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Terms in this set (64)
TEST: What are the 4 main layers of the pharynx from most SUPERFICIAL (vertebra) to deep (inner lining)?
Which layer do you see as a clinician?
You see Pharyngeal mucosa (closest layer to inside)
What kind of epithelium lines the mucosa layer of the pharynx?
TRUE or FALSE: The pharyngeal constrictor muscles are smooth muscles
(swallowing is voluntary)
What structure sits right behind the pharynx, and what layer separates the two?
TEST: What are the three main subdivisions of the pharynx?
The opening of the nasal cavity to the pharynx can be seen posteriorly by what structure?
TRUE or FALSE: The soft palate and uvula are a part of the oropharynx
(they are at the end of the nasopharynx)
The laryngopharynx spans from the inferior aspect of the ______ to the part where it diverges into the respiratory and digestive pathways.
The laryngopharynx continues as the ________ posteriorly and the _______ anteriorly
Uvula (or soft palate)
Esophagus (digestive) posteriorly
Larynx (respiratory) anteriorly
At what vertebra level does the esophagus start?
How many constrictor muscles of the pharynx are there? Are they circular or longitudinal, and what are they?
(superior, middle, inferior constrictor muscles)
What muscle forms the upper esophageal sphincter?
How many elevator muscles of the pharynx are there?
Are they circular or longitudinal, and what are they?
Which longitudinal pharyngeal muscle is innervated by a different nerve than the one that innervates the others?
, innervated by CN IX
The other two longitudinal pharyngeal muscles are innervated by the VAGUS nerve (CN X)
RECALL: When you swallow, what laryngeal structure folds over to cover the larynx so that food doesn't go down the wrong tube?
RECALL: The thyroid cartilage is big in the (front/back) and small in the (front/back).
What attaches to the posterior surface of the thyroid cartilage?
Big in the FRONT, smol in the BACK
The VOCAL CORDS attach to the posterior surface of the thyroid cartilage!
TEST: The vocal folds attach anteriorly to the ________ cartilage and posteriorly to the _________, which are extensions of the ________ cartilage. These are what can pivot and allow for __________.
Thyroid cartilage anteriorly
ARYTENOIDS (extensions of the CRICOID cartilage) posteriorly
Pivot and allow for
What membrane joins the thyroid and cricoid cartilages? What is clinically relevant about this?
Can do emergency tracheotomies here!
What are the holes in the thyrohyoid membrane for?
For passing of the internal branch of the superior laryngeal N. (coming off of vagus n.)
What laryngeal muscles are vocal fold ADDUCTORS?
What laryngeal muscle is a vocal fold ABDUCTOR?
Posterior cricoarytenoid m
Which TWO laryngeal muscles make up the laryngeal inlet sphincter?
The region between the two vocal cords is called the ______, and the only time you close this space is when you are (eating/talking). Why?
Only time it is closed is when you are TALKING, as this allows the air going through them to cause VIBRATIONS in the cords to produce different sounds
TEST: The main nerve that innervates the larynx is the ______ nerve, and it gives off a major branch called the _______ laryngeal n.
What are the two main branches of this, and which one is the sensory branch?
Gives off the SUPERIOR LARYNGEAL NERVE
Internal laryngeal n. (SENSORY)
External laryngeal n.
TEST: What nerve ascends up the tracheoesophageal groove and innervates the majority of the muscles of the larynx?
What is the only laryngeal muscle not innervated by this nerve, and what is it actually innervated by?
RECURRENT LARYNGEAL N
The only laryngeal muscle it doesn't innervate is the CRICOTHYROID muscle (EXTERNAL branch of the superior laryngeal nerve)
The recurrent laryngeal nerve ultimately becomes the ______ laryngeal nerve, above the ________ joint
inferior laryngeal nerve
above cricothyroid joint
RECALL: What do the right and left recurrent laryngeal nerves each loop under as it ascends?
Left - aortic arch
Right - subclavian vein
TEST: What are the two layers that make up the pleural cavity? What is contained within the pleural cavity?
Parietal pleura (outer)
Visceral pleura (inner)
Contains pleural fluid (serous) made of water
TEST: What keeps the lungs from collapsing on itself?
What is significant about the fluid within the pleural cavity in regards to this?
Pressure of fluid (keeps lungs from collapsing on selves)
Since the fluid within the pleural cavity is made of water, water is an INCOMPRESSIBLE fluid. This is significant because as the diaphragm flattens and the cavity expands, the volume inside the pleural cavity CANNOT CHANGE (since water can't expand or compress). The only way the lungs can compensate for this increased cavity space is for the lungs to breathe in AIR!!
- Likewise, when the diaphragm moves up into the lungs as it relaxes, it is the fluid inside the cavity that prevents it from compressing the lungs!!
Why are the intercostal muscles important for respiratory function?
Maintain pressure inside the pleural cavity (so the lungs won't collapse on themselves!)
TEST: What happens if air gets into the pleural cavity space?
Pneumothorax (collapsed lung!)
What space contains pleural cavity but no lung?
(The lung can't get into this tiny space between the diaphragm and the ribs)
The ________ fascia lines the parietal pleura, and at the apex it thickens to become ______ Fascia. What is clinically significant about this?
Endothoracic (lines parietal pleura)
Thickens to become
(This is clinically relevant because when you're doing surgery up in the neck, and you poke a hole in this fascia, you poke a hole in the underlying parietal pleura. This introduces AIR into the parietal cavity --> PNEUMOTHORAX!!)
TRUE or FALSE: The lung goes all the way down to the diaphragm
(but pleural cavity does)
TRUE or FALSE: The R lung has 3 lobes while the L lung has 2 lobes
TRUE or FALSE: The R lung has a cardiac notch
False (left lung)
The lingula on the (right/left) lung is equivalent to the _______ lobe on the (right/left) lung.
Lingula = left lung
The cardiac notch on the (right/left) lung leaves a __________ recess
TRUE or FALSE: The middle lobe of the right lung extends fully to the back
TEST: Most of the back of the lung will be the (superior/inferior) lobe
TEST: The horizontal fissure of the R lung lies around the level of the ___ rib
TEST: List the rib level that the LUNG and the PARIETAL PLEURA reach inferiorly at each of the following lines:
1) Midclavicular line
2) Midaxillary line
3) Paravertebral line
Lung = rib 6
Parietal pleura = rib 8
Lung = rib 8
Parietal pleura = rib 10
Lung = rib 10
Parietal pleura = rib 11
The apex of the lung sits on the (midclavicular/midaxillary) lung
TEST: What is the most posterior structure in the lung hilum?
TEST: The pulmonary (arteries/veins) are always on top in the lung hilum. Why?
Pulmonary ARTERIES, because the pulmonary trunk goes UP and then divides
Explain the orientation of the primary bronchus, pulm arteries, pulm veins on the hilum of the L lung.
(RALS - arteries in Left lung SUPERIOR)
Bronchus - posterior
Arteries - superior
Veins - inferior
What are the key visceral impressions on the L lung?
The left lung has a (horizontal/oblique) fissure
The posterior surface of the trachea is lined by _______ ______. Why?
The esophagus sits right behind the trachea and when you swallow food, it pushes against the trachea. The smooth muscle is there to prevent the trachea from collapsing and cutting off the airway.
TEST: The (right/left) bronchus has an intermediate segment
The right superior bronchus has ___ divisions, the middle bronchus has ___ divisions, and the inferior bronchus has ____ divisions
Superior - 3 (apical, posterior, anterior)
Middle - 2 (lateral, medial)
Inferior - 5 (anterior/posterior basal, medial/lateral basal, posterior basal)
TEST: What is the clinical significance of the bronchus that drains the superior segment of the inferior lobe?
The position of that bronchus is horizontal, so if a patient has a pulmonary infection and they lie down, the excess fluid could build up and go through that bronchus and affect the inferior lobe
Explain the segmental branching of the L bronchi. Superior lobe has how many branches? Inferior lobe?
Superior - 2 branches, 2 divisions each
Inferior - 2 branches, 2 divisions each
What is the major difference between the superior bronchus of the right lung versus the left lung?
Left superior bronchus has
w/ 2 additional divisions (4 divisions total)
What arteries supply the bronchi and lung tissues? Why are these arteries here?
These are here because the oxygen within the bronchi can't actually pass through the cartilage, so without these arteries the bronchi and lung tissue would die!
TEST: List at least 4 major attachment points for the diaphragm
Xiphosternal junction (anteriorly)
Costal cartilage on ribs 6-10 (anteriorly)
Ribs 10-12 on back
L1-L2 vertebral bodies (crura)
TEST: In normal breathing, the rib cage (is/is not) expanding so on inhalation, the diaphragm (domes/flattens)
TEST: In order for the lung to collapse on exhalation, what needs to happen?
Relax the diaphragm
The dome of the diaphragm extends up to the ___ ICS on the right side and the ___ rib on the left side
4th on right
5th on left (heart keeps it from going any higher)
TEST: The diaphragm gives rise to three openings at its (anterior/posterior) surface. List the vertebral levels and the major structure that passes through each of these openings.
8 - IVC
10 - Esophagus
12 - Aorta
TEST: A diaphragmatic hernia is most likely to occur at the ___ hiatus. Why?
T10 - esophageal hiatus
(This is the most likely site of a diaphragmatic hernia because the seal at this hiatus is naturally weaker than the other ones, as the esophagus needs to be able to slide up and down when swallowing food)
Diaphragm pain carried by the _____ nerve can be referred to what part of the body?
Referred to shoulder
List three arteries that supply the superior surface of the diaphragm
Superior phrenic a
List the major artery that supplies the inferior surface of the diaphragm
Inferior phrenic a
Innervation to the diaphragm is mostly to the (superior/inferior) surface
THIS SET IS OFTEN IN FOLDERS WITH...
LG 1 - Restrictive Lung Disease
Obstructive Lung Diseases
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