Respiratory Flashcards
1
Q
Label upper respiratory tract
A
See diagram
2
Q
What surrounds the trachea?
A
Tracheal rings
3
Q
What are the tracheal rings made of?
A
Hyaline cartilage
4
Q
What shape are the tracheal rings?
A
C shaped
5
Q
What is the purpose of the tracheal rings?
A
Support the trachea, allow it to still move and flex in breathing
6
Q
What muscle surrounds the trachea?
A
Trachealis muscle
7
Q
What type of muscle is the trachealis muscle?
A
Smooth under ANS control
8
Q
What is the purpose of the trachealis muscle?
A
Decreases diameter of trachea to help move air faster out
9
Q
What type of epithelium lines the trachea?
A
Puesdo stratified ciliated columnar epithelum
10
Q
Where does the trachea bifurcate (the carina)?
A
- T4/T5 intervetebral disc
- Transthoracic plane
- Sternal angle
11
Q
Give the order of the bronchial tree
A
Trachea —> Primary (principle/main) bronchi —> Secondary (lobar) bronchi —> Tertiary (segmental) bronchi —> bronchioles —> Alevoli
12
Q
What are the trends in smooth muscle and cartilage down the bronchial tree?
A
- Increase in smooth muscle
- Decrease in cartilage
13
Q
How many secondary bronchi are on the right?
A
3
14
Q
How many secondary bronchi are on the left?
A
2
15
Q
What attaches the lungs to the mediastinum?
A
The hilum
16
Q
What are the two pleuras?
A
- Parietal pleura
- Visceral pleura
17
Q
What cavity are the lungs surrounded by?
A
Pleural cavity
18
Q
What are the two pleuras continuous with each other as?
A
Lung hilum
19
Q
What is the parietal pleura adhered to?
A
Thoracic wall/rib change
20
Q
What is the visceral pleura adhered to?
A
The lungs
21
Q
What type of epithelium lines the pleura?
A
Simple squamous epithelium
22
Q
What do the pleura secrete?
A
Lubricating fluid, allows free movement of lungs against chest wall
23
Q
How many lobes does the left lung have?
A
2
24
Q
Why does the left lung have less lobes than the right?
A
Heart is overlapping
25
How many lobes does the right lung have?
3
26
What are the names of the right lung lobes?
- Upper
- Middle
- Lower
27
What are the names of the left lung lobes?
- Upper
| - Lower
28
What is the name of the fissure on the left lung?
Oblique fissure
29
What are the names of the fissures on the right lung?
Oblique fissure
| Horizontal fissure
30
What lies posterior to the trachea? (2)
- Left brachiocephalic vein
| - Thyroid isthmus at 2nd/3rd tracheal cartilage
31
What lies posterior to the trachea?
Oesophagus
32
What lies lateral to the trachea? (2)
- Carotid sheath : vagus nerve, common carotid, internal jugular
- Thyroid gland lobes
33
Label diagram of lungs
See notes
34
Give the 3 surfaces of the lungs
- Mediastinal surface
- Costal surface
- Diaphargmatic surface
35
Where does the mediastinal surface of the lung face?
Lateral aspect of middle mediastinum
36
What surface is the lung hilum on?
Mediastinal surface
37
What does the diaphragmatic surface of the lung form?
The base of the lung
38
What is the shape of the diaphragmatic surface of the lung?
Concave
39
Why is the concavity of the diaphragmatic surface deeper in the right lung?
Due to the higher position of the right dome overlying the liver
40
What is the shape of the lung costal surface?
Smooth and convex
41
Where does the costal surface of the lung face?
Chest wall
42
What are the 3 borders of the lungs?
- Anterior
- Inferior
- Posterior
43
What is the anterior border of the lung formed by?
Convergence of mediastinal and costal surfaces
| Has cardiac notch
44
Is the anterior border sharp/smooth and rounded?
Sharp
45
Is the inferior border sharp/smooth and rounded?
Sharp
46
Is the posterior border sharp/smooth and rounded?
Smooth and rounded
47
What is the inferior border of the lung?
Separates lung base from mediastinal surface and costal surface
48
What is the posterior border of the lung formed by?
Meeting of the mediastinal and costal surfaces posteriorly
49
Is the hilum on the medial/posterior side of lung?
Medial
50
What is the only part of the lung not covered in pleura?
Hilum
51
What is the lung hilum?
The site of exit/entry into the lung
52
What makes up the hilum and what are their positions?
- Pulmonary artery (normally above and medial to bronchus) and primary bronchus (both superior)
- Superior and inferior pulmonary veins
53
Describe the lymphatic drainage of the lung and visceral pleura
Bronchiopulmonary nodes (bifurcation of larger bronchi) ---> Tracheobronchial nodes (trachea bifurcation) in mediastinum ---> nodes along trachea ---> drain superiorly: right lymphatic duct (right lung) or thoracic duct (left lung)
54
Describe innervation of the lungs
Autonomic innervation through sympathetic trunks and vagus nerves via pulmonary plexi
55
What does parasympathetic innervation of the lung do?
Constricts bronchioles
56
What does sympathetic innervation of the lung do?
Dilates bronchioles
57
What type of membrane are the pleura?
Mesothelial
58
What cavity do the pleura line?
Thoracic cavity
59
Is the visceral pleura innervation autonomic/somatic?
Autonomic
60
Is the parietal pleura innervation autonomic/somatic?
Somatic
61
What nerves innervate the parietal pleura?
Phrenic and intercostal nerves
62
What are the parts of the parietal pleura? (4)
- Cervical
- Mediastinal
- Costal
- Diaphragmatic
63
Label the diagram of the parietal pleura
See notes
64
What is the arterial blood supply of the lungs and visceral pleura?
Bronchial arteries from thoracic/descending aorta
65
What is the venous blood drainage of the lungs and visceral pleura?
Bronchial veins drain to hemiazygous and azygous vein
66
What is the posterior border of the thoracic inlet?
T1
67
What is the lateral border of the thoracic inlet?
First pair of ribs (forming C shaped curves posterior to anterior)
68
What is the anterior border of the thoracic inlet?
Manubrium and costal cartilage of 1st rib
69
What is the thoracic inlet?
Opening at the top of the thoracic cavity
70
What structures run through the thoracic inlet? (10)
- Oesophagus
- Trachea
- Brachiocephalic veins
- Internal jugular veins
- Subclavian vein
- Left subclavian artery
- Left and right common carotid
- Vagus nerve
- Phrenic nerve
- Thoracic duct
71
Label the sternum
See notes
72
What are the 3 parts of the sternum?
- Manibrium
- Body
- Xiphoid process
73
What 2 notches are on the sternum?
- Jugular notch (top)
| - Clavicular notch (sides)
74
What attaches at the facets of the manibrium?
Costal cartilages of ribs 1-7
75
What type of joint is the manubriosternal joint?
Secondary cartilaginous (symphisis)
76
What plane passes through the manubriosternal joint?
Thoracic plane
77
What is the manubriosternal joint also known as and what vertebral level is it at?
- Sternal angle
| - T4/T5 intervertebral disc
78
What rib articulates at the sternal angle?
2nd
79
Label a rib
See notes
80
What are costochondral junctions?
Sites of articulation with costal cartilage
81
Where does the costal groove lie?
Inferior border of rib
82
What lies in the costal groove?
Intercostal neurovascular bundle
83
What are the vessels in the intercostal neurovascular bundle tributaries of?
Branches of subclavian artery and vein
84
Where should needles be inserted in thoracic cage and why?
Above a rib to avoid damage to intercostal neurovascular bundle
85
What is the order of the intercostal neurovascular bundle?
- Vein
- Artery
- Nerve (VAN)
86
What does the head of a rib articulate with?
Demifacets on vertebral body
87
What does the tubercle of a rib articulate with?
Costal facets on vertebral transverse processes
88
Which ribs are the true ribs?
1-7
89
What are true ribs?
Ribs attached to sternum by costal cartilages
90
What are false ribs?
Ribs not joining sternum directly but attached to 7th rib by cartilage
91
Which ribs are the false ribs?
8-12
92
What are atypical ribs?
Ribs with features not common to all ribs
93
Which ribs are atypical?
- 1st rib
| - Floating ribs (11th and 12th ribs)
94
What is atypical about the 1st rib?
- Shorter and wider
| - Superior surface marked by grooves for passage of subclavian vessels
95
What are the floating ribs?
- No neck
- Very short
- Do not attach to sternum anteriorly
96
What is the costal margin?
Curved lower margin of thoracic wall
97
What costal cartilages form costal margin?
7th-10th cartilages
98
What vertebrae is the lowest level of the costal cartilage opposite to?
L3
99
What type of joint is the costovertebral joint?
Synovial planar (gliding)
100
What are the articulations of the costovertebral joint?
Head of ribs and demifacets on vertebral body
101
What type of joint is the costotranverse joint?
Synovial planar
102
What are the articulations of the costotransverse joint?
Tubercules of ribs with costal facets on vertebral transverse processes
103
What type of joint is the sternocostal joint?
Synovial planar (except 1st=synchondrosis)
104
What are the articulations of the sternocostal joints?
Cartilages of true ribs with sternum
105
What type of joint is the sternoclavicular joint?
Synovial planar
106
What are the articulations of the sternoclavicular joint?
Manibrium and clavicle
107
What type of joint is the interchondral joint?
6-9 ribs: synovial gliding (freely moveable)
| 9-10ribs: synovial fibrous (slightly moveable)
108
What is the articulation of the interchondral joint?
Between costal cartilages ribs 6-9
109
What type of joint is the xiphisternal joint?
Primary cartilagenous
110
What is the articulation of the xiphisternal joint?
Between the sternum body and the xiphoid process
111
What type of joint is the manubriosternal joint?
Hyaline secondary cartilagenous
112
What are the articulations of the manubriosternal joint?
Manibrium and sternum body
113
Label the bones of the nasal cavity
See notes
114
What bones make up the nasal cavity? (5)
- Ethmoid
- Vomer
- Palatine
- Lacrimal
- Maxillary
115
Label the bones of the nasal septum (3)
- Perpendicular plate of ethmoid
- Septal cartilage
- Vomer
116
List the paranasal air sinuses
- Frontal
- Maxillary
- Sphenoid
- Ethmoid
117
Label the paranasal air sinuses
See diagram
118
What is the position of the frontal sinus?
Most superior, under forehead
119
What is the shape of the frontal sinus?
Triangular
120
Which paranasal sinus is absent at birth?
Frontal
121
What is the position of the sphenoid sinus?
2nd most superior, most posterior (in sphenoid bone)
122
What are the 3 ethmoid sinuses?
- Anterior ethmoid
- Middle ethmoid
- Posterior ethmoid
123
What is the position of the anterior ethmoid sinus?
Hiatus semilunaris
124
What is the position of the middle ethmoid sinus?
Ethmoid bulba
125
What is the position of the inferior ethmoid sinus?
Superior meatus
126
What is the position of the maxillary sinus?
Largest and most inferior and lateral
127
What does the maxillary sinus drain into?
Nasal cavity at hiatus semilunaris
128
What is the nasopharnyx posterior to?
Nasal cavity
129
What does the nasopharynx extent to and from?
From: skull
To: soft palate
130
What does the oropharynx extent to and from?
From: soft palate
To: superior epiglottis border (C3)
131
What does the laryngopharynx extent to and from?
From: superior epiglottis border (C3)
To: cricoid cartilage inferior border (C6)
132
What is the laryngopharnyx posterior to?
Larynx
133
What is the oropharynx posterior to?
Oral cavity
134
Name all 4 tonsils superior to inferior
- Pharyngeal
- Tubal
- Palatine
- Lingual
135
What is the ring of lymph tissue around the pharynx known as?
Waldeyer's ring
136
Describe the blood supply to the pharynx (branches of 4 main arteries)
Network of arteries ---> branches of:
- Facial artery
- Maxillary artery
- Laryngeal artery
- Lingual artery
137
What does the pharynx drain to?
Internal jugular vein
138
Describe the lymphatic drainage of the pharynx
Retropharyngeal nodes ---> Deep cervical nodes
139
What plexus innervates the pharynx?
Pharyngeal plexus
140
What cranial nerve innervates the motor actions of the pharynx?
Vagus
141
What cranial nerve innervates the sensory information of the pharynx?
Glassopharyngeal
142
List the laryngeal cartilages
- Thyroid
- Cricoid
- Epiglottis
- Artenyoid
- Corniculate
- Cuneiform
143
Which laryngeal cartilages are paired? (3)
- Artenyoid
- Cuneiform
- Corniculate
144
Which laryngeal cartilages are unpaired? (3)
- Epiglottis
- Cricoid
- Thyroid
145
What is the thyroid cartilage also known as?
Adam's Apple
146
What is special about the cricoid cartilage?
The only complete ring of cartilage surrounding larynx
147
What type of cartilage is cricoid cartilage?
Hyaline
148
What is the position of the cricoid cartilage?
C6 - larynx inferior border
149
What type of cartilage is the epiglottis?
Elastic
150
What is shape of the artenyoid cartilages?
Pyramid
151
Where does the artenyoid cartilage lie on top of?
Cricoid cartilage
152
Where does the corniculate cartilage lie on top of?
Artenyoid cartilage
153
What are the three membranes of the larynx?
- Thyrohyoid
- Cricothyroid
- Cricotracheal
154
What is the position of the thyrohyoid membrane?
Between upper border of thyroid cartilage and hyoid bone
155
What is the position of the cricothyroid membrane?
Between the thyroid and cricoid membrane
156
What is the position of the cricotracheal membrane?
Between cricoid membrane and the 1st tracheal ring
157
What is the aryepiglottic fold?
Triangular folds of mucous membrane
158
Where is the aryepiglottic fold found?
Extends from the epiglottis lateral borders to the arytenoid cartilage
159
What is the position of the quadrangular membrane?
Between lateral aspect of epiglottis and anterolateral arytheroid cartilage
160
Are the false vocal cords or true vocal cords superior?
The false vocal cords
161
What is the purpose of the false vocal cords?
Protection of larynx
162
What are the false vocal cords also known as?
Vestibular cords
163
Define "glottis"
Aperture between vocal cords
164
What is the rima glottidis?
Aperture between true vocal cords
165
What is the rima vestibuli?
Aperture between vestibular cords
166
Label cords, cartilages and membranes of larynx
See notes
167
What level is the angle of louis?
2nd intercostal space
168
What cavities does the diaphragm separate? (2)
- Thoracic
| - Abdominal
169
What are the 2 parts of the diaphragm?
- Central tendon
| - Peripheral muscle
170
What is the diaphragm?
Dome shaped sheet of skeletal muscle
171
What are the 2 purposes of the diaphragm? (2)
- Seperates thoracic and abdominal cavity
| - Contraction and relaxation to alter the volume of the thoracic cavity and the lungs = inspiration and expiration
172
What are the 3 hiatuses of the diaphragm and what level are they at?
- T8: caval hiatus
- T10: oesophageal hiatus
- T12: aortic hiatus
173
What structures pass through the diaphragm at T8 (caval hiatus)?
- Inferior vena cava
| - Right phrenic nerve
174
What structures pass through the diaphragm at T10 (oesophageal hiatus)? (2)
- Oesophagus
| - Left and right vagus nerve
175
What structures pass through the diaphragm at T12 (aortic hiatus)? (3)
- Aorta
- Thoracic duct
- Azygous
176
Describe the actions of the diaphragm in inhalation (3)
- Contracts and moves in inferior direction
- Causes partial vaccum in thoracic cavity
- Forces lungs to expand and fill with air
177
Describe the actions of the diaphragm in exhalation (2)
- Diaphragm relaxes
| - Air inhaled by elastic recoil process of lung
178
What provides motor supply to the diaphargm and what are its nerve roots?
Phrenic nerve (C3-C5)
179
Label the underside of the diaphragm
See notes
180
What is the difference between the way the left and right phrenic nerves pierce the diaphragm?
```
Right = at the caval hiatus
Left = inferior surface of diaphragm
```
181
What surface of the diaphargm do the phrenic nerves innervate?
Inferior surface
182
What level is the diaphargm at?
- Fifth intercostal space
- Rib 6
- T10/T11
183
What is at the same level as the diaphargm?
Apex of the heart
184
What is the sensory supply to the central diaphargm?
Phrenic nerves
185
What is the sensory supply to the peripheral diaphargm? (2)
- Intercostal nerves (T5-T11)
| - Subcostal nerves (T12)
186
What is the mediastinum?
Broad central compartment of thoracic cavity
187
What is the superior border of the thoracic cavity?
Thoracic inlet
188
What is the inferior border of the thoracic cavity?
Diaphragm
189
What are the parts of the mediastinum?
- Superior
| - Inferior (anterior, middle, posterior)
190
What divides the superior and inferior mediastinum?
Thoracic plane
191
What is the surface landmark of the thoracic plane?
Sternal angle (T4/T5)
192
What is the thoracic plane?
Line from the sternal angle to T4 vertebrae
193
What are the 3 parts of the inferior mediastinum?
- Anterior
- Middle
- Posterior
194
What is the anterior border of the anterior mediastinum?
Sternum body
195
What is the posterior border of the anterior mediastinum?
Pericardium
196
What are the contents of the anterior mediastinum? (2)
- Loose connective tissue
| - Thymus
197
What are the contents of the middle mediastinum? (9)
- Heart
- Pericardium
- Tracheal bifurcation
- L/R bronchi
- Ascending aorta
- Pulmonary trunk
- Superior vena cava
- Phrenic nerves
- Tracheobronchial lymph nodes
198
What is the anterior border of the middle mediastinum?
Anterior margin of pericardium
199
What is the posterior border of the middle mediastinum?
Posterior margin of pericardium
200
What is the anterior border of the posterior mediastinum?
Pericardium
201
What is the posterior border of the posterior mediastinum?
T4-T12 vertebrae
202
What are the contents of the posterior mediastinum? (7)
- Oesophagus
- Azygous vein (drains into superior VC)
- Sympathetic chain
- Descending thoracic aorta
- Abdominal aorta (T12 level)
- Posterior intercostal veins, arteries, nerves
- Thoracic duct
203
What are the contents of the superior mediastinum?
BATS TENT
- Brachiocephalic veins
- Aortic arch/azygous
- Thymus
- Superior VC
- Trachea
- Esophagus
- Nerves (phrenic and vagus)
- Thoracic duct
204
What is the purpose of the posterior cricothyroid muscle (intrinsic muscle)?
Breathing
205
What is the purpose of lateral cricoarytenoids muscle (intrinsic muscle)?
Adduct vocal cords
| Whispering
206
What is the purpose of oblique and transverse arytenoids muscle (intrinsic muscle)?
Normal speech
207
What is the purpose of cricothyroid muscle (intrinsic muscle)?
Singing and pitch
