Respiratory Anatomy Flashcards

1
Q

What are the passageways between the ambient environment and gas exchange units of the lungs (alveoli) known as?

A

Conducting Airways

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2
Q

What does the upper airway consist of?

A

Nose, oral cavity, pharynx, and larynx.

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3
Q

The function of the upper airway includes

A

To act as a conductor of air; to humidify cool and warm inspired air;

Prevent foreign materials from entering the tracheobronchial tree;

Serve as an important area in speech and smell

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4
Q

Where is stratified squamous epithelium found?

A

The anterior portion of the nasal cavity, oral cavity oropharynx, and laryngopharynx.

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5
Q

What are the three bony protrusions on the lateral walls of the nasal cavity?

A

Superior, middle and inferior nasal turbinates or conchae.

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6
Q

What are turbinates?

A

Play a major role in humidification and warming of inspired air.

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7
Q

What are the two nasal passageways between the nares and the nasopharynx called?

A

Choanae

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8
Q

What patient problems can be seen regarding the soft palate and uvula?

A

Patients will have difficulty swallowing, sucking, blowing, and speech sounds.

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9
Q

What elevates the soft palate?

A

Levator veli palatine.

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10
Q

What is the oral cavity lined with?

A

Nonciliated stratified squamous epithelium.

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11
Q

Where is stratified squamous epithelium found?

A

The anterior portion of the nasal cavity, oral cavity oropharynx, and laryngopharynx.

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12
Q

What is pseudostratified ciliated columnar epithelium?

A

These have hair like projections that extend from the outer surface (mucous-producing goblet cells). It is found two-thirds of the nasal cavity in the traceobronial tree.

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13
Q

What is simple cuboidal epithelium?

A

Substances of O2 and C02 passes through this tissue. These cells form the walls of the alveoli (Pulmonary capillaries that sound the alveoli).

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14
Q

What is the nasopharynx lined with?

A

Pseudostratified ciliated columnar epithelium.

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15
Q

What is the other name of pharyngeal tonsil?

A

Adenoid.

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16
Q

What happens if the pharyngeal tonsil is inflamed?

A

It may block the passage of air between the nose and throat.

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17
Q

Otitis media and ear infection

A

Commonly seen in children due to Inflammation and excessive mucus production in the pharyngotympanic tube may disrupt the pressure equalizing process with impair hearing

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18
Q

What is the vallecula epiglottica?

A

Important landmark during the insertion of the endotracheal tube in the trachea.

Located between the glossoepiglottic folds on each side of the posterior oropharynx.

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19
Q

Where is the larynx located?

A

Between the base of the tongue and the upper end of the trachea.

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20
Q

Where is mucous produced?

A

Goblet cells and submucosal or bronchial glands.

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21
Q

What gland produces the most mucous?

A

The submucosal glands

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22
Q

Cartilage of the Larynx

A

9 cartilages form the framework of larynx:

Largest Single Structure

  1. Thyroid Cartilage
  2. Epiglottis
  3. Cricoid Cartilage

Pairs of Accessory Cartilage

4, 5. Arytenoids

6, 7. Corniculate

8,9. Cuneiform

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23
Q

Narrowest part of the airway in infants

A

Cricoid Cartilage

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24
Q

What is the epiglottis?

A

It is a broad, spoon-shaped fibrocartilaginous structure. It prevents the aspiration of foods and liquids by covering the opening of the larynx during swallowing.

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25
Q

What is the narrowest point of the larynx?

A

Glottis.

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26
Q

What NS controls mucous production

A

The parasympathetic nervous system innervated the mucous glands

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27
Q

Trachea

A

from C6 to T5

11 cm long in adults

1.5-2.5 cm in diameter

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28
Q

Carina

A

The carina is the bifurcation of the trachea into the right and left bronchi

Cough receptors are located at the carina

The right bronchus is 20-30 degrees from midline

Likely route the endotracheal tube will take if advanced too far because of its smaller angle

The left bronchus is 45-55 degrees from midline

Smaller in diameter but twice as long

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29
Q

Lobar Bronchi

A

There is 5 lobar bronchi the correspond to the five lobes of the lung

The epithelial lining of the lobar bronchi is pseudostratified cilated columnar epithelium

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30
Q

What are lobal bronchi?

A

There is 5 lobar bronchi the correspond to the five lobes of the lung

The epithelial lining of the lobar bronchi is pseudostratified cilated columnar epithelium

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31
Q

What are the segmental bronchi?

A

Sometimes referred to as tertiary bronchi

18 segmental bronchi with 18 segments of the lung

Third generation of bronchi branch off the lobar bronchi to form the segmental bronchi.
10 semental bronchi in the right lung and 8 in the left.

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32
Q

Lobes of the Left Lung

A

Left lung is divided into two lobes: superior and inferior (Upper, Lower)

There is the oblique fissure which divides the lobes and is located at the 6th rib midclavicular, 5th rib midaxillary and T3

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33
Q

Right Lobes of the Lung

A
  • Right lung is divided into three lobes; superior, middle, and inferior
  • The oblique fissure isolates the right lower lobe from the right middle and upper lobe. The oblique fissue is located
    • 6th rib and midclavicular line
    • 5th rib and midaxillary line
    • T3
  • Horizontal fissure divides the right upper and middle lobe
    • 5th rib and midaxillary line
    • Medial course of 4th rib
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34
Q

Functional units of the Lung

A

Lobes are further divided into functional units (bronchopulmonary segments)

Ten segments in the right lung

Eight segments in the left lung

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35
Q

Type I Epithelial Cells

A

Squamous pneumocytes that are extremely flat

Comprise most of alveolar surface area (~95%)

36
Q

Type II Epithelial Cells

A

Granular pneumocytes that are compact and polygonal shaped

Will protrude into the alveolar airspace

Contains lamellar bodies

Secrete surfactant

Can morph into type 1 cells

37
Q

Nonepithelial Cells of Alveoli

A

Alveolar Macrophages: Wandering killer cells

Eosinophils: Associated with asthma caused by allergens

Neutrophils: Associated with bacterial infections

Mast Cells: On epithelial surface of airways, mediators of inflammation released from granules

38
Q

Primary muscles used for quiet breathing

A

Diaphragm (major effect)

Parasternal intercostals (minor effect)

Scalenes (minor effect)

39
Q

Accessory muscles used for increased work of breathing (WOB)

A

Scalenes (inspiration)

Sternocleidomastoids (inspiration)

Pectoralis major (inspiration)

Abdominals (expiration)

40
Q

What is the lamina propria?

A

The submucosal layer of the tracheobronchial tree. Within there is loose, fibrous tissue that contains tiny blood vessels, lymphatic vessels, and branches of the vagus nerve.

41
Q

What surrounds the lamina propria?

A

Thin connective tissue called peribronchial sheath.

42
Q

What is the immune response and which cells are responsible for this action?

A

Mast cells play an important role in the immunologic mechanism. They are found in the lamina propria.

Substances that can significantly alter the diameter of broncial airways and chemical mediators that are released as the mast cell degranulates.

43
Q

What is the composition of the tracheobronchial tree?

A

Branching airways commonly referred as generations or orders; cartilaginous airways and non-cartilaginous airways.

44
Q

What are cartilaginous airways?

A

Serve only to conduct air between the external environment and the sites of gas exchange.

45
Q

What are non-cartilaginous airways?

A

Serve as both as conductors of air and sites of gas exchange.

46
Q

What layers is the tracheobronchial tree composed of?

A

Epithelial lining, lamina propria and cartilaginous layer.

47
Q

. How many c shaped cartilages support the trachea?

A

15 to 20.

48
Q

What is the right mainstem bronchus?

A

Branches off the trachea are 25 degree angle. It is wider and 5 cm shorter than the left. The right is wider and more vertical than the left.

49
Q

What is the left mainstem bronchus?

A

40 to 60 degrees with the trachea.

50
Q

What are the non-cartilaginous airways?

A

Bronchioles and the terminal bronchioles.

51
Q

How much of patients cardiac output feeds the tracheobronchial tree?

A

The normal bronchial arterial blood flow is 1 % of the cardiac out.

52
Q

What is venous admixture?

A

The mixing of venous blood and freshly oxygenated blood.

53
Q

What are type 1 cella?

A

Also called squamous pneumocytes. They consist of cytoplasmic ground substance 95 percent alveolar surface. 0.1 to 05 nanometer thick are major sites of alveolar gas exchange. Type 1 cells die and they are not able to reproduce.

54
Q

What is a type 2 cell?

A

Granular pneumocytes.

They can reproduce and convert to type 1 cells.

Remaining 5% of the total alveolar surface.

They have pulmonary surfactant. Plays a major role in decreasing the surface tension of the fluid that lines the alveoli (alveolar epithelium).

55
Q

What are pores of Kohn and where are they located?

A

Small holes in the walls of the interalveolar septa; 3-13 nanometers in diameter and permit gas to move between adjacent alveoli; the desquamation (shedding or peeling) of the epithelial cells; the normal degeneration of tissue cells as a result of age; and, the movement of macrophages which may leave holes in the alveolar walls.

56
Q

What role do the alveolar macrophages play?

A

For type 3 plays a major role in removing bacteria and other foreign particles

57
Q

What is the role and importance of the pleural linings and cavity?

A

Visceral: the outer surface of each lung; parietal: inside the thoracic walls, thoracic surface of the diaphragm and the lateral portion of the mediastinum; and, pleural cavity: space between the visceral and parietal contains pleural fluid which provides lubrication as lung expands and contact during respiration.

58
Q

What is the joint between the manubrium and the body of the sternum called?

A

The manubriosternal joint also referred to the sternal angle or angle of Louis.

59
Q

What are the first 7 ribs?

A

True ribs because they are attracted directly to the sternum.

60
Q

What are the 8-10 ribs?

A

False ribs because it attaches to the cartilage of the ribs above.

61
Q

What are the 11-12 ribs?

A

Floating ribs, they are 11 intercostal spaces between the ribs and contain veins arteries and nerves.

62
Q

What is the major muscle for ventilation?

A

The diaphragm is the major muscle for ventilation.

63
Q

What are the accessory muscles of inspiration?

A

External intercostal, scalenus, sternocleidomastoid, pectoralis muscle and trapezius muscle.

64
Q

What are the accessory muscles of expiration?

A

Rectus abdominis muscle, external abdominis oblique muscle, internal abdominis obliques muscle, transverse abdominis muscle, and internal intercostal muscle.

65
Q

What does an increased AP diameter represent?

A

Air trapping in the lungs. Commonly seen in patient with COPD.

66
Q

What is the normal AP diameter?

A

1:2 in normal adults.

67
Q

What are the three layers of tissues in an arterial vessel?

A

Inner layer (tunica intima) composed of endothelium and a thin layer of connective and elastic its.

Middle layer (Tunica Media) composed of elastic connective tissue in large arteries and smooth muscle.

And, outer layer (Tunica adventitia) composed of connective tissue that is suited for carrying blood under high pressures in the systemic system.

68
Q

What is the importance of the capillary beds of the lungs?

A

Gas and fluid exchange, they play an important biochemical role in the production and destruction of a broad range of biologically active substances

69
Q

What are the resistance vessels?

A

Arterioles play an important role in the distribution and regulation of blood.

70
Q

Why are veins referred to as capacitance vessels?

A

Because they are capable of collecting a large amount of blood with very little pressure change.

71
Q

What is the lymphatic system?

A

Removes excess fluid and protein molecules that leak out of the pulmonary capillaries.

72
Q

What is peristaltic moment?

A

The larger lymphatic channels are surrounded by smooth muscle bands that actively produce peristatlic movements regulated by the ANS.

73
Q

What role do the lymph nodes serve?

A

The nodes act as a filter, keeping particulate matter and bacteria from entering the bloodstream.

74
Q

What is the majority of the lymph structure found and how does this affect the possibility of pleural effusions comparatively between the left and right lung?

A

The majority of them are found in the surface of the lower lung lobes. Bilateral effusion patients have more fluid in the lower right then in the lower left.

75
Q

What are alpha cells?

A

Alpha receptors of the smooth muscles of the arterioles causing the pulmonary vascular system to constrict. The parasympathetic nervous system is activated causing the constriction of the bronchial smooth muscle.

76
Q

What are beta receptors?

A

It is called propranolol. If the patient receives a parasympathetic and it causes the bronchial relation occurs.

77
Q

To what extent do the apices rise relative to the thorax?

A

The apices rise to about the level of the first rib.

78
Q

How does the horizontal fissure extend?

A

Horizontally from the oblique fissure to about the level of the 4th costal cartilage and separate the middle from the upper lobe.

79
Q

What of the following line the anterior one- third of the nasal cavity?

A

Stratified squamous epithelium.

80
Q

Where are the canals of lambert found?

A

Terminal bronchioles.

81
Q

What cells does ninety- five percent of the alveolar surfaces composed of?

A

Type 1 and squamous pneumocytes.

82
Q

What are released when the parasympathetic nerve fibers are stimulated?

A

Acetycholine.

83
Q

What is released when the sympathetic nerve fibers are stimulated?

A

Norepinephrine and epinephrine.

84
Q

Pseudostratified ciliated columnar epithelium lines what?

A

Trachea and nasopharynx.

85
Q

What are accessory muscles of inspiration?

A

Trapezius and scalene muscles.

86
Q

What does the horizontal fissure separate?

A

Middle and upper lobes of the right lung.

87
Q

What supplies motor innervation of each hemidiaphragm?

A

Phrenic and glossopharyngeal nerve (9th cranial nerve).