Chapter 2: Thorax (continued) Flashcards
What are pleural reflections?
lines along which individual regions of parietal pleura merge
What are pleural recesses?
potential spaces not occupied by lung tissue except during deep inspiration
Costodiaphragmatic recesses?
spaces below the inferior borders of the lungs where costal and diaphragmatic pleura are in contact
Costomediastinal recess?
a space where the left costal and mediastinal parietal pleura meet, leaving a space caused by the notch of the left lung
What structures pass through the hilum of the lung?
pulmonary vessels, primary bronchi, nerves, and lymphatics
Each lung has how many surfaces? Name them.
3 surfaces
- costal surface
- mediastinal surface
- diaphragmatic surface
A tumor at what part of the lung may result in thoracic outlet syndrome? Also what is the name of this type of tumor?
apex of neck
Pancoast tumor
What are the 3 lobes of the right lung?
superior, middle, inferior
What are the fissures that separate the right lung?
2 fissures the horizontal and oblique
Label the image.
The horizontal fissure of the right lung separates what lobes?
the superior from the middle lobe
The oblique fissure of the lung separates what lobes in the right lung?
middle from the inferior lobe
The left lung is divided into how many lobes? What are their names?
2 lobes
superior
inferior
What fissure separates the superior and inferior lobes of the left lung?
oblique fissure
What is the lingula of the lung?
the tip or tongue-like projection of the upper lobe of the left lung
The oblique fissure of both lungs projects anteriorly at approximately what ICS in midclavicular line?
5th
Where does the horizontal fissure of the rt lung run in relation to the ICS?
runs horizontally from the oblique fissure in the rt 5th ICS to the rt 4th costal cartilage
The superior lobe of the right lung projects anteriorly on the chest wall above which rib?
4th rib
A small portion of the inferior lobe of both lungs projects below which rib anteriorly?
6th rib anteriorly but primarily to the posterior chest wall
How do we listen to breath sounds of the superior lobes?
for rt and lft lungs, stethoscope is placed on the superior area of the anterior chest wall (above the 4th rib for rt lung)
How do we listen to breath sound from the middle lobe of the right lung?
stethoschope placed on the anterior chest wall inferior to the 4th rib and medially toward sternum
How do we listen to breath sounds for the inferior lobes of both lungs?
primarily heard on the posterior chest wall
Aspiration of a foreign body will most often enter which bronchus?
right primary bronchus; which is shorter, wider, and more vertical than the left primary bronchus
Which lobe, when a person is vertical will a foreign body most likely be aspirated into?
foreign body usually falls into the posterior basal segment of rt inferior lobe
What are the 2 main ways that lymph flow will return to the blood?
right lymphatic duct
thoracic duct
Where do the right lymphatic duct and the thoracic duct drain into?
the junction of the internal jugular and subclavian veins on their respective sides
The thoracic duct carries all lymphatic drainage from the body from where in the body?
from the body below the diaphragm and on the left side of the trunk and head above the diaphragm
The right lymphatic duct drains lymph flow from what areas of the body?
from the right head and neck and the rt side of the trunk above the diaphragm
What are the major nodes involved with draining the superficial and deep lymphatic plexus of the lungs?
bronchopulmonary (hilar) nodes
tracheobronchial nodes
bronchomediastinal nodes
Which lymphatic nodes drain the lungs?
superficial and deep lymphatic plexuses
Label the image.
The lymphatic drainage from the lower lobe of the left lung also drains across the midline and into which lymph nodes?
the right bronchomediastinal lymphatic trunk and nodes
Label the image.
Label the image
The enzyme that converts Angiotensin I to Angiotensin II is produced by what organ of the lung?
the lung endothelial cells (ACE)
Label this image.
Fill in the chart.
What are the major parts of the lining of the trachea? (Iayers)
composed of concentric rings of mucosa, submucosa, an incomplete muscularis, and a complete adventitia
Mucosa of the trachea have what components?
a pseudostratified epithelium, an underlying vascularized loose connective tissue (lamina propria) that contains immune cells, and a thin layer of smooth muscle cells (muscularis mucosa)
Describe the submucosa of the trachea?
vascular surface area containing large blood vessels. Collagen fibers, lymphatic vessels and nerves
Describe the adventitia of the trachea?
outside covering composed of several layers of loose connective tissue
Describe pseudostratified columnar epithelium.
all cells lie on the same basal membrane but only some reach the luminal surface
Where is the only other place in the body with pseudostratified columnar epithelium?
the male reproductive tract
The action of cilia moving dust and particles from the respiratory system up and out to be swallowed is called what?
mucosciliary escalator system
What are PNE cells? What does it stand for?
Pulmonary Neuroendocrine Cells; they are comparable to the endocrine cells in the gut
What are other names for PNE cells?
- APUD cells (amino precursor uptake decarboxylase)
- DNES cells (Diffuse Neuro Endocrine System)
- K (Kulchitsky) cells
Where are Kultchitsky cells found?
they occur in clusters and are often located at airway branch points
What are brush cells of the lungs?
may represent goblet cells that have secreted their product or intermediate stages in the formation of goblet or the tall ciliated cells
What are basal cells of the lungs?
stem cells for the ciliated goblet cells
Intensive irritation from smoking leads to the change from ciliated epithelium in the bronchioles to what type of epithelium?
squamous metaplasia
Bronchial metastatic tumors arise from what type of cells?
kultchitsky cells
The number of goblet cells and submucosa increases or decreases from the trachea to the small bronchi?
decreases
Are goblet or basal cells present or absent in terminal bronchioles?
absent
Where are Clara cells found?
in the bronchioles
Cystic fibrosis can result in abnormally thick mucous, in part due to defective chloride transport by what type of cells?
Clara cells
What is another name for Clara cells?
bronchiolar secretory cells
Describe what is secreted from Clara cells?
a serous solution similar to surfactant
What is emphysema caused by?
a loss of elastic fibers ; results in chronic airflow obstruction
Which is reversible? Asthma or emphysema?
asthma
What is the major cell lining of the alveoli?
Type I pneumocytes
Other names for Type I pneumocytes?
small alveolar cell
alveolar type I cell
Which is primarily involved in gas exchange? Type I or Type II pneumocytes?
type I pneumocytes
Which produces surfactant? Type I or Type II pneumocytes?
Type II pneumocytes
Explain the component of surfactant that make it efficient in its major function? What is the major function of surfactant?
phospholipids act as detergent which lowers the surface tension of the alveoli and prevents alveolar collapse during expiration
T/F. Corticosteroids induce the fetal synthesis of surfactant.
True
High insulin levels in diabetic mothers potentiate or antagonize the effects of corticosteroids?
antagonize
What is responsible for the recoil of lungs during expiration?
elastic fibers in the alveoli
What are pores of Kohn?
openings in the wall of most alveoli
thought to be important in collateral ventilation
