Pulm Anatomy; Final Exam Flashcards
Larynx- Superior thyroid cartilage connects to the inferior hyoid bone via thyrohyoid membrane
- Thyroepiglottic membrane
- Inferior Horn- Connects to cricoid cartilage
- Cricothyroid joint
- Cricoarytenoid ligaments
- Corniculate cartilage
- Epiglottic Cartilage
Inferior, posterior trachea has an opening.
Tracheal rings are not continuous- allowing space for the esophagus
Trachea- What does it connect to? How long/wide is it? Annular ligaments? Tracheal rings?
- Trachea is connected to the base of the larynx
- Usually 10-13cm in length, 2cm wide
- An estimate for the internal diameter of the trachea is the size of the thumb
- 4cm of the superior trachea is extra-thoracic, the rest is intrathoracic
- Tracheal cartilage pieces are C-shaped, not a continuous ring
- Consists of annular ligaments that connect the tracheal cartilage pieces together
- On average, an adult has 20 pieces of tracheal cartilage
Coughing- What happens to the trachea?
- When coughing, we can generate up to ~100mph wind through the trachea
- The connective tissue on the posterior trachea folds inward during coughing, decreasing the diameter in the trachea, allowing for the upper respiratory system to generate enough force (turbulence) to remove the irritant from the airway
- Cilia lines the endothelium in the upper airway –> pushes irritants out of the upper airway
Why doesn’t the trachea have continuous cartilage rings?
- To allow space for swallowing
- To generate turbulent airlfow when coughing
Bronchopulmonary segments:
* 10 in the R. Lung
* 8 in the L. Lung
- This happens due to fusion in the lung of two bronchopulmonary segments
Right Mainstem
* Wider
* Short, ~2cm long. Branches into bronchopulmonary segments almost immediately
* Deviates 25° from vertical
Left Mainstem
* Narrower
* Longer in order to route the incoming/outgoing air past the position of the heart. ~4-6cm
* Deviates 45° from vertical–> more horizontal
Total angle of bifurcation?
* 70°
Carina
* Last piece of cartilage that serves as the bifurcation point for the two mainstems
Invasive airway locations
- Tracheostomy would be placed here
- Cric would be placed in the median cricothyroid ligament
- Bypassing the nose/mouth means we are losing the humidification and warming functions of the nose
- Need to humidify inspired air
How does position of the head change the size of the trachea?
Extending the head backwards:
Trachea gets longer, becomes narrower
Flexing the head forward:
Trachea becomes slightly shorter, diameter becomes larger
- Cricoid cartilage connects to the thyroid cartilage
- Continuous circular ring
- Lamina
-Side of cricoid cartilage - Articular facet for arytenoid cartilage (x2)
-Place for arytenoid cartilage to attach cricoid cartilage to the vocal cords - Articular facet for inferior horn of thyroid cartilage (x2)
-This is what allows the voice box to pivot forward
4 & 7. Articular facet x arytenoid cartilage
5 & 8. Articular facet x thryoid cartilage
6. Lamina
Most narrow portion of upper airway? What does cricoid pressure do?
10 years or younger:
Cricoid cartilage is the most narrow portion of the upper airway
11 years or older:
Trans-glottic space (vocal cords) are the most narrow portion of the upper airway
Cricoid Pressure:
Placing pressure on the anterior cricoid cartilage can obstruct the esophagus, preventing stomach contents from entering the airway
Downside of doing this: Applies pressure on the LES. If the patient is awake or has a abdominal muscle spasm, can cause damage to the LES
Should be able to feel the pilot balloon inflate where?
Sternal notch
Trachea is located directly underneath that
