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Respiratory > EXAM #1: ANATOMY > Flashcards

EXAM #1: ANATOMY Flashcards

1
Q

Relate the apex of the lung to the bony anatomy.

A
  • Apex extends above the clavicle

- Lateral to C7

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2
Q

What is the rule of two’s for the visceral pleura of the lung?

A

The visceral pleura extends to the following ribs, in the following planes:
Mid-clavicular= 6th rib
Mid-axillary= 8th rib
Paraverteral= 10th rib

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3
Q

What is the rule of two’s for the parietal pleura of the lung?

A

The parietal pleura extends to the following ribs, in the following planes, and generally is 2x ribs below visceral pleura*

Mid-clavicular= 8th rib 
Mid-axillary= 10th rib 
Paraverteral= 12th rib
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4
Q

What is the best place to listen to the middle lobe of the right lung?

A

Between 4th and 6th intercostal space in the mid-clavicular line

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5
Q

What is the best way to access a pleural effusion? Why?

A

Posterior b/c:

  • Deep posterior gutter
  • Wider intercostal spaces vs. anterior approach
  • NV bundle is closer to the inferior margin
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6
Q

What is the superior pulmonary sulcus?

A
  • This is a posterior concave region of the thoracic wall
  • Groove is formed by the subclavian artery as it curves in front of the pleura

*Associated with T3

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7
Q

What cancer progresses along the superior pulmonary sulcus?

A

Pancoast tumor

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8
Q

What structures can be affected by a pancoast tumor?

A

Brachial plexus components:

  • C8/T1– claw hand
  • SNS– Horner’s Syndrome
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9
Q

What is the mnemonic to remember the sx. of Horner’s Syndrome?

A

PAM is horny

P= ptosis 
A= anhidrosis 
M= miosis
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10
Q

How many lobes does the left lung have?

A

2

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11
Q

How many lobes does the right lung have?

A

3

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12
Q

What lung/lobe is the lingula associated with?

A

Left lung, superior lobe

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13
Q

How many bronchopulmonary segments does the right lung have?

A

10

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14
Q

How many bronchopulmonary segments does the left lung have?

A

8

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15
Q

What is the hilum of the lung?

A

Doorway into/out of the lung

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16
Q

What is the mnemonic to remember the features/ relationships in the hilum of the right and left lungs?

A

RALS

  • Right= pulmonary a. ANTERIOR
  • Left= pulmonary a. SUPERIOR

*In relationship to the bronchus

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17
Q

Describe the branching of the airway from the trachea to the bronchioles.

A

1) Trachea
2) Primary bronchi
3) Secondary (lobar) bronchi*
4) Tertiary (segmental) bronchi**
5) Many divisions
6) Bronchioles
- Primary
- Terminal
- Respiratory

  • Equal to the number of lobes per lung
  • *Equal to the number of bronchopulmonary segments
18
Q

In relationship to the vertebral column, where does the trachea begin and where does it divide at the carina?

A 
C6= beginning
T4= end

Note that the trachea is ~10cm long

19
Q

What is unique about the respiratory bronchioles?

A

These are the bronchioles that are associated with the alveolar ducts/ alveoli

20
Q

What type of epithelium is associated with the true vocal fold? Why?

A

Stratified squamous epithelium to protect against the vibratory stress

21
Q

What is Reinke’s Space?

A

Space between:

1) Epithelium of the vocal fold lamina propria
2) Vocal ligament

22
Q

What is the general histological “theme” in the airway?

A
  • Larger airways have more diversity

- Smaller airways have much less diversity

23
Q

Describe the epithelium of the respiratory tract, and the various transitions that occur from proximal to distal.

A

1) Anatomic dead space i.e. to terminal bronchioles= pseudostratified ciliated columnar epithelium
2) Respiratory bronchioles= cuboidal cells, no cilia
3) Alveoli= simple squamous cells, no cilia

24
Q

Are there normally goblet cells in the bronchioles?

A

No

*Note that there ARE in smokers

25
Q

What are the basal cells of the airway?

A

Stem cells/ regenerative cells

26
Q

What is the name of the neuroendocrine cells in the airway?

A

Cells of Kolchinsky

27
Q

What are the brush cells in the airway?

A

Sensory receptors of the airway

28
Q

What major differences are there between the intrapulmonary bronchi and the more superior bronchi?

A

The intrapulmonary bronchus has:

1) Smooth muscle
2) Glandular secretions

29
Q

What are the components of the glandular secretions in the intrapulmonary bronchi?

A

1) Mucus
2) Lactoferrin (bactericidal)
3) Lyzozyme (bactericidal)
4) IgA
5) Alpha-1 antitrypsin

30
Q

How is the respiratory wall modified in asthma?

A

1) Increased mucus
2) Increased thickness of the basal lamina
3) Increased thickness of the lamina propria
- Edema
- Leukocytes
4) Increased thickness of the muscularis
5) Increased glands in the mucosa

31
Q

What is the Reid index used to diagnose?

A

Chronic bronchitis

32
Q

What is the Reid Index?

A

Gland thickness/ airway wall thickness

*In the ppt diagram, this is “bc/ad”

33
Q

What is the normal Reid Index?

A

Less than 0.4

34
Q

What is a Reid index that is positive for chronic bronchitis?

A

Greater than 0.5

gland is bigger relative to the wall

35
Q

Where do the majority of lung cancers originate?

A

First three divisions of the airway

  • Primary
  • Secondary
  • Tertiary

Bronchi

36
Q

How do bronchioles differ from the bronchi?

A

1) No cartilage
2) No submucosa
3) Goblet cells only in large bronchioles

37
Q

What are club/ clara cells? What are their functions?

A

These are cells found in terminal and respiratory bronchioles that:

1) Secrete a surfactant-like substance
2) Represent a stem-cell population
3) Degrade toxins

38
Q

What is a Type I pneumocyte?

A

Squamous cells (small) in the alveoli that function as the location of gas exchange

*Make up 97% of the surface area of the alveoli

39
Q

What is a Type II pneumocyte? What are the major functions of the Type II penumocytes?

A

Larger cells in the alveoli that:

1) Secrete surfactant
2) Function as stem cells i.e. can replace Type I pneumocytes
3) Secrete alpha-1 antitrypsin

40
Q

What are heart failure cells?

A

Macrophages that are breaking down RBCs

Respiratory (35 decks)

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