Anatomy-Lungs

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Author:
heather.barber
ID:
112357
Filename:
Anatomy-Lungs
Updated:
2011-10-26 13:19:11
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Lungs
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Description:
Lung Anatomy
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  1. Thoracic Cage
    • Vertebrae
    • Sternum (Manubrium, Body, Xiphoid)
    • Ribs
    • Apertures
    • Landmarks
  2. Ribs
    • Vertebrosternal (1-7)
    • Vertebrochondral (8-10)
    • Vertebral (11-12)
  3. Apertures
    • Superior
    • Inferior
  4. Landmarks
    • Midclavicular
    • Midaxillary
    • Infrascapular
    • Sternal angle (Louis)
  5. innermost intercostal muscle
    • fibers run down and backwards
    • perpendicular to external intercostal muscle
    • same as internal intercostal
    • under n. a. and veins
  6. internal intercostal muscle
    • fibers run down and backwards
    • perpendicular to external intercostal muscle
    • above n. a. and veins
  7. external intercostal muscle
    • can see through
    • fibers run downward and medially
    • "hands in pocket"
  8. Nerves that supply the intercostal spaces
    • mixed spinal nerve
    • dorsal primary rami-supply skin
    • posterior cutaneous n.
    • lateral cutaneous n.
    • anterior cutaneous n.
    • ventral primary rami-around entire space
  9. Artery supply to intercostal spaces
    • posterior cutaneous artery
    • lateral cutaneous artery
    • anterior cutaneous artery
  10. intercostal nerve block to relieve pain of fractured ribs
    • after fracture back to spinal cord
    • closest to spinal cord prefered
    • do not hit nerve fiber-just want in vacinity
  11. pleural cavities
    • parietal
    • visceral
    • pleural reflection-root of lund
    • recesses and surface projection
  12. pareital
    • cervical
    • costal-against rib cage
    • diaphragmatic
    • mediastinal-all structures sandwiched between 2 pleura cavities
  13. recesses and surface projections
    • costodiaphragmatic-
    • costomediastinal-fluid accumulates if on back
  14. nerve supply to compartments
    • parietal: intercostal, phrenic
    • visceral: NO sensory
  15. Aspirations
    solid vs. liquid
  16. hemothorax
    • pleural tap-float on top of fluid
    • push lungs upward by fluid filling in csotodiaphragmatic recess
  17. pneumothorax
    • open (sucking) pneumothorax
    • -pull trachea/midline structures to other side
    • -exhale and trachea moves back to normal
    • tension (closed) pneumothorax
    • -accumulate air-can't get out
    • -trachea is fixed to other side and pressure builds up on empty side
    • -compress venous return to heart-turn blue and can lose consciousness if enough time
  18. surface anatomy of lungs
    • apex, base, costal, mediastinal
    • ant. and inf. borders
    • hilus (root of lung)
    • -major: bronchi, pulmonary a. and v.
    • -minor-lymph nodes, nerves, bronchial a.
  19. fissures and lobes
    • right-oblique and transverse fissures
    • left-lingula division, cardiac notch, oblique fissure
  20. trachea and bronchi
    • primary (1), lobar (2), segmental (3)
    • right main-shorter, wider, more vertical (25%)
    • -swallow something solid-right side
    • left main-twice as long, narrower, less vertical (45%)
    • -aspirate vomit run down to lowest level can find-depends on which way patient is leaning
  21. bronchopulmonary segments
    • lung tissue developed from segmental bronchi
    • central core of bronchial tree and pulmonary artery
    • pulmonary veins and lymphatics intersegmental
  22. blood supply
    • 2 independent systems: 1) pulmonary artery and vein, 2) bronchial artery and vein
    • artery-unoxygenated
    • vein-oxygenated
    • small amount of veins and artery meet-doesn't affect anything
    • to get to tissues-capillaries need arteriole pressure-send back to lung by bronchial artery
  23. lymphatic drainage
    • superficial and deep lymphatic vessels
    • pulmonary, bronchopulmonary (hilar), tracheobronchial and tracheal (paratracheal) nodes
  24. relations
    • vagus n.-behind lung
    • phrenic n.-front of lung
    • periphery-pulmonary vein
  25. thoracic volume
    • birth to 2 years thorax is circular-abdominal breathing (diaphragmatic)
    • progressive flattening from front to back-shift to intercostal breathing
    • transverse, A-P and vertical diameters all increase-Pump and Bucket Mechanisms
  26. primary muscles of respiration
    • diaphragm
    • intercostals (external and internal)
    • erector spinae
    • abdominal muscles
  27. diaphragm
    • origin-sternal, costal and lumbar
    • insertion-central tendon
    • nerve supply-phrenic (C3, 4, & 5)
    • action-flatten dome-inc. vertical diameter proportion of respiration: 75%
  28. intercostal (external and internal)
    • origin/insertion: adjoining ribs
    • nerve supply-T1-12
    • Action
    • -passive: fill gaps between ribs
    • -active: assist in respiration
    • -proportion of respiration: 25%
  29. erector spinae
    • origin/insertion: verterbral spines or transverse processes
    • actions
    • -medial column-inspiration (straighten spine)
    • -lateral column-expiration (depress ribs)
    • nerve supply-posterior primary rami
  30. abdominal muscles
    • external and internal obliques, transverse, and rectus abdominis
    • nerve supply-lower 6 intercostals
    • actions-antagonists to diaphragm (expiration, coughing)
  31. accessory (secondary) muscles
    • cervical muscles: scalenes, sternomastoid and trapezius
    • axial muscles: pectoralis major, serratus ant., latissimus dorsi
    • airway muscles: laryngea (post,. cricoarytenoideus) and bronchial smooth muscles-spasm, asthma

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