APE 7: The Respiratory System Flashcards
Where is the nasal septum found?
Midline of the nose (sagittal plane)
What are the three types of turbinate bones?
Superior, middle and inferior
What are the spaces found beneath the tubrinate bones?
Meatuses
What are the three types of meatuses?
Superior, middle and inferior
Which 4 bones are found around the nose and what type of bones are these?
Maxilla, sphenoid, ethomoid and frontal
Pneumatic bones
What are the paranasal sinuses?
Air-filled extensions of the respiratory part of the nasal cavity
What are the 4 paired sinuses?
Maxillary, frontal, ethmoid and sphenoid
Where do the paranasal sinuses drain into?
Meatuses
What is the purpose of the paranasal sinuses?
- lighten skull
- clean out and humidify air being inhaled
- clean out particles in mucus
What forms the floor of the nasal cavity?
The hard palate
What is found beneath the superior, middle and inferior nasal conchae?
The superior, middle and inferior meatuses, respectively, and the sphenoethmoidal recess
What are the nares?
Piriform opening into the vestibule of the nasal cavity
What are the choanae?
The internal nares
What is the vestibule?
Where your nostrils are
Where is the olfactory and respiratory region of the nasal mucosa found?
Olfactory= at the roof Respiratory= main part of nasal cavity
What is the pharynx?
A fibro-muscular tube
What is its position relative to the base of the skull and the oesophagus?
Attached to the base of the skull superiorly and continuous with the oesophagus inferiorly
What are the 3 divisions of the pharynx and what do they lie posterior to?
Nasopharynx- posterior to nasal cavity
Oropharynx- posterior to oral cavity
Laryngopharynx- posterior to larynx
What is the raised area in the lateral wall of the nasopharynx for?
The opening of the auditory (pharyngotympanic/Eustachian) tube
What does the auditory tube lie directly posterior to?
The floor of the nasal cavity
What are the pharyngeal tonsils?
Enlargements of lymphatic tissue
Where is the isthmus of the fauces found?
The space behind the uvula
What is found in between the palatoglossal and palatopharyngeal folds?
The palatine tonsil
Where is the lingual tonsil found?
At the back of the tongue
What does the lingual tonsil complete?
Waldeyer’s Ring of lymphatic tissue
What is the purpose of Waldeyer’s Ring?
It is the first line of defence into the respiratory tract
How many constrictor muscles does the pharynx consist of?
3
What does a deficiency in the musculature of the inferior constrictor muscle lead to? What does this cause a difficulty in?
Leads to a protrusion (pharyngeal pouch)
Causes difficulty in swallowing (dysphagia)
What prevents food entering the nose or larynx?
The epiglottis
What might obstruct the pharynx in an unconscious patient and how is it remedied?
The tongue
Tilt head back and lift chin (recovery position)
At which vertebral level is the larynx found?
C3-C6
What is the purpose of the larynx?
- provides a protective sphincter for the air passage
- fundamental to phonation
How many cartilages make up the larynx?
9
How many paired/single cartilages does the larynx contain?
3 single and 3 paired
What are the cartilages in the larynx connected by?
Ligaments and membranes
What type of muscles does the larynx have?
Intrinsic and extrinsic
What is the purpose of the intrinsic muscles?
Altering the tension in the vocal cords with corresponding changes to the aperture of the glottis
How many muscles open the glottis?
Only 1
What are the laryngeal muscles supplied by and what is the exception to this?
The recurrent laryngeal branch of the vagus nerve
Except for the cricothyroid muscle
What is the cricothyroid muscle supplied by?
The superior laryngeal nerve
When is the recurrent laryngeal branch of the vagus nerve liable to be injured and what does it cause?
Penetrating trauma
Causes a coarse voice
What is the opening of the larynx called?
The laryngeal orifice
Where is the aryepiglottic fold found?
On either side of the epiglottis
What is the position of the true vocal cord relative to the false vocal cord?
The true vocal cord is inferior to the false vocal cord
What indicates the position of the larynx?
The laryngeal priminence, Adam’s apple
What are the superior and inferior attachments of the larynx?
Superior= hyoid bone Inferior= trachea
What is found in between the hyoid bone and the thyroid cartilage?
The thyrohyoid ligament
What is found in between the thyroid cartilage and the cricoid cartilage?
The cricothyroid ligament
Which muscles move the cricoid, thyroid and arytenoid cartilages and the vocal folds?
The intrinsic laryngeal muscles
Which veretebral level is the hyoid bone found?
C3
What does the larynx lead to?
It leads to the trachea below the cricoid cartilage
What do severe allergic reactions (anaphylaxis) lead to and what does this result in?
Leads to laryngeal occlusion from oedema
Results in obstruction of airways
What emergency measure relieves anaphylaxis?
Puncturing a pen between the hyoid bone and Adam’s apple to allow air to go through
Or use an adrenaline injection
How long is the trachea?
12cm
What does the trachea bifurcate into?
The right and left main bronchi
Which vertebral level does the trachea bifurcate?
T4
Where are the tracheal cartilages incomplete?
Incomplete posteriorly where the oesopagus lies
What is the carina?
A ridge of cartilage in the trachea that occurs between the division of the two main bronchi
Which bronchus is shorter and wider?
The right bronchus
What is the clinical significance of the right bronchus being shorter and wider?
Things are more likely to get stuck there
What is the clinical importance of the vertebral level of T4?
It is where the 2nd intercostal joint is found- used to listen to heart sounds
On clinical examination what might cause deviation of the trachea?
Collapse of one of your lungs
Air filling up in the trachea moves organs to one side
Why is the trachea easily identifiable on a plain chets X-ray?
As it is made of cartilage which is dense
It’s filled with air
Where is the apex on the lung?
The blunt superior end of the lung
Where does the apex project towards?
Above the level of the first rib and into the floor of the neck
Where is the base of the lung?
The inferior surface of the lung, which sits on the diaphragm
What are the borders/marigns of the lungs?
Anterior, inferior and posterior
What are the 3 surfaces of the lungs?
Costal, mediastinal and diaphragmatic
How many lobes do the right and left lung have and what are they?
Right= 3 lobes- superior, middle and inferior Left= 2 lobes- superior and inferior
Why does the left lobe of the lung only have 2 lobes?
Because the heart sits on the left side
Where is the mediastinal border?
Close to the heart
What is the lingula of the lung and which lung is it found on?
The tongue of the lung, found on the left
What is the cardiac notch and which lung is it found on?
Where the heart sits and touches the lung, found on the left
What are the two fissures that divide the lobes of the lung?
Oblique and horizontal
How does the oblique fissure run and which lung(s) is it found on?
Runs from the inferior border of the lung in a superoposterior direction, until it meets the posterior lung border
Found on both lungs
How does the horizontal fissure run and which lung(s) is it found on?
Runs horizontally from the sternum, at the level of the 4th rib, to meet the oblique fissure
Found on the right lung
What is the medial surface of the lung called?
The mediastinal surface
What is found on the mediastinal surface?
The hilum of the lung
What is the hilum of the lung?
Where structures enter and leave the lung
What do the 2 main bronchi divide into at the hilum?
The pulmonary artery and vein
What is the positioning of the structures in the hilum?
Arteries are above the veins and bronchus is at the back
Surface markings of the lungs?
Apex= above clavicle Inferior= 10th rib
What is the lungs suspended in?
The pleural cavity
Where is the lungs attached?
At the hilum
What is the purpose of the pleural cavities?
To maintain atmospheric pressure and act as a lubricant
What are the two pleural cavities within in the thoracic cavity?
Visceral and parietal
What are the different parietal pleuras?
Costal, diaphragmatic, cervical and mediastinal
What are the recesses?
The spaces between the cavities that fill up during deep inspiration
What are the 2 pleural recesses?
Costodiaphragmatic, and costomediastinal
What is the visceral pleura continuous with?
With the mediastinal pleura at the root of the lung
What is the pressure in the thoracic cavity and what will happen if there’s any connection from within the lung or the outside?
Sub-atmospheric pressure, any connection from within the lung/outside will lead to air rushing in to the pleural cavity
What causes air rushing into the pleural cavity ad what is the result?
Penetrating trauma, causes pneumothorax
What are the names given to blood or pus in the pleural cavity?
Haemothorax or pyothorax
How is haemothorax/pyothorax treated?
Chest drain
What are the surface markings of the pleura?
Mid-clavicular, mid-axillary and mid-scapular lines
What is the mediastinum divided into?
Superior and inferior
Inferior is further divided into anterior, middle and posterior compartments
What is found in the thoracic cavity?
Sternum, thoracic vertebrae, ribs and costal cartilages
How many thoracic vertebrae are there?
12
How many ribs are there?
12 pairs
What forms the roof and floor of the thoracic cavity?
Roof= supra-pleural membrane Floor= diaphragm
What is the purpose of the thoracic cage?
It protects vital organs and enables breathing
What is the importance of the level of the manubriosternal joint?
As it forms the sternal angle which is an important clinical landmark for identifying other anatomical points
What does the diaphragm do?
Separates the thorax from the abdomen
What are the 3 types of rib?
True, false and floating
What is the difference between the different types of rib?
True= connect directly to the sternum False= ribs which connect to the costal cartilages of the rib above Floating= only connect at the back
How many true, false and floating ribs are there?
True= 7 False= 3 Floating= 2
What is the structure of a typical rib?
Head, neck and body/shaft
What is the position of the external and internal intercostal muscles and membrane relative to the thoracic cage?
External= anterior to the thoracic cage Internal= posterior to the thoracic cage
What is the position of the neurovascular bundle of the intercostal space?
Between 2 ribs, each bundle is inferior to its rib (NAV)
Where would a chest drain be inserted with respect to the ribs?
Superior to the inferior rib
What do the intercostal muscles do?
Assist in the expansion of the rib cage
What other muscles, other than the intercostal muscles, assist in breathing and what type of breathing?
Accessory muscles
Heavy breathing
Give some examples of accessory muscles
Trapezius, pec minor and major, latissimus dorsi, serratus anterior
