Lower Respiratory Tract

Question 1

What is the rough diameter of the bronchioles?

Answer 1

<1mm

Question 2

What is the difference between the structure of the bronchioles and the bronchi?

Answer 2

Mostly smooth muscle, no glands, simple columnar or cuboidal epithelium, gradual decrease in goblet cells and cilia

Question 3

What helps to support the alveoli structure?

Answer 3

Elastic fibres

Question 4

What epithelium lines the alveoli?

Answer 4

Simple squamous

Question 5

Which cells are involved in gas exchange in the alveoli?

Answer 5

Type I pneumocytes

Question 6

What cells are there to provide immune defense in the alveoli?

Answer 6

Alveolar macrophages

Question 7

Why are type II pneumocytes important?

Answer 7

Produce surfactant which reduces the surface tension and prevents alveolar collapse during expiration.

Question 8

What separates the capillary endothelium from the alveolar epithelium?

Answer 8

Interstitium

Question 9

What is the space between two alveoli called?

Answer 9

Alveolar septum

Question 10

Where does the lower respiratory tract start?

Answer 10

Trachea

Question 11

Describe the division of the trachea into bronchi

Answer 11

Trachea > principal bronchi > lobar bronchi > segmental bronchi

Question 12

Which bronchi bifurcates first and is wider?

Answer 12

Right

Question 13

The left main bronchus passes under what structure?

Answer 13

Arch of aorta

Question 14

What lies posterior to the trachea?

Answer 14

Oesophegus

Question 15

What is the conduction part of the respiratory system?

Answer 15

From the nose to the terminal bronchioles

Question 16

What is the respiratory part of the respiratory system?

Answer 16

Respiratory bronchioles and alveoli

Question 17

What is the significance of the broncho-pulmonary segments?

Answer 17

They are functionally separate and have their own arterial supply and segmental bronchi. This means they can be respected without affecting the surrounding segments.

Question 18

How many segments does the left lung have?

Answer 18

Between 8-10

Question 19

What are the superior and lingula segments of the left lung?

Answer 19

Superior apical, posterior, anterior, superior lingula and inferior lingula

Question 20

What are the inferior segments of the left lung?

Answer 20

Apical basal, medial basal, anterior basal, lateral basal, posterior basal.

Question 21

Which segments in the left lung can be combined in some patients?

Answer 21

Superior apical and posterior

Question 22

Which segment in the left lung can be absent or small and what segment can it share it’s bronchi with?

Answer 22

Medial basal, anterior basal

Question 23

Which two segments of the lungs are most likely to collect secretions and fluid in a patient who is supine?

Answer 23

Apical basal and posterior basal

Question 24

How many lobes does the right lung have?

Answer 24

3

Question 25

How many segments does the right lung have?

Answer 25

10

Question 26

What are the segments of the upper lobe of the right lung?

Answer 26

Apical, posterior, anterior

Question 27

What are the segments of the middle lobe of the right lung?

Answer 27

Lateral and medial

Question 28

What are the segments of the inferior lobe of the right lung?

Answer 28

Apical basal, medial basal, anterior basal, lateral basal, posterior basal

Question 29

What acronym can you use to remember the upper and lower lobes of the right lung respectively?

Answer 29

APALM, AMALP

Question 30

What does the horizontal fissure separate in the right lung?

Answer 30

Middle and superior lobe

Question 31

Which lung has the deepest cardiac impression?

Answer 31

Left

Question 32

The diaphragmatic surface of which lung is higher up? Why?

Answer 32

Right lung, liver

Question 33

What lies under the diaphragm on the left side?

Answer 33

Stomach

Question 34

What vessels make an impression on the left lung?

Answer 34

Aortic arch, descending aorta

Question 35

What vessels make an impression on the right lung?

Answer 35

Superior and inferior vena cava, arch of azygous veins

Question 36

What structures does the hilum provide a doorway into the lungs for?

Answer 36

Principle bronchus, bronchial arteries & veins, broncho-pulmonary lymph nodes, pulmonary artery, 2x pulmonary veins, pulmonary plexus.

Question 37

The branches of which nerves make up the pulmonary plexus?

Answer 37

CN X (Vagus) and ganglia from the sympathetic chain

Question 38

Describe the positions of the main structures entering the hilum?

Answer 38

Pulmonary artery lies superiorly, the two pulmonary veins lie inferiorly and posteriorly, the bronchus usually lies between the them.

Question 39

Where does the phrenic nerve arise and what does it supply?

Answer 39

C3-5, cervical plexus. Motor and sensory function to the diaphragm.

Question 40

Where does the phrenic nerve run in relation to the hilum?

Answer 40

Anterior

Question 41

Where does the Vagus nerve runs in relation to the hilum?

Answer 41

Posterior

Question 42

What delivers deoxygenated blood to the lungs and where does it arise from?

Answer 42

Pulmonary arteries -> pulmonary trunk -> right ventricle

Question 43

How many pulmonary veins are there in total?

Answer 43

4

Question 44

What carries oxygenated blood back to the heart?

Answer 44

Pulmonary veins

Question 45

Where do the bronchial arteries arise from?

Answer 45

Descending thoracic aorta

Question 46

Where does the right bronchial vein drain?

Answer 46

Azygous vein

Question 47

Where does the left bronchial vein drain?

Answer 47

Accessory hemi-azygous vein

Question 48

What supplies parasympathetic innervation to the lungs and what outcome does this have?

Answer 48

Vagus nerve (X), stimulate gland secretion, contraction of bronchial smooth muscle and vasodilation of pulmonary vessels

Question 49

What is the outcome of sympathetic innervation of the lungs?

Answer 49

Relaxation of bronchi smooth muscle and vasoconstriction of the pulmonary vessels

Question 50

What nerve carries pain signals from the lungs?

Answer 50

Visceral afferent nerve to the sensory ganglion of the Vagus (X)

Question 51

How many lymphatic plexuses are there?

Answer 51

2

Question 52

Which lymphatic plexus drains the lung parenchyma?

Answer 52

Superficial

Question 53

Which lymphatic plexus drains the lung root?

Answer 53

Deep

Question 54

What structures form the posterior peripheral attachment of the diaphragm, and what are these parts of the diaphragm called?

Answer 54

L1-L3, right and left crura

Question 55

What perforates the diaphragm and at what level?

Answer 55

IVC and right phrenic nerve, T8. Oesophagus and right/left Vagus nerve, T10. Aorta, thoracic duct and azygous vein, T12.

Question 56

What artery supplies the diaphragm and where does it arise from?

Answer 56

Inferior phrenic, abdominal aorta