Pleura & Lungs

_______ is the superior of the manubrium: lies opposite the ______ border of the body of T_

Suprasternal notch, lower, 2

_________ ______ is between the sternal attachment of the ___ costal cartilages.

Subcostal angle, 7th

______ _____ is the lowest part (formed by ___ rib) is at the level of the ______ vertebrae

Costal margin, 10th, 3rd lumbar

_________ is the muscle behind the xiphisternal joint.

Diaphragm

__________ summit of the _______ dome of the diaphragm is at the _______ border of _th rib at the midclavicular line .

Midrespiratory, right, upper, 5

_____ dome reaches as far as the lower border of rib __ on the left.

Left, 5

_____ is in the ___ intercostal space _ inches from midline (male); _______ of T4 crosses the nipple.

Nipple, 4th, 4, dermatome

______ is in the ______ ventricle; point of maximum pulsation;____ intercostal space ___ from the midline.

Apex beat, left, 5th, 3.5

Levels of the landmarks of the Scapula:

1. Superior Angle: ________

2. Spine: ________

3. Inferior Angle: ________

T2, T3, T7

The Right Lung forms the __________________ joint, and reaches the midline behind _______ _______ and continues until the __________ joint.

Sternclavicular, sternal angle, Xiphisternal

______ lung deviates laterally and extends for a variable distance beyond lateral margin of sternum at the ____ costal cartilage to become the _________ _______.

Left, 4th, cardiac notch

_______ border: Curved line crossing __ rib and ___ rib and reaches the __ rib.

Lower, 6th, 8th, 10th

In the Lower border:

1. 6th rib = mid-_________

2. 8th rib = mid-_________

3. 10th rib = _________

Clavicle, axillary, vertebral column

________ border: extends down from spinous process of ___ cervical to the ____ thoracic vertebra ___ inches from the midline.

Posterior, 7th, 10th, 1.5

_______ fissure - from spinous process of __ to __ angulation.

Oblique, T2, T6

The _________ fissure is present only in the ______ lung, which meets the oblique fissure at the mid_______ lne in the ___ intercostal space.

Horizontal, right, axillary, 4th

______ line of pleural reflection is identical to the apex of the lung

Cervical pleural

_______ border of _ pleura - behind SC joint almost reaching the midline behind sternal angle up to xiphisternal joint.

Anterior, R

________ border of __ pleura, at the level of __ costal cartilage; deviates lateral to extend to lateral margin of the sternum to form the ________ _______

Anterior, L, 4th, cardiac notch

______ border of pleura - cross ___ rib in midclavicular line and ___ rib midaxillary line and reach ____ rib lateral border of erector spinae

Lower, 8th, 10th, 12th

________________ recess - distance between two (lung and pleural border)

Costodiaphragmic

True or False: The Lung and the pleura all have the same landmarks except for the lower border of the lung.

True

Surface Anatomy of the Heart:

_________ - formed by the left ventricle, corresponds to apex beat at ____ left intercostal space ___ inches from midline.

Apex, 5th, 3.5

Surface Anatomy of the Heart:

1. ______ border

2. ______ ____ costal cartilage (Sternal angle)

3. _______ is also found here.

Superior, 2nd, left, roots of great blood vessels

Surface Anatomy of the Heart:

1. ______ border

2. ___ right costal cartilage form the edge of sternum to the ___ right costal cartilage

3. ________ is also found here.

Right, 3rd, 6th, Right atrium

Surface Anatomy of the Heart:

1. _____ border

2. _______ costal from sternum to ____ ____

3. _____ is also found here.

Left, 2nd, apex beat, left ventricle

Surface Anatomy of the Heart:
_______ border formed by the right ventricle and apical part of the left ventricle; from ___ right costal cartilage from sternum to apex beat

Inferior, 6th

______ not common; occurs in motor accidents, heart may be severely contused by the impact.

Sternum fracture

_______ is the most common injury and is the bruising of the rib due to trauma.

Rib contusion

_________ commonly occurs at the ______ of the rib: ___ to ___ ribs are the common sites.

Rib fracture, angle, 5th, 10th

Common complication is ____________ due to penetration to lungs.

Pneumothorax

_______ is an injury to the ribs where a section of the rib cage has been detatched due to multiple fractures…

Flail chest

These are indications of?…

• Hemothorax

• Pneumothorax

• Open pneumothorax

• Prophylaxis

Thoracosectomy

Position of chest drain (tube) is determined by the “_____ _______”

Boundaries:

1. Anterior border of __________ ______

2. Lateral border of _______ _______

3. ______ of axilla

4. _________ line level of ______

safe triangle, latissimus dorsi, pectoralis major, apex, horizontal, axilla

2nd intercostal space at the midclavicular line for the ______ approach

Anterior

2nd intercostal space at the midaxillary line for the ______ approach

Lateral

Classification of Diaphragmatic hernia?…

Congenital

In a diaphragmatic hernia, abdominal contents may move ________.

Upward

Involuntary spasmodic contraction of diaphragm..

Hiccups

Singultus (Hiccups) - Can be a symptom of _____ (inflammation of pleura).

Pleurisy

The pulmonary _____ allows movement of pulmonary ________ and large _____ during respiration.

ligament, vessels, bronchi

The pleural cavity contains ________ fluid, which lessens friction between pleural layers.

parietal

______ is found in the Inner surface of ribs, costal cartilage and sides of vertebral bodies and back of sternum…

Costal pleura

The costal pleura is supplied by the ________ nerves.

intercostal

The superior boundary of the pleural cavity above rib _ to the ________.

1, root of neck

The inferior boundary of the pleural cavity extends just above the ________.

costal margin

The space between the parietal and visceral pleura is called the ________.

pleural cavity

_____ covers thoracic surface of diaphragm; supplied by _____ and _ intercostal nerves.

Diaphragmatic pleura, phrenic nerve, 6

_____ is a Dome shape layer of _____ pleura lining the cervical extension and covers the ____.

Cervical, parietal, apex

Pleura sensitivities…

1. Visceral; _____

2. Parietal;______ & ______

stretch, pain, stretch

______ is a lower area of pleural cavity into which lung expands vertically during inspiration

Costodiaphragmatic recess

________ is to give space to the heart when it beats and for the lungs when it expands

Costomediastinal recess

Nerve that innervates both the mediastinal pleura and the diaphragm…

Phrenic nerve

Normal amount of pleural fluid is __-__ mL, and disorder when too much is produced is called _____ ______.

5, 10, pleural effusion

Collection of pus in the pleural cavity is called _______.

Empyema

The trachea starts at the lower border of the ________, and bifurcates at the ____ ____.

cricoid, sternal angle

True or False: The trachealis muscle is a voluntary muscle

False

Differences between right & left bronchi… (Type 1)

1

______ is the end junction of trachea and principal bronchi that separates the opening of bronchi (start of bifurcation)

Carina

______ possess outpouching from their walls; blood exchange between blood and air takes place in the walls

Terminal bronchioles

Bronchopulmonary segments (Type 1)

1

• ___: structure projecting upward into the neck above clavicle

• ___: sits on the diaphragm

• ______ surface: corresponds to concave chest wall

• ______ surface: molds into the pericardium and other mediastinal structure

• _____: depression in which the root of lung is attached

Apex, Base, Costal, Mediastinal, Hilum

Non-respiratory circuit: (No gas exchange)

1. Bronchial ______ supplies the bronchi, connective tissue of lung and visceral pleura

2. Bronchial ______ rains to azygos and hemiazygos veins

arteries, veins

The ________ ______ is where gas exchange occurs.

Respiratory circuit

Intersegmental veins carry ________ blood from alveolar capillaries.

de-oxygenated

Intersegmental veins carry ________ blood from alveolar capillaries.

oxygenated