Basic Topography of the Lower Respiratory Tract: Lungs and Pleura (AP)

Question 1

Order of airways from trachea to alveoli

Answer 1

• Trachea
• Primary bronchi
• Secondary bronchi
• Tertiary bronchi
• Bronchioles
• Alveoli

Question 2

Under what pathological circumstances would the trachea be moved?

Answer 2

Injuries or conditions that cause pressure to build in the chest (eg. tension pneumothorax)

Question 3

In which bronchus is aspirated material likely to be found and why?

Answer 3

• Right main
• It is steeper (more in-line) + wider

Question 4

What causes Horner’s syndrome and what are the symptoms?

Answer 4

• Apical lung tumour damaging sympathetic chain above 2nd thoracic ganglion
• Symptoms:
  > Partial ptosis (droop/falling eyelid)
  > Miosis (constric. pupil)
  > Facial anhidrosis (no sweat)

Question 5

What is pneumonia, and which bit of the tracheobronchial tree does it affect?

Answer 5

• Inflammation of the lungs, usually caused by infection
• Alveoli

Question 6

What is pulmonary embolism, and which bit of the tracheobronchial tree does it affect?

Answer 6

• Blood vessel in lung blocked by blood clot
• Pulmonary arteries

Question 7

What is emphysema, and which bit of the tracheobronchial tree does it affect?

Answer 7

• Inner walls of alveoli damaged, causing rupture
• Alveoli

Question 8

What is bronchiectasis, and which bit of the tracheobronchial tree does it affect?

Answer 8

• Airways of lung become widened, leading to excess mucous build-up
• Bronchi

Question 9

Where do each of the bronchi bifurcate in relation to the lung?

Answer 9

• Right = before entering
• Left = after entering

Question 10

What exists in the pleural space?

Answer 10

Thin film of fluid

Question 11

What is the costophrenic angle and why is it important to maintain?

Answer 11

• Point where chest wall + diaphragm meet
• Allows diaphragm to exert a pull on the costal margin to move it superolaterally

Question 12

When would the costophrenic angle become lost?

Answer 12

Pleural effusion

Question 13

What is the parietal pleura sensitive to, and what provides the necessary innervation?

Answer 13

• Pain
• Phrenic + intercostal nerves

Question 14

What is the visceral pleura sensitive to, and what provides the necessary innervation?

Answer 14

• Stretch
• Pulmonary plexus

Question 15

Borders of triangle of safety

Answer 15

• Pec major (anterior)
• Mid-axillary line (posterior)
• Level of nipple (inferior)
• Armpit (superior)