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HSF > HSF 2 - Unit 2 Anatomy: Lungs and the Pleurae > Flashcards

HSF 2 - Unit 2 Anatomy: Lungs and the Pleurae Flashcards

1
Q

what are the anatomical components of the respiratory system?

A

diaphragm, rib cage, intercostal muscles, abdominal muscles, elastic CT (lungs)

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2
Q

what causes inspiration and expiration?

A

pressure differences move air into and out of the lungs

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3
Q

what are the functions of the respiratory system?

A

conducts and conditions inspired air, gas exchange between air and blood, olfaction, phonation, defense (components of immune system in the walls; coughing)

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4
Q

right and left lungs are contained within separate _______ _____

A

pleural sacs

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5
Q

how are the right and left lungs separated from one another?

A

by the heart and great vessels (middle mediastinum)

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6
Q

why are the lungs elastic?

A

elastic fibers in the walls of the alveoli

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7
Q

what forms the pleural cavity?

A

visceral (organ) and parietal (wall of cavity) pleura

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8
Q

how are the lungs suspended?

A

from the mediastinum by the lung root - collection of structures entering and leaving the lungs; the medial surfaces of both lungs lie in close proximity to several mediastinal structures

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9
Q

what is the apex of the lung?

A

covered by cervical pleura and projects 2-3 cm through the superior thoracic aperture into the root of the neck

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10
Q

what is the base of the lung?

A

it is against the dome of the diaphragm

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11
Q

what is the costal surface of the lung?

A

it is adjacent to the sternum, costal cartilages, rubs, and vertebrae

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12
Q

what is the mediastinal surface of the lung?

A

adjacent to the mediastinum

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13
Q

what is the anterior border of the lung?

A

where costal and mediastinal surfaces meet anteriorly and overlap the heart

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14
Q

what is the posterior border of the lung?

A

where the costal and mediastinal surfaces meet broad and rounded

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15
Q

what are the characteristics of the right lung?

A

3 lobes: superior, middle, inferior lobes; oblique fissure between superior/middle and inferior and horizontal fissure between superior and middle; larger and heavier than left lung, also shorter and wider

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16
Q

what are the characteristics of the left lung?

A

2 lobes: superior and inferior; separated by oblique fissure; has the cardiac notch for the heart and the lingula which is analogous to the middle lobe of the right lung

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17
Q

what is the root of the lung?

A

structures contained in the pulmonary sleeve and entering the hilum of the lung

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18
Q

what is the hilum of the lung?

A

refers to the area where the structures forming the root of the lung actually touch lung tissue

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19
Q

what is the pulmonary ligament?

A

where the mediastinal pleura passes laterally from the mediastinum to the visceral surface of the lung

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20
Q

what structures form the root of the lung?

A

pulmonary arteries (superior), main bronchi (posterior), pulmonary veins (1 anterior, 1 inferior); in right root bronchus to superior lobe may be most superior structure rather than pulmonary arteries

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21
Q

what are impressions on the right lung surface?

A

azygous vein, right brachiocephalic vein, superior vena cava, esophagus, heart

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22
Q

what are the impressions of the left lung surface?

A

aortic arch, descending aorta, subclavian artery, cardiac impression, esophagus

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23
Q

what are the primary bronchi? what is their epithelial type?

A

two of them; left and right; lined by respiratory epithelium; right bronchi has a smaller angle relative to the trachea and is thus more likely to aspirate things

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24
Q

what is respiratory epithelium?

A

pseudostratified columnar epithelium with goblet cells

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25
Q

what are the secondary bronchi?

A

number of secondary bronchi = number of lobes; also called lobar bronchi; wall structure is similar to main bronchi except that supporting cartilages form irregular plates or islands rather than rings

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26
Q

what are the tertiary bronchi?

A

smaller diameter than lobar bronchi, multiple branchings and eventually bronchioles

27
Q

what is a bronchopulmonary segment? what does each consist of?

A

the anatomical, functional and surgical unit (subdivision) of the lungs; each consists of a segmental bronchus, a segmental branch of the pulmonary artery, and a segment of lung tissue surrounded by a thin CT septum; they are drained by intersegmental pulmonary veins (in the CT between adjacent segments)

28
Q

what happens in gas exchange?

A

occurs between air in the alveoli and blood in the capillaries; oxygen diffuses across the alveolar wall and enters the bloodstream, while CO2 diffuses from the blood across the alveolar wall to enter the alveoli

29
Q

pulmonary arteries run

A

parallel to the bronchi, usually on the anterior aspect of the corresponding bronchus

30
Q

pulmonary veins run

A

independent courses from arteries and bronchi

31
Q

bronchial arteries supply

A

blood for nutrition of structures of the root of the lungs, supporting tissues of the lungs, and visceral pleura

32
Q

bronchial veins drain

A

into the azygos (R) or accessory hemiazygos system/superior intercostal (L)

33
Q

what drains to the pulmonary veins?

A

some parts of the lung (visceral pleura, peripheral/distal portions drain to pulmonary veins)

34
Q

what are the general features of the pleural membrane?

A

serous membranes forming closed sacs: 2 layers, visceral pleura (continuous with parietal pleura at the root of the lung) and parietal pleura (lines the thoracic cavity)

35
Q

what is the purpose of the pleural cavity?

A

contains a small amount fo serous pleural fluid that lubricates pleural surfaces and allows layers to slide smoothly over one another during respiration

36
Q

what are the pleural reflections?

A

sternal line of pleural reflection; vertebral line of pleural reflection; costal line of pleural reflection

37
Q

sternal line of pleural reflection

A

anterior, occurs where the costal pleura becomes continuous with the mediastinal pleura, sharp and abrupt

38
Q

vertebral line of pleural reflection

A

this is the posterior counterpart of the sternal line, occurs where the costal pleura becomes continuous with the mediastinal pleura posteriorly, rounder and more gradual than the anterior

39
Q

costal line of pleural reflection

A

sharp, occurs where the costal pleura becomes continuous with diaphragmatic pleura inferiorly

40
Q

what are pleural recesses?

A

places where the parietal pleura apposes each other; lung does not fill these places unless with forced deep inspirations; provides spaces in which fluid can collect in certain diseases and are areas for aspiration and or drainage of fluid

41
Q

what are the 2 pleural recesses?

A

costomediastinal recess, costodiaphragmatic recess

42
Q

costomediastinal recesses

A

posterior to the sternum, left recess markedly larger than on the right side because of the cardiac notch

43
Q

costodiaphragmatic recesses

A

located superiorly to the diaphragmatic dome, more pronounced from 8th to 10th ribs, contains only pleural fluids so is ideal site for thoracentesis

44
Q

what is a thoracentesis?

A

a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall; done to remove excess fluid, known as a pleural effusion, from the pleural space to help the patient breathe easier, it may be done to determine the cause of the pleural effusion

45
Q

where is the needle inserted for a thoracentesis? why?

A

right above rib 8; so it is below lungs, in the costodiaphragmatic recess

46
Q

how could we explain parasthesia from a thoracentesis?

A

normally caused by some sort of nervous insult; impingement, cutting, or rough handling of a cutaneous nerve during a medical procedure

47
Q

what are the symptoms and treatments of a pneumothorax? tension pneumothorax?

A

sudden chest pain and shortness of breath; inserting a flexible tube or needle between the ribs to remove the excess air, small ones may heal on their own; rapid HR, anxiety, shallow breathing, blue or ashen skin; catheter used to treat

48
Q

subpleural blebs

A

air filled spaces between the lung parenchyma and the visceral pleura

49
Q

subpleural bullae

A

air filled spaces within the lung parenchyma itself

50
Q

what is the blood supply of the visceral pleura?

A

arterial: supplied by branches of the bronchial and pulmonary arterial systems
venous: drain to the pulmonary vein

51
Q

what is the blood supply of the parietal pleura?

A

arterial: cervial pleura - intercostal vessels
costal pleura - intercostal vessels
diaphragmatic pleura intercostal vessels (periphery) and outer portion - intercostal vessels and pericardiacophrenic vessels (central tendon)
mediastinal pleura - pericardiacophrenic vessels

52
Q

what is the nerve supply of the parietal pleura?

A

sensitive to pain, temperature, touch, and pressure
costal - segmentally supplied by intercostal nn.
mediastinal - supplied by phrenic n.
diaphragmatic - supplied over the domes by the phrenic n. and around the periphery by the lower six intercostal nn.

53
Q

what is the nerve supply of the visceral pleura?

A

sensitive to stretch but is insensitive to common sensations such as pain and touch. it receives an autonomic nerve supply from the pulmonary plexus

54
Q

nerves enter at _____ and run in the ______ around ________

A

root, CT, the airways

55
Q

what stimulates bronchial constriction? dilation?

A

vagus n. (CN X), parasympathetic fibers, respiratory prioception are stretch receptors from CN X; sympathetic fibers cause dilation (thoracic organ/splanchnic nerves)

56
Q

what do sensory fibers do in the respiratory system?

A

carry visceral afferents; poorly localized pain, monitor airway irritants and are involved in the cough reflex

57
Q

what is asthma a result of? what are the types? what is the treatment?

A

inflammation, mucus plugging account of bronchial smooth muscle hyperactivity; extrinsic and intrinsic; oxygen and beta-2 agonists (albuterol) act to cause smooth muscle relaxation, binds to epinephrine sympatheomimetic bronchodilators (e.g. epinephrine)

58
Q

what do lymph nodes around bronchi do?

A

around bronchi and within the CT pick up carbon, dust particles and pollutants not filtered by the epithelium

59
Q

what is the lymph flow in the lungs?

A

pulmonary nodes in the lung - bronchopulmonary nodes (hilum) - tracheobronchial nodes - L/R bronchomediastinal trunks

60
Q

what is an MPM?

A

malignant pleural mesothelioma; rare and aggressive form of cancer that originates in the pleura; approximately 85% of cases of MPM are thought to be due to past exposure to asbestos, which is usually occupation related; most common symptom is shortness of breath that is typically caused by a pleural effusion, which is fluid that accumulates around the lung due to secretion of fluid by tumor cells, and the fluid does not allow the lung to fully expand. chest pain, cough, weight loss, generalized malaise, and occasionally fevers may also be present

61
Q

what is emphysema?

A

smoking-related disease; main form of COPD; loss of area (alveoli) available for gas exchange due to destruction of elastic tissue; alveoli lose the ability to stretch and recoil, alveoli expand but cant contract/exhale air; stagnant, oxygen-poor air becomes trapped in the dilated alveoli and barrel chest can result

62
Q

what is pneumonia?

A

left lung affected by bacterial pneumonia (could be viral or fungal), may involve segment, lobe, or entire lung; swelling of alveolar walls and fluid in the alveolar spaces; reduces capacity for gas exchange; acute inflammation caused by the infection resulted in the solidification of the lower lobe, which became filled with inflammatory cells and exuded plasma rather than air

63
Q

what is bronchogenic carcinoma? what are the signs?

A

lung gets infiltrated by a large carcinoma arising from the main bronchus, can obstruct the bronchi; weight loss, dysphagia, dyspnea and chronic cough, hemoptysis and malignant squamous cells from sputum analysis; atelectasis (collapse or closure of a lung resulting in reduced or absent gas exchange) and hoarseness due to involvement of left recurrent laryngeal nerve

64
Q

why does hoarseness present with lung cancer patients?

A

result of recurrent laryngeal nerve palsy (paralysis or weakness in that nerve); tumors in the left lung can press on the nerve, causing hoarseness, or recurrent laryngeal nerve palsy

HSF (23 decks)

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