ANATOMY RESPIRATORY SYSTEM

Question 1

what are the lobes and fissures of the lungs ?

2

Answer 1

right lung has : 3 lobes ( superior, middle , inferior )
oblique and horizontal fissures (4th int cost space)
Left lung has : 2 lobes ( superior and inferior )
oblique fissure -4th to 6th rib

Question 2

outline the pleura and structure of the lung
size of lung
(3)

Answer 2

1- parietal pleura furthest on outside (next to ribs)
2-interpleural space = filled with pleural fluid
3-Visceral pleura = next to lungs
4-structures entering the lung =HILUM
5-the left lung is smaller than the right lung because the heart leans toward the left ( less space ), take note of cardiac notch

Question 3

outline the Hila structure of the right and left lung?

Answer 3

1-top = pulmonary artery (does blood to lung)

2inferior =pulmonry veins ( carry ox blood to heart)

Question 4

describe the procedure when there is too much air/fluid in pleural cavity ?
(2)

Answer 4

pleural tap -Needle goes into the Costodiaphragmatic recess

Chest tube-for larger volumes of air (

Question 5

outline the structure of the trachea

3

Answer 5

1-oeasophagus is behind the trachea
2-Trachealis = muscles bridge the gap between C-shaped cartilage =soft spot so that food can be digested in the oesophagus
3-C-shaped cartilage rings to keep trachea open

Question 6

describe the diaphragm 
attachments 
central tendons and vessels 
innervation 
blood supply 
CASE STUDY 
(10)

Answer 6

domed sheet of skeletal muscle
attachments :
1-front = Xiphoid process and costal cartilages of ribs7-10
2-anteriorly =costal cartilage of rib 11/12
lumbar vertebrae and arcuate ligaments = median (middle), medial (right next to median ), Lateral ( furthest on the outside )
3-central attachments =Central tendon

Central Tendon : 3 openings
1-top = caval foramen contains IVC
2-Oesophagal foramen ( oesophagus and vagus nerve = oesoph-Vagus )
3-Aortic hiatus = aorta , thoracic duct , azygous vein

Innervation :
C3,4,5 keeps diaphragm alive!
-R/L phrenic nerve

Blood supply :
1-muscophrenic and pericardiophrenic arteries
2-Inferior and superior phrenic arteries

Question 7

outline what happens in inspiration

basic 2

Answer 7

diaphragm contracts (moves down )
inter pleural volumes increases ,hence pressure decreases =>air is sucked in

Question 8

Describe the histology of the :
a)Nasal cavity 
b)conchae 
c)Larynx
(9)
think about :
epithelium , purpose , specialisation

Answer 8

a) nasal cavity =divided by the central nasal septum
lined with pseudostratified columnar ciliated epithelium (PSCC) , ROOF =olfactory epithelium for smell

b) Conchae =snail like bones to make air turbulent =to trap foreign matter =filters air
- PSCC
- Tubuloacinar seromucous glands
- venous plexus which brings warm blood to warm incoming air

c) Larynx = lined with PSCC connects the pharynx to trachea aka voice box
- cartilage , CT, skeletal muscle , vocal chords, epiglottis
- guards against entry of foreign bodies

Question 9

outline the passage of the air through conducting and respiratory portions
(5)

Answer 9

Nasal cavity–>Nasopharynx—>Larynx–>Trachea–>Bronchi–>Bronchioles –>Respiratory Bronchioles–>Alveolar Ducts –>Alveolar Sacs–>Alveoli

Question 10

Describe the histology of 
a)trachea 
b)bronchus
c)Bronchioles 
(12)

Answer 10

a) Trachea = C-shaped Hyalin cartilage , stretch , transport air to thorax
- PSCC and goblet cells
- Tubuloacinar seromucous acinar glands
- cilia = wafts up mucociliary escalator

b)Bronchi /Bronchus = C-shaped cartilage starts to fade out (extra pulmonary )
intrapulmonary incomplete cartilage plates
-PSCC+ goblet cells
-spirally arranged smooth muscle

c) Bronchioles (air–>respiratory passage )
- simple columnar /cuboidal epithelium
- less goblet cells, cilia
- NO GLANDS OR CARTILAGE
- smooth muscle vvvv small
- CLARA cells –>respiratory bronchioles (secrete surfactant and protects epithelium )

in the bronchiole = Clara or club cell
in the alveoli = type 2 pneumocytes

Question 11

outline the alveoli 
histology 
cells 
capillaries 
immune cells

Answer 11

Alveoli = main site for gas exchange

• Simple squamous epithelium
• TYPE1 pneumocytes= gas exchange (can’t reproduce themselves so TYPE 2 make them )
• TYPE2 pneumocytes = make type 1 and also surfactant
• Capillaries , elastic and reticular fibres surround them
• Immune cells = alveolar macrophages to clear any allergic particles

Question 12

what happens to the following as you go down the respiratory airways ...
a) epithelium 
b)goblet cells
c) cilia
d)glands
e)lamina propria = part of the mucosa( loos connective tissue like papillary dermis of skin )
f)elastic fibers
g) smooth muscle 
h) cartilage 
(10)

Answer 12

a) epithelium = PSCC–>simple columnar –>simple cuboidal –>simple squamous –
b)Goblet cells decrease slowly = stop at terminal bronchiole
c)Ciliated epithelium = None from respiratory bronchiole onwards
d)Glands = mixed up until bronchus and then none
e) Lamina propria= thick up until trachea , then starts decreasing and thin from bronchiole onwards . Only few collagen fibres in alveolus
f)elastic fibres = increase as you go down , and they are a prominent part of the brochioles–>alveolus even though number decreases
g)smooth muscle = present until bronchus , then there are fewer smooth muscle cells relative to the size of the lumen
h)cartilage :
1-conchae= nasal septum
2-larynx= present
3-Trachea = c-shaped rings
4-Bronchus =plates of cartilage
the rest has decreasing / no cartilage