10.1 Respiratory System

Question 1

How can one locate the 2nd rib?

Answer 1

The 2nd rib attaches at the height if the sternal angle where the manubrium and the sternum connect.

Question 2

Where can one feel the apex of the lungs?

Answer 2

Above the collar bone

Question 3

What sort of epithelial tissue lines the conducting portion of the respiratory tract?

Answer 3

Mucous membrane (= mucosa; lines cavities and organs and consists of one or more epithelial layers overlaying a layer of connective tissue, the lamina propria)

Question 4

what is the name of the lungs serosa?

Answer 4

pleura (visceral and parietal with in between a very thin layer of fluid)

Question 5

The pleural cavity can sometimes fill with … rather than the normal thin layer of lubricaitng fluid

Answer 5

• Air (pneumothorax)
• Blood (haemothorax)
• Pus (empyema)
• a watery transudate or exudate (pleural effusion)

Question 6

What is pleural effusion?

Answer 6

When the pleural cavity contains a watery transudate or exudate

Question 7

What does one call the pathological state where pus can be found in the pleural cavity?

Answer 7

Empyeme

Question 8

What maintains the lungs open?

Answer 8

The attraction of the visceral and parietal pleura to eachother.
the visceral is attached to the thoracic wall, and keep the lungs open because they are covered by the visceral pleura.
The lungs always want to collapse because of their elastic fibers.

Question 9

If we want to drain fluid form a lung, how do we procede, and where?

Answer 9

Insert a wide-bore needle through the 7th intercostal space just above the superior border of the lower rib.
The inferior border of ribs have intercostal nerves and vessels running along them!
below the 7th intercostal space, there is a danger of penetrating the diaphragm.

Question 10

Which intercostal space is first choice when looking to drain a lung?

Answer 10

7th

Question 11

Below the 7th intercostal rib, inserting a needle for drainage is running the risk of what?

Answer 11

penetrating the diaphragm

Question 12

What difference in colour do we see on XR between a lung and a collapsed lung?

Answer 12

Lungs normally fill the space and show up gray. if balck, then the lung is no linger there, and has collapsed.

Question 13

what runs along the inferior broder of each rib?

Answer 13

Intercostal nerves and vessels.

Question 14

What impact can lung cancer have on the activity of the diaphragm?

Answer 14

The tumour can cause paralysis of one side of the diaphragm if it imoinges on the lieft or right phrenic nerve.

Question 15

In what can muscle wasting in the lower arm be linked the lung cancer?

Answer 15

Pancoast tumours affect the apex of lungs and can impinge on the brachial plexus affecting hand and arm innervation.

Question 16

Which muscle will typically be affected by wasting due to Pancoast tumour?

Answer 16

• Thenar eminence

- Interosseous muscles

Question 17

Which nerves are typically affected by a Pancoast tumour?

Answer 17

C8 and T1 roots of the brachial plexus.

(leading to muscle wasting of the small muscles of the hand and some pain and paraesthesia of the forearm.

Question 18

What is Horners syndrome?

Answer 18

a Pancoast tumour can not only impinge on the brachial plexus inducing small muscle wasting but it can also cause Horners Syndrome. Horners syndrome arises when the tumour also exerts pressure on the sympathetic trunk, leading to

• miosis (pupil constriction)
• ptosis (droopy eyelid)
• decreased sweating
• inset of eyeball

Question 19

What is a pancoast tumour?

Answer 19

It is a cancer of the apex of the lung.

Question 20

What 3 problems/conditions can arise from a Pancoast tumour?

Answer 20

1. Impingement of brachial plexus and muscle wasting in the hand
2. Horners syndrome - impingement on sympathetic trunk leading to miosis, prosis and decreased localised sweating
3. Hoarse voice - impingement on left recurrent laryngeal nerve that innervates the vocal cords.

Question 21

From where to where does the conducting portion of the respiratory tract run?

Answer 21

Nasal cavity to Bronchioles

Question 22

From where to where does the respiratory portion of the respiratory tract run?

Answer 22

From respiratory brinchioles to alveoli

Question 23

In what is the conducting portion of the respiratory tract different to the respiratory portion?

Answer 23

In the conducting portion NO gas exchanges occur

Question 24

Which portion of the respiratory tract marks the transition between extra- and intrapulmonary?

Answer 24

The primary Bronchi.

They start outside the lungg and divide ince inside the lungs.

Question 25

which strucutres, in order, are extrapulmonary?

Answer 25

Nasal cavity
Pharynx
Larynx
Trachea
Primary bronchi

Question 26

Which structures, in order, are intrapulmonary?

Answer 26

Primary bronchi
Secondary Bronchi
Bronchioles
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts 
Alveoli