48 Questions
Which muscle is NOT considered as an accessory muscle of respiration?
Diaphragm
What is the viceral pleura?
The Internal serous membrane attached to the lung surface
Which type of ribs are directly attached to the sternum?
Vertebrosternal
What is the structural alteration associated with a pneumothorax?
Collapse of a lung due to air in the pleural space
Which division of the mediastinum contains the heart and roots of the great vessels?
Inferior mediastinum
Which muscles are active during inspiration and help elevate the ribs?
External intercostal muscles
Which muscles are accessory muscles of active expiration and help depress the ribs?
Middle intercostal muscles
Which lung has three lobes?
Right lung
Which lung has two lobes?
Left lung
Where is the hilum located in the lungs?
Wedge-shaped area on the mediastinal surface
Which nerves provide autonomic innervation to the lungs?
Pulmonary plexuses
What is the role of bronchial vessels in the lungs?
Supplying the lung stroma
Where does lymphatic drainage of the lungs not follow a predictable path?
Left inferior lobe
Where do lymphatics arise in the lungs?
Terminal bronchioles
Which muscles are inactive during inspiration and expiration, but play a role in maintaining posture and supporting movements of the abdominal wall?
Internal oblique muscles
Where do the middle intercostal muscles located ?
Between the superficial and deep intercostal muscles
How many surfaces does each lung have?
Four
What is the primary function of the diaphragm?
To separate the thoracic and abdominal cavities
How many regions of origin does the diaphragm have?
Three
Which nerve provides motor innervation to the diaphragm?
Phrenic nerves
What happens if the connective tissues of the hemi-diaphragms do not fuse properly during gestation?
Herniation of abdominal viscera
Which muscle can assist inspiration by elevating the rib cage?
Sternocleidomastoid
What is the role of the central tendon of the diaphragm?
Connect to the pericardial sac
Which muscles function as accessory muscles of respiration?
Anterior, middle, and posterior scalene muscles
What is the embryological origin of the diaphragm?
'Hemi-diaphragms' that fuse during gestation
Which nerve innervates the sternocleidomastoid muscle?
Spinal accessory nerve (CN XI)
What is the role of superficial anterior thoracic muscles in respiration?
Function as accessory muscles by elevating ribs during inspiration
Which of the following landmarks marks the junction of the manubrium and body of the sternum?
Sternal angle of Louis
Which part of the thoracic cage is formed by four sternabrae and lies in the same plane as the 2nd thoracic vertebra?
Body of sternum
Which ribs do not have tubercles and do not articulate with the sternum?
Ribs 11 and 12
What is the location between the medial ends of the clavicles called?
Suprasternal notch
Which type of ribs have no sternal connection?
Floating ribs
Which part of the sternum can be palpated externally?
Manubrium
Which part of the rib cage has a broad inferior thoracic aperture?
Floating ribs
What does the sternabrae form?
Body of sternum
Which structure marks the division of breasts?
intermammary cleft
What is the function of the thin layer of pleural fluid in the pleural cavity?
Preventing alveolar collapse and reducing resistance during breathing movements
Which blood supply provides nourishment to the parietal pleura?
Internal thoracic, intercostal, and musculophrenic arteries
What happens if the pleural cavity is disrupted?
Pulmonary collapse
Which structures are contained within the superior mediastinum?
Trachea, aortic arch, esophagus, vagus and phrenic nerves, and part of the thymus
Which muscles are used during expiration?
internal intercostals muscles
What can happen if a patient receives bilateral interscalene brachial plexus blocks?
Potential complications of diaphragmatic paralysis and respiratory failure
Which arteries supply blood to the visceral pleura?
Bronchial arteries from the aorta
What are pleural reflections?
Regions where the parietal pleural membrane turns back and folds on itself
What is the function of the intact pleural space?
Maintaining lung inflation at end-expiration
What is the purpose of the mediastinum?
Contain all thoracic viscera except the lungs
What are pleural recesses?
Potential spaces within pleural reflections where pleural fluid accumulates during eupnea
Which ribs are most responsible for the pump-handle effect?
Ribs attached to sternum (true ribs)
Study Notes
- The pleural cavity is a potential space created by the lungs being located within pleural sacs, composed of two layers of serous membrane.
- The parietal pleura is the external serous membrane lining the internal thoracic wall, while the visceral pleura is the internal serous membrane attached to/covering the lung surface.
- The thin layer of pleural fluid in the pleural cavity couples the visceral and parietal pleura, preventing alveolar collapse and reducing resistance during breathing movements.
- The intact pleural space is required to maintain lung inflation at end-expiration.
- The parietal pleura is named according to the structures it lines, such as the costal, diaphragmatic, mediastinal, and cervical pleura.
- Pleural reflections are regions where the parietal pleural membrane turns back and folds on itself, and pleural recesses are potential spaces within these reflections where pleural fluid accumulates during eupnea.
- The parietal pleura receives its blood supply from branches of adjacent structures, such as the internal thoracic, intercostal, and musculophrenic arteries.
- Visceral pleura receives blood from bronchial arteries, branches off the aorta, and blood is drained by pulmonary veins.
- Disruption of the pleural cavity can cause pulmonary collapse, such as with pneumothorax, bronchopulmonary fistulas, and hemothorax or hydrothorax.
- The mediastinum is the central compartment of the thoracic cavity and contains all thoracic viscera except the lungs, with superior and inferior divisions.
- The superior mediastinum contains the trachea, aortic arch and its branches, esophagus, vagus and phrenic nerves, and part of the thymus.
- The inferior mediastinum has three subdivisions: anterior, middle (containing the heart and pericardial sac), and posterior (containing structures that vertically traverse the thorax), such as the esophagus, carina/primary bronchi, descending thoracic aorta, azygos system of veins, and vagus and sympathetic nerves.
- During expiration, the diaphragm and internal intercostals muscles are used.
- The ribs most responsible for the pump-handle effect are all ribs.
- Bilateral interscalene brachial plexus blocks should not be performed due to potential complications, such as diaphragmatic paralysis and respiratory failure.
Explore the various functions of the diaphragm, the primary muscle of inspiration in the respiratory system. Learn about its role in respiration, venous return, and as a barrier that separates different body cavities.
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