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MSS - CV Exam 1 > Heart and Lungs - 1 > Flashcards

Heart and Lungs - 1 Flashcards

1
Q

what is in the upper respiratory tract?

A

nose, nasal cavity, paranasal sinuses
pharynx
larynx

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2
Q

what is in the lower respiratory tract?

A

trachea
bronchii
lungs

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3
Q

what is contained in the pulmonary cavities?

A

lungs, pleura, pleural cavity

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4
Q

tracheobronchial tree?

A

multiple levels of airway branching from trachea to alveoli

18 to 22 divisions

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5
Q

course of trachea?

A

begins CV6
runs along midline
bifurcates at transverse thoracic plane

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6
Q

structure of trachea?

A

has C-shaped hyaline cartilage bars

posteriorly filled with trachealis muscle

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7
Q

trachealis

A

longitudinal smooth muscle on posterior portion of trachea cartilage

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8
Q

carina?

A

last cartilage ring located at bifurcation of trachea

projects into lumen

identifiable on chest xray

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9
Q

vascular supply for trachea?

A

bronchial, inferior thyroid vessels

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10
Q

lymphatic supply for trachea?

A

paratrachea lymph nodes

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11
Q

innervation of trachea?

A

recurrent laryngeal branches of vagus nerve

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12
Q

bronchial carcinomas?

A

can cause carina to be distorted

due to spread of metastatic cancer into tracheobronchial lymph nodes

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13
Q

right vs left bronchi?

A

right - wider, shorter, vertically oriented

**foreign objects more likely in right bronchi

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14
Q

secondary bronchi?

A

branches of primary

left - 2 branches
right - 3 branches

goes to the lobes of the lung

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15
Q

tertiary bronchi?

A

aka segmental bronchi

branches of the secondary bronchi

right - 10 segments
left - 8-10 segments

supply bronchopulmonary segments

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16
Q

branching of tertiary bronchi?

A

branch 18-20 times
bronchioles gives rise to alveolar ducts

alveolar ducts give rise to alveoli

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17
Q

alveoli

A

thin walled structures which compose parenchyma of lungs are and visualized with microscopy

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18
Q

composition of pleura

A

simple squamous epithelial cells and thin layer of loose connective tissue

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19
Q

function of pleura

A

smooth surface for lungs to move

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20
Q

secretions of pleura?

A

serosal fluid

fills pleural cavity and provides lubrication

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21
Q

visceral pleura

A

adherent to all external surfaces of lungs
-including fissures

continuous with parietal pleura at hilum of the lung

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22
Q

parietal pleura

A

lines internal surface of thoracic wall

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23
Q

surfaces of parietal pleura?

A

costal
diaphragmatic
mediastinal
cervical

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24
Q

mediastinal surface of parietal pleura

A

line mediastinal surfaces, continuous with visceral pleura at root of the lung

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25
Q

pulmonary ligament

A

formed by mediastinal surface of parietal pleura and the visceral pleura

inferior extension of pleura which assists in maintaining position of lung in thoracic cavity

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26
Q

cervical surface of parietal pleura

A

extends superiorly into root of neck reaching its apex slightly superior to neck of first rib

reinforced by suprapleura membrane

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27
Q

lines of reflection of parietal pleura?

A

vertebral - costal continuous with mediastinal posteriorly
costal - costal continuous with diaphragmatic inferiorly
sternal - costal continuous with mediastinal anteriorly

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28
Q

extent of cervical pleura?

A

significant because it may be punctured as a result of wound to this region

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29
Q

pleuritis?

A

pleura become inflamed and can no longer slide easily over each other

parietal pleura receives extensive sensory innervation fro intercostal and phrenic nerves

pain referred to area of thoracic wall or to point of shoulder via phrenic nerve (C345)

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30
Q

visceral pleura sensory nerves?

A

travel with autonomic fibers of bronchial vessels

31
Q

important location for pericardiocentesis?

A

left sternal reflection passes inferiorly in medial plane to level of 4th costal cartilage then turns alterally and inferiorly to level of 6th costal cartilage

creates notch allowing small part of pericardium to be in direct contact with anterior thoracic wall

32
Q

pleural recess?

A

area of pleural cavity which lung does not completely occupy during quiet respiration

two layers of parietal pleura come into contact with each other

with deep inspiration - lungs fill medially and inferiorly to the costomediastinal and costodiaphragmatic pleura recess

33
Q

costomediastinal pleura recess?

A

where mediastinal pleura contacts costal pleura anteriorly

34
Q

costodiaphragmatic pleura recess?

A

where costal pleura contacts diaphragmatic pleura (around periphery of diaphragm)

-can be inadvertently damaged during procedures or injuries to abdomen

35
Q

pneumothorax?

A

potential space of pleural cavity becomes a real space

air, blood, or fluid can accumulate in space

36
Q

tension pneumothorax?

A

air enters pleural space but cannot leave

results in shift in mediastinal contents to contralateral side because of increased pressure

37
Q

beck’s triad?

A

distended neck veins
muffled heart sounds
hypotension (low cardiac output)

signs of tension pneuomthorax**

38
Q

apex of lungs?

A

extends to level of neck of first ribs

39
Q

right lung?

A

at midclavicular - projects inferior to rib 6
at midaxillary - projects inferior to rib 8
at scapular - projects inferior to rib 10

2 interspaces above the parietal pleura

40
Q

left lung?

A

midsternal - projects inferiorly to rib 4, then turns inferolaterally to 6th righ MCL (creates cardiac notch)
midaxillary - projects inferior to rib 8
scapular - projects inferior to rib 10

2 interspaces above the parietal pleura

41
Q

cupula

A

apex of lung

42
Q

surfaces of lung?

A

costal, mediastinal, diaphragmatic

43
Q

hilum

A

area where all structures enter lung and leave lung (on mediastinal surface of lung)

44
Q

right lung lobes and fissures?

A

3 lobes - superior, middle, inferior

2 fissures - oblique and horizontal

45
Q

left lung lobes and fissures?

A

2 lobes - superior and inferior

1 fissure - oblique

46
Q

cardiac notch and lingula?

A

on the left lung

47
Q

oblique fissures?

A

begin posteriorly at level of 4th rib, pass anteroinferiorly, crossing 4th and 5th intercostal spaces to 6th rib and costal cartilage anteriorly

**in both lungs

48
Q

horizontal fissure?

A

follows course of 4th rib

**in right lung only

49
Q

root of lung?

A

all structures that enter or leave lung

pulmonary artery
pulmonary veins (superior and inferior)
primary bronchi (right superior may branch within lung)
bronchial arteries and veins - 1 right / 2 left
pulmonary plexus of nerves
lymphatic vessels and lymph nodes

50
Q

bronchopulmonary segment

A

smallest functional unit of lung

area supplied by 1 tertiary bronchus and associated branch of pulmonary artery

separated from adjacent segments by connective tissue septa

pulmonary veins run between bronchopulmonary segments

51
Q

disease of lung where?

A

lungs/abscesses often localized to bronchopulmonary segments

can be surgically resected without altering other segments

52
Q

pneumonectomy

A

surgical removal of one lung

53
Q

lobectomy

A

surgical removal of one lobe of one lung

54
Q

segmentectomy

A

surgical removal of a bronchopulmonary segment

55
Q

pulmonary arteries

A

carry poorly oxygenated blood from right ventricles to lungs

originate from pulmonary trunk at sternal angle

**branch and course with bronchial airways

56
Q

pulmonary veins

A

superior and inferior veins

return oxygenated blood to left atrium

originate from capillary beds around alveoli and course intersegmentally

57
Q

pulmonary embolism

A

when blood clot enters a pulmonary artery or one of its branches and blocks blood flow to a portion of lung
-life-threatening because of decreased blood oxygenation and obstruction of pulmonary blood flow

large emboli (block main artery)
-can result to death in matter of seconds to minutes

smaller emboli - pulmonary infarction

58
Q

bronchial arteries

A

originate from thoracic aorta

two on left, one on right
right often originates from 3rd right posterior intercostal artery

courses with bronchial tree
supply trachea and bronchii

59
Q

bronchial veins

A

course with bronchial arteries, terminate in azygous veins

60
Q

pulmonary nodes?

A

within substance of lung, along bronchial tree

61
Q

bronchopulmonary nodes

A

at hilum of lung

62
Q

trachobronchial nodes

A

at tracheal fiburcation

63
Q

subpleural plexus lymphatic system?

A

aka superficial

drains visceral pleura and most of lung parenchyma

drains to bronchopulmonary nodes > superior and inferior tracheobronchial nodes > bronchomediastinal trunk

64
Q

bronchomediastinal trunk

A

drains into the thoracic duct on the left and to the right lymphatic duct on the right

65
Q

deep pulmonary plexus

A

drains larger bronchioles and bronchi

drains to pulmonary nodes > bronchopulmonary nodes > tracheobronchial nodes > bronchomediastinal trunk

66
Q

lymph from left inferior lobe?

A

drains to right tracheobronchial nodes

67
Q

lymph drainage from parietal pleura

A

to thoracic wall

-mainly intercostal, but also parasternal, diaphragmatic, axillary lymph nodes

68
Q

innervation of lungs?

A

both sympathetic and parasympathetic innervation

69
Q

pulmonary plexuses

A

located along primary bronchi

continuation of deep cardiac plexus

70
Q

sympathetic innervation of lungs?

A

preganglionic T2-T6

postganglionic upper thoracic and cervical portions of sympathetic chain ganglion

postganglionic nerve cells processes from cardiac branches which are called cardiopulmonary splanchnic nerves

efferent: vasoconstriction, bronchodilation, inhibit gland secretion

71
Q

primary sympathetic innervation of lungs?

A

cardiopulmonary splanchnic nerves

72
Q

parasympathetic innervation of lungs?

A

preganglionic nerve cell bodies in brain stem, processes travel with vagus nerve

in thorax, vagus gives off thoracic cardiac parasympathetic branches

postganglionic nerve cell bodies are in wall of arteries

efferent: vasodilation, bronchoconstriction, gland secretion

73
Q

innervation of parietal pleura?

A

via nerves supplying thoraci wall including intercostal and phrenic

pain referred to area of thoracic wall supplied by intercostal nerve or to root of neck/shoulder via phrenic nerve

MSS - CV Exam 1 (14 decks)

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