Respiratory system Flashcards
1
Q
What are the two types of anatomy systems in the respiratory system?
A
airway anatomy
lung anatomy
2
Q
Which part of the respiratory system includes a conducting system with no gas exchange?
A
airway anatomy
3
Q
Which part of the respiratory system includes a conducting system within the lungs and a lung parenchyma where gas exchange occurs?
A
lung anatomy
4
Q
Which lung (right or left) is more involved in pneumonia aspiration?
A
right lung
5
Q
What are the different parts of the upper respiratory tract (URT)?
A
-nasal cavity/oral cavity
-pharynx
-larynx
6
Q
What are the different parts of the lower respiratory tract (LRT)?
A
-trachea
-bronchial tree to alveoli
7
Q
What is the pattern of the tracheobronchial tree?
A
- trachea
- right and left main bronchi (R and L lungs)
- lobar bronchi (lobes of the lungs)
8
Q
How much lobes does the right lung have?
A
3
9
Q
How many lobes does the left lung have?
A
2
10
Q
What is the function of the trachealis muscle?
A
- contract - reduce diameter of trachea - more forceful coughing
- relax during swallowing - allow esophagus to expand for passage of bolus of food towards stomach
11
Q
Where is the trachea located?
A
superior mediastinum
12
Q
What level does the trachea bifurcate at?
A
the level of the transverse thoracic plane (or sternal angle)
13
Q
What does the trachea bifurcate into?
A
main bronchi, one to each lung, passing inferolaterally to enter the lungs at the hila
14
Q
Around what vertebral level does the trachea begin?
A
C6
15
Q
At what cartilage does the trachea begin?
A
the cricoid cartilage
16
Q
How many incomplete hyaline cartilaginous rings does the trachea have that open posteriorly?
A
18 to 20
17
Q
What do the hyaline cartilaginous rings that the trachea has prevent?
A
prevents the trachea from collapsing during exhalation & allows it to stay up and down
18
Q
What serves as an important landmark during bronchoscopy because it lies between the superior ends of the right and left main bronchi?
A
the carina
19
Q
How is the carina usually positioned?
A
usually positioned slightly to the left of the median plane of the trachea
20
Q
Why is it that when foreign bodies are aspirated, they usually enter the right main bronchus?
A
because it is wider and more vertically oriented than the left main bronchus
21
Q
What are the names of the 3 lobes of the right lung?
A
-superior lobe
-middle lobe
-inferior lobe
22
Q
What are the names of the 2 lobes of the left lung?
A
-superior lobe
-inferior lobe
23
Q
What separates the superior and middle lobe from the inferior lobe of the right lung?
A
oblique fissure
24
Q
What separates the superior lobe from the middle lobe of the right lung?
A
horizontal fissure
25
What separates the superior lobe from the inferior lobe of the left lung?
oblique fissure
26
What is thought to be a remnant of the middle lobe of the right lung and means "tongue"?
lingula
27
What lung is the lingula on?
the left lung
28
What landmark is where structures enter or exit the lung?
hilum of the lung
29
What structures enter/exit the lung at the hilum?
-bronchi
-pulmonary a. and v.
-bronchial a. and v.
-lymphatics
-nerves
30
What is a pedicle (3-dimensional structure) connecting the lungs with the mediastinum?
root of the lung
31
What do the lobar bronchi divide into?
segmental bronchi
32
What do the segmental bronchi divide into?
bronchopulmonary segments
33
What is the largest subdivisions of the lobes and has a distinct airway and arterial supply?
bronchopulmonary segments
34
How many bronchopulmonary segments are there per lung?
10
35
What structures are included in the conducting zone of the lower respiratory tract?
-trachea
-bronchi
-all bronchioles that lack alveoli
36
What structures are included in the respiratory zone of the lower respiratory tract?
-respiratory bronchioles
-alveolar sacs
37
How many successive bifurcations are there between the trachea and alveoli?
23
38
What do the alveolar sacs allow for?
gas exchange
39
What is a serous membrane forming a closed sac (pleural cavity)?
pleura
40
What invaginates the pleural sacs and become surrounded by a double layer of pleura?
developing lungs
41
What are the two layers of pleura around the lung?
parietal and visceral
42
The parietal and visceral layers of the lung are continuous at what?
root of the lung
43
The pleural cavity is a space filled with about how much pleural fluids?
about 15 mL (1 Tbsp)
44
What are the different parts of the parietal pleura?
-cervical pleura
-costal part
-diaphragmatic part
-mediastinal part
45
What are the right and left pulmonary cavities (pleural cavities) separated by?
middle mediastinum
46
What does the visceral pleura adhere to?
the lungs
47
What does the parietal pleura adhere to?
the body wall, mediastinum, and diaphragm
48
What separates the lungs from surrounding structures in the thorax?
pleural cavity with constant volume of pleural fluid
49
Expansion of the thoracic cavity (chest wall, diaphragm, and adherent parietal pleura) will be transferred directly to?
the lungs
50
What "keeps the diaphragm alive"?
(phrenic n.)
51
What are the two types of movement in the transverse dimension for an increase in thoracic cavity volume?
-pump handle movement
-bucket handle movement
52
What happens in the pump handle movement of the thoracic cavity?
elevates the upper ribs
increases AP diameter
53
What happens in the bucket handle movement of the thoracic cavity?
elevates lower ribs
increases lateral diameter
54
What muscles are involved in quiet breathing inspiration/inhalation?
external intercostal muscles and interchondral part of the internal intercostal muscles
55
What are the functions of the external intercostal muscles (and interchondral part of internal intercostal muscles)?
-draw ribs up, increase thoracic transverse diameter
-supports intercostal space (resists interchondral retraction with inhalation)
56
What is the sequence of events in quiet breathing inspiration/inhalation?
1. inspiratory muscles contract (diaphragm descends, rib cage rises)
2. thoracic cavity volume increases
3. lungs stretched; intrapulmonary volume increases
4. intrapulmonary pressure drops
5. air (gases) flows into lungs down its pressure gradient until intrapulmonary pressure is 0 (equal to atmospheric pressure)
57
What prevents total collapse of the lung during exhalation?
elastic recoil of the chest wall (passive)
58
What is the sequence of events in quiet breathing expiration/exhalation?
1. inspiratory muscles relax (diaphragm rises; rib cage descends due to gravity)
2. thoracic cavity volume decreases
3. elastic lungs recoil passively; intrapulmonary volume decreases
4. intrapulmonary pressure rises
5. air (gases) flows out of lungs down its pressure gradient until intrapulmonary pressure is 0
59
What type of mechanism is quiet breathing expiration/exhalation?
passive mechanism (muscle relaxation)
60
What occurs in active breathing inspiration/inhalation?
1. enhance engagement of primary respiratory muscles
2. recruitment of accessory inspiratory muscles to raise clavicle, sternum, and upper ribs
61
What does the sternocleidomastoid do in active inspiration/inhalation?
elevates sternum
62
What does the scalenes muscle do in active inspiration/inhalation?
fix or elevate ribs 1-2
63
What does the pectoralis minor muscle do in active inspiration/inhalation?
elevates ribs 3-5
64
What do the internal intercostal muscles (interchondral part) do in active inspiration/inhalation?
aid in elevating ribs
65
What does the diaphragm do in active inspiration/inhalation?
descends and increases depth of thoracic cavity
66
What muscles are involves in active or forced exhalation/expiration?
-internal intercostals (interosseous part)
-diaphragm
-rectus abdominis
-external abdominal oblique
67
What does the internal intercostal muscles (interosseous part) do in active/forced expiration/exhalation?
depresses ribs 1-11; narrow thoracic cavity
68
What does the diaphragm do in active/forced expiration/exhalation?
ascends and reduces depth of thoracic cavity
69
What do the rectus abdominis muscles and external abdominal oblique muscles do in active/forced expiration/exhalation?
depresses lower ribs; pushes diaphragm upward by compressing abdominal organs
70
What are the accessory muscles of inspiration?
-sternocleidomastoid
-scalenes group
-pectoralis minor
71
What are the accessory muscles of inspiration innervated by?
accessory nerve
cervical spinal nerves
72
What are the principal muscles of inspiration?
-external intercostals
-interchondral part of internal intercostals
-diaphragm
73
What are the principal muscles of inspiration innervated by?
intercostal nerves (T1-T11)
phrenic nerve
74
What is involved in quiet breathing expiration?
results from passive, elastic recoil of the lungs, rib cage, and diaphragm
75
What are the muscles of expiration of active breathing?
-internal intercostals except interchondral part
-abdominals
-quadratus lumborum
76
What are the muscles of expiration in active breathing innervated by?
intercostal nerves (T1-T11)
thoracic and lumbar spinal nerves
77
What is the superior attachment of the external intercostal m, internal intercostal m, and innermost intercostal m.?
inferior border of the rib above
78
What is the inferior attachment of the external intercostal m, internal intercostal m, and innermost intercostal m.?
superior border of the rib below
79
What is the action of the external intercostal muscles?
elevates the rib below
80
What is the action of the internal intercostal and innermost intercostal muscles?
depresses the rib above
81
What is the innervation of the external intercostal m, internal intercostal m, and innermost intercostal m.?
intercostal nerves
82
What occurs in the alveoli and pulmonary capillary bed?
gas exchange
83
Which circulation provides O2 and nutrients to cells and removes metabolic waste?
systemic circulation
84
Which circulation allows for gas exchange?
pulmonary circulation
85
In pulmonary circulation, O2 poor blood from the right side of the heart travels to the pulmonary trunk and aa to the lungs for what?
gas exchange
86
Oxygen travel _______ toward alveoli (intrasegmental)
with airway
87
Where happens in the pulmonary capillary bed?
gas exchange
88
What travels out of the lungs between the bronchopulmonary segments to the left side of the heart?
pulmonary veins
89
What level oxygen is found in bronchial arterioles?
high
90
What level oxygen is found in pulmonary venules?
high
91
What level oxygen is found in pulmonary arterioles?
low
92
Bronchial aa. branch off?
aorta
93
Bronchial vv drain into?
azygos venous system
94
Bronchial circulation supplies ________ tissues of airway
non-gas exchanging (non-aveolar)
95
What is bronchial circulation part of?
systemic circulation
96
The source of pulmonary circulation is what?
right ventricle
97
What % cardiac output and pressure does pulmonary circulation have?
100% cardiac output
low pressure
98
What oxygen levels do arteries and veins have in pulmonary circulation?
arteries: low
veins: high
99
What does pulmonary circulation supply?
alveolar structures
100
What is the source of bronchial circulation?
aorta
101
What is the cardiac output and pressure in bronchial circulation?
1-2% cardiac output
high pressure
102
What oxygen level do arteries and veins have in bronchial circulary?
arteries: high
veins: low
103
What does bronchial circulation supply?
bronchi to bronchioles
104
What is the lymphatic drainage of both the lungs?
1. pulmonary (intrapulmonary)
2. bronchopulmonary (hilar) at the hilum
3. tracheobronchial nodes at the tracheal bifurcation
4. paratracheal nodes
105
Parasympathetic, sympathetic, and motor fibers all innervate the ?
lungs
106
What are the different sympathetics that innervate the lungs?
-postganglionics from upper thoracic and cervical ganglia
-preganglionics from upper thoracic lateral horn
-sympathetic pulmonary nn through pulmonary plexus
107
What is the parasympathetic innervation of the lungs?
vagus n
108
In the smooth muscle of the bronchial tree, GVE sympathetic fibers do what?
bronchodilation (reduce airway resistance)
109
In the smooth muscle of the bronchial tree, GVE parasympathetic fibers do what?
bronchoconstriction
110
In the glands of the bronchial tree, GVE sympathetic fibers do what?
inhibits secretion
111
In the glands of the bronchial tree, GVE parasympathetic fibers do what?
secretomotor
112
Local factors at alveoli have a _________ effect on pulmonary vascular tone
more potent
113
In vascular smooth muscle, GVE sympathetic fibers do what>
vasoconstriction
114
In vascular smooth muscle, GVE parasympathetic fibers do what?
vasodilation
115
What provides sensory innervation of the lungs?
GVA fibers
116
All GVA fibers travel to the brainstem with what?
vagus n
117
What is the motor response in the lungs of GVA fibers?
coughing
118
What is the parietal pleura innervated by?
adjacent spinal nerves
119
What is the parietal pleura very responsive to?
painful stimuli
120
What is generally considered to be insensitive to pain?
visceral pleura
121
Intercostal and phrenic nerves are what type of fibers for pain?
GVA
122
The parietal pleura is innervated by what nerves?
phrenic and intercostal
123
What is the visceral pleura innervated by?
autonomic nn
124
The phrenic nerve refers pain for?
mediastinal pleura
125
Reflections of parietal pleura form recesses where there is?
no intervening lung tissure so there are no lung sounds and may have liquid
126
The inferior margin of the lung is how many ribs higher than the parietal pleura?
2
127
What is the midclavicular, midaxillary, and paravertebral lines of the inferior margin of the lung?
midclavicular: 6th rib
midaxillary: 8th rib
paravertebral: 10th TV
128
What is the midclavicular, midaxillary, and paravertebral lines of the inferior margin of the pleural cavity?
midclavicular: 8th rib
midaxillary: 10th rib
paravertebral: 12th rib
129
In the right lung, where does the horizontal fissure course from?
4th rib (parasternal) to 5th rib (midaxillary)
130
Where does the oblique fissure course from?
from the 6th rib (midclavicular) to T3 spinous process
131
Where do a lot of cases of spontaneous pneumothorax occur?
cupula
132
Where can you find the cupula, or apex of the lung?
1 fb above medial 1/3 of clavicle
133
What is at risk in stab wounds to base of the neck?
cupula
134
What will be the main increase in vertical diameter of the thorax?
diaphragm
135
What nerve keeps the diaphragm alive?
phrenic nerve
136
What is the primary muscle of inspiration?
diaphragm
137
Inspiration is what type of process?
active
138
In thoracentesis, do you go above or below the ribs?
above the ribs
