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RESP > Lecture 1: Respiratory system > Flashcards

Lecture 1: Respiratory system Flashcards

1
Q

How does the respiratory system develop?

A

As a ‘diverticulum’ (pouching) from your gut

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2
Q

What are the functions of the nasal cavity?

A

-olfaction (smell)
-warm (cold air can irritate the airways) and moistens inspired air (easy diffusion)
-recovers moisture from the expired air
-speech production
Reliant on the huge SA of the nasal mucosa

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3
Q

What epithelium sits at the top of the nasal cavity?

A

Olfactory epithelium

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4
Q

How is the nasal epithelium adapted?

A

Nasal conchae- scrolls coming off, increasing the SA

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5
Q

What plane is the floor of the nasal cavity in?

A

Horizontal plane

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6
Q

How is the nasal cavity connected to the oral cavity?

A

Via the pharynx

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7
Q

What are the 3 sections of the pharynx?

A

(superior to inferior)

  • nasopharynx
  • oropharynx
  • laryngopharynx
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8
Q

What are paranasal sinuses?

A

Air spaces which surround your nasal cavity and lighten the head

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9
Q

What is the function of the larynx?

A
  • speech

- making sure that food doesn’t go into the airways (via the epiglottis)

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10
Q

What are the different sections of the upper airway (in order)?

A

(proximal to distal)

  • larynx
  • trachea (composed of horse shoe shaped rings of cartilage)
  • primary (main) bronchi
  • secondary (lobar) bronchi: go to each individual lobe of each lung
  • tertiary (segmental) bronchi: go to individual segments within each lobe
  • bronchioles
  • terminal bronchioles
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11
Q

Why does the trachea not contain full rings of cartilage?

A

Allows the oesophagus to bulge into the trachea, allowing larger sizes of food to pass through it

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12
Q

How many lobes do the lungs have?

A

Right: 3 lobes (superior, middle, inferior)
Left: 2 lobes (superior and inferior)

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13
Q

What bones surround the thoracic cavity to form a ‘wall’?

A

-ribs
-vertebrae
-sternum
(diaphragm is the floor)

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14
Q

What is the opening at the top of the ribcage called?

A

Superior thoracic aperture

the inferior thoracic aperture is covered up by the diaphragm

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15
Q

What is the thoracic cage’s primary component?

A

The ribs. They start posteriorly with the head of the rib and then curve round to the front of the body until they articulate with the costal cartilage

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16
Q

How many points of articulation are there b/w the ribs and the vertebrae?

A

3 points on the posterior/proximal portion of the rib
-superior and inferior articular facets
-articular facet on side (transverse process one)
Articulate withe the body of the vertebrae and the transverse processes

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17
Q

What separates the left and right lungs?

A

Mediastinum

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18
Q

How do you increase the volume of the thorax?

A
  • lateral dimension increases due to the ‘bucket handle movement’
  • sternum moves upwards and forwards due to the ‘pump handle movement’: increases the AP dimension (anterior/posterior)
  • diaphragm (flattens when you breath in)
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19
Q

How does air enter the lungs?

A

Air is not forced into the lungs, it enters due to a pressure decrease inside the body

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20
Q

What shape is the diaphragm?

A

Dome structure, and is attached to the inferior thoracic aperture

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21
Q

How is the diaphragm innervated?

A

Right and left phrenic nerves (from the C3-5)
C 345 KEEPS THE DIAPHRAGM ALIVE
-motor to diaphragm
-sensory to diaphragm and pericardium
-diaphragm originated up near the neck then descended inferiorly, hence the cervical innervation

22
Q

What is the function of the intercostal muscles?

A

-ventilation (moreso during forced ventilation during exercise, in normal breathing the diapragm contributes more)

23
Q

How are the intercostal muscles arranged?

A

3 layers

  • external: fibres run in anteroinferior direction (most superficial)
  • internal: fibres run perpendicular to the external fibres
  • innermost: fibres run in the same direction as the internal fibres
24
Q

What/where is the neurovascular supply to the intercostal muscles?

A

Found b/w internal and innermost intercostal muscles
-major bundle which sits below each rib
-minor bundle which sits above each rib
(try to cut above a rib rather than below it to avoid trauma to the major bundle)

25
Q

What structures pierce the diaphragm?

A
  • inferior vena cava (passes through at T8)
  • oesophagus (T10)
  • aorta (T12) (passes through the aortic hiatus)
26
Q

What structures pass through the aortic hiatus?

A
  • aorta

- thoracic duct

27
Q

Why do people bend down after then have done exercise?

A

Using the accessory muscles of respiration

-pectoral muscles

28
Q

What muscles do people with COPD use for respiration?

A

-SCM to raise up thoracic cage (accessory muscles)

29
Q

What is the blood supply to the intercostal muscles?

A

-Intercostal artery branches off from the aorta
-Internal thoracic arteries which give off intercostal arteries which extend round the front
DUAL BLOOD SUPPLY= RISK FACTOR FOR BLEEDING

30
Q

What is the venous drainage of the intercostal muscles?

A

Azygous (unpaired) vein: not paried to an artery

  • main azygous vein sits to the right
  • additional vessles from the azygous that drain the left hand side
  • need this to drain the muscle near the heart
31
Q

Why do people get pain in their neck/shoulder during an MI?

A

If the pericardium gets irritated, this gets picked up by the phrenic nerve, which originates fron the cervical spine

32
Q

What are the lobes in the lung separated by?

A

Fissures

  • oblique fissure separating the lower lobe from the rest of the lung
  • transverse fissure between the superior lobes in thr right lung
33
Q

Why are the fissures of the lung anatomically important?

A

Most of the back of the lung is inferior lobe due to the oblique fissure. Significant as when you listen to the lungs, you listen on the back.

Transverse fissure can fill with fluid- can see this on chest X-Ray

34
Q

Which bronchus sits more straight and what is its significance?

A

The right side bronchus. The left side bronchus sits at more of an angle, so therefore most inhaled forgein bodies go down the right hand side due to the shallower angle.

35
Q

What are the subdivisions of the medisatinum?

A

Superior and inferior, split by a plane that passes through the angle of louis (sternal angle- notch b/w manubrium and sternum) (T4/5 level)

36
Q

What is found in the superior mediastinum?

A

All the stuctures comminucating with the neck.

37
Q

What is found in the inferior mediastinum?

A

Separated into 3 sections
Anterior: in front of heart, mostly fat
Middle: heart and pericardium
Posterior: behind the heart, aorta, oesophagus, azygous veins, thoracic duct

38
Q

What is the hilum of a structure?

A

Where you have vessels going in and out

39
Q

What 3 major structures are found in the hilum of the lung?

A
  • pulmonary artery
  • pulmonary vein
  • bronchi
40
Q

What is the pleura?

A

Serous membrane
Viscera: area of membrane in contact with the lungs
Parietal: area of membrane in contact with the thoracic wall
Cavity b/w the two filled with fluid
Reflections of the membrane

41
Q

If you hit the parietal pleura will it hurt?

A

Yes, it has a rich somatic innervation from the intercostal nerves (visceral pleura doesn’t feel pain the same way as the parietal pleura)

42
Q

What is it called when fluid enters the pleural cavity?

A

Pleural effusion

43
Q

What is the function of the pleural fluid?

A

Transmits forces from the thorax to allow the lungs to ventilate

44
Q

What is the name of the angle at the lateral base of the ribs called?

A

Costophrenic angle- creates by the shape of the diaphragm and the ribs

45
Q

What is the costophrenic recess?

A

The lower most portion of the pleura forming the costophrenic angle

46
Q

Where does the pleura extend into superiorly/medially?

A

Superiorly into the neck- pleura may be damaged if there is a neck stabbing
Medially, very near the midline
You try not to cut the pleura during heart surgery, as this can cause air to enter the pleural cavity and create a pneumothorax

47
Q

Where does the pleura extend inferiorly?

A

Below the lungs to allow the lungs to expand when we take a huge breath in= this part is known as the costophrenic recess

48
Q

What is the blood supply to the lungs?

A

Pulmonary artery, however if there is a pulmonary embolism in a branch of the pulmonary artery, only part of the lung dies suggesting there is another blood source: Bronchial arteries

49
Q

Why is the right side of the diaphragm higher than the left side?

A

The liver pushes up upwards (the liver is partly underneath the ribs)

50
Q

Why is it important to know that the diaphragm is quite superior/very domed?

A

Because it means that many abdominal features are underneath the ribs

51
Q

What are the signs of a pneumothorax on X-Ray?

A

-trachea deviated to the right (trachea appears dark)
-air in the pleural cavity
Air appears black
(can get a pneumothorax if a central line enters the apex of the lung)

RESP (18 decks)

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