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Anatomy ICOM > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

Pleural sac

A

Pleura and pleural cavity that enclose each side

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2
Q

Pleura

A
  1. Visceral: mesothelium lining surfaces of lungs
  2. Parietal: lines internal thoracic cavity and adheres to body wall by endothoracic fascia
    A. Parts:
    1. Costal
    2. Mediastinal
    3. Diaphragmatic
    4. Cervical (cupula)
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3
Q

Suprapleural membrane (Sibson fascia)

A

Fibrous extension of endothoracic fascia

  1. Reinforces cervical pleura
  2. Attaches rib 1 and transverse process C7
  3. Fxn: provide rigidity to superior thoracic aperture and prevents distortion w/ breathing
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4
Q

Pleura reflections

A

Abrupt lines where parts of pleura transition

1. Ex: costodiaphragmatic

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5
Q

Pleural cavity

A

Space between parietal and visceral pleura
1. Thin layer serous fluid
A. Keeps lungs in contact w/ wall
B. Lubrication

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6
Q

Lung gross anatomy

A
  1. Apex: superior peak, superior to 1st rib and into neck
  2. Base: inferior, rests on diaphragm
  3. Lobes: divisions created by fissures
    A. Right: oblique and horizontal fissures -> 3 lobes
    1. Superior
    2. Middle
    3. Inferior
      B. Left: oblique fissure -> 2 lobes
    4. Superior
    5. Inferior
  4. Surfaces
    A. Costal
    B. Diaphragmatic: concavity deeper right than left
    C. Mediastinal: contain hilum of lungs
  5. Impressions:
    A. Right
    1. Esophagus
    2. Azygos arch
    3. Superior vena cava
    4. Cardiac (shallow)
      B. Left
    5. Descending aorta
    6. Aortic arch
    7. Ascending aorta
    8. Cardiac
  6. Borders
    A. Anterior: sharp edge where costal and mediastinal surfaces meet anterior
    B. Right anterior: straight
    C. Left anterior: indented by cardiac notch -> lingula
    D. Posterior: rounded edge where costal and mediastinal meet posterior
    E. Inferior: sharp edges between diaphragmatic, costal, and mediastinal surfaces
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7
Q

Bronchopulmonary segment

A
  1. Lung supplied by segmental bronchus and accompanying pulmonary artery branch
  2. Pulmonary vein tributaries pass intersegmentally
  3. Smallest functionally independent region that can be removed that can be removed w/o affecting other areas
  4. Right: 10
  5. Left: 8 or 9
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8
Q

Tracheobronchial tree gross anatomy

A
  1. Trachea
  2. Main bronchi
  3. Lobular (secondary) bronchi
  4. Segmental (tertiary) bronchi
  5. Bronchioles
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9
Q

Trachea

A
  1. Begins inferior to larynx, anterior esophagus, ends sternal angle
  2. C-shaped hyaline cartilage = support
  3. Trachealis muscle: posterior wall, connects rings, limited constriction
  4. Carina: cartilage ridge demarcates split into main bronchi
    A. T4 level
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10
Q

Main bronchi

A
  1. Pass inferolaterally to lungs at hilum
  2. C-shaped hyaline cartilage
  3. Right: wider, more vertical
  4. Left: passes inferior aortic arch and anterior thoracic aorta
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11
Q

Lobular bronchi

A

Branches named for corresponding lobes

  1. Right: superior, middle, inferior
  2. Left: superior and inferior
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12
Q

Segmental bronchi

A

Supply corresponding segments

  1. Right = 10
  2. Left = 8-10
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13
Q

Bronchioles

A 
Lack cartilage in walls
1. Conducting: 20-25 generations of branches
  A. End w/ terminal bronchioles
  B. Transport air
  C. No glands or alveoli
2. Respiratory: from terminal bronchiole
  A. Scattered alveoli in walls
  B. Start respiratory zone
3. Alveolar ducts arise from bronchioles -> alveolar sacs
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14
Q

Pulmonary circulation

A
  1. Arteries: deoxygenated blood to lungs

2. Veins: oxygenated blood to heart

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15
Q

Bronchial circulation

A
  1. Arteries from aorta and/or posterior intercostals
    A. Oxygen and nutrients to lung tissue
  2. Veins: drain only proximal parts of lungs
    A. Rest drained by pulmonary veins
    B. Right -> azygos vein
    C. Left -> accessory hemiazygos or left superior intercostal vein
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16
Q

Lymphatic drainage

A
  1. Lungs -> hilum -> subpleural lymphatic plexus -> bronchopulmonary nodes -> intrapulmonary nodes -> bronchopulmonary nodes -> superior and inferior tracheobronchial nodes -> paratracheal nodes -> bronchomediastinal trunks
  2. Left -> thoracic
  3. Right -> right lymphatic duct
  4. Right lung and inferior lobe left -> right lymphatic
17
Q

Lungs and visceral pleura Innervation

A

Nerves from pulmonary plexus
1. Sympathetic and parasympathetic efferent and visceral afferent
2. Sympathetic efferent: presynaptic from T1-T5 spinal N. Synapse in paravertebral ganglia of sympathetic trunk w/ postsynaptic -> cardiopulmonary splanchnic n. -> pulmonary plexus
A. Actions:
1. Bronchodilation: inhibits smooth muscle
2. Vasoconstriction
3. Secretory reduction
3. Parasympathetic efferent: vagus n. Enters superior thoracic aperture -> sandwiched between mediastinal pleura and fibrous pericardium
A. Presynaptic -> pulmonary plexus
B. Synapse along branches of bronchial tree
C. Actions
1. Bronchoconstriction
2. Vasodilation
3. Secretomotor
4. Visceral afferent: sensory arm of reflexes and nociception
A. Reflexive follow vagus
1. Bronchial mucosa (tactile)
2. Bronchial small muscle (stretch)
3. Interalveolar CT
4. Pulmonary arteries (baroreceptor)
5. Pulmonary veins (chemoreceptors)
B. Nociception afferents follow sympathetics
1. Input to: upper thoracic spinal n. From bronchi and bronchioles
2. Trachea follow vagus

18
Q

Parietal pleura and diaphragm innervation

A
  1. Phrenic (C3-C5)
    A. Somatic efferent stimulate diaphragm contraction
    B. Somatic afferent stimulated from mediastinal pleura and central diaphragmatic pleura
  2. Intercostal nerves: transmits somatic afferent from peripheral regions of diaphragmatic and costal pleura
19
Q

Chest pain

A
  1. Many causes

A. Heart attack: “crushing” sub sternal pain

20
Q

Rib fractures

A 
1. 1st rib 
  A. Rare
  B. Usually blunt trauma
  C. Often other damage (brachial plexus)
2. Middle ribs
  A. Most common
  B. Anterior to angle
3. Lower
  A. Can tear diaphragm -> diaphragmatic hernia
4. Painful
21
Q

Flail chest

A
  1. Mult. Fractures
  2. Loose segment moves w/ breath
  3. Extremely painful
  4. Surgical plates/wires
22
Q

Thoracotomy

A

Posterolateral of 5th-7th intercostal spaces important

23
Q

Supernumerary ribs

A
  1. Cervical/lumbar
24
Q

Ossified xiphoid process

A
  1. ~40 y/o

2. Lump -> fear tumor

25
Q

Sternal fracture

A
  1. Rare
  2. Crush injuries
  3. Comminuted = several pieces
  4. Underlying injuries
    A. 25-45% mortality
26
Q

Median sternotomy

A

Sternal splitting

  1. Tumors removal
  2. Heart surgery
27
Q

Sternal biopsy

A

Bone marrow needle biopsy

28
Q

Complete sternal cleft

A

Bands don’t fuse

1. Heart can protrude

29
Q

Partial sternal cleft

A

Manubrium and body don’t fuse

  1. V or U-shaped
  2. Usually fixed
30
Q

Thoracic outlet syndrome

A

Obstructions of superior thoracic aperture

1. Involve upper limbs

31
Q

Rib dislocation

A

Costal cartilage displaced from sternum

  1. Usually ribs 8-10
  2. Lump at site
32
Q

Rib separation

A

Costochondral junction displaced

1. Ribs 3-10 -> perichondrium and periosteum tearing

33
Q

Diaphragm paralysis

A

Individual halves can be affected

1. Seen radiographically

Anatomy ICOM (34 decks)

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