"Gross Anatomy Lungs Susan Stearns" SANA

Question 1

The thin serous membrane covering the boundaries of the thoracic cavity is called the _____________

Answer 1

Parietal pleura

Question 2

The thin membrane covering the boundaries of the lungs is called the ___________

Answer 2

Visceral pleura

Question 3

How does the pleural cavity help in maintaining lung inflation?

Answer 3

The pleural cavity contains the pleural fluid, which allows there to be surface tension between the lung surface and thoracic wall, thus sustaining inflation.

Question 4

Which structure marks the lower margins of the pleural cavity?

Answer 4

The costodiaphragmatic recess

Question 5

How far below the inferior margin of the lungs does the costodiaphragmatic recess extend?

Answer 5

2 ribs below the inferior borders of the lungs

Question 6

Name the four parts of the parietal pleura

Answer 6

Mediastinal pleura, costal pleura, diaphragmatic pleura and cervical pleura

Question 7

A patient stabbed in the side of his right chest comes into your ER. Upon imaging of the chest, you notice that the patient’s left lung is being compressed. Why is this happening?

Answer 7

The patient’s costodiaphragmatic recess has been punctured and the wound has probably reached the lung. Patient’s right lung has thus collapsed, so that when she inhaled, air enters her pleural cavity, and when she exhales, air is trapped in the cavity, causing the mediastinum to shift in the opposite side.

Question 8

Midclavicularly, the inferior border of the lung is at the ___ rib, while posteriorly, the inferior border of the lung is at the ____ rib

Answer 8

6th; 10th

Question 9

Midclavicularly, the inferior border of the pleura is at the ___ rib, while posteriorly, the inferior border of the pleura is at the ____ rib

Answer 9

8th, 12th

Question 10

What is a serious consequence of tension pneumothorax causing compression of the heart?

a. decreased venous return
b. increased cardiac output
c. decreased right atrial pressure
d. increased risk of pleural effusion

Answer 10

a: decreased venous return

Question 11

Where does most of the diaphragmatic pleura receive most of its sensory fibers from?

Answer 11

Phrenic nerve (C3-C5)

Question 12

A patient comes in to your office complaining of a sharp localized pain over his shoulders. This is likely caused by an inflammation of _____ called ______

Answer 12

Parietal (specificall, diaphragmatic) pleura; pleurisy

Question 13

The parietal pleura is mostly innervated by ______

Answer 13

Intercostal nerves

Question 14

Why is inflammation of the diaphragmatic pleura usually manifested in localized pain over the shoulders?

Answer 14

The phrenic nerves supplies the diaphragmatic pleura and has cervical origins

Question 15

A patient in the ICU has aspirated on some food. In which principal bronchi has the food probably lodged itself? Why?

Answer 15

Probably in the right principal bronchi as it is shorter, wider and more vertical than the left.

Question 16

What is a major way to identify a respiratory bronchiole?

Answer 16

Respiratory bronchioles have alveoli branching off

Question 17

All of the following are parts of the respiratory portion of the bronchial tree, except:

a. alveoli
b. Tertiary bronchi
c. respiratory bronchioles
d. type I alveolar epithelial cells

Answer 17

b: tertiary bronchi are part of the conducting portion.

The conduction portion consists of the trachea and the bronchi.

Question 18

What is the most distal structure in the conducting portion of the bronchial tree?

Answer 18

The terminal bronchiole

Question 19

The bifurcation of the trachea (at the carina) occurs at the levels of the:

a. 2nd rib
b. clavicle
c. sternal angle
d. manubrium

Answer 19

c: sternal angle

Question 20

What is the difference between Type I and type II alveolar epithelial cells?

Answer 20

type I cells function in gas exchange while type II cells produce surfactant

Question 21

Bronchopulmonary segments are served by ______ bronchi

Answer 21

tertiary

Question 22

A tumor localized to the left superior bronchopulmonary segment has been detected in your patient. If you elect to excise this tumor, what effect could this theoretically have on the other bronchopulmonary segments?

Answer 22

Minimum effect because bronchopulmonary segments are functionally independent units.

Question 23

A disease process that has infected a few alveolus in an alveolar sac is present in your patient. However, the patient’s alveoli are carrying on gas exchange as normal. How?

Answer 23

Collateral air flow has been established with the help of the pore of Kohn in neighboring, unaffected alveolus, thus allowing normal flow.

Question 24

Describe the pathway of the pulmonary arteries as they make their way to the alveoli with deoxygenated blood.

Answer 24

They flow the branching bronchial tree.

Question 25

How are the pulmonary veins formed?

Answer 25

oxygenated pulmonary capillaries from the alveoli unite to form intersegmental pulmonary veins, running in between bronchopulmonary segments, and coming together to form the pulmonary veins.

Question 26

At what structure do the intersegmental pulmonary veins join to form the right and left pulmonary veins?

Answer 26

The hilum of the lungs.

Question 27

What is the main difference in the pathway followed by the pulmonary arteries and the pulmonary veins?

Answer 27

The pulmonary arteries follow the branching bronchial tree while the intersegmental pulmonary veins organize in between the bronchopulmonary segment.

Question 28

What is the main function of the lymphatic system?

Answer 28

To pick up interstitial fluid leaked from the capillaries and other vessels.

Question 29

Arrange the following lymph nodes of the deep plexi from the most deep to the most superficial:
paratracheal nodes, pulmonary nodes, tracheobronchial nodes, bronchomediastinal lymph trunnks.

Answer 29

Pulmonary nodes –> tracheobronchial nodes –> paratracheal nodes –> bronchomediastinal lumph trunks.

Question 30

The pulmonary nodes are the first stop in the deep plexi drainage route and they are located at which level of bronchi?

Answer 30

Tertiary bronchi

Question 31

The superficial lymphatics drains into which nodes?

Answer 31

Bronchopulmonary/hilar nodes

Question 32

Your patient comes in which changed quality of voice and hoarseness. You determine that her bronchopulmonary nodes are enlarged on the left side. Why does she have hoarseness?

Answer 32

The enlarged nodes are compressing the left laryngeal nerve, causing the hoarseness.This is indicative of lung disease.

Question 33

A pancoast tumor can impinge on the sympathetic trunk. What symptoms can result from this?

Answer 33

Horner’s syndrome: myosis, ptosis, anhydrosis

Can also result in paresthesia and difficult limb movement

Question 34

Your patient complains of a sensation of fullness of head and neck, persistent headache, edema and dyspnea. When you ask him to raise his hand up above his head, , the veins in his arms do not empty. What disease is this likely?

Answer 34

Superior vena cava syndrome

Question 35

What are the components of the pulmonary plexus?

Answer 35

Parasympathetic fibers, sympathetic fibers, vagal affarent fibers and some ‘pain’ affarent fibers from the intercostal and phrenic nerves.

Question 36

Parasympathetics within the pulmonary plexus control the smooth musculature of the ______

Answer 36

airways (bronchoconstrict)

Question 37

Sympathetics within the pulmonary plexus control the smooth musculature of the ______

Answer 37

blood vessels (vasomotor)

Question 38

Match the following words:

1. Pulmonary arteries
2. Pulmonary veins
3. Hilum

a. site where root of lung is located (T5-T7)
b. Pressoreceptors
c. chemoreceptors

Answer 38

1-b
2-c
3-a

Question 39

A chronic smoker, with severe dyspnea comes into the emergency room. X-ray shows severely enlarged airwyas, and diminished lung functions tests. What is this likely?

Answer 39

Emphysema cauasing damage to lung elastic fibers.

Question 40

Match the following words:

1. Anatomic lung base
2. clinical lung base
3. oblique fissure
4. Horizontal fissure

a. divide the superior and middle lobes of right lung
b. diaphragmatic surface
c. divide superior and inferior lobes of both lungs
d. lowest point of inferior lobe

Answer 40

1-b
2-d
3-c
4-a