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Front Back
True ribs are numbers ___ to ____
1-7
The eigth, ninth, and tenth ribs are referred to as ____ ribs.
False ribs
Ribs eleven and twelve are called ______.
Floating ribs
Define how far the thorax extends anteriorly and posteriorly

  • Extends from C7 vertebra to the diaphragm

  • From just above the clavicle to the 6th rib anteriorly

  • To the 11th rib posteriorly

  • Bounded anteriorly by the sternum and posteriorly by the vertebra

Define "pump handle" motion.
  • Sternum moves upward
  • Causes anterior-posterior portion of thorax to increase
  • Increases A/P diameter
Define "bucket handle" motion.
  • External intercostal muscles work during inspiration to elevate lateral portion of thoracic cavity.
  • Increases lateral diameter
Define hilum
  • Center of mediastinal border
  • Where main stem bronchi, blood vessels, lymph vessels and nerves enter and exit lungs
Name 3 lung fissures
  • Right lung - Oblique and horizontal
  • Left lung - Oblique
Define right lung oblique fissure
  • Seperates the upper and middle lobes from lower lobe
  • Extends from costal to mediastinal borders of lung
Define  right lung horizontal fissure
  • Seperates middle from the upper lobe.
  • Extends horizontally from the oblique fissure to the level of fourth costal cartilage
Define left lung oblique fissure
  • Seperates the upper and lower lobes
  • Extends from costal to mediastinal borders
List accessory muscles of inspiration
  • External intercostals
  • Scalene
  • Sternocleidomastiod
  • Pectoralis Major
List accessory muscles of expiration
  • Abdominal muscles
  • Internal intercostals
Length of the adult trachea
  • 10-13 cm in length
  • 1.5-2.5 cm in diameter
Describe function of external intercostals
  • Principle muscle of inspiration
  • Inervated by intercostal nerves
  • Contraction elevates ribs increasing chest volume
Describe the lamina propria
  • Loose fibrous tissue that contains tiny blood vessels, lymphatics, smooth muscle, mast cells, submucosal glands and elastic fibers.
Describe function of scalene muscles in inspiration
  • Elevate the first and second ribs. This decreases intrapleural pressure
  • Three seperate muscles anterior, medial, and posterior that function as a unit.
Describe the function of sternocleidomastoid muscles in inspiration.
  • Pulls from it's insertion on the skull and elevates the sternum.
  • This increases anteroposterior diameter of chest
Describe the function of pectoralis major muscles in inspiration.
  • Pull from humeral insertion and elevate chest.
  • This increases anteroposterior diameter
  • Copd pts brace their arms and use pectoralis majors
Describe the function of external oblique, internal oblique, transverse abdominal and abdominal rectus muscles in expiration
  • They assist in compressing the abdominal contents
  • This pushes the diaphragm into the thoracic cage.
Describe function of internal intercostals in expiration
  • Contract and pull ribs downward and inward
  • This decreases both lateral and anteroposterior diameter of thorax.
  • Decreases lung volume
Define mediastinum
  • Central structure in chest
  • Contains trachea, heart, major blood vessels, nerves and esophagus.
  • Occupies space between lungs and between sternum and vertebra
  • Very little tissue any compression or invasion will compromise it's structures
Name three layers of trachea
  • Cartilaginous layer
  • Lamina Propria
  • Epithelial layer
Describe the structure of the larynex
  • Consists of framework of 9 cartilages
  • Three single cartilages: thyoid, cricoid, and epiglottis.
  • Three paired cartilages: arytenoid, corniculate, and cuneiform.
Which is the largest cartilage in the larynx ?
Thyroid (Adams Apple)
Which is the most inferior cartilage in the larynx ?
Cricoid

The cartilaginous airways consist of in order :





  • Trachea 0
  • Main stem bronchi 1
  • Lobar bronchi 2
  • Segmental bronchi 3
  • Subsegmental bronchi 4-9
The noncartilaginous airways consist of in order :
  • Bronchioles 10-15
  • Terminal bronchioles 16-19
The sites of gas exchange in order consist of :
  • Respiratory bronchioles 20-23
  • Alveolar ducts 24-27
  • Alveolar sacs 28
  • Alveoli
Define visceral pleura
  • Thin film attached to the outer surface of each lung
Define parietal pleura
  • Thin film lines the inside of the thoracic walls.
Differences between left and right lung
  • Right lung is shorter and broader than left due to liver pushing up on diaphragm
  • Left lung is smaller due to heart occupying portion of thorax
  • Average weight of both lungs is 800-1000g for an adult (50% blood, 50% tissue)
Define Canals of Lambert
  • Found in terminal bronchioles
  • Provide collateral ventilation
Differences between the right main stem bronchus vs the left main stem bronchus
  • Right branches off trachea at 25 degree angle left at 40-60 degrees.
  • Right is wider, more vertical and 5 cm shorter.
Describe Radford nanogram
  • Used to determine starting point to Vt when starting mechanical ventilation
  • Uses three parameters : sex, weight and RR
  • Based on healthy subjects. Tends to underestimate volume
The Bohr equation calculates _____ ______.
Anatomic deadspace
The Modified Bohr equation calculates _____   ______.
Physiologic deadspace
x of y cards