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Airway anatomy Flashcards

week 2

1
Q

What sites are most sensitive sites for cough reflex initiation?

A

post wall of trachea, larynx and carina

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2
Q

What are the structural features of the nasal cavity?

A

Olfactory receptors, medial wall: septum, lateral wall: superior, middle, and inferior nasal conchae.

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3
Q

What is the structure and function of the conchae?

A

Curved shell-like bones that allow for increased surface area for contact with inspired air, aiding in filtration, warming, and moistening. Beneficial for cold climates.

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4
Q

What are paranasal sinuses and what are their functions?

A

Air-filled spaces within skull bones. Functions: Weight reduction, humidify air, adds resonance to speech, and acts as a crush zone.

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5
Q

What are the 3 regions of the pharynx?

A

Nasopharynx, oropharynx, laryngopharynx.

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6
Q

What structures make up the respiratory system?

A

Nose, nasal cavity, paranasal sinuses, pharynx, larynx, trachea to alveoli.

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7
Q

What are the structures of the respiratory conducting zone?

A

Trachea, primary bronchi (for each lung), secondary bronchi (for each lobe), segmental bronchi (for each bronchopulmonary segment).

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8
Q

What maintains patency of the trachea?

A

16-20 C-shaped cartilaginous rings.

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9
Q

What muscle constricts the trachea?

A

Trachealis during coughing/sneezing.

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10
Q

What marks the end of the conduction zone?

A

Terminal bronchioles.

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11
Q

What marks the start of the respiratory zone?

A

Respiratory bronchioles.

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12
Q

What are the structures of the respiratory zone?

A

Alveolar ducts, alveolar sacs, alveoli.

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13
Q

What is the difference between root and hilum?

A

Root: collection of structures that connect lung and mediastinum. Hilum: where root structures enter/leave lung.

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14
Q

How many lobes/fissures does the right vs left lung have?

A

Right: 3 lobes, oblique and transverse fissure. Left: 2 lobes, oblique fissure.

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15
Q

What is reflection in respiratory anatomy?

A

Abrupt direction change of pleura.

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16
Q

What are recesses in respiratory anatomy?

A

Areas of pleura not occupied by lung during normal inspiration (only deep in).

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17
Q

What do bronchial veins drain into?

A

Into pulmonary venous system and azygous veins.

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18
Q

What innervates the lungs?

A

Pulmonary plexus (vagus and cervical & thoracic sympathetic ganglia).

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19
Q

What does PNS stimulation of the respiratory system cause?

A

Bronchoconstriction, vasodilation, and increased mucus secretion.

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20
Q

What does SNS stimulation of the respiratory system cause?

A

Bronchodilation, vasoconstriction, and decreased mucus secretion.

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21
Q

What are the features of the trachea at high and low magnification?

A

Low: C-shaped hyaline cartilage. High: goblet cells, pseudostratified ciliated columnar epithelium, seromucous cells, blood vessels, and cartilage rings.

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22
Q

What are the functions of submucosal seromucinous cells?

A

Trap bacteria, contain lysosomes for immune response, humidify air (watery secretion).

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23
Q

What are the histological features of the bronchus?

A

Respiratory epithelium, thinner basement membrane, submucosal glands, cartilaginous plates.

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24
Q

What are the histological features of terminal bronchioles at high magnification?

A

Ciliated simple columnar epithelium, no goblet cells or submucosal glands, smooth muscle rather than cartilaginous plates.

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25
What is the function of type I pneumocytes?
Form alveolar walls - 90% surface area.
26
What is the function of type II pneumocytes?
Produce surfactant - remaining 10% surface area.
27
What does smoking do to the respiratory epithelium?
Metaplasia.
28
Describe upper respiratory tract development.
From ventral wall of foregut, separates from foregut at tracheoesophageal folds, forms a septum and two completely separate tubes, begins in 4th week of gestation.
29
Describe lower respiratory tract development.
Trachea divides into lung buds, buds form lobar bronchi = 10 bronchopulmonary segments, lungs grow into pleural spaces.
30
What is a tracheoesophageal fistula and its consequences?
Incomplete separation of the trachea and esophagus, leading to feeding and/or breathing difficulties.
31
How does tracheoesophageal fistula cause polyhydramnios?
The baby normally swallows and voids amniotic fluid; with fistula, the baby cannot swallow amniotic fluid so it accumulates.
32
What are the 4 stages of lung maturation?
Pseudoglandular, canalicular, terminal saccular, alveolar.
33
What occurs in the pseudoglandular stage?
Major elements (conducting system) develop; parts for gas exchange not yet formed.
34
What occurs in the canalicular stage?
Lumina of bronchi and terminal bronchioles enlarge, tissues become highly vascular, simple cuboidal epithelium, differentiation into type I/II pneumocytes begins, surfactant production.
35
What occurs in the terminal saccular stage?
Epithelial/endothelial cells form the blood-air barrier, differentiation continues, compatible with life.
36
What occurs in the alveolar stage?
No mature alveoli at birth; continued differentiation of type II alveolar cells into type I.
37
What are the functions of the larynx?
Phonation, patent airway for breathing, routes air and food.
38
What is vocal phonation?
Intrinsic muscles that change tension, length, and position of vocal cords.
39
Name the paired and unpaired cartilages of the larynx.
Unpaired: epiglottis, thyroid, and cricoid. Paired: cuneiform, corniculate, and arytenoid.
40
What is the attachment of the cricothyroid membrane?
Cricoid cartilage to arytenoid process and thyroid cartilage.
41
What is the attachment of the quadrangular membrane?
Epiglottis to free margin (forms false vocal ligament).
42
What is the role of the cricothyroid?
Tilts thyroid cartilage anteriorly, lengthens cords, increases pitch.
43
What is the role of the thyro-arytenoid/vocalis?
Contraction shortens cords, lowers pitch.
44
What is the role of the posterior cricoarytenoid?
Rotates arytenoid cartilage medially, abducts cords.
45
What is the role of the lateral, oblique, and transverse cricoarytenoid?
Rotates arytenoid cartilage laterally, adducts cords.
46
What is the course of the vagus nerve?
Descends in neck with common carotid artery and internal jugular vein, crosses superior thoracic aperture, gives rise to cardiac, pulmonary, and esophageal plexuses, continues into abdomen for foregut and midgut.
47
What are the components of the cough reflex arch
cough receptors afferent nerves = vagus and glossopharyngeal nerves control Centre= medullary cough centre Efferent nerves: vagus, phrenic and spinal motor neurons Effectors: respiratory muscles
48
what are the 3 phases of a cough?
inspiratory compression expiratory
49
what occurs in the inspiratory phase of the cough reflex
Ensures lung volume is enough
50
What occurs in the compressive phase of the cough reflex?
Larynx closes Chest wall, diaphragm and abd muscles contract = increased intrathoracic pressure
51
What occurs in the Expiratory phase of the cough reflex?
Vocal chords open = high expiratory airflow Trachealis contracts = reduce airway diameter
52
What are the possible complications of coughing?
- exhaustion - insomnia - headache - dizziness - MSK pain - hoarseness - urinary incontinenc
53
What are the possible complications of NOT coughing?
- atelectasis - recurrent pneumonia - chronic airway disease from aspiration and retention of secretion
54
-Why might a cough be ineffective?
- respiratory muscle weakness - expiratory airflow limitation - lung hyperinflation
55
Describe the R bronchi
wider, shorter and more vertical has 3 whereas L has 2
56
when does bronchioles start?
When the bronchi reach less than 1mm
57
what does the root of lung contain?
pulmonary arteries and veins pri bronchi brocnhial arteries pulmonary nerve plexuses lymphatics
58
motor innervation of the larynx
Recurrent laryngeal nerve (from Vagus) provides all expect for cricothyroid (CT) External Branch of the Superior Laryngeal Nerve supplies CT
59
Sensory innervation of the larynx
Internal Branch of the Superior Laryngeal Nerve (SLN)= laryngeal mucosa above the vocal cords. Recurrent Laryngeal Nerve (RLN) = laryngeal mucosa below the vocal cord
60
what is the attachment and function of the cricoidthyroid muscle?
Anterolateral cricoid cart --> inf margin of thyroid Cartlidge Tilts thyroid Cartlidge anteriorly = lengthens vocal cords = increase in pitch
61
what is the attachment and function of vocalis (thyroartenoid)
Inner surface of thyroid Cartlidge --> anterolateral surface of arytenoid Cartlidge Contraction shortens vocal chords = decrease in pitch
62
what is the attachment and function of posterior cricoarytenoid
Post surface of cricoid lamina --> muscular process of arytenoid cart Rotates process of arytenoid medially = abducts vocal chords
63
what is the attachment and function of Lateral cricoarytenoid
Sup border of CC --> muscular process of AC Roates muscular process of arytenoid laterally = adducts chords
64
what is the attachment and function of transverse arytenoid muscle?
Lat margin of one AC --> lat margin of opposite AC Slides ACs closer together = adduction of vocal chords
65
what is the attachment and function of oblique artenoid muscle
Post surface of muscular process on one AC --> apex of opposite AC Slides ACs closer together = adducts vocal chords
66

RM (8 decks)

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