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Lungs Flashcards

1
Q

The Lungs are

A

paired organs in the thoracic cavity that extend from the diaphragm to just slightly superior to the clavicles and lie against the ribs anteriorly and posteriorly

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2
Q

The horizontal fissure follows

A

the curvature of the 4th rib and end at 4th costal

cartilage

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3
Q

The Oblique fissure:

A

projects at 5th intercostal space

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4
Q

a. The Superior lobe

b. The Middle lobe

A

a. of right lung projects anteriorly above the 4th rib

b. projects anteriorly below the 4th rib

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5
Q

Breath Sounds:

A

of the superior lobes of the both lungs can be heard above the 4th rib for the right lung
• Breath sounds of the middle right lobe can be heard below the 4th rib
• Breath sounds from the inferior lobes can be heard on the posterior chest wall

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6
Q

the left lung has

A

two lobes separated by one fissure and a depression, the cardiac notch

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7
Q

the right lung has

A

three lobes separated by two fissures

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8
Q

Which lung is smaller and why?

A

Left lung is 10% smaller than right due to space occupied by heart

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9
Q

Which lung is shorter / why?

A

Liver pushes up diaphragm on Right

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10
Q

The lungs are enclosed and protected by the

A
  • The parietal pleura is the outer layer which is attached to the wall of the thoracic cavity covering the rib cage & the upper surface of diaphragm
  • The visceral pleura is the inner layer, covering the lungs themselves
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11
Q

Between the pleurae is

A

a small potential space called the pleural cavity, which contains a lubricating fluid secreted by the membranes.
The pleural cavities may fill with air (pneumothorax) or blood (hemothorax).
A pneumorthorax may cause a partial or complete collapse of the lung

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12
Q

The Mediastinal Surface of the Lung

A
  • has blood vessels & airways (enter lungs at hilus)
  • Forms root of lungs
  • Covered with pleura (parietal becomes visceral)
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13
Q

What structures lie within the mediastinum?

A

Heart, thymus, esophagus, trachea, large blood vessels

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14
Q

As the trachea approaches the lungs

A

it divides into the right and left pulmonary bronchi which enter the lungs.
The air passageways continue to divide and become smaller collectively forming a brochial tree

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15
Q

The Bronchial Tree consists of

A

the trachea, primary bronchi, secondary bronchi, tertiary bronchi, bronchioles, and terminal bronchioles (the end of the conducting zone).

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16
Q

i)Each primary bronchus supplies a lung:

A

Right primary bronchus divides into 3 “secondary (lobar) bronchi”
• Left primary bronchus divides into 2 ”secondary (lobar) bronchi”
• Right is more vertical, shorter and wider than the left; therefore, an aspired object is more likely to enter the right primary bronchi

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17
Q

ii) Each secondary bronchus supplies a lobe of the lung

A

Right and left secondary (lobar) bronchi divided into “tertiary (segmental) bronchi”
• Each lung has a total of 10 tertiary bronchi

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18
Q

iii) Each tertiary bronchus supplies a triangular shaped unit of the lung called a “brochopulmonary segment”

A

Each tertiary bronchi divides into several smaller bronchioles which give off even smaller “terminal bronchioles”
• Each “bronchopulmonary segment” is divided into many small compartments called lobules

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19
Q

iv)Each terminal bronchiole supplies a lobule

A

Each lobule is supplied by a terminal bronchiole, a single arteriole, venule, a lymphatic vessel & a branching of a terminal bronchiole all wrapped by elastic CT
• terminal bronchioles subdivide into “respiratory bronchioles” lined with simple squamous epithelium
• terminal bronchioles mark the end of the conducting zone and the beginning of the respiratory zone

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20
Q

Histology of Bronchial Tree

A

• Epithelium changes from pseudostratified ciliated columnar to non-ciliated simple cuboidal as pass deeper into lungs
• Incomplete rings of cartilage replaced by rings of smooth muscle & then connective tissue
– sympathetic NS & adrenal gland release epinephrine that relaxes smooth muscle & dilates airways

21
Q

Each respiratory bronchiole supplies

A

a respiratory unit consisting of “alveoli” (air cells) arranged in alveolar sacs
• occasionally sacs are found on the respiratory bronchiole wall

22
Q

Alveoli:

A

participate in gas exchange

23
Q

Alveolar ducts ( end of the respiratory bronchiole)

A

are surrounded by alveolar sacs & alveoli

– sac is 2 or more alveoli sharing a common opening

24
Q

Histology of Alveoli: Alveolar walls consist of

A

type I alveolar (squamous pulmonary epithelial) cells,
type II alveolar (septal) cells,
and alveolar macrophages (dust cells)

25
Q
  1. Type I alveolar cells
A

• where gas exchange occurs

26
Q
  1. Type II alveolar cells (septal cells)
A

free surface has microvilli
• secrete alveolar fluid, which keeps the alveolar cells moist and which contains a component called surfactant. Surfactant lowers the surface tension of alveolar fluid, preventing the collapse of alveoli with each expiration.

27
Q
  1. Alveolar dust cells
A

wandering macrophages remove debris

28
Q

Alveoli & Gas Exchange:

A

Exchange of gas is from alveoli to blood

Gas exchange occurs across the alveolar-capillary membrane

29
Q

Gas exchange occurs across

A 
4 Layers of membrane to cross
– alveolar epithelial wall of type I cells
– alveolar epithelial basement membrane
– capillary basement membrane
– endothelial cells of capillary
30
Q

Vast surface area of gas exchange =

A

raquetball court= approx. 70m squared (900 ml of blood can participate in gas exchange at one time)

31
Q

Briefly explain the two ways that blood is supplied to the lungs:

A

1.Deoxygenated blood arrives through pulmonary trunk from the right ventricle
Pulmonary arteries leave ventricle of the heart and go to lungs/ Pulm veins leave the lungs and enter the atrium of the heart
2.Bronchial arteries branch off of the aorta to supply oxygenated blood to lung tissue
• Venous drainage returns all blood to heart
• Less pressure in venous system
• Pulmonary blood vessels constrict in response to low O2 levels so as not to pick up CO2 on there way through the lungs

32
Q

Nebulization;

A
  • a procedure for administering medication as small droplets suspended in air into the respiratory tract, is used to treat many different types of respiratory disorders
  • inhaled mist with chemicals relaxes muscles and reduce thickness of mucus
33
Q

Asthma attacks or allergic reactions constrict

A

distal bronchiole smooth muscle

34
Q

In the lungs vasoconstriction in response to hypoxia diverts pulmonary blood from poorly ventilated areas to well ventilated areas. This phenomenon is known as

A

ventilation – perfusion coupling.

35
Q

Respiratory Distress Syndrome (RDS)

A

a disorder of premature infants in which the alveoli do not have sufficient surfactant to remain open

36
Q

Respiration occurs in 3 Basic Steps:

A

1) pulmonary ventilation
2) external respiration
3) internal respiration

37
Q
  1. Pulmonary Ventilation aka Breathing
A

Is the inhalation and exhalation of air; involves the exchange of air between the atmosphere and the lungs

38
Q

Inspiration (inhalation)

A

is the process of bringing air into the lungs.

39
Q

Expiration (exhalation)

A

is the movement of air out of the lungs.

40
Q
  1. External Respiration
A

Exchange of gases between the alveoli of the lungs and the blood in the pulmonary capillaries

41
Q
  1. Internal Respiration
A

Exchange gases between blood in the systemic capillaries and tissue cells

42
Q

Pressure Changes during

Inspiration:

A
  • Inspiration is induced by the contraction of the diaphragm and some accessory muscles.
  • Chest wall expands.
  • Intrapleural pressure becomes more negative.
  • Lung expansion causes gases in the alveoli to expand and the alveolar pressure becomes more negative.
43
Q

Pressure Changes during End of Inspiration

A

• Lung expands and recoil force increases to equal intrapleural pressure.

44
Q

Pressure Changes during Expiration:

A

• Under resting conditions, expiration is produced by relaxation of muscles of inspiration.

45
Q

Laboured breathing:

• Forced expiration

A

– abdominal mm force diaphragm up

– internal intercostals depress ribs

46
Q

Laboured breathing:

• Forced inspiration

A

– sternocleidomastoid, scalenes & pectoralis minor lift chest upwards as you gasp for air

47
Q

Alveolar Surface Tension

A

• Thin layer of fluid in alveoli causes inwardly directed force = surface tension
– water molecules strongly attracted to each other
• Causes alveoli to remain as small as possible
• Detergent-like substance called surfactant produced by Type II alveolar cells
– lowers alveolar surface tension
– insufficient in premature babies so that alveoli collapse at end of each exhalation

48
Q
  1. Compliance of the Lungs
A
  • Ease with which lungs & chest wall expand depends upon elasticity of lungs & surface tension.
  • Change in volume/ change in pressure.
  • Obstructive Vs. Restrictive patterns.
49
Q
  1. Airway Resistance
A 
• Resistance to airflow depends upon airway size
– increase size of chest
• airways increase in diameter
– contract smooth muscles in airways
• decreases in diameter

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