Anatomy Practical 2

Question 1

what is the clinical significance structure of the right main bronchus

Answer 1

• it is vertical

- objects go down the right bronchi whereas left is horizontal so they are more likely to go down the right

Question 2

describe the cartilaginous ring in the trachea

Answer 2

360 degrees

Question 3

describe the cartilaginous ring in the bronchi

Answer 3

plaques

Question 4

which structures make up the hilum of the lung

Answer 4

• pulmonary artery
• pulmonary vein
• bronchus lobar
• pulmonary lympahtic vessels

Question 5

how many bronchopulmonary segments are there

Answer 5

There are 10 bronchopulmonary segments in the right lung (3 in superior lobe, 2 in middle lobe, 5 in inferior lobe) and 9 segments on the left (4 in upper lobe, 5 in lower lobe).

Question 6

what is the blood supply to the lungs

Answer 6

• The bronchi, connective tissue and the visceral pleura receive their blood supply from the bronchial arteries (systemic arteries from the descending aorta).
• Bronchial veins drain to the azygos and hemiazygos veins (but also communicate with the pulmonary veins).
• The alveoli receive deoxygenated blood from the terminal branches of the pulmonary arteries. The oxygenated blood leaving the alveolar capillaries drain to the tributaries of the pulmonary vein.

Question 7

where do the lymph vessels originate from

Answer 7

The lymph vessels originate in superficial and deep plexuses; they are not present in alveolar walls.

Question 8

where does the superficial plexus lie

Answer 8

The superficial plexus (sub-pleural) lies beneath the visceral pleura and drains over the surface of the lung to the lung hilum. (Often they contains carbon deposit, giving the lungs their darker appearance.)

Question 9

where does the deep plexus lie and where does it drain

Answer 9

The deep plexus travels along the bronchi and pulmonary vessels toward the hilum of the lung, passing through pulmonary nodes located in the lung, and the lymph then enters the bronchopulmonary nodes which are concentrated around the lung hilum.

Question 10

where does all lymph from the lung drain into

Answer 10

All the lymph from the lung leaves the hilum and drains into the tracheobronchial nodes and then into bronchomediastinal lymh trunk

Question 11

where is the nerve supply of the lungs

Answer 11

At the root of each lung is a pulmonary plexus composed of efferent and afferent autonomic nerve fibres. The plexus is formed from branches of the sympathetic trunk (T1-T5) and receives parasympathetic fibres from the vagus nerve

Question 12

what is the effect of sympathetic innervation to the bronchi, bronchial and pulmonary vessels

Answer 12

sympathetic system
= bronchi - bronchiodilation
- bronchial - bronchodilaiton
- pulmonary vessel - vasoconstriction

Question 13

what is the effect of parasympathetic innervation to the bronchi, bronchial and pulmonary vessel

Answer 13

bronchi = bronchoconstriction
bronchial = bronchoconstriction
pulmonary vessels = vasodilation
pulmonary glands = mucus secretion

Question 14

how is the diaphragm attached to the thorax

Answer 14

1) The sterna part
2) The costal part
3) The lumbar part (the crura)

Question 15

describe where the right and left dome of the diaphragm reach

Answer 15

The right dome reaches as high as the upper border of the 5th rib, and the left dome reaches the lower border of the 5th rib

Question 16

how does the vagus nerve pass through the diaphragm

Answer 16

• it passes through the diaphragm with the oesophagus

Question 17

what is the two functions of the diaphragm

Answer 17

• separates it from the abdominal cavity

- takes part in inspiration

Question 18

what type of muscle is the diaphragm

Answer 18

skeletal muscle

Question 19

what type of nerve is the phrenic nerve

Answer 19

Somatic nerve

Question 20

what direction to the fibres of the external intercostal muscle pass and what is there function

Answer 20

• quiet inspiration

- inferoanteriorly

Question 21

what direction do the fibres of the internal and innermost intercostal muscles pass and what is there function

Answer 21

• forced expiration

- inferoposteriory

Question 22

what are the surface markings for the hozitonal fissure

Answer 22

Runs horizontally from the sternum, at the level of the 4th rib, to meet the oblique fissure.

Question 23

what are the surface markings for the oblique fissure

Answer 23

The fissure extends on the left from the tip of the spinous process of the T3 vertebra inferiorly around the thorax to the level of sixth costochondral junction anteriorly.

Question 24

what happens if air enters the pleural space

Answer 24

pneumothorax

Question 25

what is the difference between a pneumothorax and a tension pneumothorax

Answer 25

• tension pneumothorax is where there is a mediastinal shift of the organs in the mediastinum, it is also when each time you breath air leaves the pleural space

Question 26

how is a tension pneumothorax treated

Answer 26

needle decompression into the 2nd intercostal space midclavicular line
then a chest drain, 5th intercostal space mid axillary line

Question 27

what is considered a normal CTR

Answer 27

less than 50%

Question 28

what are the two causes the emphysema

Answer 28

Tobacco smoke.
Marijuana smoke.
Air pollution.
Chemical fumes and dus

Question 29

what is the cause of hyperinflamtion in the emphysema

Answer 29

• this is when the alveoli breath in the air but they haven’t got enough elastic tissue in order to deinflate the tissue therefore the air is trapped and is not expelled

Question 30

what happens to pulmonary arterial pressure in an emphysemic patient

Answer 30

increases

Question 31

what are the risk factors of TB

Answer 31

Infection with HIV, the virus that causes AIDS and weakens the immune system
Diabetes mellitus
Low body weight
Head or neck cancer, leukemia, or Hodgkin’s disease
Some medical treatments, including corticosteroids or certain medications used for autoimmune or vasculitic diseases such as rheumatoid arthritis or lupus, which suppress the immune system.
Silicosis, a respiratory condition caused by inhaling silica dust.
- population that you live in
- living in crowded conditions