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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
How many lobar bronchi are there is each lung?
Same as the number of lobes for each
26
What is the branching order of the bronchi in each lung?
Lobar Segmental Lobular Terminal
27
How many segmental bronchi are there in each lung?
10 in the right, 8 in the left
28
Where do the respiratory airways begin?
At the level of the Respiratory bronchioles
29
What are the four division of the respiratory bronchioles?
Respiratory bronchioles Alveolar ducts Alveolar sacs Alveoli
30
What is the epithelium that lines the vocal cords?
Stratified squamous
31
What are the divisions of the mucosa of the larynx?
Epithelium Basal lamina lamina propria
32
What is the epithelial type of most of the larynx?
ciliated pseudostratified columnar cells
33
The vocalis muscle is an element of what larger muscle?
Thyroarytenoid muscle
34
What is Reinke's space?
Area between the vocal ligament and the epithelium of the vocal cord (a potential space between the vocal ligament and the overlying mucosa)
35
What is Reinke's edema?
Fluid between the vocal ligament and its overlying mucosa, causing edema of the vocal cords
36
What is the general rule of cellular diversity as you progress down the airway?
Less diverse the lower you go
37
What are the two types of cells that are present in the alveoli?
Type I and II pneumocytes
38
What are the 6 cell types in the bronchial airways?
- Ciliated columnar cells - Goblet cells - Basal cells - Seromucous gland cells - Neuroendocrine cells - Brush cells
39
Where is the stopping point of goblet cells?
Level of the lobar bronchioles
40
What is the effect of smoking on goblet cells?
Proliferate downward
41
What are the cells in the bronchi that are the stem cells?
basal cells
42
What is the role of the neuroendocrine cells in the bronchi?
Development, but may become cancerous
43
What is the role of the brush cells in the bronchi?
Cells with a well developed brush border-- | Sensory cells
44
What are the 6 layers of the trachea?
- Respiratory epithelium - Basal lamina - Submucosa - Perichondrium - Hyaline cartilage
45
What is the secretory product of goblet cells?
Mucin
46
What happens to the basement membrane of the trachea with chronic insult?
thickens
47
Where is the smooth muscles found in the trachea? (histologically)
Interface between the lamina propria and submucosa of the intrapulmonary bronchi
48
What happens to the smooth muscle layer of the trachea/bronchi as you progress down the airway?
Increases in thickness
49
What is the role of the glands in the submucosa of the trachea? (5)
Contains seromucous glands that are responsible for secreting: - mucins - lactoferrin - lysozyme - IgA - alpha-1-antitrypsin
50
Why is it that the submucosal glands secrete but do not produce IgA?
Plasma cells produces IgA, then transport it to the submucosal glands for secretion
51
75% of lung cancers originate from what order bronchi?
1 2 3
52
what are the histological changes that occur with asthma? (5)
- increased mucus - increased thickness of the BL - Increased thickness of the lamina propria - Increased thickness of the muscularis - Increased glands in the submucosa
53
What causes the increased thickness of the lamina propria in the bronchial wall with asthma?
Emigration of inflammatory cells
54
What is the Reid index used for? What is it?
Determines whether someone has bronchitis length of BM to mucus glands / glands to cartilage
55
What is the normal Reid index value? What indicates chronic bronchitis?
Normal less than 0.4 | Chronic bronchitis greater than 0.5
56
What is bronchiectasis?
dilated bronchi due to tissues damage
57
What is the thickness of bronchioles?
Less than 1 mm
58
True or false: bronchioles lack cartilage
True
59
True or false: bronchioles lack a submucosa
True
60
True or false: all bronchioles lack goblet cells
False--large ones have them
61
What are club cells, and what do they do?
cells found in the terminal and respiratory bronchioles that secrete surfactant
62
What is the role of type I alveolar cells? can these divide?
Form the wall of the alveoli, where gas exchange occurs cannot divide
63
What is the role of type II alveolar cells? can these divide?
Secrete surfactant, and are stem cells Found along the borders of the alveoli
64
What are heart failure cells?
macrophages with hemosiderin d/t RBC breakdown
65
What is the signature histological feature of type II alveolar cells?
Presence of lamellar bodies, which contain its secretory product, pulmonary surfactant
66
What are the two divisions of the lung circulation?
Pulmonary and bronchial (which supply the O2 and stuff)
67
What forms the blood gas barrier?
Type I alveolar cells, fused with the basal lamina of the capillary
68
What is contained within the intra-alveolar septum?
type III collagen and/or elastin
69
Where are macrophages found in the alveoli?
Alveolar lumen and migrate of the epithelial surface

Respiratory (34 decks)

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