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Respiratory Sytem > Anatomy Of The Respiratory Tract > Flashcards

Anatomy Of The Respiratory Tract Flashcards

1
Q

Identify the region known as the Upper Respiratory Tract and state what structures comprise it?

A

From nostrils to lower border of Cricoid Cartilge of larynx

  • Nose
  • Paranasal sinuses
  • Pharynx
  • Larynx
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2
Q

Describe the structure of the Nasal Cavity

A

Divided into left and right cavities by Median Nasal Septum

The lateral wall of each nasal cavity contains 3 Conchae/ Turbinates (3 bony projections)

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3
Q

What are the Paranasal Sinuses?

A

4 air containing cavities, lined by respiratory epithelium which open into the (nasal cavity

(into the spaces below the Turbinates/ Conchae)

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4
Q

Name the 4 Paranasal Sinuses (named for the skull bones which they’re situated in)

A
  • Frontal
  • Ethmoidal
  • Maxillary
  • Sphenoidal
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5
Q

How is inhaled air warmed and humidified?

A

The vascular mucosa lining the surface area created by the turbinates and Paranasal sinuses allow this.

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6
Q

Other than warming and humidifying, what do the turbinates do to inhaled air

A

Cause turbulence and slow down airflow

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7
Q

How does the respiratory system develop?

A

Develops as a diverticulum from the pharynx

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8
Q

List the functions of the nasal cavity

A
  • Induce turbulent flow
  • Warm and moisten inspired air
  • Recover H2O from expire air
  • Speech production (Phonation)
  • Olfaction
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9
Q

The larynx links the pharynx to the trachea. What does it contain? What do these do?

A

Vocal cords/ vocal folds/ vocal ligaments, which guard the entrance to the trachea

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10
Q

What do you call the vocal cords + the aperture between the cords

A

Glottis

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11
Q

What happens to the laryngeal inlet, epiglottis and vocal cords (lies over the glottis) when swallowing?

A
  • Laryngeal inlet narrows
  • Epiglottis folds downwards
  • Vocal cords come together

In combination they act as a sphincter to close the trachea entrance

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12
Q

Which muscles cause vocal cord movement?

What is their innervation?

A

Intrinsic Laryngeal Muscles, by Recurrent Laryngeal Nerve (except for Cricothyroid muscle)

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13
Q

Why can Intra-thoracic disease result in a hoarse voice?

Lung cancer, aortic aneurysm

A

Part of the LEFT Recurrent Laryngeal Nerve is in thoracic cavity so gets compressed/ irritated, leading to Paralysis of the LEFT Vocal Cord

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14
Q

The Bony Thorax, Intercostal Muscles and Diaphragm act together as a Respiratory Pump

What are the components of the Bony Thorax

A 
Sternum
Ribs 
Thoracic vertebrae 
Costovertebral joints
Rib movements
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15
Q

What are the 3 parts of the Sternum?

A
  • Manubrium
  • Body
  • Xiphisternum/ Xyphoid process (Remains cartilaginous into adult life_
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16
Q

What is the Sternal Angle? (Angle of Louis)

The Costal Cartilage of which Rib articulates with the sternum at this level?

A

The junction between the Manubrium and Body of the sternum

CC of rib 2

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17
Q

What are the 4 parts of a typical rib (3-9)

A
  • Head
  • Neck
  • Tubercle
  • Shaft
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18
Q

The Head of a typical rib has 2 articular facets that articulate with the corresponding vertebrae and the one above.

What are these joints called?

A

Costovertebral joints.

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19
Q

At which 2 synovial joints do rib movements during respiration take place?

A

Costovertebral joints (with corresponding and superior vertebrae)

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20
Q

The Tubercle of a rib has 1 articular facet that articulates with the transverse process of the corresponding vertebrae.

Name this joint

A

Costotransverse joint (not in T11 and T12)

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21
Q

The Shaft of a typical rib is flat, curved and has a Costal Groove

Where on the rib is the Costal groove? What structures run in the groove?

A

Lower border of inner surface of rib

Intercostal vessels and nerve

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22
Q

Each Intercostal space contains 3 muscles innervated by the same nerve.

Identify the nerve
Name them from superficial to deep

A

Intercostal nerve

External Intercostal
Internal Intercostal
Innermost Intercostal

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23
Q
  1. Describe the fibre orientation of the External Intercostal Muscles.
  2. What is their action?
  3. What proportion of chest expansion during respiration is done by these muscles?
  4. What abdominal muscle are they continuous with?
A
  1. Fibres run Infero-anteriorly from rib above to rib below
  2. Elevate the ribs (increase antero-posterior and transverse diameters of chest)
  3. 30% of chest expansion
  4. External Oblique
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24
Q
  1. Describe the fibre orientation of the Internal Intercostal Muscles
  2. What is their action?
  3. When are they active?
  4. What abdominal muscle are they continuous with?
A
  1. Run Infero-posteriorly from rib above to rib below
  2. Pulls ribs down from position of chest expansion
  3. Active during Forced Expiration (quiet expiration is passive)
  4. Continuous with Internal Oblique
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25
Q

Name 3 structures supplied/ drained by Intercostal Nerves and Vessels

A
  • Intercostal muscles
  • Parietal pleura
  • Overlying skin
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26
Q

What is the main muscle of inspiration?

What proportion of chest expansion during respiration is it responsible for?

A

Diaphragm

70%

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27
Q

The diaphragm is dome shaped and bulges into the thorax.

It’s peripheral fibres arise from the lower thoracic cavity and insert into the central tendon.

What is the central tendon fused with superiorly?

A

Inferior part of the fibrous pericardium

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28
Q

What nerves Innervate the diaphragm?

How does it move when contracted?

What does damage to its innervating nerve result in? How does this appear on a CXR

A
  • Left and right Phrenic neves (C3,4,5)
  • Moves downwards
  • Paralysis of affected side, elevated hemi-diaphragm
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29
Q
  • What structures does the Diaphragm have openings for?
  • At what levels?
  • At what levels do the right and left dome lie?
A
  • IVC (T8 level) (Vena Cava is 8 letters)
  • Oesophagus (T10 level) (10 letters)
  • Aorta (T12 level) (Aortic hiatus is 12 letters)

Right dome: At level of rib 5
Left dome: At level of 5th Intercostal space (slightly lower)

30
Q

The Neurovascular supply to the Intercostal muscles sits between which 2 muscle layers?

A

Internal and Innermost Intercostal muscles

31
Q

What is a Hemi-thorax?

A

Left/ right half of the Bony thoracic cage, diaphragm and mediastinal surfaces

32
Q

How does the thoracic cage have a dual blood supply

A

Intercostal arteries from back from aorta + intercostal arteries from front from Internal Thoracic Artery (Runs alongside sternum)

33
Q

Describe the veinous drainage of the thoracic cage

A

Intercostal veins drain into Azygos vein into SVC

Azygos means unpaired as this vein is not paired with an artery

34
Q

What structure is in the Middle Mediastinum?

A

Heart

Anything in front is in the Anterior Mediastinum, posterior mediastinum is full of structures

35
Q

Describe the Pleura of the lung

A

The Visceral Pleura lies the inside of each Hemi-Thorax and is continuous (at the hilum of the lung) with the Parietal Pleura which lines the outside of the lung

The Parietal Pleura extends across lobes of the lung into the depths of the Oblique and Horizontal fissures

36
Q

Does the Parietal Pleura have any innervation?

A

Yes, it has Somatic Innervation so can feel pain

37
Q

What is the Costo-diaphragmatic recess?

A

A peripheral gutter around the diaphragm into which only the Parietal Pleura extends

38
Q

How does the pleura link the movement of the chest wall and lungs?

A

Pleural fluid (in the pleural cavity) connects the 2 pleurae, ensuring that when the thoracic cage expands the lungs will too.

39
Q

Where does the Trachea commence and Terminate?

What do you call the angle between the Right and Left primary bronchi?

A
  • Starts at lower border of cricoid cartilage of larynx
  • Ends at level of sternal angle by dividing into Right and Left Primary Bronchi

The Carina

40
Q

Why are inhaled foreign bodies more likely to lodge in the right primary bronchus

A

Right primary bronchus is;

  • Wider
  • Shorter
  • More vertical
41
Q

Describe the branching of the right and left primary bronchi

A
  • Primary Bronchi divide into Lobar Bronchi (3 on right, 2 on left)
  • Lobar Bronchi divide into Segmental Tertiary Bronchi
42
Q

Each Segmental Bronchus supplies a Bronchopulmonary Segment.

What is this?

A

An area of lung supplied by a segmental bronchus, an accompanying segmental branch of the pulmonary artery.

It is drained by a segmental pulmonary vein.

43
Q

Describe the pyramidal shape of a Bronchopulmonary segment

A

Apex faces towards the segmental bronchus and the base towards lung surface

(Can be removed without much bleeding/ air leakage/ interference with other segments)

44
Q

The airway divides 23 times between the trachea and alveoli.

Divisions 1-16 do not take part in gas exchange.

What is this region known as? What structures does it extend to?

A

The Conducting Zone, extends to and includes the Terminal Bronchioles

45
Q

The last 7 divisions of the airway make up the Respiratory Zone where gas exchange occurs.

What 3 structures are included

A
  • Respiratory Bronchioles (Occasionally alveoli budding from walls)
  • Alveolar Ducts (Completely lined with alveoli budding off)
  • Alveolar Sac (An airspace open to numerous alveoli)
46
Q

How many alveoli are there

A

About 3 million

47
Q

State the Lobes and Fissures of the Left Lung

A

Upper and Lower lobes separated by Oblique Fissure

48
Q

State the Lobes and Fissures of the Right Lung

A
  • Upper and Middle lobes separated by Horizontal Fissure

- Oblique fissure separates Upper and Middle lobes from the Lower Lobe

49
Q

Where does the Apex of both lungs extend into

Where does the Base of the lung rest?

A

Extends above Rib 1 level into root of neck

Rests on each hemi-diaphragm

50
Q

Why can Lung Apex tumours cause neurovascular problems in upper limb

A

In the neck, the Apex is closely related to the Brachial Plexus and Subclavian Vessels

51
Q

What does the Mediastinal Surface of each lung contain?

A

The Hilum (through which bronchi, vessels, lymphatics, nerves enter and leave the lung)

52
Q

List 7 structures adjacent to the Mediastinal surface of the Right Lung?

A
  • SVC
  • Azygos vein
  • Right Atrium
  • Oesophagus
  • Right Phrenic Nerve
  • Vagus Nerve
  • Sympathetic Trunk (more posteriorly)
53
Q

List 7 structures adjacent to the Mediastinal surface of the Left Lung?

A
  • Heart
  • Aortic Arch
  • Descending Aorta
  • Oesophagus
  • Left Phrenic Nerve
  • Left Recurrent Laryngeal Nerve (Branch of Phrenic)
  • Sympathetic Trunk (more posteriorly)
54
Q

Give 3 examples of mediastinal structures close to the lungs being involved/ damaged by lung pathologies.

A
  • Phrenic nerve: Paralysis of effected hemi diaphragm-> Breathlessness
  • Recurrent Laryngeal Nerve: Paralysis of Intrinsic Laryngeal Muscles on affected side-> Vocal cord paralysis and voice hoarseness
  • SVC Obstruction
55
Q

The lungs have a dual blood supply from the Pulmonary AND Bronchial Arteries.

What do bronchial arteries supply?

A

Supply the bronchial tree and visceral pleura

56
Q

Most of the blood supplied by the Bronchial arteries returns via the Pulmonary veins.

Describe the pathway taken by the blood that does return via Bronchial Veins

A

Drain from Bronchial Veins-> Azygos vein-> SVC

57
Q

Describe the anastomoses between Bronchial and Pulmonary arteries

A

Few anastomoses at pre-capillary and capillary level

58
Q

How many pulmonary veins leave each hilum?

A

2 per hilum (Draining the upper and lower lobes)

59
Q

Describe the Lymphatic drainage of the lungs

Enlargement of which group of nodes can cause widening of the Carina angle

A
  • Lungs drain to Hilar/ Bronchopulmonary Nodes

- Efferents from there drain into Tracheobronchial Nodes (Enlargement of these can cause widening of Carina)

60
Q

Parasympathetically, the lung receives fibres from the right and left vagus nerves.

Describe the Vagal Afferent and Efferent fibres’ function

A

Vagal Efferent:

  • Motor to bronchial smooth muscle (Bronchoconstrictor)
  • Secretomotor to mucous glands

Vagal Afferent:
- For cough reflex

61
Q

What are 2 actions of Sympathetic innervation to the lungs from the Sympathetic Trunk

A
  • Bronchodilator

- Vasoconstrictor

62
Q

State the surface markings of the Left and Right Oblique Fissures

A
  • Starts T2 Spinous process/ T4 body posteriorly
  • Moves Antero- inferiorly
  • To Costochondral Junction 6
63
Q

State the Rib level of the Lower Edge of the Lung at the;

  • Mid Clavicular line
  • Mid Axillary line
  • Scapular line

Also, state Rib level to which the pleural cavity extends

A
  • Rib 6, Pleural Cavity extends to Rib 8
  • Rib 8, PC extends to R10
  • Rib 10, PC extends to R12
64
Q

In a pleural effusion, where does fluid collect in the upright position

A

In the Costo-diaphragmatic space

65
Q

Name the 3 surfaces of the Parietal Pleura

A
  • Mediastinal
  • Diaphragmatic
  • Costal
66
Q

When looking at the Hilum, explain the anatomical relationship between the Pulmonary Artery and Bronchus?

A

Bronchus is posterior to Pulmonary Artery

67
Q

In left lung explain the Bronchus position relative to Pulmonary Artery?

A

In Left lung, bronchus is inferior or next to pulmonary artery

68
Q

In Right lung explain the Bronchus position relative to Pulmonary Artery?

A

In right lung, Bronchus is superior to Pulmonary Artery

69
Q

Which vessels run in the intercostal neurovascular bundle?

A

Anteriorly: Anterior intercostal artery and vein
Posteriorly: Posterior intercostal artery and vein

(Anastomose with each other anteriorly)

70
Q

Describe the drainage of the posterior and anterior intercostal veins

A

Posterior: Into Azygous vein and Accessory hemiazygous vein which drain into SVC

Anterior: Into Internal Thoracic vein which drains into Braciocephalic Vein

71
Q

Describe the origin of the anterior intercostal arteries

A

Branches of internal thoracic artery which comes off the subclavian artery

Respiratory Sytem (21 decks)

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