Human Respiratory System Anatomy
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Questions and Answers

Which of the following structures does the 2nd Intercostal nerve connect with?

  • Medial cutaneous nerve of the arm (correct)
  • Azygos vein
  • Phrenic nerve
  • Lateral cutaneous branch
  • What is the main function of the Azygos vein?

  • Supplies blood to the heart
  • Drains blood from the head and neck
  • Carries blood to the lungs
  • Connects the superior and inferior vena cava (correct)
  • What happens to the margins of the base of the lung during deep inspiration?

  • They disappear
  • They decline (correct)
  • They remain constant
  • They increase
  • What is the central tendon of the diaphragm?

    <p>A central aponeurosis that the peripheral muscular portion inserts into</p> Signup and view all the answers

    What is the name of the lower zone of the pleural cavity that the lung enlarges into during inspiration?

    <p>Costodiaphragmatic recess</p> Signup and view all the answers

    What are the three components of the muscular part of the diaphragm?

    <p>Vertebral, sternal, and costal</p> Signup and view all the answers

    What is the primary function of the phrenic nerves?

    <p>Motor innervation of the diaphragm</p> Signup and view all the answers

    What is the name of the part of the parietal pleura that extends into the root of the neck?

    <p>Cupola</p> Signup and view all the answers

    What is the function of the suprapleural membrane?

    <p>It covers the cervical pleura</p> Signup and view all the answers

    What is the sensory supply of the central part of the diaphragm?

    <p>Phrenic nerves</p> Signup and view all the answers

    Which artery rises above the subclavian artery?

    <p>Vertebral artery</p> Signup and view all the answers

    What is the relationship between the scalenus anterior muscle and the cervical pleura?

    <p>The muscle envelops the anterolateral part of the pleura</p> Signup and view all the answers

    What is the direction of the costocervical trunk?

    <p>It arcs towards the back</p> Signup and view all the answers

    What is the location of the first thoracic sympathetic ganglion in relation to the dome of the pleura?

    <p>Medial to the dome</p> Signup and view all the answers

    Which of these structures reinforce the cervical pleura?

    <p>Sibson fascia</p> Signup and view all the answers

    Where does the sternal line of pleural reflection occur?

    <p>Where the costal pleura meets the mediastinal pleura</p> Signup and view all the answers

    Which of these lines of pleural reflection is described as gradual and round?

    <p>Vertebral line</p> Signup and view all the answers

    Which of these structures is innervated by somatic afferent fibers?

    <p>Parietal pleura</p> Signup and view all the answers

    What is the main nerve innervating the diaphragmatic pleura?

    <p>Phrenic nerves</p> Signup and view all the answers

    What is the main nerve innervating the costal pleura?

    <p>Intercostal nerves</p> Signup and view all the answers

    Where does the visceral pleura become continuous with the parietal pleura?

    <p>At the hilum of the lung</p> Signup and view all the answers

    What is the relationship between the visceral pleura and the lung?

    <p>Firmly attached</p> Signup and view all the answers

    What is the inferior boundary of the Superior Mediastinum?

    <p>Transverse thoracic plane</p> Signup and view all the answers

    What is the main function of the thymus gland?

    <p>Production of white blood cells</p> Signup and view all the answers

    Where does the Superior Vena Cava enter the right atrium?

    <p>Level of the 3rd right costal cartilage</p> Signup and view all the answers

    Which of the following is NOT a branch of the aortic arch?

    <p>Right subclavian artery</p> Signup and view all the answers

    What is the Ligamentum arteriosum?

    <p>A fibrous remnant of the ductus arteriosus</p> Signup and view all the answers

    Which of the following nerves is NOT found in the Superior Mediastinum?

    <p>Facial nerve</p> Signup and view all the answers

    Which of the following is NOT a structure found in the Posterior Mediastinum?

    <p>Thymus gland</p> Signup and view all the answers

    What is the correct order of structures in the Superior Mediastinum, from anterior to posterior?

    <p>Thymus gland, Trachea, Great Vessels, Esophagus</p> Signup and view all the answers

    Where is the parietal pleura located?

    <p>Lines the chest wall and mediastinum</p> Signup and view all the answers

    What is the clinical significance of the pleural surface projection?

    <p>It guides the placement of central venous cannulas and abdominal surgery</p> Signup and view all the answers

    What is the location of the apex of the pleura relative to the clavicle?

    <p>2.5 cm above the medial third of the clavicle</p> Signup and view all the answers

    At what level does the pleura run toward the midline behind the angle of Louis?

    <p>Second costal cartilage</p> Signup and view all the answers

    Where does the right pleura continue downward?

    <p>Right side of the xiphisternal joint</p> Signup and view all the answers

    Which rib does the lower limit of the costal pleura cross in the midaxillary line?

    <p>Tenth rib</p> Signup and view all the answers

    What is the relationship between the surface markings of the lungs and the pleura?

    <p>The lung markings closely follow the pleural markings</p> Signup and view all the answers

    In quiet respiration, how much higher is the lower edge of the lung compared to the lower limit of the pleura?

    <p>5 cm</p> Signup and view all the answers

    Study Notes

    Intercostal Nerve and Angina Pectoris

    • The 2nd intercostal nerve connects to the medial cutaneous nerve of the arm via the intercostobrachial nerve.
    • Pain from angina pectoris and myocardial infarction can be referred to the medial side of the arm, following this nerve pathway.
    • The upper six intercostal nerves innervate the skin, parietal pleura, and intercostal muscles within their respective spaces.

    Azygos Vein

    • Connects the inferior vena cava (IVC) with the superior vena cava (SVC).
    • Originates in the abdomen from the IVC at the level of L2.
    • Enters the thorax through the aortic opening of the diaphragm on the right side of the thoracic duct and aorta.
    • Passes behind the right border of the esophagus and the root of the right lung in the posterior mediastinum.
    • Crosses above the root of the right lung in the superior mediastinum and enters the back of the SVC.

    Respiratory Diaphragm

    • Separates the thoracic and abdominal cavities, consists of a peripheral muscular part and a central tendon.
    • The muscular part is derived from vertebral, sternal, and costal components.

    Nerve Supply to the Diaphragm

    • Motor supply arises from the phrenic nerves (C3, C4, C5), primarily facilitating inspiration.
    • Sensory innervation to the diaphragm's periphery comes from lower intercostal nerves, while central sensory information is supplied by phrenic nerves.

    Pleural Reflection Lines

    • Abrupt lines mark where parietal pleura shifts direction within the pleural cavity.
    • Sternal line: where costal pleura meets mediastinal pleura anteriorly.
    • Costal line: where costal pleura joins diaphragmatic pleura inferiorly.
    • Vertebral line: a gradual transition point for costal pleura connecting with mediastinal pleura posteriorly.

    Innervation of Parietal Pleura

    • Somatic afferent fibers provide innervation to the parietal pleura.
    • Costal pleura innervated by intercostal nerves, causing pain sensation related to the thoracic wall.
    • Diaphragmatic and mediastinal pleura mainly receive sensory input from phrenic nerves, with referred pain to C3, C4, C5 dermatomes.

    Visceral Pleura

    • Continuous with parietal pleura at the lung hilum, firmly adheres to lung surfaces.
    • The costodiaphragmatic recess is the space into which the lung expands during inspiration, found at the base.

    Mediastinum Divisions

    • Divided into superior and inferior mediastinum by the transverse thoracic plane.
    • Superior mediastinum includes thymus, great vessels, vagus and phrenic nerves, trachea, esophagus, thoracic duct, and pleura.
    • Inferior mediastinum is subdivided into anterior (thymus remnants), middle (heart and great vessels), and posterior (esophagus, great vessels, vagus nerves, sympathetic trunks).

    Superior Mediastinum Contents

    • Thymus gland located behind the manubrium, involutes post-puberty.
    • Great vessels include Brachiocephalic veins and superior vena cava.
    • Arch of the aorta spans from behind the 2nd right sternoclavicular joint to the 2nd left sternoclavicular joint; branches include Brachiocephalic trunk, left common carotid artery, and left subclavian artery.

    Thoracic Inlet and Pleura Position

    • The thoracic inlet is defined by the first rib, with the pleural apex lying 2.5 cm above the medial end of the clavicle and more at the apex.
    • The pleura descends laterally towards the midline, with crucial surface projections detailed for clinical significance to avoid pneumothorax during procedures.

    Lung Surface Markings

    • Lung edges are typically above pleural edges due to fluid separation, with the excursion during deep respiration reaching 7.5 cm.
    • The inferior lung border crosses the sixth rib at the midclavicular line, eighth rib at the midaxillary line, and tenth rib near the erector spinae.

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