Anatomy of Respiratory WB

Question 1

Where does the Upper Respiratory Tract (URT) extend from and what does it consist of?

Answer 1

URT - from nostrils to lower border of cricoid cartilage of larynx

Contains - Nose, paranasal sinuses, Pharynx, Larynx

Question 2

What is a nasal concha?

Answer 2

These are bony projections.

Each nasal cavity contains 3 so there is a total of 6 within the nose.

They are also known as Turbinates

Question 3

What are the paranasal sinuses?

Answer 3

Four air containing cavities lined by respiratory epithelium (pseudoctratified cilliated columnar) which open into the spaces below the concha / turbinates in the nasal cavity

Question 4

How is a large surface area in the nose created?

Answer 4

By the paranasal sinuses and the turbinates / concha

Question 5

What is the effect of a large surface area in the nose?

Answer 5

It allows inhaled air to be warmed and humidified. This allows for better gas exchange.

The turbinates also cause turbulence and slow down airflow, increasinf the time for the air to be warmed and humidified.

Question 6

How are particles trapped when inhaled?

Answer 6

• Corse hair that lines the nostrils.
• Mucus secreted by goblet cells - cillia waft mucus to oropharynx where it is swallowed.

Question 7

Air and food have a common passage through parts od the pharynx, if the methods to prevent aspiration of food particles goes wrong, what could happen?

Answer 7

Aspiration of food particles or liquid - life threatening obstruction or infection (aspiration pneumonia)

Question 8

Where is the larynx and what does it contain?

Answer 8

Links pharynx to trachea and contains vocal cords which guard entrance to trachea.

Question 9

What causes the movement of the vocal cords?

Answer 9

Intrinsic laryngeal muscles which are controlled by the recurrent laryngeal nerve.

Question 10

What are the three parts of the sternum?

Answer 10

• Manubrium
• Body
• Xiphisternum (remains cartilagenous into adult life)

Question 11

What are the three layers of intercostal muscles?

Answer 11

External, internal and innermost - They are all innevated by the intercostal nerve.

Question 12

What is the role of the external intercostal muscles?

Answer 12

Responsible for 30% of chest expansion during quiet respiration - Contraction elevates rib in a bucket handle type movement.

Question 13

What are the roles of the internal and innermost intercostal muscles?

Answer 13

Both pull ribs down from position of chest expansion. Active during forced expiration.

Question 14

What innervates the diaphragm?

Answer 14

The phrenic nerve

C3,4,5 keeps the diaphragm alive

Question 15

What is the costo-diaphragmatic recess?

Answer 15

The space into which the lungs don’t extend so, only the parietal pleura is here.

Question 16

What is the role of the pleura?

Answer 16

The molecules of pleural fluid create a seal which ensures that when the thorax expands in respiration, the lungs expand along with it.

Question 17

What is the angle between the left and right bronchi known as and why is it significant?

Answer 17

Carina

Significant as sensitive

Question 18

What is a bronchopulmonary segment and why are they significant?

Answer 18

Area of lung supplied by a segmental bronchus and the accompanying branch of the segmental artery.

Pyramid shaped

Important as they are the smalled resectable divisions of the lung as they can be removed without much bleeding, air leakage or interferance with other segments.

Question 19

What does the oblique fissure separate?

Answer 19

Separates the right upper and middle lobes from the lower lobes

Question 20

What does the horizontal fissure separate?

Answer 20

Separates the right upper and middle lobes of the lung

Question 21

Where is the apex of the lung?

Answer 21

Above the first rib into the root of the neck.

It is closely associated with the subclavian vessels and the brachial plexus. Therefore, tumours of the apex can invove these structres and cause neurological and vascular problems.

Question 22

What does the medialstinal surface of the lung lie adjacent to on the left?

Answer 22

• Heart
• Aortic arch
• Descending aorta
• Oesophagus
• Nerves
  
  • Phrenic
  • Vagus
    
    • Recurrent laryngeal branch

Question 23

What does the mediastinal surface of the lung lie adjacent to on the right?

Answer 23

• Superior vena cava
• Azygous vein
• Right atrium
• Oesophagus
• Nerves
  
  • Phrenic
  • Vagus
  • Sympathetic trunk

Question 24

What is the lymphatic drainage of the lungs?

Answer 24

Lungs drain into the hilar nodes (bronchopulmonary nodes).

Efferents from these nodes run to tracheobrinchial nodes.

Enlarged trachiobronchial nodes can cause widening of the angle of carina.

Question 25

What do the parasympathetic efferent fibres of the vagus nerve supply?

Answer 25

Motor - bronchial smooth muscle (bronchoconstrictor)

Secretomotor - Mucous glands

Afferent fibres - Cough reflex and subserving pain

Question 26

What do the sympathetic efferent fibres of the vagus nerve supply?

Answer 26

Bronchodilator and vasoconstrictor

Question 27

Where does the oblique fissure extend form and to?

Answer 27

Spinous process of T2 posteriorly to 6th costal cartilage anteriorly.

Approx follow medial scapula when arm abducted

Question 28

Where does the horizontal fissure extend from and to?

Answer 28

Mid auxillary line anterirorly along 4th rib to anterior edge of lung - sepparating right upper and middle lobes