Respiratory II Flashcards
3 portions of respiratory system
air conducting = conditions inspired air
respiratory = gas exchange
ventilation = insp/exp thoracic cage
air conduction portion
warmed by venous plexus and hoisted by secretions of seromucous glands in GOBLET cells
nasal conchae
turbulence to help warm and moisten air
pharynx, where does it begin and end
begin: base of skull
end: inferior cricoid cartilage C6
3 parts of pharynx
nasopharynx
oropharynx
laryngopharynx
larynx
anterior neck, windpipe
functions of larynx
phonation, cough reflex, protect lower respiratory tract
3 parts of larynx
supra glottis
glottis
subglottis
supra glottis
epiglottis to false VC (vestibular folds)
glottis
VCs and 1cm below
rima glottidis
opening between VCs
subglottis
inferior glottis to inferior cricoid cartilage
epiglottis
flap of cartilage behind tongue, at top of larynx
clinical relevance of larynx
emergency intubation, apply cricoid pressure to cricoid of larynx to occlude esophagus and prevent regurgitation of gastric contents
laryngeal muscles
phonation and breathing
3 UNPAIRED cartilages
epi, thy, cri
3 paired cartilages
arytenoid
corniculate
cuneiform
is the larynx continuous with the trachea?
yes, opens superiorly into trachea
cricothyroid muscle: innervated by what
external laryngeal nerve (CN X)
posterior cricoarytenoid muscle
abducts vocal folds, sole opener of vocal folds
clinical relevance = vocal cord paralysis. what is the movement of VC controlled by?
what is it innervated by?
movement of VC is controlled by intrinsic muscles of larynx
innervated by: RECURRENT LARYNGEAL NERVE
(motor innervation to all laryngeal except cricothyroid)
Recurrent laryngeal nerve (RLN) palsy: causes
thyroid cancer
apical lung tumor
aortic aneurysm
unilateral RLN palsy
one VC, speech not affected
hoarseness
bilateral RLN palsy
both VCs paralyzed
breathing impaired
no phonation
if rima glottidis closes –> emergency
what are the trachea and bronchi supported by
C-shaped rings
what does the trachea bifurcate into
main bronchi (primary, mainstem)
right mainstem bronchi
shorter & wider
develops week 4 with laryngeal diverticulum
primary R and L bronchi
R and L lungs
carina
separates right and left primary bronchi
secondary/lobar bronchi
# of lobes R=3, L=2
What are the right and left lungs separated by
middle mediastinum = heart and great vessels
right lung
horizontal and oblique fissure
larger, shorter, wider
surface impressions on R lung
azygous R brachiocephalic SVC esophagus heart
what does horizontal fissure separate on R lung
upper and middle lobe
what does oblique fissure separate on R lung
lower from upper and middle
left lung, what are the 2 unique features
oblique fissure
2 unique features:
1. cardiac notch on upper lobe
2. lingula (analogous to middle lobe of R lung)
what does oblique fissure separate on L lung
lower and upper
surface impressions on L lung
esophagus
thoracic aorta
L SC
heart
hilum of lung
doorway; area where structure forming the root of the lung actually touches lung tissue
main primary bronchi
C-shaped rings
R = wider and more vertical than left, 2-3cm
ASPIRATED OBJECTS LODGE MORE R THAN L
L = narrower and more horizontal, 5cm
lobar secondary bronchi
crescent shaped rings
= # of lobes
tertiary segmental bronchi
cresent shaped rings
R = 10
L = 8
bronchopulmonary segment = unit of lung tissue
blood supply: lungs
Lungs supplied with DE-OX via paired pulm arteries
once OX, leaves lungs via 4 pulm veins
blood supply: bronchi/roots/tissues
bronchial arteries, descending aorta
innervation: lungs
parasympathetic
sympathetic
visceral afferent/sensory
derived pulmonary plexuses
PARA = vagus = vasoD, secretion, contract bronchial sm. m
SYMPATHETIC = sympathetic trunks (cardiopulmonary, thoracic splanchnic = relax sm. m, vasoC
VISCERAL = conduct pain impulse to sensory ganglia of vagus (REFLEX)
lymphatic drainage: lungs
lymph –> pulm nodes –> bronchopulmonary nodes (hilum) –> tracheobronchial nodes –> L/R bronchomediastinal trunks
visceral pleura of lungs: function
blood supply
veins
nerve supply
=covers lungs
blood supply = bronchial artery
veins = azygous/hemiazygous v.
nerve supply = NONE
parietal pleura of lungs: function
blood supply
veins
nerve supply
= covers internal surface of thoracic cavity
blood supply =
1. cervical, costal = intercostal
2. diaphragmatic = intercostal (peripheral), pericardiacophrenic (central tendon)
3. mediastinal = pericardiacophrenic
veins: drain companion veins of arterial supply
nerve:
pleural cavity
between visceral and parietal layer
pleural recesses
where parietal pleurae can oppose
occupied by lungs only on forced/deep inspiration
why are the pleural recesses important
fluid collects in disease areas for aspiration and or drain fluid
costomediastinal recess
between costal and mediastinal pleurae, ant. border of lung
deep insp
costodiaphragmatic recess
between costal and diaphragmatic pleurae, along inf. border of lung
deep insp
