Anatomy of Respiratory System Flashcards
1
Q
What are the functions of the nose?
A
To filter, humidify, condition warm and cool air.
2
Q
Does gas exchange occur in conducting airways?
A
No, no it does not.
3
Q
Where is stratified squamous epithelium found?
A
The anterior portion of the nasal cavity, oral cavity oropharynx, and laryngopharynx.
4
Q
What is pseudostratified ciliated columnar epithelium?
A
These have hair like projections that extend from the outer surface (mucous-producing goblet cells). It is found two-thirds of the nasal cavity in the traceobronial tree.
5
Q
What is simple cuboidal epithelium?
A
Substances of O2 and C02 passes through this tissue. These cells form the walls of the alveoli (Pulmonary capillaries that sound the alveoli).
6
Q
What are turbinates?
A
Play a major role in humidification and warming of inspired air.
7
Q
What are the two nasal passageways between the nares and the nasopharynx called?
A
Choanae.
8
Q
What happens if the pharyngeal tonsil is inflamed?
A
It may block the passage of air between the nose and throat.
9
Q
Where is the vallecula epiglottica located?
A
Between the glossoepiglottic folds on each side of the posterior oropharynx.
10
Q
Where is the larynx located?
A
Between the base of the tongue and the upper end of the trachea.
11
Q
What single cartilages do the Larynx consists of?
A
Thyroid cartilage, cricoid cartilage, and epiglottis.
12
Q
What composes the interior of the larynx?
A
It is lined with mucous membrane.
13
Q
What is the epiglottis?
A
It is a broad, spoon-shaped fibro cartilaginous structure. It prevents the aspiration of foods and liquids by covering the opening of the larynx during swallowing.
14
Q
What is the narrowest point of the airway in adults
A
Glottis.
15
Q
What are the two vital functions of the larynx?
A
The larynx is to ensure a free flow of air to and free the lungs and its effort closure during exhalation knowns as the Valsalva maneuver.
16
Q
What is the composition of the tracheobronchial tree?
A
Branching airways commonly referred as generations or orders; cartilaginous airways and non-cartilaginous airways.
17
Q
What are cartilaginous airways?
A
Serve only to conduct air between the external environment and the sites of gas exchange.
18
Q
What are non-cartilaginous airways?
A
Serve as both as conductors of air and sites of gas exchange.
19
Q
What layers is the tracheobronchial tree composed of?
A
Epithelial lining, lamina propria and cartilaginous layer.
20
Q
What is epithelial lining?
A
Pseudostratified ciliated columnar epithelium with numerous mucous glands separated from the lamina propria.
21
Q
Where does the pseudostratified ciliated epithelium extend?
A
From the trachea to the respiratory bronchioles.
22
Q
How is mucous produced?
A
Goblet cells and submucosal or bronchial glands.
23
Q
What gland produces the most mucous?
A
The submucosal glands.
24
Q
What are gel and sol layer and their differences?
A
The sol layer is thin and adjacent to the epithelial lining while the gel layer is thicker (vicious layer) adjacent to the inner luminal surface.
25
What is the lamina propria?
The submucosal layer of the tracheobronchial tree. Within there is loose, fibrous tissue that contains tiny blood vessels, lymphatic vessels, and branches of the vagus nerve.
26
What chemicals, when released, increases vascular permeability, smooth muscle contraction, increased mucus secretions and vasodilation with edema?
Histamine, Heparin, platelet activating factor (PAF), esinophillic chemotatic factor of anaphylaxis (ECF-A) and Leikotriences.
27
How many c shaped cartilages support the trachea?
15 to 20.
28
What is the right mainstem bronchus?
Branches off the trachea are 25 degree angle. It is wider and 5 cm shorter than the left. The right is wider and more vertical than the left.
29
What is the left mainstem bronchus?
40 to 60 degrees with the trachea.
30
What are lobal bronchi?
Part of the cartilgnous airways. The right main stem bronchus divides into upper middle and lower lobar bronchi. Tracheobronchial trees second generation.
31
What are the segmental bronchi?
Third generation of bronchi branch off the lobar bronchi to form the segmental bronchi.
10 semental bronchi in the right lung and 8 in the left.
32
What are Clara cells and where are they located?
Clara cells are located in the terminal bronchioles. It has thick protoplasmic extensions that budge into the lumen of the terminal bronchioles. Secretory functions that contribute to the extracellular liquid lining the bronchioles and alveoli.
33
What is venous admixture?
The mixing of venous blood and freshly oxygenated blood.
34
What are type 1 cells?
Also called squamous pneumocytes. They consist of cytoplasmic ground substance 95 percent alveolar surface. 0.1 to 05 nanometer thick are major sites of alveolar gas exchange. Type 1 cells die and they are not able to reproduce.
35
What is a type 2 cell?
Granular pneumocytes. They can reproduce and convert to type 1 cells. Remaining 5% of the total alveolar surface. They have pulmonary surfactant. Plays a major role in decreasing the surface tension of the fluid that lines the alveoli (alveolar epithelium).
36
What are pores of Kohn and where are they located?
Small holes in the walls of the interalveolar septa; 3-13 nanometers in diameter and permit gas to move between adjacent alveoli; the desquamation (shedding or peeling) of the epithelial cells; the normal degeneration of tissue cells as a result of age; and, the movement of macrophages which may leave holes in the alveolar walls.
37
What are the first 7 ribs?
True ribs because they are attracted directly to the sternum.
38
What are the 8-10 ribs?
False ribs because it attaches to the cartilage of the ribs above.
39
What are the 11-12 ribs?
Floating ribs, they are 11 intercostal spaces between the ribs and contain veins arteries and nerves.
40
What is the major muscle for ventilation?
The diaphragm is the major muscle for ventilation.
41
. What are the accessory muscles of inspiration?
External intercostal, scalenus, sternocleidomastoid, pectoralis muscle and trapezius muscle.
42
What are the accessory muscles of expiration?
Rectus abdominis muscle, external abdominis oblique muscle, internal abdominis obliques muscle, transverse abdominis muscle, and internal intercostal muscle.
43
What is the normal AP diameter?
1:2 in normal adults.
44
What are the three layers of tissues in an arterial vessel?
Inner layer (tunica intima) composed of endothelium and a thin layer of connective and elastic its. Middle layer (Tunica Media) composed of elastic connective tissue in large arteries and smooth muscle. And, outer layer (Tunica adventitia) composed of connective tissue that is suited for carrying blood under high pressures in the systemic system.
45
What is the importance of the capillary beds of the lungs?
Gas and fluid exchange, they play an important biochemical role in the production and destruction of a broad range of biologically active substances.
46
What are the resistance vessels?
Arterioles play an important role in the distribution and regulation of blood.
47
Why are veins referred to as capacitance vessels?
Because they are capable of collecting a large amount of blood with very little pressure change.
48
What is peristaltic moment?
The larger lymphatic channels are surrounded by smooth muscle bands that actively produce peristatlic movements regulated by the ANS.
49
What role do the lymph nodes serve?
The nodes act as a filter, keeping particulate matter and bacteria from entering the bloodstream.
50
What is the majority of the lymph structure found and how does this affect the possibility of pleural effusions comparatively between the left and right lung?
The majority of them are found in the surface of the lower lung lobes. Bilateral effusion patients have more fluid in the lower right then in the lower left.
51
What is the sympathetic nervous system?
Cause the heart rate to increase and increases strength in contraction.
52
What are alpha cells?
Alpha receptors of the smooth muscles of the arterioles causing the pulmonary vascular system to constrict. The parasympathetic nervous system is activated causing the constriction of the bronchial smooth muscle.
53
What are beta receptors?
It is called propranolol. If the patient receives a parasympathetic and it causes the bronchial relation occurs.
54
What is the description of the right lung?
Larger and heavier than the left. It is divided into upper, middle, and lower lobes by oblique and horizontal fissures.
55
What is the description of the left lung?
Divided into upper and lower lobs separated by the oblique fissure which extends from the costal to the mediastinal borders of the lung.
56
To what extent do the apices rise relative to the thorax?
The apices rise to about the level of the first rib.
57
How does the horizontal fissure extend?
Horizontally from the oblique fissure to about the level of the 4th costal cartilage and separate the middle from the upper lobe.
58
What of the following line the anterior one- third of the nasal cavity?
Stratified squamous epithelium.
59
Where are the canals of lambert found?
Terminal bronchioles.
60
Where are the pharyngotympanic (auditory) tubes found?
Nasopharynx.
61
What is the inferior portion of the larynx composed of?
Cricoid cartilage.
62
What has the greatest combined cross-sectional area?
The terminal bronchioles.
63
What cells does ninety- five percent of the alveolar surfaces composed of?
Type 1 and squamous pneumocytes.
64
Pseudostratified ciliated columnar epithelium lines what?
Trachea and nasopharynx.
65
What are accessory muscles of inspiration?
Trapezius and scalene muscles.
66
What does the horizontal fissure separate?
Middle and upper lobes of the right lung.
67
What supplies motor innervation of each hemidiaphragm?
Phrenic and glossopharyngeal nerve (9th cranial nerve).
68
What structure of the tracheobronchial tree does the cartilage found?
Respiratory bronchioles
69
Major function of respiratory system
Continuous supply of oxygen for metabolic activities in the body
Remove carbon dioxide
Regulate blood pH
70
External Nares
Two anterior opening of the nose known as nostrils. The anterior portion of each nostril is a vestibule and contains coarse hairs for trapping foreign particles
71
Nasal Cavities
The nose is separated into right and left halves by the nasal septum
Three bony projections called conchae are located on the lateral walls of the nasal cavities; they increase the surface area of the cavities providing:
A very rich supply of blood that warms and moistens incoming air
Lots of sticky mucus that traps foreign particles
72
Internal Nares
Posterior openings of the nasal cavities providing a connection between the nose and pharynx
73
Paranasal Sinuses
These air-filled cavities are called maxillary, frontal, ethmoidal and sphenoidal sinuses
o Provide sites for mucus drainage
o Lighten the skull, warm and moisten air and provide chambers for speech resonance
74
Nasopharynx
• Behind the nose, extends to soft palate
• Right and left eustachian tubes
• Pharyngeal tonsils
o Called adenoids when enlarged
75
Oropharynx
* Palatine tonsils (most commonly removed)
* Lingual tonsils (rarely removed)
* Tongue is located in the oral cavity and base of tongue in the oropharynx – base attached to hyoid bone
* Tongue and soft tissue collapse is the most common cause of upper airway obstruction – will hear low-pitched snoring sound
76
LARYNX (VOICE BOX)
* Positioned between the root of the tongue and the upper end of the trachea
* Triangle shaped inlet at the epiglottis that extends to a circular outlet at cricoid cartilage
* Lined primarily with respiratory mucosa – pseudostratified ciliated columnar epithelium
77
Mucous Membrane in Larynx
• Mucous membrane lining forms two pairs of folds:
o Vestibular folds (false vocal folds)
o Vocal folds
78
What is the narrowest part of the airway in infants
Cricoid Cartilage
79
Pairs of accessory cartilage
Arytenoids
Corniculate
Cuneiform
80
Trachea
* 8-20 C shaped cartilage rings that will maintain structure
* Located from C6-T5
* 11 cm long in adults
* 1.5-2.5 cm in diameter
* Site of tracheostomy
81
CARINA
• Bifurcation of trachea into right and left bronchi
• Cough receptors are located at the carina
• The right bronchus bifurcates 20-30 degrees from midline, this is why the right bronchus is the likely route for the ETT to take when advanced too far due to the smaller angle
• The left bronchus bifurcates at a 45-55 degree angle from midline
o Smaller in diameter but twice as lone
82
Costal Surface of the Lung
Lies against the ribs
83
Left Lung
Divided into two lobes (superior and inferior)
| The heart fits into the caridac notch of the left lung
84
Right Lung
Superior
Middle
Inferior
85
Terminal Bronchioles
Contain no cartilage only bronchial smooth muscle which can contract (bronchospasm)
86
CONDUCTING AIRWAY HISTOLOGY
* Mucous-secreting epithelium lines lumen of airway (Pseudostratified cilliated columnar epithelium)
* Basement membrane is next
* Lamina propria contains
87
Lamina Propria Contains
o Smooth muscle
o Elastic fibers
o Blood vessels
o Nerves
88
MUCOCILIARY CLEARANCE
• Ciliated epithelial cells
• Mucus blanket
o Two layers of mucus
Gel
Sol
• Cilia reaches into the gel layer to exert rapid forward strokes which will pull the gel layer towards the pharynx
o Impairment can be caused through cigarette smoke, air pollution, dehydration, etc
89
Acinus
Gas portion of the lung
90
Pores of Khon
Collateral air channels between alveoli
91
Canals of Lambert
Collateral air channels between terminal bronchioles and alveoli
92
Type I Epithelial Cells
Majority
| Flat
93
Type II Epithelial Cells
Square shaped
Protrude into alveolar airspace
Secrete surfactant
Can morph into type I
94
Alveolar Macrphages
Wandering Killer Cells
95
Eosinophils
Associated with allergens
96
Neutrophils
Associated with bacterial infections
97
Mast Cells
On epithelial surface
| Mediators of inflammation
98
Lung Parenchyma
Functional tissue of the lung
| Contains elastic fibers which are retractie tethering forces that will hold the airways open during forceful exhalation
99
Visceral Pleura
Attaches to lung surface
| No pain fibers
100
Parietal Pleura
Attaches to inner chest wall surface
| Many pain fibers
101
Thorax
Two pleural divisions (left and right) that is occupied by the lungs
Mediastinum (central)
102
Diaphragm Parts
• Costal part
o Fibers originate from lower ribs and sternum
• Crural part
o Fibers originate from L1-L3 forming two muscle bands
• Central tendon
o Common insertion of costal and crural fibers
• Right and left hemidiaphragms
o Each independently innervated by phrenic nerves
103
Diaphragm During Inspiration
Contraction of Fibers
104
Costal Fiber Contraction
Lower Diaphragm dome
Pulls and lifts lower ribs
Increase vertical dimension of thorax
105
Crurual Fiber Contraction
Increase only vertical dimension of thorax
| No attachment to the ribs
106
Diaphragm During Exhalation
Mainly inactive allowing for passive exhalation
• Some muscle tone maintained during early exhalation
o Provides “braking” action
o Provides smooth transition between inhalation and exhalation
107
Primary Muscles of Quiet Breathing
```
o Diaphragm (major effect)
o Parasternal intercostals (minor effect)
o Scalenes (minor effect)
```
108
Accessory muscles used for increased work of breathing (WOB)
```
o Scalenes (inspiration)
o Sternocleidomastoids (inspiration)
o Pectoralis major (inspiration)
o Abdominals (expiration)
```
109
Intercostal Muscles
• Internal intercostals
o Parasternal fibers
Insertion into sternum; elevate ribs causing inspiration
o Interosseous fibers
Between ribs; depress ribs, causing expiration
• External intercostals
o Elevate ribs, causing inspiration
110
Scalene Muscles
Minimal activities at rest
| High activity indicates WOB
111
Sternomastoid Muscle
Used to assist inspiration at rest
112
Pectoralis Major Muscle
Activates when a patient is tridoing to elevate sterum and ribs
113
Abdominal Muscles
• Accessory muscles of expiration
o Rectus abdominis is the most important
Compresses abdominal cavity, raising its pressure
• Normally inactive during quiet expiration
o Become active to assist forced exhalation (during strenuous exercise) or if resistance to outflow (seen in COPD) is high
