| sternum anterioly, vertebrae T1-12 posterioly and ribs 1-12 laterally | what structures are in the thoracic wall |
| clavicle (in the sternoclavicular joints) | What bones articulate with the manubrium at its superolateral angles? |
| plane hyaline cartilaginous joints | What type of joints are the sternoclavicular ones? |
| Jugular notch | What is the name given to the median notch formed by the superior borders of the manubrium? |
| cartilaginous section of the lower end of the sternum that isnt attached to any ribs and gradually ossifies later on in life, located at T10 | What is the xiphiod process and where is it located? |
| vertebrial level T4, rib 2 | Where is the sternomanubrial joint (sternal angle)? |
| head, neck,tubrercle,angle,costal groove, attchement of ribs/costal cartilage | Name the different parts of a typical rib (3-9) |
| 1-7 | which ribs are true ribs? |
| 8-12 | which ribs are false ribs? |
| 11-12 | which ribs are floating ribs |
| short, wide and flat, scalene tubercle (for attachment of anterior scalene muscle), subclavian artery groove, subclavian vein groove | What define the first rib? |
| body with head, transverse process with tubercle | what do the demi-facets of thoracic vertebrae articulate with? |
| first ribs, T1, manubrium | Which bones form the thoracic inlet? |
| T12, rib 11-12, costal cartilage of 7-10, xiphiod process | which bones/costal cartilages form the thoracic outlet? |
| a)1-7, b)8-10 | Which costal cartilages are a) attached directly to sternum and b) attached indirectly? |
| located under ribs and comprise of veins, arteries and nerves | what are the neurovascular bundles? |
| external intercostal (superficial), Internal intercostal (intermediate), innermost intercostal (deep) | What are the three intercostal muscles |
| costal groove (underneath rib), between the internal and innermost intercostal muscles | Where and between which two muscles is the neurovascular bundle located? |
| anteriorly- tranverse thoracis muscles posteriorly- subcostal muscles
the intercostal muscles also end in an internal (posterior) and external (anterior) intercostal membrane | What other muscles make up the intercostal space? |
| at the top of each rib | Where is the collateral branch of the neurovascular bundle located? |
| in the fifth intercostal space in the midaxillary line | where is chest drain normally inserted? |
| Mucosa (epithelium + lamina propria), submucosa, cartilage, adventitia | What is the composition of the extrapulmonary tubes (trachea + bronchi outside of lungs) from lumen to outside of tube? |
| hyaline and smooth muscle | what type of cartilage and muscle fibres are found in the respiratory tract? |
| goblet cells and ciliated cells | what are the two types of cell found in the epithelial layer? |
| pseudostratified ciliated columnar epithelium | what is the name of the respiratory epithelium |
| mucus | what substance is secreted by the glands in the submucosa (submucosal glands)? |
| trachialis muscle | what is the name given to the smooth muscle found in the posterior wall of the trachea? |
| eosphagus | what tubular structure lies immediatly prosterior to the trachea? |
| set of cartilage/membranes/ligaments that produce noise from expired air. attached to the hyiod bone superiorly and connects to the trachea at C6, its supplied by branches of the vagus nerve | What is the larynx and where is it situated? |
| hyaline cartilage (all layrgeal cartilages are hyaline except epiglottis which is elastic) | What cartilage makes up the laryngeal prominence (adams apple) |
| epiglottis | what structure prevents solids and liquids entering the larygeal inlet? |
| carina | what is the keel shaped cartilage ring at the bifurcation of the trachea called? |
| pulmonary plexus from upper thoracic vertebrae levels and parasympathetic fibres from the vagus nerve | How is the LRT innovated (trachea and main bronchi) |
| common carotid arteries in neck and vagus nerves | what lies immediatly lateral to the trachea? |
| Right main bronchus gives off a superior branch just before it enters the lung (the superior lobar bronchus) | which bronchi branches before it enters the lung? |
| apex, borders (anterior, posterior, inferior), surfaces (costal=anteriolateral, inferior=diaphragmatic=base, medial=mediastinal), fissures (oblique and transverse), lobes (superior, inferior and middle), hilum (on medial surface), cardiac notch, lingula | Name the parts of the lung |
| the structures that enter and leave the lung at the hilum | What is the root of the lung? |
| main bronchus, pulmonary artery, superior pulmonary vein, inferior pulmonary vein | What structures make up the root of the lung? |
| liver | which abdominal organ causes the right lung to be shorter and thicker? |
| endothoracic fascia/suprapleural membrane (its fuction is to ensure the rigidity of the thoracic inlet when breathing) | what fascial membrane covers the apex of the lung? |
| bronchopulmonary lymph nodes (bifurcation of bronchi at hilum), these then drain into the tracheobronchial nodes at the bifurcation of the trachea | where do the lymphatics of the visceral pleura and lungs drain to? |
| lung segments with individual air and blood supplies which can be surgically removed without adversely affecting the neighbouring segments | What are bronchopulmonary segments? |
| Plates of hyaline cartilage | What tissue is present in the wall of the bronchus that allows it to be easily identified? |
| one posterior bronchus, one superior pulmonary artery and superior and inferior pulmonary veins (both below the bronchus) | left lung root |
| eparterial (above) and hypertial (below) | Name the two bronchi in the right hilum |
| blood circulation in lungs, deoxygenated blood from right ventricle via arteries and returns oxygenated blood via veins to left atrium | What is the pulmonary circulation? |
| T2 | what dermatome supplies the skin at the sternal angle? |
| in the armpit | where are the axillary lymph nodes located |
| around large veins | where do lymph nodes tent to be clustered? |
| between ribs 2-6 and between the lateral border of the sternum and midaxillary line | Where is the glandular part of the breast located? |
| extensive adipose (fatty) tissue | What is the glandular part of the breast surrounded by? |
| the anterior (pectoral) group of axillary lymph | Where does the majority of the lymph drain into? |
| right as has the liver underneath | Which dome of the diaphragm reaches higher and why? |
| look for shadow of breasts to identify gender | CXR |
| Look for defining features such as bifurcation of the trachea ect | CT |
| the part where no gas exchange occurs, this is from trachea through to the terminal bronchioles | What is the conducting portion of the respiratory system? |
| bronchioles have no hyaline cartilage | How do you distinguish bronchioles from bronchus? |
| no cartilage, glands or goblet cells, some smooth muscle and cilia are present, diameter of 1mm or less. Secretes surfactant from CLUB/CARA cells. Contains columnar or cubiod epithelium | What is the structure of terminal bronchioles? |
| Their diameter is controlled by smooth muscle tone so they can be almost totally occluded if these muscle cells contract | Whats the danger of an asthma attack to bronchioles? |
| elastic tissue and reticular fibres (collagen) | Name two types of connective tissue found in alveoli |
| macrophages- phagocytosis, and breakdown any particles/pathogens in the lungs preventing infection
Type I pneumocytes- very thin and large surface area to allow gas exchange
Type II pneumocytes- produce surfactant that reduces water tension and makes breathing easier | Name 3 types of cell found in avleoli walls and give their function |
| double layer of serous membrane that surround the lung (outer parietal layer and inner visceral layer) | What is the pleura? |
| space between these two membranes that contains the pleural fluid | what is the pleaural cavity? |
| the visceral plura (adhered to the lungs) | which layer of the pleura enters and lines the fissures of the lungs? |
| the parietal pluera which is innovated by the phrenic and intercostal nerves (the visceral is only sensitive to stretch and supplied by pulmonary plexus) | Which pleura is sensitive to pain? |
| mediastinal, diaphragmatic, costal and apical | The parietal pleura is named according to its location in the thoracic cavity, name these 4 different areas |
| occurs when the parietal pleura lining one surface of the chest wall changes it direction to line another surface ie costal to diaphragmatic, its named the costo-diapgragmatic reflection | what is a pleural reflection and how are they named? |
| fount at the pleural reflections, the parietal pleura is further from the visceral pleura thus forming a space. These are named in the same way as the pleural reflections and are clinacally useful for needle aspiration | what is a pleura recess? |
| midclavicular line a)rib 6 b)rib 8
midaxillary line a)rib 8 b) rib 10
midscapular line a)rib 10 b)rib 12
There is always a 2 intercostal space difference between the inefrior border of the lung and parietal pleura | What is the number of the rib at which the inferior border of the a) lung and b) parietal pleura descend to in the midaxillary, midclavicular and midscapula lines? |
| the heart | what organ occupies the notch seen in the anterior border of the left lung between ribs 4-6? |
| 6th | The oblique fissure follows the course of which rib? |
| 4th | the horizontal fissure lies at the level of which rib? |
| vertebrae level C7 to T10 | The posterior border of the lung extends from where to where? |
| 9th intercostal space | At what place in the midaxillary line is it safe to aspirate? |
| left + right domes, central tendon, left and right crus, openings/hiatuses for IVC, Oesophagus, Aorta | structure of the diaphragm |
| Left- L1-2, Right- L1-3 | to which vertebrae are the left and right crura attached? |
| clover (trefoil) | what is the shape of the central tendon? |
| central tendon | to which tendon is the diaphragm attached? |
| xiphiod process | to which part of the sternum is the diaphragm attached? |
| T8 | on what level does the opening for the inferior vena cava occur? |
| T10 | on what level does the opening for the oesophagus occur |
| T12 | on what level does the opening for the aorta occur? |
| abnormal protrusion of a structure into the thorax through tear or weakness in the diaphragm ie caused by coughing, heavy lifting ect | what is a hiatus hernia? |
| paired phrenic nerves (both motor and sensory) and lower intercostal nerves provide sensory supply to periphery parts | what nerves supply the diaphragm? |
| C3,4,5 (keep the diaphragm alive) injury at these levels may cause paralysis of the diaphragm | what vertebrae contribute to the phrenic nerve? |
| penetrating injuries below the nipples should be suspected of causing damage to the diaphragm | penetrating injuries of the diaphragm |
