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Respiratory > Anatomy and Histology > Flashcards

Anatomy and Histology Flashcards

1
Q

Where do the apices of the lung lie in relation to the surface anatomy?

A
  1. 5 cm above the medial 1/3 of the clavicle

2. 5 cm lateral to the spine of C7

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2
Q

What are the three vertical axes with respect to the lungs? Where is the edge of the lung at each of these points?

A

Midclavicular 6
Midaxillary 8
Paravertebral 10

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3
Q

Where are the edges of the parietal pleura with respect to the three vertical axes of the thorax?

A

Midclavicular 8
Midaxillary 10
Paravertebral 12

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4
Q

Where is the middle lobe of the lung located?

A

4th intercostal space, midclavicular line

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5
Q

Where is the appropriate site for a thoracocentesis?

A

Between the 7th, 8th, or 9th intercostal space posteriorly

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6
Q

Why should you go posteriorly for a thoracocentesis?

A
  • Posterior gutter is deeper (diaphragm)
  • Intercostal spaces are wider
  • Neurovascular bundle is closer to the inferior margin of the rib above
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7
Q

What is a pleural effusion?

A

Fluid accumulation between the visceral and parietal pleura of the lung

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8
Q

What is the pulmonary sulcus? What is its significance?

A

Posterior curvature of the thoracic wall

Location of a pancoast tumor

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9
Q

When a pancoast tumor grows superiorly, what may it eventually involve?

A

may impact the brachial plexus

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10
Q

What muscles weakness may be the first sign of a pancoast tumor?

A

Intrinsic muscles of the hand

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11
Q

What is the syndrome that may develop with a pancoast tumor?

A

Horner’s syndrome (ptosis, miosis, anhidrosis)

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12
Q

What vessels may be obstructed with a pancoast tumor?

A

Subclavian

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13
Q

Which lung is larger?

A

Right

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14
Q

What are the two fissures of the right lung?

A

Oblique

horizontal

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15
Q

What is the single fissure of the left lung?

A

Oblique

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16
Q

What is the depression on the medial surface of the left lung?

A

Cardiac notch

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17
Q

How many bronchopulmonary segments are there in the right lung? Left?

A 
Right = 10
Left = 8
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18
Q

True or false: bronchopulmonary segments are interdependent in their blood/venous/air supply, thus you cannot resect a single segment

A

False– fully independent

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19
Q

What sits superiorly in the hilum of the right lung? Inferiorly? Anteriorly between the two?

A

Bronchi on top
Pulmonary artery anterior between
Vein inferiorly

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20
Q

What sits superiorly in the hilum of the left lung? Inferiorly? Posteriorly between the two?

A 
Superiorly = pulmonary artery
Posteriorly = bronchus
Inferiorly = pulmonary vein
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21
Q

What is the RALS mnemonic for remembering where the pulmonary artery sits relative to the bronchus?

A

Right anterior

left superior

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22
Q

What spinal level does the trachea begin? Where does it bifurcate?

A

C6

T4/5

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23
Q

How long is the trachea?

A

10-11 cm

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24
Q

Which pulmonary bronchus is more vertically directed?

A

Right

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25
Q

How many lobar bronchi are there is each lung?

A

Same as the number of lobes for each

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26
Q

What is the branching order of the bronchi in each lung?

A

Lobar
Segmental
Lobular
Terminal

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27
Q

How many segmental bronchi are there in each lung?

A

10 in the right, 8 in the left

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28
Q

Where do the respiratory airways begin?

A

At the level of the Respiratory bronchioles

29
Q

What are the four division of the respiratory bronchioles?

A

Respiratory bronchioles
Alveolar ducts
Alveolar sacs
Alveoli

30
Q

What is the epithelium that lines the vocal cords?

A

Stratified squamous

31
Q

What are the divisions of the mucosa of the larynx?

A

Epithelium
Basal lamina
lamina propria

32
Q

What is the epithelial type of most of the larynx?

A

ciliated pseudostratified columnar cells

33
Q

The vocalis muscle is an element of what larger muscle?

A

Thyroarytenoid muscle

34
Q

What is Reinke’s space?

A

Area between the vocal ligament and the epithelium of the vocal cord

(a potential space between the vocal ligament and the overlying mucosa)

35
Q

What is Reinke’s edema?

A

Fluid between the vocal ligament and its overlying mucosa, causing edema of the vocal cords

36
Q

What is the general rule of cellular diversity as you progress down the airway?

A

Less diverse the lower you go

37
Q

What are the two types of cells that are present in the alveoli?

A

Type I and II pneumocytes

38
Q

What are the 6 cell types in the bronchial airways?

A
  • Ciliated columnar cells
  • Goblet cells
  • Basal cells
  • Seromucous gland cells
  • Neuroendocrine cells
  • Brush cells
39
Q

Where is the stopping point of goblet cells?

A

Level of the lobar bronchioles

40
Q

What is the effect of smoking on goblet cells?

A

Proliferate downward

41
Q

What are the cells in the bronchi that are the stem cells?

A

basal cells

42
Q

What is the role of the neuroendocrine cells in the bronchi?

A

Development, but may become cancerous

43
Q

What is the role of the brush cells in the bronchi?

A

Cells with a well developed brush border–

Sensory cells

44
Q

What are the 6 layers of the trachea?

A
  • Respiratory epithelium
  • Basal lamina
  • Submucosa
  • Perichondrium
  • Hyaline cartilage
45
Q

What is the secretory product of goblet cells?

46
Q

What happens to the basement membrane of the trachea with chronic insult?

47
Q

Where is the smooth muscles found in the trachea? (histologically)

A

Interface between the lamina propria and submucosa of the intrapulmonary bronchi

48
Q

What happens to the smooth muscle layer of the trachea/bronchi as you progress down the airway?

A

Increases in thickness

49
Q

What is the role of the glands in the submucosa of the trachea? (5)

A

Contains seromucous glands that are responsible for secreting:

  • mucins
  • lactoferrin
  • lysozyme
  • IgA
  • alpha-1-antitrypsin
50
Q

Why is it that the submucosal glands secrete but do not produce IgA?

A

Plasma cells produces IgA, then transport it to the submucosal glands for secretion

51
Q

75% of lung cancers originate from what order bronchi?

52
Q

what are the histological changes that occur with asthma? (5)

A
  • increased mucus
  • increased thickness of the BL
  • Increased thickness of the lamina propria
  • Increased thickness of the muscularis
  • Increased glands in the submucosa
53
Q

What causes the increased thickness of the lamina propria in the bronchial wall with asthma?

A

Emigration of inflammatory cells

54
Q

What is the Reid index used for? What is it?

A

Determines whether someone has bronchitis

length of BM to mucus glands / glands to cartilage

55
Q

What is the normal Reid index value? What indicates chronic bronchitis?

A

Normal less than 0.4

Chronic bronchitis greater than 0.5

56
Q

What is bronchiectasis?

A

dilated bronchi due to tissues damage

57
Q

What is the thickness of bronchioles?

A

Less than 1 mm

58
Q

True or false: bronchioles lack cartilage

59
Q

True or false: bronchioles lack a submucosa

60
Q

True or false: all bronchioles lack goblet cells

A

False–large ones have them

61
Q

What are club cells, and what do they do?

A

cells found in the terminal and respiratory bronchioles that secrete surfactant

62
Q

What is the role of type I alveolar cells? can these divide?

A

Form the wall of the alveoli, where gas exchange occurs

cannot divide

63
Q

What is the role of type II alveolar cells? can these divide?

A

Secrete surfactant, and are stem cells

Found along the borders of the alveoli

64
Q

What are heart failure cells?

A

macrophages with hemosiderin d/t RBC breakdown

65
Q

What is the signature histological feature of type II alveolar cells?

A

Presence of lamellar bodies, which contain its secretory product, pulmonary surfactant

66
Q

What are the two divisions of the lung circulation?

A

Pulmonary and bronchial (which supply the O2 and stuff)

67
Q

What forms the blood gas barrier?

A

Type I alveolar cells, fused with the basal lamina of the capillary

68
Q

What is contained within the intra-alveolar septum?

A

type III collagen and/or elastin

69
Q

Where are macrophages found in the alveoli?

A

Alveolar lumen and migrate of the epithelial surface

Respiratory (34 decks)

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