Diaphragm Flashcards

root of the lung
Terms Definitions
Diaphragm
Separates the thoracic cavity from the abdominal cavity.
Attached peripherally to what?
Xiphoid process, costal margin of the thoracic wall, ends of the ribs 11 and 12, ligaments that span across structures of the posterior abdominal wall and vertebrae of lumbar region.
Median Sagittal plane the diaphragm does what?
Slopes inferiorly from its anterior attachment to the xiphoid at T8\T9 to its posterior attachment to the median arcuate ligament at T12
Inferior vena cava passes through the central tendon at where?
Vertebral level T8
Esophagus passes where?
Muscular part of the diaphragm just to the left of midline, at T10
Vagus nerve
Through the diaphragm with the esophagus.
Aorta
Passes behind the position attachment of the diaphragm at the vertebral level T12
Thoracic duct
Passes behind the diaphragm with the aorta
Azygos and hemiazygos veins
Pass through the aortic hiatus or through the cruel of the diaphragm.
Arterial supply?
From above, the pericardicophrenic and musculophrenic arteries supply diaphragm. From below, superior phrenic Arteries and inferior phrenic arteries which branch directly from thoracic aorta. Inferior is the biggest supply of diaphragm.
Veins drain into
Brachiocephalic veins in the neck. Azygos system of veins. Abdominal veins
Innervation of diaphragm
Phrenic nerve (c3-c5)
Contractions does what
Flattens the diaphragm and increases the thoracic wall volume
What's the pump handle?
Angle of the body of sternum and manubrium becomes less acute when ribs moving downward
What's the bucket handle
When the shafts are elevated, the middle of the shafts move laterally. This bucket handle movement increases the lateral dimensions of the thorax.
Pleural cavities border
Sup: extend above rib 1 into the root of the neck. Inf: extend to a level just above the costal margin. Med: mediastinum
Pleura is lined by
A single layer of flat cells known as mesothelium, and associated connective tissue.
Pleural space
Potential space between visceral and parietal pleura, has only a thin layer of serous fluid.
Names given to parietal pleura
Costal part is ribs and intercostal spaces, diaphragmatic part is diaphragm, mediastinal part is mediastinum, and cervical pleura is dome shaped layer of parietal pleura lining the cervical extension.
Supra pleural membrane
Dome like layer fascia coving the superior surface of the cervical pleura and is attached laterally to the medial margin of the first rib, and behind to the transverse process of vertebrae C7
Supra pleural membrane provides
Support for the pleural cavity in the root of neck. (Apical)
Root of the lung
A tubular sleeve like covering for structures that's between the lungs and mediastinum in T5 to T7
Root joins the what?
Medial surface of the lung at an area referred to the hilum of the lung.
Here what happens?
The mediastinal pleura is continuous with the visceral pleura.
Parietal pleura innovated by?
Somatic sufferer fibers.
Costal pleura innervated by
Branches from intercostal noes and pain would be felt in relation to the thoracic wall.
Diaphragmatic pleura and mediastinal pleura innervated by
Phrenic nerves and pain would refer to dermatomes
Why can't pleural cavity extend past rib 1?
Caused by the inferior slope of rib 1 to its articulation with the manubrium.
In the midclavicular line, the pleural cavity extends inferiorly to wht
Rib 8 inferiorly
In the mid axillary line?
It extends to rib 10
From that pint, the inferior margin courses where?
Somewhat horizontally crossing ribs 11 and 12 to reach vertebrae T12
Where is visceral pleura continuous with parietal pleura?
At the hilum of each lung.
Although visceral pleura is innervated by visceral afferent nerves that accompany the bronchial vessels, pain is what
Generally not elicited from this tissue.
Pleural recesses are what
The lungs do not completely fill the anterior or posterior inferior regions so this results in recesses in which two layers of parietal pleura become opposed. Expansion of these areas only during forced inspiration. Where fluids may accumulate.
Costomediastinal recess
On each side anteriorly where costal pleura is opposed to the mediastinal pleura. The largest is on left side overlying the heart.
Costodiaphragmatic recess 1
Largest and most important recess between the costal pleura and diaphragmatic pleura.
During quiet respiration, costodiaphragmatic recess
Inferior margin of the lung is at rib 6 in midclavicular, rib 8 in midaxillary, and vertebral T10
Pleural cavity?
Inferior margin is rib 8, rib 10, and T12
What happens during expiration,
The inferior margin of the lung rises and the costodiaphragmatic recess becomes larger.
How's the right lung compared to the left lung?
Right lung is a littl enlarger because the mediastinum contains the heart, bulges more to the left than the right.
What does each lung have?
A half cone shape, a base, an apex, two surfaces and three borders
Base sits on
Diaphragm
Apex
Projects above rib 1 and into the root of the neck
Two surfaces
Costal surfaces lie immediately adjacent to the ribs and intercostal spaces of the thoracic wall. The mediastinal surface lies against the mediastinum anteriorly and vertebral column posteriorly and contains the hilum.
Three borders
Inf. is sharp and separates the base from the costal surface. Ant. Pos. separate the costal surface from the medial surface, however the pos is smooth and rounded.
The heart and major vessels form?
Bulges in the mediastinum.
Ribs indent?
The costal surfaces.
Root of each lung
A short tubular collection of structures that together attach the lung to structures in the mediastinum
Hilum
Region outlined by pleural reflection of the medial surface of the lung and is where structures enter and leave
Pulmonary ligament. Function
A thin blade like fold of pleura projects inferiorly from the root of the lung and extends for the hilum of the mediastinum. Stabilize the position of the inferior love and may also accommodate the down and up translocations of structures in the root during breathing
Vagus nerve passes
Immediately posterior to the roots of lungs, while the phrenic nerve passes immediately anterior to them.
Within each root and located in the hilum are
Pulmonary artery, two pulmonary veins, a main bronchus, bronchial vessels, nerves and lymphatics
Pulmonary artery, vein, and bronchi
Sup., inf, pos.
Right lung has
Three lobes and two fissures.
Oblique fissure
Separates the inferior love from the superior love and the middle lobe of the right lung.
Horizontal fissure
Separates the superior lobe from the middle lobe.
Approximate position of the oblique fissure
Curved line on the thoracic wall that begins roughly at the spinous process of T4, crosses the fifth interspace laterally, and then follows the contour of rib 6 anteriorly
Horizontal fissure follows what?
The fourth intercostal space from the sternum until it meets the oblique fissure as it crosses rib 5.
Right lung lies adjacent to wht?
Heart, inf. vena cava, sup vena cava, Azygos vein, and esophagus
What arches over?
Right subclavian artery and vein and are related to the superior lobe of the right lung as they pass over the cervical pleura into the axilla
Left lung is what compared to right lung
Smaller and has two lobes separated by an oblique fissure,
How can it be marked
Between spinous of T3 and T4, crosses fifth interspace laterally, and follows the contours of rib 6 anteriorly.
Why's the inferior portion of the medial surface of the left lung notched?
Because the hearts projection into the left pleural cavity from the mediastinum.
Lingula of the left lung?
Anterior border of the lower part of the superior love a tongue-like extension projects over the heart bulge.
Medial surface of the lung lies adjacent to what
Heart, aortic arch, thoracic aorta, and esophagus,
What arches over?
Left subclavian artery and vein and are related to the support lobe of the left lung as they pass over the dome of the cervical pleura and into the axilla.
Trachae
Flexible tube from C6 to T5 in the mediastinum where it bifurcates into a right and left main bronchus.
Held open by what?
C shaped transverse cartilage rings embedded in its wall.
Carina
The lowest tracheal ring, a hook like structur that projects backwards in the midline between th eorigins of the two main bronchi
Right main bronchus compared to left
More vertical course than the left so a lot of shit will be stuck there.
Main bronchus divides within the lung into
Lobar bronchi supplying a lobe, on the right side, the lobar bronchus to the superior lobe originates within the root of the lung.
Lobar bronchi divide into what
Segmental bronchi which supply bronchopulmonary segments.
Within each bronchopulmonary segment
The segmental bronchi gives rise to multiple generations of divisions and ultimately to bronchioles, which subdivide and supply spirit org surfaces.
Walls of bronchi are held open by what?
Discontinuous elongated plates of cartilage, but these are not present in bronchioles,
Bronchopulmonary segments
Area of lung supplied by a segmental bronchus and its accompanying pulmonary artery branch.
A bronchopulmonary segment is the what?
Smallest, functioning independent region of a lung and the smallest area of a lung that can be isolated and removed without affecting adjacent regions,
Pulmonary arteries originate from
Pulmonary trunk and carry deoxygenated blood to the lungs from the right ventricle of the heart"
Bifurcation of the pulmonary trunk
Left of the midline just inferior to vertebral level T4/5 and anteroinferiorly to the left of the bifurcate of the trachae.
Right pulmonary artery is what to the left
Longer than the left. And horizontal across the mediastinum.
What does it pass
Anteriorly and slightly inferior to the tracheal bifurcation and anteriorly to the right main bronchus. Posteriorly to the ascending aorta, sup vena cava, and upper right pulmonary vein.
It entre what?
The root of the lung and gives off a large branch to the superior lobe of the lung. It continues through the hilum and gives off a second branch to the superior lobe and then divides to supply the middle and inferior lobes.
Left pulmonary artery is what to the right?
Shorter than the right and lies anterior to the descending aorta and position to the sup pulmonary vein.
What carries oxygenated blood from the lung back to the heart
Superior pulmonary vein and inferior pulmonary vein.
Where do veins begin?
At the hilum of the lung, pass through the root of the lung, and immediately drain into the left atrium
What do the bronchial arteries and veins constitute?
Nutritive vascular system of the pulmonary tissues. They interconnect within the lung kith branches of the pulmonary arteries and veins.
Where do the bronchial arteries originate
Thoracic aorta or one of its branches
Branches?
A single right bronchial artery normally arises from the third intercostal artery or upper left bronchial artery. Two left bronchial arteries arise directly from the anterior surface of the thoracic aorta - the superior left bronchial arty arises at T5 and inferior one inferior to the left bronchus.
Bronchial veins drain into
Either the pulmonary veins or the left atrium. Into the Azygos veins on the right or into the superior intercostal vein or hemiazygos vein on the left.
Innervations
Structures of the lung and visceral pleura are supplied by visceral afferents and efferents distributed through the anterior pulmonary plexus and pos pulmonary plexus.
Where are these interconnected plexus eps?
Lie anterior and posterior to the tracheal bifurcation and main bronchi.
Visceral efferents from where?
The vagus nave constrict the bronchioles and the sympathetic system dilates the bronchioles.
Superficial and deep lymphatics of the lung drain into where?
Lymph nodes called tracheobronchial nodes around the roots of lobar and main bronchi and along the sides of the trachae.
Efferent vessels from these nodes pass superiorly along the trachae to unite with
Similar vessels from parasternal nodes and brachiocephalic nodes,
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