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RESPIRATORY EXAM 1 > ANAT EMBRYO > Flashcards

ANAT EMBRYO Flashcards

1
Q

What forms the external nose?

A

Nasal bones, external part of cartilaginous nasal septum, and nasal cartilages

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2
Q

3 things that form the medial wall of the nose i.e. nasal septum?

A

perpendicular plate of the ethmoid, external part of the cartilaginous septum, and the vomer

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3
Q

What epithelium covers the conchae?

A

pseudostratified epithelium with goblet cells and mucus glands

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4
Q

Name 3 structures that open into the semilunar hiatus

A

frontal sinus, ethmoid cells, and maxillary sinus

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5
Q

Where does the sphenoid sinus drain?

A

sphenoethmoidal recess

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6
Q

Which portion of the pharynx contains the 1. piriform recess and 2. the opening of the eustachian tube -name?

A
  1. laryngopharynx 2. oropharynx; opening is called the torus tubarius
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7
Q

Which cartilage also contains articular surfaces for the thryoid and arytenoid cartilages?

A

the cricoid cartilage

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8
Q

What are the 3 joints of the larynx? Which has attachments to bone?

A

Cricothyroid joint, Cricoarytenoid joint, and thyrohyoid membrane which attaches to hyoid BONE.

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9
Q

Which muscle widens the rima gottidis?

A

Posterior cricoarytenoideus

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10
Q

Which muscle stretches the vocal cord? Which muscle tenses the vocal cord?

A

Cricothyroid muscle stretches and vocalis tenses

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11
Q

Which 3 muscles constrict/close the rima glottidis?

A

Thyroarytenoideus constricts and arytenoideus obliquus and transversus close

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12
Q

Define the following as applies to the larynx: vestibulum, ventricle, and infraglottic cavity

A

The vestibulum is between the aditus laryngis and the vestibular folds? The ventricle is between the vestibular and vocal folds, and the infraglottic cavity is located undeneath the vocal folds

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13
Q

Compare the size of the rima glottidis in: normal respiration, forced expiration, and whispered speech

A

In normal respiration it is approximately mid-position, in forced expiration it is very wide, and in whispered speech it is barely open

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14
Q

The hyoid bone corresponds to which vertebral levels?

A

C3-C5

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15
Q

Which three structures of the larynx are externally palpable?

A

The laryngeal prominence, the cricoid cartilage, and the cricothyroid ligament

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16
Q

What is the difference between a laryngostomy and a tracheotomy?

A

Laryngostomy splits the cricothyroid ligament, and the tracheostomy opens the trachea above or below the isthmus of the thryoid

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17
Q

What 2 nerves supply the larynx? What do they innervate?

A

Superior laryngeal nerve: only innervates the cricothyroid muscle as well as mucosa above vocal folds; the recurrent laryngeal nerve innervates ALL other muscles and the mucosa below the vocal folds (both are CN X)

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18
Q

What 2 arteries supply the larynx? Parent arteries?

A

Superior laryngeal artery from superior thyroid artery and inferior laryngeal artery from inferior thryoid artery

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19
Q

What ligaments connect tracheal cartilages? Which wall of the trachea contains smooth muscle? What vertebral level is the carina associated with?

A

Annular ligaments; posterior wall where there is no cartilage; tracheal bifurcation, or carina, is at 5th thoracic vertebral level

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20
Q

What is the heirarchical difference between a segmental and lobar bronchus?

A

After the main stem bronchi there are secondary (lobar) bronchi followed by tertiary (segmental) bronchi

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21
Q

What wraps around the left main bronchus? What lies in front of it?

A

Aortic arch wraps around and the pulmonary bifurcation lies in front

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22
Q

What passes in front of the right mainstem bronchus? Where is it going? What lies between the trachea and esophagus?

A

Azygous vein passes in frong on its way the the SVC, and the left recurrent laryngeal nerve passes between the esophagus and trachea

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23
Q

Name 4 things that occur in the horizontal plane from the angle of Louis to thoracic vertebrae

A

Sternal angle correlates to T4-5; FOUR THINGS: 1. arch of aorta begins and ends 2. Trachea bifurcates 3. R/L brachiocephalics form the SVC and 4. the pulmonary trunk bifurcates

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24
Q

Which lung has the horizontal fissure? Which lobes does it separate?

A

The right lung, it separates the upper lobe and middle lobe, it does not affect the lower lobe

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25
Q

What are the 4 impressions on the medial side of the left lung?

A

Aorta, esophagus, subclavian artery, and the cardiac notch

26
Q

Discuss the relationship of the bronchus, pulmonary artery, and pulmonary veins at the hilum of the lungs:

A

The pulmonary artery is superior to both the bronchus and the pulmonary veins; the bronchus then, is posterior to the pulmonary veins.

27
Q

What are the four impressions on the medial side of the right lung?

A

Azygous vein, SVC, subclavian, artery, and cardiac

28
Q

Which structures form impressions on the mediastinal surfaces of BOTH lungs?

A

Subclavian artery and heart

29
Q

What type of bronchus supplies a bronchopulmonary segment? What is the relationship of pulmonary veins to these segments?

A

Tertiary bronchi supply them; pulmonary veins run between bronchopulmonary segments

30
Q

What is the significance of bronchopulmonary segments? Which other organ in the body has an analogous arrangement?

A

They allow for individual resection of bits of lung; the liver

31
Q

What 3 structures form the blood-air barrier?

A

Capillary endothelium, type I pneumocyte, and the fusion of their basement membranes

32
Q

What autonomic afferents relay information about lung stretch? Which for acute pain?

A

Parasympathetic afferents via vagus, pain is sympathetics T1-6

33
Q

What is the effect of bronchial glandular activity from both arms of the ANS?

A

Sympathetic decreases glandular activity, parasympathetic increases glandular activity

34
Q

What is the cupula? What does it overlie? What overlies it? Name the 2 pleural recesses:

A

Cupula is the bit of pleura that overlies the apex of the lung, Sibson’s fascia overlies the cupula? Costomediastinal recess and costodiaphragmatic recess

35
Q

Where are 2 areas that the pleura is in danger that is technically outside of the thoracic cage?

A

Below rib 12 posteriorly, and above rib 1 superiorly

36
Q

What arteries supply the parietal and visceral plurae?

A

Parietal from intercostal arteries, Visceral from bronchial arteries

37
Q

Which areas of parietal pleura are innervated by intercostal and phrenic nerves?

A

Intercostal nerves: costal and peripheral diaphragmatic? Phrenic: mediastinal and central diaphragmatic

38
Q

From what side may a “shunt” of lymphatic drainage occur in the lungs?

A

Lower left may drain to right

39
Q

Discuss what allows the thoracic cavity to expand in the following dimensions: 1. AP 2. lateral and 3.vertical

A

Lateral: bucket handle ribs 6-10? AP: pump handles 2-5 and vertical: the diaphragm

40
Q

Where does the mediastinum shift in pneumothorax vs. tension pneumothorax

A

Tension pnuemo shifts to healthy side regular pneumo shifts to diseased in expiration and healthy in inspiration

41
Q

How is mediastinal shifting different in bronchial narrowing vs pneumothorax?

A

Pneumo: shifts to diseased in inspiration and healthy in expiration; narrowing: shifts to healthy in inspiration and diseased in expiration

42
Q

Where is laryngeal epithelium from? What about laryngeal cartilages?

A

The laryngeal epithelium comes from endoderm but the cartilages are from neural crest

43
Q

If a baby were born with only laryngeal muscle, which aortic arch failed to develop? Explain.

A

Arch 6 because the cricothyroid muscle is from arch 4, all others are from arch 6

44
Q

What is the innervation of the laryngeal muscles arising from pharyngeal arch 6?

A

Recurrent laryngeal nerve

45
Q

What is the innervation of the laryngeal muscles arising from pharyngeal arch 4?

A

Superior larygneal nerve

46
Q

Which cranial nerves innervate the laryngeal muscles derived from arches 4 and 6?

A

ALL are from CN X just different braches

47
Q

Where does tracheal/bronchial epithelium and smooth muscle come from?

A

Epithelium is from endoderm and smooth muscle (and cartilage) is from splanchnic mesoderm

48
Q

What is a laryngeal ventricle? Which pharyngeal arches is the epiglottis associated with?

A

Laryngeal ventricle separates true/false vocal cords? Epiglottis arises in relations to the 3rd/4th pharyngeal arches.

49
Q

Name the 5 stages of lung development in order

A

Embryonic, pseudoglandular, canalicular, terminal sac, and alveolar stages

50
Q

In which stage is surfactant present for the first time?

A

Terminal sac stage

51
Q

In which stage is the first appearance of primary, secondary, and tertiary bronchi present?

A

Embryonic stage

52
Q

In which stage is gas exchange first possible?

A

Later weeks of the canalicular stage? but no surfactant yet

53
Q

In which stage are the bronchioles first present but unprepared for gas exchange?

A

Pseudoglandular stage

54
Q

What is the time interval of the alveolar stage of lung development? What’s going on?

A

From birth to age 8. Here the alveoli are maturing and increasing in size and number.

55
Q

What is the gas exchange status in the canilicular stage of lung development?

A

Gas exchange is first possible in the later weeks of this stage, but there is no surfactant

56
Q

If a baby is to be born premature, then with respect to the respiratory system, in which stage of lung development would they have the best prognosis? Why?

A

The terminal sac stage because not only is gas exchange possible but their type II cells produce surfactant

57
Q

Why would an esophageal atresia lead to a uterus disproportionately large for gestational age?

A

Because of polyhydramnios. Since the embryo cannot drink the amniotic fluid it enlarges the uterus.

58
Q

How is a laryngotrachesophageal cleft distinguished from a fistula?

A

They will be aphonic with a cleft

59
Q

Where does the skeletal muscle of the larynx come from? The smooth muscle of the trachea/bronchi?

A

SKM comes from paraxial mesoderm and smooth comes from splanchnic mesoderm which is a derivative of lateral plate mesoderm

60
Q

Maldevelopment of what structure would lead to a tracheoesophageal fistula?

A

Esophagotracheal septum

61
Q

What is VACTERL deformity associated with? What other deformities are likely present with hypoplasia of lung?

A

VACTERL is associated with oral contraceptives early in pregnancy; and lung hypoplasia is associated with congenital diaphragmatic hernia

RESPIRATORY EXAM 1 (8 decks)

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