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HS Exam 2 > Lungs and Pleura > Flashcards

Lungs and Pleura Flashcards

1
Q

where does the parietal pleura become continuous with the visceral pleurae?

A

at the hilum of the lung and the pulmonary ligament

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2
Q

what is a thoracocentesis and where is it done?

A

removing a fluid sample from the pleural cavity via needle through ICS 9 at midaxillary line superior to rib

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3
Q

what is the carina

A

cartilaginous projection of the last cartilage ring covered with a sensitive mucus membrane between the bronchi openings
responsible for the cough reflex

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4
Q

what blood vessels give nutrient supply to the lung and tissues and bronchial tree

A

bronchial circulation

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5
Q

what is the embryological basis for a tracheoesophageal fistula

A

incomplete fusion of the tracheoesophageal septum

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6
Q

at what stage of lung development can a fetus be born and live

A

cannalicular if greater than 24 weeks

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7
Q

what cavities are in the thorax?

A

2 pleural cavities

1 central mediastinum cavity

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8
Q

what is in each pleural cavity?

A

lung and pleurae (visceral and parietal)

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9
Q

what is in the central mediastinum cavity?

A 
heart
thoracic parts of great vessels
trachea
esophagus
thymus
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10
Q

what is pleura?

A

serous sac made of 2 membranes

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11
Q

what is the visceral pleura

A

serous membrane covering the lungs

adjacent to lungs

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12
Q

what is the parietal pleura

A

serous membrane lining the cavity

adjacent to thoracic wall

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13
Q

what and where are the 4 regions of the parietal pleura

A

costal- internal surface of thoracic wall
mediastinal- lateral aspects of mediastinum
diaphragmatic- superior surface of diaphragm
cervical- apex of lung and extends into superior thoracic outlet

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14
Q

what is the pleural cavity

A

space between the parietal and visceral pleura
**potential cavity
contains serous fluid layer to allow the visceral and parietal pleura to slide over each other

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15
Q

what is a pleural recess

A

where the visceral and parietal layers touch each other

lung fills it during inspiration

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16
Q

where is the costodiaphragmatic recess

A

diaphragmatic parietal pleura is in contact with costal parietal pleura

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17
Q

where is the costomediastinal recess

A

posterior to sternum, costal in contact with mediastinal pleura

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18
Q

which pleural recess is more clinically significant? why

A

costodiaphragmatic recess- where fluid accumulates

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19
Q

what is the endothoracic fascia and why is it significant

A

separates thoracic surface and diaphragm from the parietal pleura
forms cleavage plane to separate the costal parietal pleura from the thoracic wall

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20
Q

which side costomediastinal recess is larger?

A

left- cardiac notch here

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21
Q

what is the root of the lung

A

location where structures enter and exit the lung

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22
Q

what structures are in the root of the lung

A 
bronchi
pulmonary veins
pulmonary arteries
lymphatic vessels/nodes
nerves
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23
Q

what is the hilum of lung

A

area where root of the lung is and where the parietal and visceral layers are continuous

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24
Q

what is pleuritis

A

inflammation of pleura resulting in friction between the layers that manifests as a an audible sound upon auscultation known as a pleural rub

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25
Q

what are pleural adhesions

A

spots where the parietal and visceral layers stick together

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26
Q

what is pleural effusion

A

pleural cavity fills with fluid or air

3 types

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27
Q

pleural cavity filling with fluid

A

hydrothorax

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28
Q

pleural cavity filling with air

A

pneumothorax

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29
Q

pleural cavity filling with blood

A

hemothorax

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30
Q

what causes a pneomothorax

A

rib fracture or penetrating wound

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31
Q

what causes a hemothorax

A

injury to intercostal or internal thoracic artery

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32
Q

what is a thoracocentesis

A

removing fluid from the pleural cavity with a needle through ICS 9

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33
Q

what layers does a thoracocentesis go through

A

intercostal muscles and parietal pleura

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34
Q

what is the lower boarder of the lung

A

midclavicular- rib 6
midaxillary- rib 8
midscapular rib 10

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35
Q

what is the lower pleura boarder

A

midclavicular- rib 8
midaxillary- rib 10
midscapular- rib 12

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36
Q

where is the bare area and what is its significance?

A

area not covered by pleura to the left of the sternum at ICS 5
gives direct access to the heart

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37
Q

how many lobes does the right lung have

A

3- superior, inferior, middle

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38
Q

how many lobes does the left lung have

A

2- superior, inferior

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39
Q

where is the oblique fissure

A

separates the superior and inferior lobes on each lung
runs inferiorly lateral to medial
starts posterior at T3 and ends at the 6th costal cartilage

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40
Q

where is the horizontal fissure

A

right lung only

starts at the oblique fissure posteriorly and extends anteriorly at rib 4

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41
Q

what is the lingula

A

anteroinferior piece of the left lung that sticks out below the cardiac notch

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42
Q

what is the cardiac notch and why is it significant

A

indention of the left superior lobe at the end of the oblique fissure
creates the bare area that provides access to the heart

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43
Q

what a re the surfaces of the lungs and where are they

A

costal- adjacent to ribs
mediastinal- adjacent to mediastinum
diaphragmatic- adjacent to diaphragm

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44
Q

what and where are the boarders of the lungs

A

anterior- middle edge anteriorly
inferior- bottom edge
posterior- behind the root of the lung on posterior side

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45
Q

what is the lingual a homolog of

A

middle lobe of the right lung

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46
Q

epiarterial lobar bronchi

A

upper lobar of right lung branches superiorly to the pulmonary artery

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47
Q

hyperarterial lobar bronchi

A

all of the rest of the lobars branch inferiorly to the pulmonary artery

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48
Q

impressions on mediastinal aspect of left lung

A

arch of aorta- top
subclavian artery- top anterior
descending aorta- posterior to root of lung
cardiac impression- anterior large area

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49
Q

arrangement of structures in left lung root

A

bronchus- posterior to vessels
pulmonary artery- most superior
pulmonary veins- anterior and inferior (2)

50
Q

impressions on mediastinal aspect of right lung

A

arch of azygous vein- top
superior vena cava- anterior
cardiac impression- anterior, smaller than left
inferior vena cava- inferior, anterior to pulmonary ligament
esophagus- inferior, posterior to pulmonary ligament

51
Q

arrangement of structures in right lung root

A

bronchus- posterior to vessels
pulmonary artery- parallel to bronchus
pulmonary veins- anterior and inferior

52
Q

where and what is the pulmonary ligament

A

inferior to root of lung- where the visceral and parietal pleurae are continuous
helps to support the lung root

53
Q

where is the phrenic nerve

A

anterior to root of lung

54
Q

where is the vagus nerve

A

posterior to root of lung

55
Q

how many lobars does the right bronchus split into

A

3

upper (epiarterial), middle, lower

56
Q

how many lobars does the left bronchus split into

A

2

upper, lower

57
Q

which bronchus is aspirated food likely to fall into and why

A

right- straighter than the left (more oblique)

58
Q

what vertebra does the trachea overly

A

C5 to T4/5

59
Q

where does the trachea bifucate

A

sternal angle- T4

60
Q

how many segmental bronchi does the right lung have

A

10

61
Q

how many segmental bronchi does the left lung have

A

8

62
Q

what is a bronchopulmonary segment

A

functional, anatomical, and surgical unit of the lung

can be independently removed while preserving health segments

63
Q

what supplies a bronchopulmonary segment

A

single segmental bronchus

64
Q

pathway of the air in the lung

A

trachea-> bronchus->lobar-> segmental bronchus-> generational branches->terminal bronchioles->respiratory bronchioles-> alveolar ducts/sacs

65
Q

what is the functional unit of gas exchange of the lung

A

alveolar ducts

66
Q

what circulation does gas exchange

A

pulmonary circulation

67
Q

what circulation provides nutrients to the lungs

A

bronchial circulation

68
Q

what do pulmonary arteries do and how many are there

A

take deoxygenated blood from the heart to the lungs

1

69
Q

what do pulmonary veins do and how many are there

A

take oxygenated blood back to the heart from the lungs

2

70
Q

what do the pulmonary arteries branch into

A

lobar and segmental arteries- follow paths of the lobar and segmental bronchi

71
Q

what drains into the two pulmonary veins

A

intrasegmental and intersegmental veins

DO NOT follow paths of bronchi

72
Q

where do the bronchial arteries originate from

A

left- thoracic aorta

right- aorta or posterior intercostal artery

73
Q

where do the bronchial veins drain into?

A

left- azygous vein
right- accessory azygous vein
*some of the blood drains via the pulmonary veins

74
Q

where do the bronchial arteries run?

A

surface of main bronchus

75
Q

what does the subpleural lymphatic plexus drain? where is it

A

drains the lung parenchyma and visceral pleura

located deep to the visceral pleura

76
Q

where is the intrapulmonary lymphatic plexus? what does it drain

A

submucosa of bronchi and peribronchial tissue

drains the root of the lung

77
Q

what does the sub pleural lymphatic plexus drain into?

A

bronchopulmonary lymph nodes (hilar)

78
Q

what does the intrapulmonary lymphatic plexus drain into?

A

pulmonary lymph nodes (lobar) which drain into the bronchopulmonary nodes

79
Q

what do the bronchopulmonary nodes drain into

A

superior and inferior tracheobronchial nodes

80
Q

what do the trachobronchial nodes drain into

A

paratracheal nodes

81
Q

what do the paratracheal nodes drain into

A

bronchomediastinal trunk

82
Q

what do the lobes of the right lung drain into?

A

right lymphatic duct

83
Q

where does the right lymphatic duct return to the venous circulation?

A

junction of right subclavian and internal jugular veins

84
Q

what does the superior lobe of the left lung drain into?

A

thoracic duct and then the junction of left subclavian and internal jugular veins

85
Q

where does the inferior lobe of the left lung drain?

A

right side- crosses midline at the left tracheobronchial nodes and follows that path

86
Q

what is the path of lymphatic drainage

A

bronchopulmonary nodes-> tracheobronchial nodes-> paratracheal nodes-> bronchomediastinal trunk

87
Q

pnemonic for lymphatic drainage

A

brian- bronchopulmonary nodes
taylor- tracheobronchial nodes
poop- paratracheal nodes
butt- bronchomediastinal trunk

88
Q

what is an extra right lung lobe called and how is it formed

A

azygous lobe- azygous vein arches over the right lung apex instead of hilum which isolates the apex

89
Q

what causes black mottled lungs

A

smoking
urban areas
agricultural areas

90
Q

how are carbon particles handled

A

phogocytes remove them

91
Q

what is the fancy word for lung cancer

A

bronchogenic carcinoma

92
Q

what does lung cancer come from

A

mucosa of large bronchi

93
Q

what are common metastasis sites of lung cancer

A

brain

bones

94
Q

what is a bronchoscope for

A

endoscope for viewing the interior of the tracheobronchial tree

95
Q

what findings are indicative of advanced cancer using a bronchoscope?

A

enlarged lymph nodes between bronchi and distorted carina

96
Q

what is bronchial asthma

A

contraction/spasms of smooth muscle
mucosal edema
mucus in bronchi and bronchiole lumen

97
Q

when does the respiratory system start to develop

A

4 or 5 weeks

98
Q

what are the steps of respiratory development

A
  1. lung bud forms from foregut
  2. tracheoesophageal ridge forms between lung bud and foregut
  3. traheoesophageal septum forms which separates the lung bud from the foregut
  4. lung bud splits into left and right bronchi
  5. growth continues laterally and dorsally and divides into lobars
99
Q

what becomes the trachea

A

lung bud

100
Q

what becomes the esophagus

A

foregut

101
Q

lung bud

A

respiratory diverticulum

102
Q

what is a fistula

A

abnormal connection

103
Q

what is atresia

A

absence of normal opening or abnormal closing

104
Q

what is the most common abnormality in lung development

A

esophageal atresia

105
Q

what is esophageal atresia

A

blind esophagus due to incomplete fusion of the tracheoesophageal septum with esophagotracheal fistula

106
Q

what happens in an esophageal atresia

A

regurgitation in infants

107
Q

what are the 4 periods of lung development in order

A

pseudoglandular
canalicular
terminal sac
alveolar

108
Q

when is the pseudo glandular period of lung development and what happens

A 
5-16 weeks
terminal bronchioles are formed
no gas exchange
no respiratory bronchioles or alveoli
no vascularization
109
Q

when is the cannalicular period of lung development and what happens

A

16-26 weeks
terminal bronchioles divide into respiratory bronchioles which divide into ducts
beginning of oxygen exchange and vascularization
fetus may survive >24 weeks

110
Q

when is the terminal sac period of lung development and what happens

A

26 weeks to birth
terminal sacs form
capillaries are in contact with the epithelium
increased vascularity and oxygen exchange

111
Q

when is the alveolar period of lung development and what happens

A

8 months to childhood
alveoli mature
further develop epithelial-endothelial contact

112
Q

where is the groove for subclavian vein

A

closest to the anterior aspect of the first rib

113
Q

where is the groove for the subclavian artery

A

closer to the posterior aspect of the first rib (head)

114
Q

where is the scalene tubercle

A

between the subclavian grooves on the first rib

115
Q

what do the intercostal nerves supply

A

intercostal muscles
skin of thoracic wall
parietal pleura

116
Q

where are the internal thoracic artery and veins locaated

A

between the transverses thoraces muscle and costal cartilage

117
Q

where is the apex of the lung

A

superior to first rib

118
Q

what side is the azygous vein on

A

right

119
Q

what side is the hemiazygous vein on

A

left

120
Q

where does the hemiazygous vein come off of the azygous vein

A

around T9

HS Exam 2 (24 decks)

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