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Human Structure - Block 2 > HS2-15 Lungs and Pleura > Flashcards

HS2-15 Lungs and Pleura Flashcards

1
Q

Describe the process of gas exchange in the lungs.

A

deoxygenated blood from heart enters lungs via pulmonary trunk + pulmonary arteries

oxygenated blood flows from lungs to heart via pulmonary vein

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2
Q

Compare the size and weight of the two lungs.

A

right lung is wider and heavier than left

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3
Q

What fissures are found on the right lung?

A

oblique

horizontal

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4
Q

What lobes are found in the right lung?

A

superior

middle

inferior

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5
Q

Which lung is taller?

A

left lung

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6
Q

What fissures are found on the left lung?

A

only oblique fissure

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7
Q

What lobes are found on the left lung?

A

superior (featuring cardiac notch + lingula)

inferior

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8
Q

Impressions on the lung are found on which lung?

A

left lung (cardiac + aortic impressions)

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9
Q

What structures are found in the hilum, the root of the lung? (5)

A

bronchi

pulmonary arteries/veins

bronchial arteries/veins

pulmonary plexus

lymph vessels/nodes

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10
Q

Describe the arrangement of structures in the left lung hilum. Draw a diagram.

A

1 pulmonary artery superior to 1 main bronchus

pulmonary veins anterior and inferior to bronchus and artery

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11
Q

Describe the arrangement of structures in the right lung hilum. Draw a diagram.

A

1 lobar bronchus superior to main bronchus

2 pulmonary arteries, one slightly superior and anterior to each bronchus

pulmonary veins anterior and inferior to bronchi and arteries

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12
Q

What is the hierarchy of bronchi?

A

principal = main

secondary = lobar

tertiary = segmental

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13
Q

Why are inhaled objects more likely to get stuck in the right bronchus?

A

because the right bronchus is wider, shorter, and more vertically oriented

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14
Q

How many secondary/lobar bronchi are there?

A

2 left

3 right

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15
Q

What is the function of bronchial arteries?

A

supply oxygenated blood to lung tissue

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16
Q

How many bronchial arteries are there?

A

2 from thoracic aorta (supply left lung)

1 from first intercostal artery -or- superior left bronchial artery (supplies right lung)

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17
Q

What is the function of the bronchial veins?

A

drain deoxygenated blood from lung tissue

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18
Q

The bronchial veins drain into

A

azygos vein (right)

hemiazygos vein (left)

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19
Q

What are the two layers of pleura?

A

parietal

visceral

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20
Q

The parietal pleura covers

A

parts of the thoracic wall, and some of the thoracic contents

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21
Q

What are the subtypes of parietal pleura found in the thoracic cavity? (4)

A

costal

mediastinal

diaphragmatic

cervical (a.k.a. cupola)

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22
Q

Describe the features of cervical pleura. (3)

A

covers apex of lung

extends an inch above clavicle, therefore reaching into neck

also called the cupola

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23
Q

The visceral pleura covers

A

lungs

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24
Q

The visceral pleura is continuous with

A

the parietal pleura at the root of the lung

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25
Q

What is the pleural cavity?

A

space between parietal and visceral pleura

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26
Q

What is the function of the pleural fluid found in the pleural cavity? (2)

A

reduces friction

produces surface tension that keeps parietal and visceral pleural stuck to each other

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27
Q

What are lines of pleural reflection?

A

where one type of parietal pleura becomes continuous with another (ie. changes surfaces)

28
Q

What are pleural recesses?

A

areas where two layers of parietal pleura are not separated by lung during quiet respiration

29
Q

What are the three functionally significant pleural recesses?

A

right costodiaphragmatic recess

left costodiaphragmatic recess

left costomediastinal recess

30
Q

What is the significance of the right and left costodiaphragmatic recesses?

A

can accommodate inferior margins of lungs

31
Q

What is the significance of the left costomediastinal recess? (2)

A

exists due to leftward bulge of heart

accommodates lingula of left lung

32
Q

What is the innervation to the visceral pleura?

A

autonomic innervation from vagus + sympathetic trunk

33
Q

(T/F) The visceral pleura are insensitive to pain.

A

True

34
Q

What is the innervation to the parietal pleura? (1, +2)

A

somatic innervation:

costal pleura = intercostal nerves

diaphragmatic + mediastinal pleura = phrenic nerve

35
Q

Describe how the vertical plane of the thorax changes during respiration.

A

diaphgram contracts and moves inferiorly

36
Q

Describe how the transverse plane of the thorax changes during respiration. (2)

A

ribs 2-10 elevate in bucket handle motion

lateral edges of ribs move away from midline

37
Q

Describe how the anteroposterior plane of the thorax changes during respiration.

A

sternum moves superiorly in pump handle motion

anterior ends of ribs 2-6 elevate

38
Q

What are the muscles associated with quiet inspiration?

A

diaphragm

39
Q

What are the muscles associated with forced inspiration? (1 +3, 1 +3)

A

primary = external intercostals, scalenes, sternocleidomastoid

secondary = pectoralis major/minor, serratus anterior, serratus posterior superior/inferior

40
Q

What are the muscles associated with quiet expiration? (2)

A

relaxation of diaphragm

elastic recoil of lung tissue

41
Q

What are the muscles associated with forced expiration?

A

contraction of internal + innermost intercostal muscles

42
Q

Describe the mechanism of forced expiration.

A

contraction of internal and innermost intercostal muscles pulls ribs and sternum inferiorly

increase in abdominal pressure causes diaphragm to move superiorly

43
Q

What are the three common views of chest x-rays?

A

PA (posterior anterior) = frontal view, standing

lateral = lateral view, standing

AP (anterior posterior) frontal view, supine

44
Q

How is the heart imaged in the AP view?

A

because the heart is positioned further from the director, it is artifically magnified in size

45
Q

What is echocardiography?

A

ultrasound of the heart

46
Q

What is mammography?

A

specialized radiographic technique used to image the breast

47
Q

What are the bronchi?

A

main two stems of the trachea

48
Q

What is the carina?

A

branching point of main stem bronchi

49
Q

What is main stem bronchus intubation?

A

placement of an endotracheal tube that preferrably ends up in the mid trachea, proximal to the carina

50
Q

Where do malpositioned endotracheal tubes most commonly end up?

A

right main stem bronchus (for the same reason that inhaled objects tend to end up in the right main stem bronchus)

51
Q

How can a right main stem bronchus intubation affect the left lung?

A

can cause left lung collapse due to lack of ventilation on the left side caused by malpositioned tube in right side

52
Q

Differentiate between the left and right hilums in chest radiography.

A

left hilum is slightly higher than right hilum on chest x-ray

53
Q

Describe the visualization of right middle lobe pneumonia on chest x-ray.

A

abnormal, triangularly-shaped opacity that demonstrate’s the right middle lobe’s characteristic triangular shape

54
Q

Which type of chest x-ray is best for visualizing right middle lobe pneumonia?

A

lateral CXR

55
Q

What is pneumothorax?

A

presence of air in pleural space

56
Q

What is the effect of pneumothorax on the visceral and parietal pleura?

A

air occupies pleural space and pushes visceral pleura away from parietal pleura

57
Q

(T/F) In its normal state, the visceral pleura is visualizable on CXR.

A

False. That’s why if you do actually see the visceral pleura on CXR, something is not normal (such as pneumothorax).

58
Q

Where on a CXR is pneumothorax most easily visualized?

A

in the superior thorax/apical region

59
Q

In what patient position is pneumothorax most easily visualized on CXR?

A

patient in upright position

60
Q

Write out a table that shows where the lungs and parietal pleura end at the midclavicular, midaxillary, and midscapular lines.

A
61
Q

Where does the costodiaphragmatic recess extend to, posteriorly?

A

12th rib @ midscapular line

62
Q

Where does the costodiaphragmatic recess extend to, laterally?

A

extends to 10th rib @midaxillary line

63
Q

Where does the costodiaphragmatic recess extend to, anteriorly?

A

extends to 8th rib @ midclavicular line

64
Q

Which of the costodiaphragmatic recesses are best seen on CXR?

A

lateral and posterior

65
Q

Where does fluid preferentially accumulate in the pleural cavity of the thorax?

A

the lateral and posterior costodiaphragmatic recesses, because they are the most inferior regions of the thorax

66
Q

How is pleural fluid typically seen on CXR?

A

homogeneous opacity that “blunts” the typical costodiaphragmatic angle and has a concave meniscus

67
Q

Describe the movement of air after the trachea.

A

trachea

↓

principal/main bronchi

↓

secondary/lobar bronchi

↓

tertiary/segmental bronchi

↓

bronchopulmonary segments

Human Structure - Block 2 (22 decks)

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