Anatomy Of Respiratory Flashcards
anatomy lungs
what is the parietal pleaura subdivided into?
what r the sensory nerve supply to these parts?
Mediastinal adn diaphragmic>> Phrenic
the rest is> intercostal
the visceral pleura is innervated by?
vagus nerve
explain orientation of the pulmonary hiatus?
- Bronchus>> posterior (bara wara yallaaa)
- pulmonary V.>> Inferiorly
- Pulmonary A.>> superiorly ( in front of airways)
phrenic nerve
- state one intrathoracic cause for phrenic nerve palsy
- what muscle would be affected?
- how would this manifest clinically?
cardiothoracic surgey
diaphragm
unilateral paralysis>> iatorgenic
bilateral paralysis> MND> ALS
what drain the right and left intercostal veins
Azygous vein>> only drains RIGHT side
collects blood from the intercostal spaces and dumps it into the main azygous vein and to SVC
Hemizygous vein > drains left side, and dumps it into the Azygous vein
Development of the respiratory system
- Identify the costal, diaphragmatic and mediastinal surfaces of the right lung
- Label the fissures
- is this R or L lung?
Where would pain arising from inflammation of the costal pleura be felt in a patient with a right middle lobar pneumonia? Which nerves are responsible?
Inflammation of the costal (parietal) pleura by the pneumonia is therefore localised to the overlying skin,
as sensory fibres from the pleura and the skin travel in the same intercostal nerve to enter the spinal cord at the same level
What would happen if a nut had stuck fast in the larynx and what could you do?
o It would cause severe airway obstruction and asphyxia.
o Lean the child forwards and carry out up to 5 back blows; if not successful try abdominal thrusts (the Heimlich manoeuvre).
o Call an ambulance.
what is the mediastinum? location?
space (central compartment) of the thoracic cavity located btw the 2 pleaural sacs.
divided into 2 parts by imginary line that runs from the sternal angle to T4 vertebrae making
- Superior: extends till thoracic aperture
- Inferior: extends till diaphragm
which bronchi of the lung is more prone to get shit stuck there + why?
right bronchus is more vertical
(u r right and upright)
What does the upper respiratory system comprise of?
Nostrils to lower border of cricoid cartilage of layrnx and comprises of the nose and paranasal sinuses, pharynx and larynx
What r the paransal sinuses? What type of epithelium r the lined with?
4 air containing cavitites named for the skull bones w/in they r lie in.
pseudo stratified ciliated columnar epithelium
Describe how the structure of the nose and paranasal sinuses is conducive to warming, humidifying and filtering /trapping particles in inspired air
1) From the the vascular mucosa lining the surface are of the turbinates.>> warms and humidifies
2) turbinates cause turbulence &slow down airflow, making more times for warming and humidifying.
3) nostrils have coarse hair>> traps shit
4) humidification >> transudation of fluid through the epithelium & mucus secretion.
5) cilia moves muscos to oropharynx where it is swallowed
anatomy of larynx
Describe how the larynx protects the airway during swallowing
The vocal cords/ folds/ligaments + the aperture between the cords, are together termed the `glottis’ .
During swallowing, laryngeal inlet becomes narrowed, epiglottis folds downwards (like a lid) over the laryngeal inlet and the vocal cords come together (are adducted) to act as a sphincter closing off the entrance to the trachea.
Explain why hoarseness of voice /voice change may be a sign of intra thoracic disease
Bc movement of the vocal cords r caused by the intrinsic laryngeal muscles which r supplied by the recurrent laryngeal nerve.
The anatomy of LEFT part of the nerve is loooong & part of which is inside the thoracic cavity.
intrathoracic disease > compress the nerve > paralyisis of vocal cord
Describe how the cough reflex is made? Why is it important?
Vocal cords close>> intrathoracic pressure built>> then suddenly opens &; air is expelled at high velocity!
The cough reflex:
1) protective mechanism to expel inhaled particles
2) clearance mechanism, disposes excessive secretions from the airways.
state 2 sympmtoms of left recurrent laryngeal nerve damage?
- Hoarsness of voice
- paramedian vocal cords
Describe the structure of the bony thorax. how many ribs do we have?
10 true ribs
2 floating ribs
describe how a typical rib articulaes with the thoracic vertebra.
how do we know which vertebrae it belongs to?
the vertebrae in which the TRANSVERSE process is attatched to the rib!
anatomy of typical rib,
What can cause widening of the carina?
how would u identify a widened carina?
Enlarged trachiobronchiol nodes
Do bronchoscopy & chest xray
u’ll see loss of the sharp ridge
how many intercostal muscles do we have? how is each one directioned and function of each?
where does the neurovascular bundle lie in relation to them?
3 intercostal muscles
- external>>hand in pocket direction>inspiration>pulls ribs up
- Internal>> oppposite direction> vise versa
- Innermost internal
What is the mainn muscle of inspiration? Whatis its significance?
Diaphragm>> responsible for 70% of chest expansion
anatomy of diaphragm in detail (in relation to intercostal spaces) and nerve supply,
middle part attaches to xiphoid process of sternum
it is a sheet of skeletal muscle innervated by the SOMATIC nervous system>> which means it is under voluntary control!
Right side> 4th intercostal space
Left>> 5th intercostal space
what structure passes through the diaphragm?
where is the neaurovascular supply on rib situated? where should u insert needle?
VAN
needle should be above every rib
( fee another collateral branch, bs mu mohim wayid)
Describe the course of the intercostal nerves/ arteries/ veins & what they supply/drain
branches off the aorta & azygous system from the back.
supply/drain>> intercostal muscles/ parietal pleaura/overlying skin
also theres internal thoracic vessels that send branches that go posterioorly and forms an anastomoses with the posterior and anterior ones.
describe the pleural cavity / pleura, + nerve supply & role of the pleural fluid & the pleural seal in lung expansion
they r serous membranes (layer if mesothelial cells) supported by connective tissue.
they r continous w/ each other at the hilum of the lung known as the “point of reflection)
- Parietal= phrenic and intercostal nerves (pain, pressure, temp)
- Visceral=pulmonary plexus>>(stretch)
what gives space for the lungs to expand during inspiration?
the RECESS (2)
location of the trachea + blood/nerve supply
Starts from below the cricoid cartilage as a continuation of larynx>> superior mediastinum >> bifurcates at sternal angle
N= recurrent laryngeal nerve.
A=branches of the inferior thyroid a.
V= brachiocephalic, azygos &; accessory hemiazygos veins.
What is bronchoscopy? When is it used?
Bronchoscopy is used in the diagnosis of bronchial carcinoma to visualize the tumour + obtain a tissue sample for histology.
Explain the subdiviosions of the bronchiol tree
Ok
What is a bronchopulmonary segment?
is an area of lung supplied by a segmental bronchus, and the accompanying segmental branch of the pulmonary artery
Why is knowledge of the bronchopulmonary segment surgically important?
because they can be isolated and removed without much bleeding, air leakage or interfering with other bronchopulmonary segments.
there r some anastomoses btw the bronchiol artery and pulmonary artery at the pre-capillary level
(These maintain some blood supply to lung parenchyma after pulmonary embolism)
Lungs lymphatic drainage
Pic
Lung nerve suply
(sympathetic effects and parasympathetic effects)
parasympthatic= bronchoconstrictor and secretomotor to mucous glands.
vagal afferents are those for the cough reflex and some subserving pain.
<em>Sympathetic</em>>>Bronchodilator & vasoconstrictor
what do the SYMPATHETIC efferents of lung causes?
Bronchodilator & vasoconstrictor
Describe the structure (histology) of the airways and alveoli and relate it to the functions and defence of the lungs. (covered in body logistics lecture)
Ok babe
what is another name for clara cells?
club cells
Distinguish bronchi from bronchioles. Define what is meant by a terminal bronchiole, respiratory bronchiole, alveolar duct and alveolus. (covered in body logistics lecture)
Ook
Distinguish between the conducting zone and the respiratory zone of the airways. (covered in body logistics lecture)
Between the trachea and the alveolar sacs, the airway divides 23 times.
Divisions 1-16, up to and including the terminal bronchioles, do not take part in gas exchange and are known as the conducting zone.
The next 7 generations of divisions -the respiratory bronchioles, alveolar ducts and alveolar sacs - make up the respiratory zone, where gas exchange occurs. There are about 3 million of alveoli whose combined surface area totals about 70m2. The alveoli are surrounded by a network of pulmonary capillaries. Gas exchange occurs across the very thin (0.3 µm wide) alveolar capillary membrane.
the external intercostal muscles dissappear as we go anterior and vise versa with the internal
what muscles is she using here to help her breath
pectoralis muscle
has COPD
he is using his sternocleidomastoid to pull his clavicle and sternum to maximise his amount of aspiration, he’s using them as respiratory muscles!
explain layers in order starting from lungs and ending with rib
what distinguishes the right from the left lung, other than the # of lobes?
the left lung has a huge groove for the aorta
we do not ventilate our lungs by forcing air into them!
we increase the volume of the thoracic cavity, which decreases the pressure in th ethoracic cavity which makes atmospheric air flow in our lungs!
