Respiratory anatomy and histology Flashcards
what are the three lines used to demarcate the topography of the lungs?
midclavicular
midaxillary
paravertebral
what are the locations of adhesion for the lung and visceral pleura?
midclavicular - rib 6
midaxillary - rib 8
paravertebral - rib 10
what are the locations of adhesion for the parietal pleura?
midclavicular - rib 8
midaxillary - rib 10
paravertebral - rib 12
what is the best access for removal of pleural effusion fluid?
posterior 7th / 8th / 9th intercostal spaces
what is the superior pulmonary sulcus? what is the clinical relevance?
posterior concave curvature / region of thoracic wall
pancoast tumor can migrate superiorly to this sulcus
which type of tumor can migrate superiorly to the superior pulmonary sulcus?
pancoast tumor
what are the involved structures in a pancoast tumor?
sympathetics
brachial plexus
subclavian vessels
what is the brachial plexus manifestation of a pancoast tumor?
intrinsic hand muscle deficits due to C8/T1 involvement
what are the stellate ganglion manifestations of a pancoast tumor?
horner syndrome (ptosis, myosis, anhydrosis)
the lingula is associated with which lobe / region?
superior lobe of left lung
how many bronchopulmonary segments does the right lung have?
10
how many bronchopulmonary segments does the left lung have?
8-10
what is the relationship of the pulmonary artery to the bronchi in the right lung?
anterior
what is the relationship of the pulmonary artery to the bronchi in the left lung?
superior
at which thoracic level does the trachea bifurcate?
T4 / T5
the trachea begins at what vertebral level?
C6
what do segmental (tertiary) bronchi supply on the right and left sides?
right - 10 bronchopulmonary segments
left - 8 bronchopulmonary segments
what are the four components of the respiratory airways?
respiratory bronchioles
alveolar ducts
alveolar sacs
alveoli
the lamina propria of the vocal contains what structures?
vocal ligament
Reinke’s space
what is Reinke’s space?
histological space contained in the lamina propria of the vocal fold adjacent to the vocal ligament
what is the purpose of Reinke’s space?
fluid accumulation above and below (Reinke’s edema)
what constitutes the epithelium on the inner aspect of the larynx?
ciliated, pseudostratified columnar with goblet cells
what constitutes the epithelium on vocal folds, anterior surface of epiglottis, and external laryngeal surfaces?
non-keratinized stratified squamous
what cell types are the drivers of mucociliary clearance?
ciliated columnar cells
goblet cells span what regions of the respiratory tract?
trachea to primary bronchioles
what are the neuroendocrine cells of Kulchitsky?
numerous in fetal lung - proliferate in certain diseases of pulmonary system
where are smooth muscle bundles found in the respiratory tract?
interface of lamina propria and submucosa of intrapulmonary bronchi
the glands in the submucosa of the intrapulmonary bronchus secrete what substances?
mucins lactoferrin lysozyme IgA a1-antitrypsin and other protease inhibitors
75% of lung cancers originate in what bronchi?
1st, 2nd, and 3rd order bronchi
what are the histologic changes seen in asthma?
increased mucus increased thickness of basal lamina increased thickness of lamina propria due to edema and emigration of inflammatory cells increased thickness of muscularis increased glands in submucosa
what are the histological features of bronchioles?
lack cartilage
lack submucosa
goblet cells normally in large bronchiole
prominent muscle layer
where are club cells seen?
terminal and respiratory bronchioles
what is the function of club cells?
represent stem cell population
secrete surfactant
which pneumocyte makes up over 90% of the surface area?
type I
what are the functions of type I pneumocytes?
facilitate gas diffusion between blood and alveoli
which pneumocyte secretes surfactant?
type II
what are the functions of type II pneumocytes?
secrete surfactant
cell division
where are alveolar macrophages seen?
alveolar lumen
what forms the blood gas barrier?
type I pneumocytes with adluminal surfactant
fused basal laminae of type I pneumocyte and continuous capillary
