Respiratory System Flashcards
*If there were a woman with lung cancer in the right lung at the clinical base and had the affected segment removed, what air conducting tube would be cut or tied off going to the bronchopulmonary segment?
tertiary bronchus
*At what rib does the clinical base of the lung extend to?
10?
*If there were a woman with lung cancer in the right lung at the clinical base and had the affected segment removed, where would the pleura be located in this area?
Rib 12
*If there were a woman with lung cancer in the right lung at the clinical base and had the affected segment removed, what is the potential space that is normally present in this area?
costodiaphragmatic recess
*If there were a woman with lung cancer in the right lung at the clinical base and had the affected segment removed, can there be fluid or excess fluid found here? Could this be a problem?
Yes, and air can too.
*There was a woman with lung cancer in the right lung at the clinical base and had the affected segment removed. Inflammation could cause pain in this area. Irritation of what structure could result in a sharp localized pain?
2 pieces of pleura can stick to each other, so that lungs do not work as well. If pain is sharp and localized it is somatic pain and would affect the parietal pleura (not visceral pleura).
*What is the trachea?
Tube that begins at the larynx and divides into the right and left primary bronchi. Consists of 16-20 incomplete rings of hyaline cartilage, which support the tube.
*what is the purpose of the hyaline cartilage on the trachea?
support the tube. Helps keep the trachea open or patent.
*Compare the right lung with the left with respect to the number of lobes and fissures in each lung. Name the lobes and fissures of each.
right lung has three lobes and three secondary bronchi. Left lung has two lobes and two secondary bronchi. Right lung has two fissures (oblique, which divides into middle and lower lobes, and horizontal, which divides into superior and middle lobes) and left lung has one fissure (oblique, which divides into superior and inferior lobes).
Contrast the number of tertiary bronchi in each lung.
The left lung is variable in the number of segments and bronchi. It may have 8-10 segments and/or 8-10 tertiary bronchi. The right lung has 10 segments and 10 tertiary bronchi.
Contrast the hilum of the left lung with that of the right lung
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*what is the carina?
a process of cartilage formed at the bifurcation of the two primary bronchi of the trachea
what helps keeps the bronchi open?
cartilage plates
what is the difference between the right and left primary bronchi? What is the clinical significance of this?
right primary bronchus is more vertical, wider, and shorter. Aspirated objects tend to go through this passageway.
Where do the secondary bronchi go?
to the lobe of the lungs.
Where do the tertiary bronchi go?
to the bronchopulmonary segments.
What parts of the lung does the oblique fissure divide?
in the left lung the oblique fissure divides lung into upper and lower lobes. In the right lung the oblique fissure divides the lung into upper/middle and lower lobes.
What parts of the lung does the horizontal fissure divide?
In the right lung, the horizontal fissure divides the upper lobe into upper and middle lobes.
What is the lingula?
A tongue-like piece of lung around the heart found in the left lung.
How many secondary bronchi go to the left lung versus teh right lung?
three secondary bronchi go to the right lung and two go to the left lung.
Why are the bronchopulmonary segments important?
for surgery. a specific segment may be removed for a condition such as cancer. Each segment has arterial supply, which is the basis of the survival of the other segments. Each of the segments has a tertiary bronchi going to it.
What are the three segments of the upper lobe of the right lung?
apical, posterior, anterior
What are the two segments of the middle lobe of the right lung?
lateral and medial
What are the five segments of the lower lobe of the right lung?
superior, anterior, lateral basal, media basal, posterior basal.
What are the similarities and differences of the right and left lobe segments?
Right lung has lateral and medial segments in the middle lobe but the other segments are comparable to the left lung. The left lung has superior and inferior lingular segments in the upper lobe.
What are the five segments of the upper lobe of the left lung?
apical (apical and posterior may be combined), posterior, anterior, superior lingular, inferior lingular
What are the segments of the lower lobe of the left lung?
superior, anterior basal (anterior and medial basal may be combined), lateral basal, medial basal, posterior basal
Define the hilum of the lung?
the area where the vessels enter the lungs.
How do the hilum of the left and right lungs differ? How are they similar?
In the right lung the bronchi are posterior and superior, the pulmonary veins are anterior and inferior, the right pulmonary artery is more superior the veins, and there are bronchopulmonary lymph nodes. In the left lung the primary bronchus is posterior, the pulmonary veins are anterior and inferior, the left pulmonary artery is the most superior, and there are bronchopulmonay lymph nodes.
What is an easy way to identify a bronchus?
cartilagenous ring
The pulmonary arteries bring….?
unoxygenated blood to the lungs.
What do the pulmonary arteries travel with?
bronchial tree
The pulmonary arteries subdivide until they become…?
capillaries
Where do the pulmonary veins originate?
lungs
What do pulmonary veins carry?
return oxygenated blood from the lungs to the heart.
Do the pulmonary veins travel with the bronchial tree or separate from the bronchial tree?
separate
pulmonary capillaries form…
small veins, which unite into larger veins, then run with interlobular connective tissue. One vein drains each bronchopulmonary segment at the edge of the segment. These combine to form larger veins.
Two pulmonary veins from each lung do what?
return blood to the left atrium.
What do the bronchial arteries do?
supply blood to the bronchi.
Which are larger– bronchial arteries or pulmonary arteries?
The bronchial arteries are smaller than pulmonary arteries, but also travel with bronchi.
What do the bronchial veins do?
drain the bronchi supplied by a corresponding bronchial artery.
Describe the pleura of the lungs, the pleural cavity, and where the lungs are contained.
The lungs are contained in a double-layered sac that is formed by fluid secreting membranes. The lungs are not contained in the pleural cavity. The pleural cavity is a potential space between the two layers of pleura that contains serous fluid.
What is the parietal pleura?
lines the inner surface of the thoracic cage, subdivisions are based on neighboring structures (a- costal is near the ribs, b- mediastinal is from the vertebra to the sternum, c- diaphragmatic is above the diaphragm, d- cervical plerua is near the cervical region at the apex of the lung).
What innervates the parietal pleura?
central diaphragmatic portion is innervated by the phrenic nerve. the remainder is innervated by intercostal nerves.
Where can pain be referred for the parietal pleura?
Pain can be referred to the dermatomes of C3, 4, and 5, or the shoulder region.
What type of pain is pleural pain?
somatic, sharp and localized.
What does the serous pleural fluid do? What is the purpose of this?
create tension between visceral and parietal pleura, like a wet balloon. This surface tension helps the lungs stay expanded.
What is the visceral pleura?
attached to the surface of the lungs. No pain fibers.
What is the pleural cavity?
potential space between parietal and visceral pleura, which contains a serous fluid that creates surface tension between the parietal and visceral pleura.
What is a pneumothorax caused by?
entry of air into the pleural cavity– partial collapse of the lung.
What is a hydrothorax caused by?
enter of excess fluid into the pleural cavity. Excess fluid may collect in the lowest part of the pleural cavity, the pleural recesses.
What are pleural reflections?
areas of the parietal pleura where they meet or reflect upon each other. The costal pleura meets diaphragmatic pleura at the midclavicular, midaxillary, and posterior.
What are the costal reflections?
where costal pleura meets diaphragmatic pleura. It varies according to the curvature of the thoracic wall. Costal meets diaphragmatic at 8th rib at the midclavicular line, 10th rib at midaxillary line, and 12th rib at the midpoint of the shaft (posterior reflection near the vertebrae).
Where are the end of the lungs located?
rib 6 in the midclavicular line, rib 8 on the side, and rib 10 on the back.
Where does the pleura end?
two ribs below the lungs at 8th (front), 10th (side), and 12th (back) rib, or rib 8 at the midclavicular line.
What are pleural recesses?
potential spaces that are not filled during normal breathing. The lungs can expand into these recesses during full inspiration.
Which recess is located between the ribs and the diaphragm?
right costodiaphragmatic/ left costodiaphragmatic
which recess is located near the cardiac notch?
costomediastinal recess
The lingual of the lung can go into which potential space?
costmediastinal recess
What is the clinical significance of the pleural recesses?
postural drainage of excess fluid into these recesses.
Where do the tertiary bronchi go?
bronchioles.
What are respiratory bronchioles?
these structures are within the lung tissue and contain a relatively high amount of smooth muscle and no cartilage.
What could cause asthma?
contraction of the smooth muscle restricting airflow in the bronchioles of the lung tissue.
what are alveoli?
thin walled lung structures with specialized cells and many capillaries. Gas exchange occurs here and the oxygenated blood is returned to the heart hrogu hteh pulmonary veins.
what are alveolar ducts?
passgeways with alveoli
where does gas exchange occur?
alveolar ducts or alveoli
What is respiratory epithelium?
pseudostratified columnar epithelium with goblet cells. The cilia and goblet cells are important for removal of inhaled particulates by the mucucoliary escalator.
What is the sensory nerve supply to the lungs?
vagal afferants (for cough reflex)
What are the parasympathetic actions of the lungs?
constrict bronchioles, dilate blood vessels, increase mucous secretions
What are the sympathetic actions of the lungs?
dilate bronchioles, constrict blood vessels, decrease mucous secretions
What supplies blood to the pleura?
intercostal arteries (parietal pleura), bronchial arteries (visceral pleura)
What is the nerve supply to the lungs?
pulmonary plexus from the vagus nerves and sympathetic trunk.
What is the pharynx?
continuation of conducting portion.
what are the three subdivisions of the pharynx?
nasopharynx, oropharynx, larynx/laryngopharynx
*Do the primary bronchi have cartilage?
yes
*What is the difference between the right and left primary bronchi?
right primary bronchus is more vertical, wider, and shorter.
*Aspirated objects tend to go in which primary bromchi?
right primary
*What are the secondary bronchi?
division off of the primary bronchi. One goes to each lobe.
*How many secondary bronchi are there in the Right versus Left?
Three secondary bronchi go to the right and two go to the left.
*Where do to the tertiary bronchi go?
one goes to each bronchopulmonary segment.
*Do bronchioles contain cartilage or smooth muscle?
bronchioles contain an abundance of smooth muscle, but NO cartilage.
The cardiac notch is one which lung?
left lung
*Is the anterior or posterior border of the lung a sharp edge?
anterior
What are the 10 segments of the upper and lower lobes of the left lung?
upper lobe: 1) apical, 2) posterior, 3) anterior, 4) superior lingular, 5) inferior lingular.
lower lobe: 1) superior, 2) anterior basal, 3) medial basal, 4) lateral basal, 5) posterior basal
What are the 10 segments of the upper, middle, and lower lobes of the right lung?
Upper lobe: 1) apical, 2) anterior, 3) posterior. Middle lobe: 1) lateral, medial. Lower lobe: 1) superior, anterior basal, lateral basal, posterior basal
What is the difference between the upper lobe segments in the right and left lungs?
Upper left lung has superior and inferior lingular segments in addition to apical, posterior, and anterior. While right lung just has apical, posterior and anterior segments.
What segments are in the middle lobe of the right lung?
medial and lateral.
Which segments does the left lung have that the right lung does not have and which lobe are they located in?
left lung has the superior and inferior lingular segments in the upper lobe.
Which segments does the right lung have that the left lung does not and which lobe are they located in?
right lung has medial and lateral segments in the middle lobe.
*Note the relative positions of the pulmonary veins, primary bronchi, and right pulmonary artery in the hilum of the right lung.
Pulmonary veins are anterior and inferior. Bronchi are posterior and most superior in right lung. Right pulmonary artery is more superior to veins.
*Note the relative positions of the pulmonary veins, primary bronchus, and left pulmonary artert in the hilum of the left lung.
Pulmonary veins are anterior and inferior. Left primary bronchus is posterior. Left pulmonary artery is most superior.
What do the pulmonary arteries do?
bring unoxygenated blood from the right ventricle of the heart to the lungs. They eventually subdivide into capillaries surrounding the alveoli for gas exchange.
What do the pulmonary veins do?
return blood to left atrium of the heart
How many pulmonary veins are there?
4 (2 for each lung)
What drains the surface of the lungs for lymph drainage?
superficial (subpleural) plexus drains surface of lungs. Deep plexus (interlobular) drains interior of lungs.
What is the sequence of the lymph passage when it is drained from the lungs?
pulmonary, bronchiopulmonary, tracheobronchial, and bronchomediastinal.
Describe the pulmonary plexus
From the vagus (parasympathetic) and sympathetic (sympathetic) trunk. The sympathetic fibers dilate the bronchioles, constrict the blood vessels and decrease mucuous secretions. The parasympatehtic constrict the bronchioles, dilate the blood vessels, and stimulate mucous secretions.
*What are the two parts of the pleura-membrane?
1) visceral, which covers the surface of the lung. 2) parietal, which lines the surface of the rib cage.
What creates the costodiaphragmatic recess?
the fact that the lungs end 2 ribs above where the pleura ends. The lungs end at rib 10 and the pleura at rib 12 in the posterior region.
*The costomediastinal recess is associated with which lung at what spot?
left lung at cardiac notch
*the lingula of the left lung may expand into what potential space?
the costomediastinal recess
*The lungs expand into what spaces?
right and left costodiaphragmatic recesses, which is between the lower ribs and diaphragm (potential spaces between visceral and parietal pleura).
What nerve innervates the parietal pleura in the central region?
phrenic
What nerve innervates the parietal pleura in the peripheral areas?
intercostal nerves
Where are the sensory pain fibers in the visceral pleura?
the visceral pleura does not have sensory pain fibers
