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Anatomy > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

What makes up the Upper Respiratory Tract?

A

Right and Left Nasal Cavities

Oral Cavity

Naso-oropharynx

Laryngopharynx

Larynx

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2
Q

What makes up the Lower Respiratory Tract?

A

Trachea

Right and Left main bronchi

Lobar bronchi

Segmental bronchi

Bronchioles

Alveoli

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3
Q

At the level of which vertebra does

the larynx become the trachea

the pharynx become the oesophagus?

A

C6

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4
Q

Where do you palpate the trachea?

A

The jugular notch of the manubrium

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5
Q

What type of structures make up the chest walls?

A

Skin

Fascia

Skeletal Muscle

Bones/Joints

Parietal Pleura

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6
Q

What does the chest cavity contain?

A

Mediastinum

Right and Left Pleural Cavities

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7
Q

What are the three lobes of the right lung?

A

Superior

Middle

Inferior

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8
Q

What are the two lobes of the left lung?

A

Superior

Inferior

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9
Q

What are the muscles of breathing?

A

External intercostal

Internal intercostal

Innermost intercostal

Diaphragm

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10
Q

Which vein drains the posterior parts of the intercostal spaces and where is it found?

A

Azygous Vein

Anterior to the vertebrae running on the RHS of the thoracic aorta

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11
Q

Which artery supplies the posterior part of the intercostal spaces?

A

Posterior intercostal arteries, which branch from the thoracic artery.

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12
Q

Which arteries supply the anterior parts of the intercostal spaces? Where can they be found?

A

Left and Right Internal Thoracic Arteries

Either side of the deep surface of the sternum

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13
Q

Which veins drain the anterior parts of the intercostal spaces?

A

Internal thoracic veins (2 on either side).

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14
Q

Which nerves supplies the 4th intercostal space?

A

T4 anterior ramus

(4th intercostal nerve)

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15
Q

What are the branches of the intercostal nerves?

A

Lateral cutaneous branch

Anterior cutaneous branch

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16
Q

What are the opening in the diaphragm?

A

Oesophageal hiatus

Aortic hiatus

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17
Q

What is unusual about the diaphragm?

A

It has a central tendon.

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18
Q

To which bones does the diaphragm attach?

A

Sternum

Lower 6 ribs & costal cartilages

L1-L3 vertebral bodies

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19
Q

Which nerve supplies the diaphragm?

A

Phrenic nerve (C3, C4, C5 anterior rami)

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20
Q

What is the course of the phrenic nerve?

A

In the neck on the anterior surface of scalenus anterior

Descending along lateral aspect of fibrous pericardium

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21
Q

What types of nerves does the phrenic nerve supply to the diaphragm and fibrous pericardium?

A

Somatic sensory

Sympathetic

Somatic motor (diaphragm only)

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22
Q

What provides the stimulation for coughing?

A

Sensory receptors in the mucosa of the

oropharynx

laryngopharynx

larynx

respiratory tree

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23
Q

What is the mechanism of coughing?

A

Deep inspiration using diaphragm, intercostal muscles & accessory muscles of inspiration

Adduction of vocal cords to close rima glottidis

Contraction of anterolateral abdominal wall muscles, building up intra-abdominal pressure pushing diaphragm superiorly

Sudden abduction of vocal cords

Tensing and elevation of soft palate to close of air into nasopharyx

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24
Q

Which nerve stimulates the closing and opening of the rima glottidis

A

Vagus nerve

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25
Q

Which nerve causes the tensing of the soft palate?

A

CN V (trigeminal)

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26
Q

Which nerve causes the elevation of the soft palate?

A

Vagus nerve

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27
Q

The epiglottis is at the level of which vertebra?

A

Top of C3

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28
Q

Which nerves are stimulated in sneezing?

A

CN V (trigeminal) or CN IX (glossopharyngeal)

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29
Q

Which nerves are stimulated in coughing?

A

CN IX (glossopharyngeal) or CN X (vagus)

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30
Q

In what structure does the vagus nerve descend to the mediastinum?

With which other structures?

A

Carotid sheath

Internal carotid artery

Common carotid artery

Internal jugular vein

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31
Q

Which part of the brain reacts to sensory signals triggering a cough or sneeze?

A

Medulla

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32
Q

How are the mucous glands and bronchiolar smooth muscle supplied by motor axons?

A

Motor axons travel from tracheal bifurcation along branches of respiratory tree

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33
Q

What is the pulmonary plexus and where can it be found?

A

sympathetic axons

parasympathetic axons

visceral afferents

at the branch of the trachea

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34
Q

What are the accessory muscles of deep/forced inspiration?

A

sternocleidomastoid

pectoralis major

pectoralis minor

scalenus anterior, medius and posterior

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35
Q

What are the attachments of pectoralis major?

A

sternum/ribs

humerus

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36
Q

What is the movement created by pectoralis minor?

A

Pulls ribs 3-5 superiorly towards the coracoid process of the scapula

37
Q

What are the attachments of the sternocleidomastoid?

A

Sternum

Clavicle

Mastoid process of temporal bone

38
Q

What are the attachments of scalenus anterior, medius and posterior?

A

Cervical vertebrae and ribs 1 & 2

39
Q

What are the functions of the intrinsic muscles of the larynx?

A

Attach between cartilages and move the cartilages, with the result that the vocal cords are also moved.

40
Q

What are the accessory muscles of deep/forced expiration?

A

Anterolateral abdominal wall muscles:

external oblique

internal oblique

transversus abdominus

rectus abdominus

41
Q

What are the attachments of the external oblique muscles?

A

superior aspect of the lower ribs

anterior part of the iliac crest & pubic tubercle

aponeurosis of right external oblique blends with aponeurosis of left external oblique at the linea alba

42
Q

What are the attachments of the internal oblique muscles?

A

inferior border of lower ribs

iliac crest and thoracolumbar fascia of lower back

aponeurosis of left internal oblique blends with aponeurosis of right interior oblique at linea alba

43
Q

What are the attachments of the transversus abdominus?

A

Deep aspects of lower ribs

iliac crest and thoracolumbar fascia of lower back

aponeurosis of left transversus abdominus blends with aponeurosis of right transversus abdominus at linea alba

44
Q

What is the rectus sheath constructed from?

A

The aponeuroses of the

external oblique

internal oblique

transversus abdominus

45
Q

What do the tendinous sheathes of the rectus abdominus do?

A

Divide the long flat muscles into 3 or 4 smaller quadrate muscles to form a 6 or 8 pack, giving improved mechanical efficiency

46
Q

How are the somatic motor, somatic sensory and sympathetic fibres supplying the abdominal body wall conveyed?

A

Within the thoacoabdominal nerves, which branch from the 7-11th intercostal nerves

47
Q

What is the name given to the T12 anterior ramus?

A

Subcostal nerve

48
Q

What are the two halves of the L1 anterior ramus?

A

Iliohypogastric nerve

Ilioinguinal nerve

49
Q

What are the functions of the muscles of the abdominal body wall?

A

Tonic contractions - maintain posture, support vertebral column

Movements of vertebral column

Guarding contraction protect abdominal viscera

Contractions increase intra-abdominal pressure to assist defecation, micturition and labour

Forced expiration

50
Q

What is a small pneumothorax?

A

Less than 2cm gap between lung and parietal pleura

51
Q

How is a pneumothorax caused?

A

Penetrating injury to parietal pleura

Rupture of visceral pleura

52
Q

What is a tension pneumothorax?

A

When the torn pleura creates a one way valve that lets air into the pleural cavity on inspiration but prevents it escaping.

53
Q

The sternal angle is at the level of which vertebra?

A

Between T4 and T5

54
Q

What are the consequences of mediastinal shift on the SVC?

A

Compression of SVC reduces venous return to heart leading to hypotension

55
Q

Where is a needle aspiration or chest drain sited?

A

4th or 5th intercostal space in the midaxillary line

56
Q

What forms the safe triangle?

A

Anterior border of latissimus dorsi

Posterior border of pectoralis major

Axial line superior to nipple

57
Q

What is the emergency management of tension pneumothorax?

A

Large guage cannula into pleural cavity via 2nd or 3rd intercostal space in the midclavicular line

58
Q

How is the level of rib 2 marked?

A

Sternal angle

59
Q

What factors are required for development of hernia?

A

Weakness of one structure (usually body wall). May be

normal anatomical weakness

congenital

surgical scar

Increased pressure on one side of that part of the wall

60
Q

Where do diaphragmatic herniae develop?

A

Attachments to xiphoid

Oesophageal hiatus

Posterior attachments

61
Q

What is a paraoesophageal hernia?

A

Herniated part of stomach passes through oesophageal hiatus and becomes parallel to oesophagus in the chest

62
Q

What is a sliding hiatus hernia?

A

Herniated part of the stomach slides through oesophageal hiatus into the chest with the gastro-oesophageal junction

63
Q

What type of cells are found in the nasal cavity?

A

from anterior to posterior:

vestibule - keratinized stratified squamous epithelium

stratified squamous epithelium

pseudostratified ciliated columnar epithelium with goblet cells (respiratory epithelium)

64
Q

What type of cells are found in the respiratory epithelium?

A

pseudostratified ciliated columnar epithelium

65
Q

What lies beneath the respiratory epithelium?

A

Lamina propria

Band of connective tissue containing seromucous glands and rich venous plexus which can quickly engorge with blood blocking the nose

66
Q

What is the lining of the oropharynx and the lingual/posterior surfaces of the epiglottis?

A

Non-keratinized stratified squamous epithelium

67
Q

What is the lining of the larynx? What is the exception to this?

A

Cartilage and muscle lined with respiratory epithelium,

except the vocal folds which are lined with stratified squamous epithelium

68
Q

How many cartilages is the trachea formed from, what is their structure?

A

15-20

C shaped, the open side being spanned by fibroelastic tissue and smooth muscle

69
Q

What are the layers of the walls of the larynx?

A

Respiratory epithelium

basal lamina

lamina propria

submucosa with numerous seromucous glands

70
Q

What is the structure of the walls of the bronchi?

A

Respiratory epithelium - with lamina propria containing discontinous layer of smooth muscle and seromucous glands

Irregularly shaped cartilage plates

71
Q

At which point in the respiratory tree are the cartilage plates lost?

A

Bronchioles

72
Q

Describe the walls of the bronchioles

A

Lack cartilage and glands

May contain a few goblet cells in initial portion

Epithelium decreases in height from columnar to cuboidal

Lamina propria composed of smooth muscle and elastic and collagenous fibres

73
Q

Describe the walls of terminal bronchioles

A

Cuboidal ciliated epithelium

Contain non-ciliated Clara cells projecting above level of adjacent ciliated cells

74
Q

Describe the alveolar epithelium.

A

Discontinuous squamous type I alveolar cells

75
Q

What is the function of Clara cells?

A

Stem cells

Detoxification

Immune modulation

Surfactant production

76
Q

Approximately how many alveoli are there in each lung?

A

300 million

77
Q

Describe type II alveolar cells

A

Polygonal

Free surface is covered in microvilli

Cytoplasm contains dense membrane bound lamellar bodies containing surfactant

78
Q

Where are alveolar macrophages found? What is their function?

A

In septa or migrating over luminal surfaces

Phagocytosis of inhaled particles

Migrate up bronchial tree by ciliary action to pharynx where they are swallowed

79
Q

What is the emryonic origin of the lining of the trachea and bronchial tree?

A

Endoderm

80
Q

What is the embryonic origin of the smooth muscle & cartilage in the lung tissue?

A

Visceral mesoderm

81
Q

When do the lung buds form?

A

Week 5

82
Q

What is oesophageal atrasia?

A

Blind ending of the oesophagus

83
Q

What is tracheoesophageal fistula?

A

Communication between trachea and oesophagus

84
Q

When does the initial branching to give lungs, lobes and segments occur?

A

Embryonic phase

(26 days - 6 weeks)

85
Q

When does the branching to terminal bronchioles occur?

A

Pseudoglandular phase

6 - 16 weeks

86
Q

When do the respiratory bronchioles & alveolar ducts form?

A

Canalicular phase

16 - 28 weeks

87
Q

When do the terminal sacs form?

A

Saccular phase

28 - 36 weeks

88
Q

When do the alveoli mature?

A

36 weeks - early childhood

89
Q
A

Anatomy (10 decks)

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