53 Questions
What is the diaphragm?
A curved musculo-fibrous sheet that separates the thoracic from the abdominal cavity
What is the function of the diaphragm?
To close the inferior thoracic aperture and serve as a major muscle of respiration
How is the diaphragm attached peripherally?
To the xiphoid process of the sternum, costal margin of the thoracic wall, ends of ribs XI and XII, ligaments spanning the posterior abdominal wall, and vertebrae of the lumbar region
What is the clinical description of the diaphragm?
Consisting of two halves (right and left hemidiaphragm) separated by an imaginary midsagittal plane, with each hemidiaphragm being dome-shaped
What are the origins of the diaphragm?
C3, C4, C5
How does the diaphragm project superiorly toward the thorax?
As a double-domed musculotendinous structure
What are the functionally distinct circulatory pathways in the lungs?
Pulmonary vessels and bronchial vessels
From where do the right and left pulmonary arteries originate?
Pulmonary trunk
Which lung has three lobes, and how many bronchopulmonary segments does it have?
Right lung, 10 bronchopulmonary segments
What is the innervation of the visceral pleura and other structures of the lung?
Visceral afferents and efferents distributed through the anterior and posterior pulmonary plexuses
Where do the bronchial arteries originate from?
Thoracic aorta or one of its branches
What is the role of the right lymphatic duct and the thoracic duct?
To drain lymphatic vessels from the lungs
Where do the pulmonary veins carry oxygenated blood from the lungs?
Back to the heart
What is the main function of the bronchial vessels?
To provide oxygenated blood to lung tissues
What are the main components of the bronchopulmonary segments?
Upper, middle, and lower
Where do the bronchial arteries interconnect within the lung?
With branches of the pulmonary arteries and veins
What is the distribution of the efferents from the vagus nerves and sympathetic system in the lung?
Vagus nerves constrict the bronchioles, sympathetic system dilates the bronchioles
What are the main lymph nodes involved in the lymphatic drainage of the lungs?
Tracheobronchial nodes, paratracheal nodes, bronchomediastinal trunk
What are the two layers of the pleura?
Visceral and parietal
How is the pleural sac visually described in the text?
As a balloon with the lung as a fist
What are the four parts into which the pleura is divided?
Costal, mediastinal, diaphragmatic, and cervical
What is the pleural cavity?
A potential space between the visceral and parietal pleura
What is the function of the pleural cavity?
To contain a thin film of serous fluid
What is pneumothorax?
Presence of air in the pleural cavity
What is thoracocentesis?
A procedure used to remove excess fluid or take a sample of fluid from the pleural cavity
How are the lungs described in terms of their weight?
Approximately 625g for the right and 565g for the left
What is the role of the mediastinum in the thoracic cavity?
It separates the two pulmonary cavities and contains the heart, esophagus, trachea, and major blood vessels
What are the conditions that affect the pleural cavity mentioned in the text?
Pneumothorax, pleuritis, hemothorax
What is the innervation of the pleura supplied by?
Various nerves
How can pneumothorax be caused?
By trauma or spontaneously
What are the two major factors that cause changes in the level of the diaphragm domes?
Respiration, postural changes, and abdominal distention
At complete normal expiration in a standing person, at what level is the right hemidiaphragm dome located anteriorly?
Roughly at the level of the 5th rib
Where is the left hemidiaphragm dome located at complete normal expiration in a standing person?
At the inferior border of the 5th rib at the midclavicular line
What are the strong tendons attached to the anterolateral surfaces of the upper lumbar vertebrae?
Crura
Which arteries supply the diaphragm?
Pericardiacophrenic, musculophrenic, superior phrenic, and intercostal arteries
What nerves innervate the diaphragm?
Phrenic nerves
What role does the diaphragm play in inspiration?
The domes descend to draw the lung bases towards the chest wall
During what activity does the diaphragm contract to help raise intra-abdominal pressure?
Abdominal straining
What type of muscle fibers does the diaphragm consist of?
Slow-twitch muscle fibers
What is the most likely diagnosis for the 54-year-old man with a history of smoking and presenting with acute shortness of breath and severe chest pain?
Chronic obstructive pulmonary disease (COPD)
What anatomical disorder is likely due to the long-term smoking history of the 54-year-old man?
Damage to the lung tissue and airways
What are the components of the hilum of each lung?
Pulmonary artery, pulmonary veins, primary bronchus, bronchial vessels, nerves, and lymphatics
How many lobes does the right lung consist of?
Three
What separates the superior lobe from the middle lobe in the right lung?
Horizontal fissure
What separates the inferior lobe from the superior and middle lobes in the right lung?
Oblique fissure
What are the structures adjacent to the medial surface of the right lung?
Heart, inferior and superior vena cava, azygos vein, esophagus, right subclavian artery and vein
How is the left lung different from the right lung in terms of lobes?
The left lung is smaller with two lobes
What is the function of a bronchopulmonary segment?
The smallest, functionally independent region of a lung
What are the components of the bronchial tree?
Main bronchus, lobar bronchi, segmental bronchi, and bronchioles
What supports the walls of bronchi to keep them open?
Cartilage
What structures are found within each root and hilum of the lung?
Pulmonary artery, pulmonary veins, main bronchus, and their respective branches
What is the course of the right main bronchus compared to the left main bronchus?
Wider and more vertical
What structures are adjacent to the medial surface of the left lung?
Heart, aortic arch, thoracic aorta, and esophagus
Study Notes
- Each lung has a half-cone shape with a base, apex, two surfaces, and three borders.
- The base of each lung sits on the diaphragm, the apex projects above rib I and into the root of the neck.
- The costal surface lies adjacent to the ribs, the mediastinal surface faces the mediastinum and vertebral column.
- The right lung consists of three lobes and two fissures: oblique and horizontal.
- The oblique fissure separates the inferior lobe from the superior and middle lobes, follows the contour of rib VI anteriorly.
- The horizontal fissure separates the superior lobe from the middle lobe, follows the fourth intercostal space from the sternum.
- The medial surface of the right lung is adjacent to structures like the heart, inferior and superior vena cava, azygos vein, esophagus, and right subclavian artery and vein.
- The left lung is smaller with two lobes separated by an oblique fissure, the approximate position of which can be marked by a curved line following rib VI anteriorly.
- The medial surface of the left lung is adjacent to structures like the heart, aortic arch, thoracic aorta, and esophagus.
- The hilum of each lung contains structures such as a pulmonary artery, pulmonary veins, primary bronchus, bronchial vessels, nerves, and lymphatics.
- Within each root and hilum, there's a pulmonary artery, pulmonary veins, main bronchus, and their respective branches.
- Each main bronchus enters the lung and passes through the hilum, the right main bronchus is wider and takes a more vertical course.
- The bronchial tree consists of the main bronchus, lobar bronchi, segmental bronchi, and bronchioles, which supply the respiratory surfaces.
- The walls of bronchi are held open by cartilage, but not present in bronchioles.
- A bronchopulmonary segment is the smallest, functionally independent region of a lung, each having ten segments in each lung.
- The right main bronchus is wider and takes a more vertical course, causing inhaled foreign bodies to lodge more frequently on the right side.
By Ahmed Safaa Telegram channel : https://t.me/mcqb2
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