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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
Which nerve causes the tensing of the soft palate?
CN V (trigeminal)
26
Which nerve causes the elevation of the soft palate?
Vagus nerve
27
The epiglottis is at the level of which vertebra?
Top of C3
28
Which nerves are stimulated in sneezing?
CN V (trigeminal) or CN IX (glossopharyngeal)
29
Which nerves are stimulated in coughing?
CN IX (glossopharyngeal) or CN X (vagus)
30
In what structure does the vagus nerve descend to the mediastinum? With which other structures?
Carotid sheath Internal carotid artery Common carotid artery Internal jugular vein
31
Which part of the brain reacts to sensory signals triggering a cough or sneeze?
Medulla
32
How are the mucous glands and bronchiolar smooth muscle supplied by motor axons?
Motor axons travel from tracheal bifurcation along branches of respiratory tree
33
What is the pulmonary plexus and where can it be found?
sympathetic axons parasympathetic axons visceral afferents at the branch of the trachea
34
What are the accessory muscles of deep/forced inspiration?
sternocleidomastoid pectoralis major pectoralis minor scalenus anterior, medius and posterior
35
What are the attachments of pectoralis major?
sternum/ribs humerus
36
What is the movement created by pectoralis minor?
Pulls ribs 3-5 superiorly towards the coracoid process of the scapula
37
What are the attachments of the sternocleidomastoid?
Sternum Clavicle Mastoid process of temporal bone
38
What are the attachments of scalenus anterior, medius and posterior?
Cervical vertebrae and ribs 1 & 2
39
What are the functions of the intrinsic muscles of the larynx?
Attach between cartilages and move the cartilages, with the result that the vocal cords are also moved.
40
What are the accessory muscles of deep/forced expiration?
Anterolateral abdominal wall muscles: external oblique internal oblique transversus abdominus rectus abdominus
41
What are the attachments of the external oblique muscles?
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
What are the attachments of the internal oblique muscles?
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
What are the attachments of the transversus abdominus?
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
What is the rectus sheath constructed from?
The aponeuroses of the external oblique internal oblique transversus abdominus
45
What do the tendinous sheathes of the rectus abdominus do?
Divide the long flat muscles into 3 or 4 smaller quadrate muscles to form a 6 or 8 pack, giving improved mechanical efficiency
46
How are the somatic motor, somatic sensory and sympathetic fibres supplying the abdominal body wall conveyed?
Within the thoacoabdominal nerves, which branch from the 7-11th intercostal nerves
47
What is the name given to the T12 anterior ramus?
Subcostal nerve
48
What are the two halves of the L1 anterior ramus?
Iliohypogastric nerve Ilioinguinal nerve
49
What are the functions of the muscles of the abdominal body wall?
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
What is a small pneumothorax?
Less than 2cm gap between lung and parietal pleura
51
How is a pneumothorax caused?
Penetrating injury to parietal pleura Rupture of visceral pleura
52
What is a tension pneumothorax?
When the torn pleura creates a one way valve that lets air into the pleural cavity on inspiration but prevents it escaping.
53
The sternal angle is at the level of which vertebra?
Between T4 and T5
54
What are the consequences of mediastinal shift on the SVC?
Compression of SVC reduces venous return to heart leading to hypotension
55
Where is a needle aspiration or chest drain sited?
4th or 5th intercostal space in the midaxillary line
56
What forms the safe triangle?
Anterior border of latissimus dorsi Posterior border of pectoralis major Axial line superior to nipple
57
What is the emergency management of tension pneumothorax?
Large guage cannula into pleural cavity via 2nd or 3rd intercostal space in the midclavicular line
58
How is the level of rib 2 marked?
Sternal angle
59
What factors are required for development of hernia?
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
Where do diaphragmatic herniae develop?
Attachments to xiphoid Oesophageal hiatus Posterior attachments
61
What is a paraoesophageal hernia?
Herniated part of stomach passes through oesophageal hiatus and becomes parallel to oesophagus in the chest
62
What is a sliding hiatus hernia?
Herniated part of the stomach slides through oesophageal hiatus into the chest with the gastro-oesophageal junction
63
What type of cells are found in the nasal cavity?
from anterior to posterior: vestibule - keratinized stratified squamous epithelium stratified squamous epithelium pseudostratified ciliated columnar epithelium with goblet cells (respiratory epithelium)
64
What type of cells are found in the respiratory epithelium?
pseudostratified ciliated columnar epithelium
65
What lies beneath the respiratory epithelium?
Lamina propria Band of connective tissue containing seromucous glands and rich venous plexus which can quickly engorge with blood blocking the nose
66
What is the lining of the oropharynx and the lingual/posterior surfaces of the epiglottis?
Non-keratinized stratified squamous epithelium
67
What is the lining of the larynx? What is the exception to this?
Cartilage and muscle lined with respiratory epithelium, except the vocal folds which are lined with stratified squamous epithelium
68
How many cartilages is the trachea formed from, what is their structure?
15-20 C shaped, the open side being spanned by fibroelastic tissue and smooth muscle
69
What are the layers of the walls of the larynx?
Respiratory epithelium basal lamina lamina propria submucosa with numerous seromucous glands
70
What is the structure of the walls of the bronchi?
Respiratory epithelium - with lamina propria containing discontinous layer of smooth muscle and seromucous glands Irregularly shaped cartilage plates
71
At which point in the respiratory tree are the cartilage plates lost?
Bronchioles
72
Describe the walls of the bronchioles
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
Describe the walls of terminal bronchioles
Cuboidal ciliated epithelium Contain non-ciliated Clara cells projecting above level of adjacent ciliated cells
74
Describe the alveolar epithelium.
Discontinuous squamous type I alveolar cells
75
What is the function of Clara cells?
Stem cells Detoxification Immune modulation Surfactant production
76
Approximately how many alveoli are there in each lung?
300 million
77
Describe type II alveolar cells
Polygonal Free surface is covered in microvilli Cytoplasm contains dense membrane bound lamellar bodies containing surfactant
78
Where are alveolar macrophages found? What is their function?
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
What is the emryonic origin of the lining of the trachea and bronchial tree?
Endoderm
80
What is the embryonic origin of the smooth muscle & cartilage in the lung tissue?
Visceral mesoderm
81
When do the lung buds form?
Week 5
82
What is oesophageal atrasia?
Blind ending of the oesophagus
83
What is tracheoesophageal fistula?
Communication between trachea and oesophagus
84
When does the initial branching to give lungs, lobes and segments occur?
Embryonic phase | (26 days - 6 weeks)
85
When does the branching to terminal bronchioles occur?
Pseudoglandular phase 6 - 16 weeks
86
When do the respiratory bronchioles & alveolar ducts form?
Canalicular phase 16 - 28 weeks
87
When do the terminal sacs form?
Saccular phase 28 - 36 weeks
88
When do the alveoli mature?
36 weeks - early childhood
89

Anatomy (10 decks)

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