Sternal angle (Angle of Louis) site forArch of Aorta (arches over the angle)
Bifurcation of trachea (Carina at angle)
Bifurcation of pulmonary trunk (occurs just under this angle)
Ligamentum Arteriosum (exactly on angle) - 23Contents of Superior MediastinumLocated in order, Anterior to Posterior:
■ Thymus
■ Brachiocephalic veins leading to S.V.C.
■ Vagus nerves, Cardiac Plexus & Phrenic
nerves.
■ Arch of Aorta and branches.
■ Trachea
■ Esophagus - 24Anterior mediastinum– Between pericardium and sternum
– Contains fatty tissue, lymph nodes and
internal thoracic A. & V. - 25Middle mediastinumContains Pericardial cavity and contents
– Includes pericardium, heart, ascending
aorta, pulmonary trunk - 26Posterior MediastinumPosterior to the heart.
■ Contains a small number of critical
structures.
– Descending thoracic aorta.
– Esophagus.
– Thoracic duct.
– Azygos system of veins - 27Esophageal tear■ Most often (85-90%) caused by instrument injury during medical procedures; endoscope, feeding tube, surgery.
■ Occasionally from extensive vomiting.
Boerhaave syndrome - 28Boerhaave syndromeusually accompanying
bulimia, results in esophageal rupture,
followed by mediastinitis and air in the
mediastinum (pneumomediastinum). Often followed by sepsis. Requires antibiotics; can be fatal if left untreated. - 29Azygos system of veinsAzygos is towards the right side of the
vertebrae
Superiorly, it receives the superior intercostal vein
inferiorly, it begins at the junction of the
subcostal V. with the ascending lumbar V. - 30Hemiazygos system of veinsCross midline to drain into azygos V.
Hemiazygos and accessory hemiazygos
VV may fuse to a single vein.
Usually far on left side. Note,
occasionally absent, and related intercostal VV drain directly into azygos
V. - 31Thoracic DuctLargest lymph trunk, all lymph drains into venous angles (right or left)
Composed of three primary superior trunks
Composed of two primary inferior trunks: - 32■ Composed of three primary superior trunks:Jugular trunk
Right Lymphatic duct
Bronchomediastinal trunk - 33Composed of two primary inferior trunks:right and left Lumbar trunks
- 34Thoracic duct injuryA rare complication of thoracic surgery (0.5-2% of surgeries) or neck surgery (1-3% of surgery).
Results in leakage of lymph (chyle), a milky
fluid which can be confused with pus. - 35Difficult to fix thoracic duct (too thin and hard to get to); becusmajor nutritional deficiencies
because the Thoracic Duct carries almost all the lipids absorbed in the gut and dumps it directly into circulation at the venous angle. - 36Structural relationships in right hilumMain bronchus, posterior
Pulmonary Artery, anterior
Pulmonary vv., anterior and inferior - 37Structural relationships in left hilumMain bronchus, posterior
Pulmonary Artery, superior
Pulmonary vv., anterior and inferior - 38Costomediastinal recess –in left side of thorax – space medial to lung for heart and mediastinum
- 39Costodiaphragmatic recessat margin between lung and diaphragm
- 40Trachea extends fromC7 to T4-5, then splits into left and
right main bronchi - 41Last ring of trachea, at split is thecarina
- 42Lung VasculatureBronchial aa
- 43Bronchial a arise fromthoracic aorta on the left, and the third posterior intercostal a. (usually) on the right
- 44Bronchial Foreign Body Blockage in a Child2:1 boys/girls
Often mistreated as asthma or URTI
Chest radiographs: 26% normal;
43% air trapping - 45Venous AngleSite where lymph trunks enter into
venous system. - 46right venous angleR. side, receives R. internal Jugular, R.
Subclavian and R. Bronchomediastinal
trunks - 47left venous angleL. side, receives L. internal Jugular, L.
Subclavian and L. Bronchomediastinal
trunks, and Thoracic Duct. - 48All ganglia from superior cervical to approx. T5 give postganglionic nerve fibers (axons) toAll ganglia from superior cervical to
approx. T5 give postganglionic nerve
fibers (axons) to - 49Aneurysm of the AortaThe interior lining of the aorta and blood forces layers of the muscular part
of the aortic wall apart.
level below the inury is impacted - 50Esophagus ■ Startsposterior to aorta and trachea
Stays medial as Aorta arches to
the left
Becomes anterior to aorta as the aorta moves near to the midline at the diaphragm.
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- Flashcards on tuesday jan 28, created by Shylla T on 28/01/2020.
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- Shylla T
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