39 Questions
What is the main function of the diaphragm?
Separates the thoracic from the abdominal cavity
What keeps the diaphragm alive?
C3,4,5
To which structures is the diaphragm attached peripherally?
Xiphoid process of the sternum, costal margin of the thoracic wall, ends of ribs XI and XII, ligaments of the posterior abdominal wall, and vertebrae of the lumbar region
How many halves does the diaphragm consist of?
Two
What shape does each hemidiaphragm form?
Dome-shaped
Why does the dome of the right hemidiaphragm project superiorly more than the left?
Due to the large right lobe of the liver pushing it superiorly
Which muscle is considered as a major muscle of respiration?
Diaphragm
What is altered during respiration and postural changes?
Level of the domes of each hemidiaphragm
What is the function of the pleural cavity?
To allow the lungs to expand and contract during respiration
Which nerves supply the innervation of the pleura?
Intercostal nerves, phrenic nerves, and lower five or six intercostal nerves
What is pneumothorax?
Presence of air in the pleural cavity
What is hemothorax?
Accumulation of blood in the pleural cavity
What is the weight of the right lung approximately?
$625g$
What are the surfaces that the lungs have?
Half-cone shape with various surfaces and borders
What is thoracocentesis?
Insertion of a chest tube for drainage
What is a potential space between visceral and parietal pleura, containing a thin film of serous fluid?
$Pleural cavity$
What vessels provide oxygenated blood to lung tissues which do not have close access to atmospheric oxygen?
Bronchial arteries
Where do the right and left pulmonary arteries originate from?
Pulmonary trunk
Which pulmonary artery is longer, passes horizontally across the mediastinum, and passes anteriorly to the tracheal bifurcation?
Right pulmonary artery
Where do the pulmonary veins drain oxygenated blood back to?
Left atrium
What constitutes the 'nutritive' vascular system of the pulmonary tissues?
Bronchial arteries and veins
Which plexuses lie anteriorly and posteriorly to the tracheal bifurcation and main bronchi?
Anterior pulmonary plexus and posterior pulmonary plexus
Where do intrapulmonary vessels & nodes drain into?
Bronchopulmonary (hilar) nodes
Where do superficial and deep lymphatics of the lung drain into?
Deep veins at the base of the neck
Which structure separates the thoracic and abdominal cavities?
Diaphragm
At which vertebral level does the inferior vena cava pass through the central tendon of the diaphragm?
T8
Which artery supplies the diaphragm with blood?
Inferior phrenic artery
Which nerve innervates the diaphragm?
Phrenic nerve
During which activity does the diaphragm aid in raising intra-abdominal pressure?
Abdominal straining
Which type of muscle fibers does the diaphragm mainly consist of?
Slow twitch muscle fibers
What is the most likely diagnosis for a 54-year-old man with a history of smoking two packs of cigarettes per day for 20 years, presenting with acute onset of shortness of breath and chest pain?
Pneumothorax
Which structure is attached to the middle part of the central tendon of the diaphragm?
Pericardium
Which surface of the thoracic wall is adjacent to the ribs and intercostal spaces?
Costal
How many lobes does the right lung have?
Three
Which fissure separates the inferior lobes from the superior lobes of the right lung?
Oblique
What important structures are adjacent to the medial surface of the right lung?
Heart, superior vena cava, esophagus
How many lobes does the left lung have?
Two
How many bronchopulmonary segments are there in each lung?
Ten
What keeps the walls of the bronchi open?
Elongated plates of cartilage
Study Notes
- The thoracic wall has two surfaces: costal and mediastinal. The costal surface is adjacent to the ribs and intercostal spaces, while the mediastinal surface is against the mediastinum and vertebral column.
- The right lung has three lobes (upper, middle, and lower) and two fissures (oblique and horizontal). The oblique fissure separates the inferior lobes from the superior lobes, while the horizontal fissure separates the superior lobes from the middle lobes.
- The approximate position of the oblique fissure on the thoracic wall can be marked by a curved line beginning at the spinous process of the TIV level, crossing the fifth interspace laterally, and following the contour of rib VI anteriorly.
- The horizontal fissure follows the fourth intercostal space from the sternum until it meets the oblique fissure as it crosses rib V.
- The right lung's medial surface is adjacent to important structures in the mediastinum and the root of the neck, including the heart, inferior and superior vena cava, azygos vein, esophagus, and the right subclavian artery and vein.
- The left lung is smaller than the right lung and has two lobes separated by an oblique fissure. During quiet respiration, the approximate position of the left oblique fissure can be marked by a curved line beginning between the spinous processes of TIII and TIV, crossing the fifth interspace laterally, and following the contour of rib VI anteriorly.
- The medial surface of the left lung lies adjacent to important structures in the mediastinum and root of the neck, including the heart, aortic arch, thoracic aorta, esophagus, and the left subclavian artery and vein.
- The lungs have a hilum, which contains the pulmonary artery, pulmonary vein, primary bronchus, bronchial vessels, nerves, and lymphatics.
- The bronchial tree includes the main bronchus, lobar bronchi, and segmental bronchi, which supply bronchopulmonary segments. The right main bronchus is wider and takes a more vertical course, causing inhaled foreign bodies to lodge more frequently on the right side.
- The walls of the bronchi are held open by elongated plates of cartilage, but this is not present in bronchioles.
- A bronchopulmonary segment is the area of lung supplied by a segmental bronchus and its accompanying pulmonary artery branch. Each bronchopulmonary segment is shaped like a cone with the apex at the origin of the segmental bronchus and the base projected peripherally onto the surface of the lung.
- There are ten bronchopulmonary segments in each lung.
- The lungs have two functionally distinct circulatory pathways.
By Ahmed Safaa Telegram channel : https://t.me/mcqb2
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