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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
what are pleural adhesions
spots where the parietal and visceral layers stick together
26
what is pleural effusion
pleural cavity fills with fluid or air | 3 types
27
pleural cavity filling with fluid
hydrothorax
28
pleural cavity filling with air
pneumothorax
29
pleural cavity filling with blood
hemothorax
30
what causes a pneomothorax
rib fracture or penetrating wound
31
what causes a hemothorax
injury to intercostal or internal thoracic artery
32
what is a thoracocentesis
removing fluid from the pleural cavity with a needle through ICS 9
33
what layers does a thoracocentesis go through
intercostal muscles and parietal pleura
34
what is the lower boarder of the lung
midclavicular- rib 6 midaxillary- rib 8 midscapular rib 10
35
what is the lower pleura boarder
midclavicular- rib 8 midaxillary- rib 10 midscapular- rib 12
36
where is the bare area and what is its significance?
area not covered by pleura to the left of the sternum at ICS 5 gives direct access to the heart
37
how many lobes does the right lung have
3- superior, inferior, middle
38
how many lobes does the left lung have
2- superior, inferior
39
where is the oblique fissure
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
40
where is the horizontal fissure
right lung only | starts at the oblique fissure posteriorly and extends anteriorly at rib 4
41
what is the lingula
anteroinferior piece of the left lung that sticks out below the cardiac notch
42
what is the cardiac notch and why is it significant
indention of the left superior lobe at the end of the oblique fissure creates the bare area that provides access to the heart
43
what a re the surfaces of the lungs and where are they
costal- adjacent to ribs mediastinal- adjacent to mediastinum diaphragmatic- adjacent to diaphragm
44
what and where are the boarders of the lungs
anterior- middle edge anteriorly inferior- bottom edge posterior- behind the root of the lung on posterior side
45
what is the lingual a homolog of
middle lobe of the right lung
46
epiarterial lobar bronchi
upper lobar of right lung branches superiorly to the pulmonary artery
47
hyperarterial lobar bronchi
all of the rest of the lobars branch inferiorly to the pulmonary artery
48
impressions on mediastinal aspect of left lung
arch of aorta- top subclavian artery- top anterior descending aorta- posterior to root of lung cardiac impression- anterior large area
49
arrangement of structures in left lung root
bronchus- posterior to vessels pulmonary artery- most superior pulmonary veins- anterior and inferior (2)
50
impressions on mediastinal aspect of right lung
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
arrangement of structures in right lung root
bronchus- posterior to vessels pulmonary artery- parallel to bronchus pulmonary veins- anterior and inferior
52
where and what is the pulmonary ligament
inferior to root of lung- where the visceral and parietal pleurae are continuous helps to support the lung root
53
where is the phrenic nerve
anterior to root of lung
54
where is the vagus nerve
posterior to root of lung
55
how many lobars does the right bronchus split into
3 | upper (epiarterial), middle, lower
56
how many lobars does the left bronchus split into
2 | upper, lower
57
which bronchus is aspirated food likely to fall into and why
right- straighter than the left (more oblique)
58
what vertebra does the trachea overly
C5 to T4/5
59
where does the trachea bifucate
sternal angle- T4
60
how many segmental bronchi does the right lung have
10
61
how many segmental bronchi does the left lung have
8
62
what is a bronchopulmonary segment
functional, anatomical, and surgical unit of the lung | can be independently removed while preserving health segments
63
what supplies a bronchopulmonary segment
single segmental bronchus
64
pathway of the air in the lung
trachea-> bronchus->lobar-> segmental bronchus-> generational branches->terminal bronchioles->respiratory bronchioles-> alveolar ducts/sacs
65
what is the functional unit of gas exchange of the lung
alveolar ducts
66
what circulation does gas exchange
pulmonary circulation
67
what circulation provides nutrients to the lungs
bronchial circulation
68
what do pulmonary arteries do and how many are there
take deoxygenated blood from the heart to the lungs | 1
69
what do pulmonary veins do and how many are there
take oxygenated blood back to the heart from the lungs | 2
70
what do the pulmonary arteries branch into
lobar and segmental arteries- follow paths of the lobar and segmental bronchi
71
what drains into the two pulmonary veins
intrasegmental and intersegmental veins | DO NOT follow paths of bronchi
72
where do the bronchial arteries originate from
left- thoracic aorta | right- aorta or posterior intercostal artery
73
where do the bronchial veins drain into?
left- azygous vein right- accessory azygous vein *some of the blood drains via the pulmonary veins
74
where do the bronchial arteries run?
surface of main bronchus
75
what does the subpleural lymphatic plexus drain? where is it
drains the lung parenchyma and visceral pleura | located deep to the visceral pleura
76
where is the intrapulmonary lymphatic plexus? what does it drain
submucosa of bronchi and peribronchial tissue | drains the root of the lung
77
what does the sub pleural lymphatic plexus drain into?
bronchopulmonary lymph nodes (hilar)
78
what does the intrapulmonary lymphatic plexus drain into?
pulmonary lymph nodes (lobar) which drain into the bronchopulmonary nodes
79
what do the bronchopulmonary nodes drain into
superior and inferior tracheobronchial nodes
80
what do the trachobronchial nodes drain into
paratracheal nodes
81
what do the paratracheal nodes drain into
bronchomediastinal trunk
82
what do the lobes of the right lung drain into?
right lymphatic duct
83
where does the right lymphatic duct return to the venous circulation?
junction of right subclavian and internal jugular veins
84
what does the superior lobe of the left lung drain into?
thoracic duct and then the junction of left subclavian and internal jugular veins
85
where does the inferior lobe of the left lung drain?
right side- crosses midline at the left tracheobronchial nodes and follows that path
86
what is the path of lymphatic drainage
bronchopulmonary nodes-> tracheobronchial nodes-> paratracheal nodes-> bronchomediastinal trunk
87
pnemonic for lymphatic drainage
brian- bronchopulmonary nodes taylor- tracheobronchial nodes poop- paratracheal nodes butt- bronchomediastinal trunk
88
what is an extra right lung lobe called and how is it formed
azygous lobe- azygous vein arches over the right lung apex instead of hilum which isolates the apex
89
what causes black mottled lungs
smoking urban areas agricultural areas
90
how are carbon particles handled
phogocytes remove them
91
what is the fancy word for lung cancer
bronchogenic carcinoma
92
what does lung cancer come from
mucosa of large bronchi
93
what are common metastasis sites of lung cancer
brain | bones
94
what is a bronchoscope for
endoscope for viewing the interior of the tracheobronchial tree
95
what findings are indicative of advanced cancer using a bronchoscope?
enlarged lymph nodes between bronchi and distorted carina
96
what is bronchial asthma
contraction/spasms of smooth muscle mucosal edema mucus in bronchi and bronchiole lumen
97
when does the respiratory system start to develop
4 or 5 weeks
98
what are the steps of respiratory development
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
what becomes the trachea
lung bud
100
what becomes the esophagus
foregut
101
lung bud
respiratory diverticulum
102
what is a fistula
abnormal connection
103
what is atresia
absence of normal opening or abnormal closing
104
what is the most common abnormality in lung development
esophageal atresia
105
what is esophageal atresia
blind esophagus due to incomplete fusion of the tracheoesophageal septum with esophagotracheal fistula
106
what happens in an esophageal atresia
regurgitation in infants
107
what are the 4 periods of lung development in order
pseudoglandular canalicular terminal sac alveolar
108
when is the pseudo glandular period of lung development and what happens
``` 5-16 weeks terminal bronchioles are formed no gas exchange no respiratory bronchioles or alveoli no vascularization ```
109
when is the cannalicular period of lung development and what happens
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
when is the terminal sac period of lung development and what happens
26 weeks to birth terminal sacs form capillaries are in contact with the epithelium increased vascularity and oxygen exchange
111
when is the alveolar period of lung development and what happens
8 months to childhood alveoli mature further develop epithelial-endothelial contact
112
where is the groove for subclavian vein
closest to the anterior aspect of the first rib
113
where is the groove for the subclavian artery
closer to the posterior aspect of the first rib (head)
114
where is the scalene tubercle
between the subclavian grooves on the first rib
115
what do the intercostal nerves supply
intercostal muscles skin of thoracic wall parietal pleura
116
where are the internal thoracic artery and veins locaated
between the transverses thoraces muscle and costal cartilage
117
where is the apex of the lung
superior to first rib
118
what side is the azygous vein on
right
119
what side is the hemiazygous vein on
left
120
where does the hemiazygous vein come off of the azygous vein
around T9

HS Exam 2 (24 decks)

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