Respiratory Anatomy Flashcards by Samantha Holmes

Where does the respiratory system develop from?

From diverticulum from the pharynx, which bifurcates and keeps dividing

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What structures are in the upper respiratory tract?

Nostrils to lower border of cricoid cartilage

Nose, paranasal sinuses pharynx, larynx

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Describe how the structure of the nose is conducive to warming, humidifying and filtering particles in inspired air

Moist surface

Vascular mucosa = warm and humidify

Bony prominence (nasal conchae) = increase surface area to increase contact between air and mucosa and turbulent air flow (slow = maximises gas exchange)

Cilia

Recover water from expired air

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How does turbulent flow effect gas exchange?

Higher the turbulent flow the higher the gas exchange

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What 3 regions is the pharynx divided up into?

Nasopharynx

Oropharynx

Laryngopharynx

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What is the function of the pharynx?

Ensure food and air get directed to the right area

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What are the paranasal sinuses?

4 paired air-filled spaces surrounding the nasal cavity

Help the nasal cavity to warm and moisten air

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Where are the vocal cords located?

Larynx

Glottis = cords + aperture between cords

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Describe how the larynx protects the airway during swallowing

Epiglottis is forced over the glottis’ to prevent swallowed material from entering the larynx, the larynx is also pulled upward to assist this process

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Explain how the structure of the trachea aids swallowing?

Cartilaginous rings are incomplete to allow the trachea to collapse slightly so that food can pass down the oesophagus

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Explain why hoarseness of voice /voice change may be a sign of intra thoracic disease

Left recurrent laryngeal N wraps under the aortic arch. Aneurysm/cancer can impinge the N and result in hoarseness

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What is the boundary between the thorax and the abdomen?

Diaphragm

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What bones make up the thorax?

Ribs

Thoracic vertebrae

Sternum

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What are the features of a typical rib?

Head – articulates with superior and inferior vertebrae

Tubercle – articulates transverse process

Shaft – flat and curved

Costal cartilage – articulates sternum

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What are the floating ribs?

They do not attach anteriorly to the sternum

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How can you increase the volume of the thoracic cavity?

Increase the lateral dimension = lateral elevation – bucket handle

Increase the anterior-sternum dimension = anterior elevation – pump handle

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Describe rib movements during respiration

Bucket handle = Movement at costovertebral joints 7 to 10 about an anteroposterior axis results in raising and lowering the middle of the rib

Pump handle = Movement at costovertebral joints 2 to 6 about a side-to-side axis results in raising and lowering the sternal end of the rib

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What is the contents of the costal groove?

Intercostal artery
Intercostal vein
Intercostal nerve

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How is air drawn into the lungs?

Expansion of the lungs = alveolar pressure is now lower than atmospheric pressure = air enters alveoli

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What type of muscle is the diaphragm?

Skeletal muscle

How is the diaphragm innervated?

Somatic control – phrenic nerve

Why is the diaphragm domed?

Allows for movement

Means that the liver is protected by the ribs as it can sit more superiorly

Describe the external, internal and innermost layers of the intercostal muscles

3 layers connecting ribs

All intercostal N (T1-T11)

Anteriorly the external intercostal is deficient

Posteriorly the internal intercostals is deficient

Lateral is where the innermost intercostal are found

External = anterio-medial direction of muscle fibres = contract = pull ribs upwards, increasing volume (inhalation)

Internal = right angle to external (antagonist) = contract = pull ribs down and backwards, reduces volume (forced expiration)

Innermost = depresses ribcage, reduces volume

Describe the course of the intercostal nerves, arteries and veins

Runs between the internal and innermost intercostal muscles

Below the rib

Describe how to avoid damaging them during pleural aspiration or insertion of a chest drain

always go above to rib to avoid the major neurovascular bundle

What are the 3 major structures passing through the diaphragm?

Vena cava – T8 Oesophagus – T10 Aortic hiatus - T12

What are the accessory muscles of the respiratory system?

SCM Scalene muscles – anterior, middle and posterior

What is the azygos venous system?

Collect blood from the intercostal spaces From the main azygos vein to the SVC

What are the motor and sensory functions of the phrenic nerve?

Sensory = central diaphragm, surrounding pleura and peritoneum, pericardium Motor = diaphragm

Outline the differences between the L and R lung

L = 2 lobes, lingula (remanence of middle lobe), groove for the aorta R = 3 lobes, groove for the oesophagus

When listening to the posterior chest what part of the lung is it?

Inferior lobe, makes up most of the posterior border

Why would a foreign body enter the R main bronchi rather than the left?

R = more vertical orientation

What region can the mediastinum be broken into?

Superior = trachea, aortic arch Inferior = heart, descending aorta, oesophagus, thoracic duct

What is contained in the pleural cavity

Between the visceral and parietal pleura = contain pleural fluid (few mls)

What is the pleura

Parietal -> On the chest wall Visceral -> On the surface of the lung

What is the nerve supply of the pleura

Parietal -> Sensitive to pressure/pain/temp, intercostal Ns = sharp, phrenic N Visceral -> Sensory fibres only detect stretch, pulmonary plexus

What is the role of the pleural recesses?

Allows the lungs to expand into them Pathologically – can fill with fluid (pleural effusion)

What is the role of the pleural fluid and the pleural seal in lung expansion?

Serous fluid lubricates and produces surface tension = pulls parietal and visceral pleura together = when thorax expands so does the lung

What is a pneumothorax?

When air enters the pleural cavity = surface tension lost (can cause the lung to collapse)

What are the brochopulmonary segments?

Area of lung supplied by a segmental bronchus and the accompanying segmental branch of the pulmonary artery Drained by a segmental pulmonary vein Pyramid shaped

What is the blood supply to the lung tissue?

Bronchial arteries Bronchial veins

What is the nerve supply of the lungs?

Derived from the pulmonary plexuses Parasympathetic (vagus N) – contraction bronchial smooth muscle, vasodilation pulmonary vessels Sympathetic (sympathetic trunk) – relaxation bronchial smooth muscle, vasoconstriction pulmonary vessels Visceral afferent – pain impulses

Describe the structure (histology) of the airways and alveoli and relate it to the functions and defence of the lungs

Nasal cavity/pharynx/larynx/trachea/prim bronchi/sec bronchi = pseudostatified ep, cilia, goblet cells Bronchioles/term bronchioles = simple columnar ep, cilia, clara cells Respiratory bronchioles/alveolar ducts = simple cuboidal ep, clara cells, sparse cilia Alveoli = simple squamous, type 1 + type 2 cells

Distinguish bronchi from bronchioles

Bronchi = cartilage completely encircles Bronchioles = smaller, do not contain cartilage or goblet cells, club cells prod surfactant

Define what is meant by the term bronchiole

Last generation of conducting airways Gives off respiratory bronchioles which feature alveoli

Define respiratory bronchiole

Smallest bronchioles Give off alveoli = gaseous exchange

Define alveolar duct

Connect respiratory bronchioles to alveolar sacs

Define alveolus

Tiny air filled sacs for gaseous exchange

Distinguish between the conducting zone and the respiratory zone of the airways

Conducting = trachea, primary bronchi, sec bronchi, tertiary bronchi, bronchioles, terminal bronchioles Respiratory = respiratory bronchioles, alveolar ducts, alveoli