Resp 2 - Anatomy 2

Question 1

Describe the position of the apex of the lung/pleura:

Answer 1

Apex = 3cm above medial 1/3rd of clavicle

Question 2

What is the costodiaphragmatic recess?

Answer 2

Inferior part of pleural cavity not occupied by lung (between diaphragm and rib cage)

Question 3

Describe the lobes and fissures of the left lung:

Answer 3

2 lobes = upper and lower

1 fissure = oblique fissure

Question 4

Describe the lobes and fissures of the right lung:

Answer 4

3 lobes: upper, middle and lower

2 fissures: Oblique and horizontal

Question 5

Describe the surface markings of the oblique fissure:

Answer 5

From T2 to 6th costal cartilage

Question 6

Describe the surface markings of the horizontal fissure:

Answer 6

From oblique fissure in mid-axillary line, to 4th costal cartilage

Question 7

Describe the positions of the diaphragm domes:

Answer 7

Left dome = 5th intercostal space

Right dome = 5th rib

Question 8

Name the gap formed by abduction of the vocal cords:

Answer 8

Rima glottis

Question 9

Describe the shapes of the cartilage found in the lower respiratory tract:

Answer 9

Trachea = C shaped
Primary bronchi = Circular cartilage
Secondary bronchi = Irregular islands of cartilage

Question 10

What is the approx. length and width of the trachea?

Answer 10

10 x 2.5 cm

Question 11

Why does Asthma have more of an effect on bronchiole smooth muscle, than that in the primary/secondary bronchi?

Answer 11

No cartilage in bronchiole (cartilage present in primary and secondary bronchi)
= Smooth muscle can overconstrict

Question 12

Name the type of epithelium in bronchioles (excl. respiratory bronchioles):

Answer 12

Simple ciliated columnar + Clara cells

Question 13

Name the type of epithelium found in respiratory bronchioles):

Answer 13

Simple cuboidal (some ciliated) + Clara cells

Question 14

In what areas of the respiratory tract can you find Clara cells?

Answer 14

• Bronchioles

- Alveolar ducts

Question 15

As you move down the respiratory tract, which cells slowly replace goblet cells?

Answer 15

Clara cells

Question 16

What is the main function of Clara cells?

Answer 16

Secrete surfactant lipoprotein

= prevents walls sticking together during expiration

Question 17

What measurable marker do Clara cells secrete?

Answer 17

Clara cell protein CC16

Question 18

If [CC16] is decreased in a bronchoalveolar lavage, what has happened?

Answer 18

Lung damage

= damaged Clara cells = less CC16 produced

Question 19

If [CC16] is increased in serum, what has happened?

Answer 19

Leakage across air-blood barrier

Question 20

What types of fibres form the meshwork of alveoli?

Answer 20

Reticulin

Elastic

Question 21

Name the cell types found in alveoli:

Answer 21

• T1 pneumocytes

- T2 pneumocytes

Question 22

What is the difference between T1 and T2 pneumocytes?

Answer 22

T1 = squamous epithelial cells which allow gas exchange
T2 = cuboidal epithelial cells which secrete surfactant

Question 23

What percentage of the alveoli surface area do T1 and T2 pneumocytes cover?

Answer 23

T1 = 90%
T2 = 10%

Question 24

What prevents the lower airway walls sticking together during expiration?

Answer 24

Surfactant

Question 25

Name the 2 cell types which secrete surfactant:

Answer 25

• T2 pneumocytes

- Clara cells

Question 26

Why do the lungs have 2 circulations?

Answer 26

Pulmonary circulation = gas exchange

Bronchial circulation = nutrient exchange to tissues

Question 27

Name the arteries which supply the lung tissue with O2:

Answer 27

Bronchial arteries

Question 28

Name the most common causes of Emphysema:

Answer 28

• Smoking

- alpha-1-antitrypsin deficiency

Question 29

Describe the pathology of Emphysema:

Answer 29

Destruction of alveolar walls and permanent enlargement of air spaces
= bronchial collapse, trapping air in alveoli

Question 30

Is Emphysema a restrictive or obstructive deficit?

Answer 30

Obstructive

Question 31

Name the inherited deficiency that leads to early Emphysema development:

Answer 31

Alpha-1-antitrypsin deficiency

Question 32

Why do patients with Emphysema often breath with pursed lips?

Answer 32

Maintains high pressure in lungs during expiration, preventing bronchiole collapse

Question 33

Name the cartilage/bones which form the anterior bony thorax:

Answer 33

• Costal cartilage

- Sternum (Manubrium, Body and Xiphisternum)

Question 34

Which ribs are ‘true’ and why?

Answer 34

Ribs 1-7, as directly connected to sternum (via costal cartilage)

Question 35

Which ribs are ‘false’ and why?

Answer 35

Ribs 8-12, as not directly connected to sternum

Question 36

Is the head and tubercle of a rib located anteriorly or posteriorly?

Answer 36

Posteriorly

Question 37

What part of a rib protects the associated vessels and nerves?

Answer 37

Costal groove

Question 38

What bones articulate at the costo-transverse joint?

Answer 38

• Tubercle of rib

- Transverse costal facet of vertebrae

Question 39

What bones articulate at the costo-vertebral joint?

Answer 39

• Head of rib
• Superior costal facet of corresponding vertebrae
• Inferior costal facet of vertebrae above