Anatomy of lower respiratory tract

Question 1

What is the carina?

Answer 1

Location where the bifurcation of the trachea into the primary bronchi occurs

Question 2

What are the key details of the trachea?

Answer 2

Starts at the inferior of the cricoid cartilage (C6)
Is paplable superior to the sternal notch
Bifurcates at T4 (Sternal angle)
Innervated by the vagus
Has complete ring as first cartialge and then C shaped until bifurcation

Question 3

What are the key details of the bronchi/bronchioles?

Answer 3

Left main bronchus passes under the aortic arch and is longer and narrower than the right side
Right side is more vertical
Has 3 sections - Main (primary), Lobar (secondary), Segmental (tertiary)
Has bands of smooth muscle to control dilation
Pulmonary arteries wrapped around

Question 4

What are the key details of the alveoli?

Answer 4

Contain elastin and collagen to maintain shape and prevent collapse
2 types of cell for exchange and surfactant production

Question 5

What are the orders of the lobes in each lung?

Answer 5

Right -
Superior lobe - Apical (1), posterior (2), anterior (3)
Middle lobe - Lateral (4), Medial (5)
Inferior lobe - Apical (6), Medial basal (7), Anterior basal (8), Lateral basal (9), Posterior basal (10)
Left -
Superior lobe - Apicoposterior (1+2), Anterior (3), Superior lingular (4), Inferior lingular (5)
Inferior lobe - Superior (6), Medial basal (7), Anterior basal (8), Lateral basal (9), Posterior basal (10)

Question 6

What are the fissures in the lungs?

Answer 6

Right - Oblique + Horizontal

Left - Oblique

Question 7

What is the structure of the hilum?

Answer 7

Pulmonary artery superiorally
Pulmonary veins inferiorally and anteriorally
Primare bronchus posteriorally

Question 8

What is the rough structure of the thoracic cage?

Answer 8

12 ribs, sternal plate at centre of chest, clavicle sits over 2nd rib

Question 9

What is the structure of the thoracic vertebrae?

Answer 9

spinous process angled downwards
Vertebral body (heart shaped)
Facets for attachments of ribs, and 2 vertebrae

Question 10

What are the types of rib?

Answer 10

Typical ribs - 3-9
Atypical ribs - 1-2, 10-12
True ribs - 1-7
False ribs - 8-10
Floating ribs - 11, 12

Question 11

What is the anatomy of the sternum?

Answer 11

Sternal notch (T2)
Manubrium
Sternal angle (T4/5)
Sternal body
Xiphoid process (T9/10)

Question 12

What is the anatomy of the diaphragm?

Answer 12

Gaps for Oesophagus at T10
Muscles superficially and central tendon deep
Inferior VC gap at T8
Descending aorta gap at T12
Innervated by Phrenic nerve (C3, 4 and 5 keeps the diaphragm alive)

Question 13

Intercostal space anatomy

Answer 13

3 layers of diagonal muscle - External (inspiration, diagonal away from sternum)
internal (expiration, diagonal towards sternum)
innermost (expiration, diagonal towards sternum)
Neurovascular bundle - vein (superior), artery (Middle), Nerve (inferior)

Question 14

What are the different types of collapsed lung?

Answer 14

Pneumothorax - air in pleural cavity
Haemothorax - Blood in pleural cavity
Chylothorax - Lymph in pleural cavity
Pleural effusion - fluid collecting in pleural cavity