Lower Respiratory Tract lecture Flashcards

1
Q

Parietal Pleura

A
  • lines pleural cavity, several names for the surfaces it covers
  • innervated by intercostal nerves and phrenic nerves
  • forms pulmonary ligament
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2
Q

Costal Pleura

A

Part of parietal pleura, attached to ribs and intercostal spaces

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3
Q

Mediastinal pleura

A

part of parietal pleura, attached to mediastinum

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4
Q

Diaphragmatic pleura

A

part of parietal pleura,adheres to superior surface of respiratory diaphragm

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5
Q

Cervical pleura

A

part of parietal pleura,lines pleural cavity above level of 1st ribs, in root of neck

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6
Q

Visceral Pleura:

A

covers surfaces of lungs, insensitive to pain

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7
Q

Connecting Layer

A
  • surrounds roots of lungs like a sleeve

- covers structures that pass into lungs (bronchi, nerves, lymphatics, etc)

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8
Q

Vertical Reflection

A

where costal and mediastinal pleurae become continuous posteriorly

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9
Q

Sternal Reflection

A

costal and mediastina pleurae become continuous anteriorly

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10
Q

Costal Reflection

A

costal and diaphragmatic pleurae become continuous inferiorly

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11
Q

Describe the lines of reflection of the parietal pleura.

A

Vertical, sternal, costal reflection

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12
Q

pleural recesses

A
  • occur where two layers of parietal pleura form an acute angle,in direct contact with each other
  • lungs not in these recesses normally, but with certain infections can be filled with pus
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13
Q

Right Costodiaphragmatic Recess

A

located laterally along costal reflection, allow lungs to be pulled during inspiration

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14
Q

Left Costodiaphragmatic Recess

A

located laterally along costal reflection, allow lungs to be pulled during inspiration

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15
Q

Left Costomediastinal Recess

A

located anteriorly along sternal reflection, where costal and mediastinal pleurae meet

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16
Q

Pleural Cavities

A
  • Spaces between two pleural layers

- contains pleural fluid which is secreted by the pleural membranes

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17
Q

Pleural Sacs

A
  • Beneath visceral pleura

- contains lungs

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18
Q

Intercostal nerves

A

supply fibers for pain and irritation to costal pleura in addition to supplying the periphery of the respiratory diaphragm

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19
Q

Phrenic nerves

A

supply fibers for pain and irritation to the mediastinal pleura and the diaphragmatic pleura.

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20
Q

lower respiratory tract components?

A
  • Begins with trachea, main stem bronchi, bronchial tubes, and lungs
  • Trachea, bronchi, bronchial tubes contain ciliated pseudostratified columnar epithelium
  • Cilia move up mucous toward laryngopharynx, where it can be coughed up
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21
Q

course of the trachea from the neck into the superior mediastinum

A
  • continuous with larynx
  • extends from C6 vertebrae to sternal angle at same level as T4
  • transverse thoracic plane passes through sternal angle to intersect intervertebral disc between T4 and T5, bifurcates trachea into two main bronchi
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22
Q

Describe the composition of the trachea

A
  • 20 “U shaped” cartilage rings, dont go all the way around trachea
  • smooth muscle: elastic posterior wall of trachea, next to esophagus
  • mucous glands keep surface of epithelium covered with mucous
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23
Q

Arteries of trachea

A

superior and inferior thyroid arteries

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24
Q

Veins of trachea

A

superior, middle and inferior thyroid veins

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25
Q

Right main bronchi

A

Larger diameter, more vertical, shorter, 3 lobar bronchi to lungs, branches into 10 segmental bronchi
-runs under arch of azygos vein

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26
Q

Left main bronchi

A

Small diameter, less vertical, longer, 2 lobar bronchi to lungs, 8 segmental bronchi
-runs under left pulmonary artery

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27
Q

Tertiary bronchi

A

go to bronchopulmonary segments

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28
Q

How many segmental bronchi do right and left lungs have?

A

Right lung has 10 segmental bronchi

Left lung has 8 segmental bronchi

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29
Q

Terminal bronchioles

A

branches of segmental bronchi

30
Q

Respiratory bronchioles

A

contain alveoli

31
Q

Alveoli

A

single cell in thickness, surrounded by dense capillary network

32
Q

Blood Supply

A

Three bronchial arteries from descending aorta, supply bronchial tubes but not alveoli, not a part of pulmonary circulation

33
Q

Where do bronchial veins drain?

A

bronchial veins drain to to azygos vein which are tributaries of vena cava

34
Q

Oblique Fissures

A
  • in left lung: divides into upper and lower lobes

- in right lung: divides middle from lower lobe and upper lobe from lower lobe

35
Q

Horizontal Fissure

A

-only in right lung, separated upper lobe from lower lobe

36
Q

Cardiac Notch

A

upper lobe of left lung, adjacent to heart

37
Q

Lingula

A

shaped like tongue, upper lobe of left lung, next to cardiac notch

38
Q

Apex

A

area of lungs above the first ribs; also known as the cupola

39
Q

Base

A

area of lungs adjacent to the respiratory diaphragm.

40
Q

Hilum

A

contains structures entering and exiting the lungs(ex: bronchi)

41
Q

Pulmonary trunk

A

emerges from right ventricle

42
Q

Pulmonary arteries (right and left)

A

have branching pattern similar to bronchi.

43
Q

Alveolar capillary network

A

functional part of the pulmonary circulation; provides for exchange of blood gases with air in the alveoli. The total surface area of this capillary network must be equal in size to all of the combined capillaries in all the organs in the body

44
Q

Pulmonary veins

A

collect blood from alveoli and return it to the left atrium

45
Q

Sensory (GVA neurons)

A

contained in vagus nerve (CN X)

46
Q

Stretch receptors

A

contained in alveoli and smooth muscle.

47
Q

Irritant receptors

A

located in respiratory epithelium.

48
Q

Tactile receptors

A

cough reflex

49
Q

Baroreceptors

A

in pulmonary arteries

50
Q

Chemoreceptors

A

in pulmonary veins (detect blood gases)

51
Q

Motor (GVE neurons)

A

autonomic fibers contained in pulmonary nerve plexus

52
Q

Sympathetic (post-ganglionic) nerve fibers

A

to smooth muscle and glands; function to inhibit glandular secretion, induce vasoconstriction of bronchial vessels, and dilate bronchial tubes

53
Q

Parasympathetic nerve fibers

A

to smooth muscle and glands; function to increase glandular secretion, induce vasodilation of bronchial vessels, and constrict bronchial tubes

54
Q

Pre-ganglionic parasympathetic fibers

A

are contributed to the pulmonary nerve plexus by the vagal nerves (CN X). These fibers synapse with post-ganglionic parasympathetic fibers on the surfaces of bronchial tubes and bronchial vessels

55
Q

Superficial plexus

A

lies deep to the visceral pleura; drains lymph from the visceral pleura and lung parenchyma to the bronchopulmonary lymph nodes in the hilum

56
Q

Deep plexus

A

located in the substance of the bronchi; drains lymph from the bronchi to pulmonary lymph nodes near the hilum and then goes to the bronchopulmonary nodes in the hilum

57
Q
  1. Pulmonary nodes
A

located in lungs at the bifurcations of larger bronchi

58
Q
  1. Bronchopulmonary (hilar) nodes
A

located in the hilum

59
Q
  1. Tracheobronchial nodes
A

located at the bifurcation of the trachea

60
Q
  1. Tracheal nodes
A

found on the lateral surfaces of the trachea

61
Q

Right bronchomediastinal lymph trunk

A

drains lymph from the right side of the trachea to the right lymphatic duct

62
Q

Left bronchomediastinal lymph trunk

A

drains lymph from the left side of the trachea to the thoracic duct.

63
Q

Lung Cancer

A

Can derive from actual lung tissue, or from the Bronchi (Bronchogenic
Carcinoma). Lung cancer can involve the Phrenic N., Vagus N. and Recurrent Laryngeal N. due
to the proximity of those nerves to the Lungs. Treatment can include removal of a Lung
(Pneumonectomy), a lobe of a lung (Lobectomy) or a specific Bronchopulmonary Segment
(Segmentectomy) through a procedure called Lung Resection

64
Q

Pleuritis (Pleurisy) is an inflammation of the Pleura

A

producing a roughness on the lungs

making breathing difficult

65
Q

Pulmonary Collapse

A

occurs when enough air enters the Pleural Cavity to break the surface
tension between the two layers of Pleura. The elasticity of the Lungs causes them to collapse

66
Q

Pneumothorax

A

Entry of air into the Pleural Cavity from a penetrating wound to the
Thoracic Wall or a rupture of a pulmonary lesion into the pleural cavity, which results in a
collapse of the lung

67
Q

Hydrothorax

A

Accumulation of excess fluid in the Pleural Cavity, usually the result of fluid
escape into the Pleural Cavity, or Pleural Effusion

68
Q

Hemothorax

A

Accumulation of blood in the Pleural cavity, usually the result of a chest
wound, usually the result of laceration of an Intercostal vessel or Internal Thoracic vessel rather
than laceration of the lung.

69
Q

Bronchial Asthma

A

widespread narrowing of the airways produced by contraction of
smooth muscle, edema of the mucosa and mucus in the lumen of the Bronchi and Bronchioles

70
Q

Bronchoscopy

A

Insertion of a Bronchoscope into the trachea to visualize the Main Bronchi

71
Q

bronchopulmonary segment

A
  • anatomic and functional subunit of lungs

- portion of lung supplied by each segmental bronchus and segmental artery