Respiratory System Anatomy Flashcards
What happens to air as it passes through upper respiratory conducting channels
It is warmed, filtered & humidified
What is the order of upper conducting pathways
- Nasal cavity & sinuses
- Pharynx
- Larynx
- Trachea
What separates the nasal cavities
The nasal septum
What are the anterior nares AKA
Nostrils
What are the posterior nares AKA
Choanae
Where does epistaxis usually occur in children vs adults
Children = anterior nares
Adults = posterior nares
What makes the crunching sound during nasal intubation
Displacement of turbinates
What is the cribriform plates
The thin bone that separates the brain from the nasal cavity
What is a sign of cribriform plate fracture, and why is it a contraindication for anything up the nose
CSF leaking from the nose, & because anything up the nose with a fractured cribriform plate may cause the object to enter the cranium
What is sinusitis
An infection of the sinuses
What about sinusitis can cause a brain abscess
Obstruction of fluid drainage from the sinuses, causing an infection may lead to an erosion of sinuses & ultimately a brain abscess
What are the nasal sinuses
Frontal, ethmoid, maxillary, sphenoid
What are sinuses
- Mucous membrane-lined cavities that are air filled
- Pockets inside bony skull structure
- Drains into nasal cavity
Why can a BSF cause ottorhea
Skull # causes bleeding into sphenoid sinuses = CSF leakage out the ear
Where does a FB usually occlude
The laryngeopharynx
Where does the pharynx run from/to
From the base of the skull to the larynx
Where can you find the nasopharynx
Behind the nose
Where can you find the oropharynx
Behind the mouth
When your pt has suffered laryngeal trauma what should you be cautious of
A c-spine injury
Where do ACPs insert cannulae’s for emergency AWs
Through the circothyroid membrane
Where is the larynx located
From the hyoid bone to the lower boarder of cricoid cartilage, anterior to c 3-6
What is important about the hyoid bone
It moves superiorly while swallowing, is 4-5cm wide & is horseshoe shaped
What is the Adam’s apple the prominence of
Thyroid cartilage
What is the purpose of the thyroid cartilage
To protect & attache to the vocal cords
What does the thyroid ligament do
Attach the thyroid cartilage & the hyoid bone
Where can you find the cricoid cartilage
In the gap after the Adam’s apple
What does the cricothyroid ligament & membrane attach
Connects the cricoid & thyroid cartilage
What is important the know about the epiglottis
Is a semi-rigid cartilagenous structure at the base of the tongue, directly behind the hyoid bone, is 2-3mm thick & covers the larynx during swallowing
What is important to know about the vocal cords
They are ligaments that can open/close, they stretch from the back of the thyroid cartilage to the arytenoid cartilage
What controls the vocal cords, and what happens if one is damaged
Laryngeal nerves, if one is damaged is causes ipsilateral paralysis of the vocal cord
Where can you find the trachea
Below the cricoid cartilage, from the 6th cervical vertebrae to the 5th thoracic vertebrae
The trachea bifurcates. What is the location of bifurcation called and what are the resulting stems
Carina, the right and left main stem bronchi
What is important to note about the carina
It is the point of resistance you should feel when suctioning a tracheostomy, when hit it should make the pt cough
How long is the trachea & what is it’s shape
10cm, semilunar
What can you give a pt (not in directives) to potentially help pass a FB
Glucagon IV, (larger dose than recommended in directives) to potentially loosen the esophagus & help pass the FB
What is the trachea lined with
Ciliated columnar epithelium
What is the order of structures in the lower respiratory tract
- R & L mainstem bronchi
- Secondary bronchi
- Tertiary bronchi
- Bronchioles
- Respiratory bronchioles
- Alveolar ducts
- Alveolar sacs
- Alveoli
What are the associated structures with the lower respiratory tract
- Pleura
- Pleural cavity
- Bony thorax
- Muscles of respiration
What are the mainstem bronchi AKA
Primary bronchi
Describe the similarities between the mainstem bronchi & the trachea
Look very similar (cartilaginous rings) though mainstem bronchi become less cartilaginous & transition to smooth muscle
How do the primary bronchi connect to the lungs
Through the hilum — a hole in the lateral portion of the lungs, where the bronchi, blood vessels, nerves & lymphatic vessels enter & leave the lungs
Describe the right mainstem bronchus
5cm long, shorter & more vertical (at 25°) than the left
Which mainstem bronchus is more likely to have a FB occlude it and why
The right mainstem, because it is nearly inline with the trachea
Describe the left mainstem bronchus
Slightly longer than 5cm & bifurcates at 45°
Describe the bronchial tree components
Trachea —> primary bronchi —> secondary bronchi —> tertiary bronchi/bronchopulmonary segments —> terminal/respiratory bronchioles
How many tertiary/bronchopulmonary segments are on each side of the bronchial tree
Right: 10
Left: 9
Why are the terminal bronchioles AKA respiratory bronchioles
Because they are the first site of gas exchange
What are the bronchopulmonary segments
Several branches that form alveolar ducts, where the alveoli either open directly into or pass through alveolar sacs
What makes up the respiratory membrane
A thin layer of surfactant, a layer of epithelial cells, small interstitial space, capillary basement membrane & endothelial cells forming the capillary cell wall
What is the purpose of the respiratory membrane
To separate the air in the alveoli from the blood in capillaries
What is the total alveolar surface area
70m^2
What is the only firm attachment of the lungs, and what is it AKA
The hilum, the root
Why is the respiratory membrane pertinent to understand in paramedic practice
Because anything that thickens it can impair gas exchange (ie through shunting, ex: pulmonary edema, atelectasis, pneumothorax)
What surrounds the alveoli
Because anything that thickens it can impair gas exchange (ie through shunting, ex: pulmonary edema, atelectasis, pneumothorax)
What shape describes the lungs
Cone
Where do the lungs sit in the body
The thorax, to which of most space they take up aside from the mediastinum
What is the mediastinum
The central compartment of the thoracic cavity between the lungs, which holds the heart & major vessels
Where are the apex & base of the lungs located
The central compartment of the thoracic cavity between the lungs, which holds the heart & major vessels
Describe the right lung
Larger, 3 lobes w 2 fissures
Describe the left lung
Smaller, 2 lobes w 1 fissure, has a lingula & cardiac notch
Describe the lingula
The tongue of the left lobe
What is the pleura
2 serous sacs enclosing the lungs (visceral & parietal), separated by a thin layer of serous fluid
Describe the visceral pleura
Adheres to lung surface
Describe the parietal pleura
Is the outer layer of the pleura (root of lung onto inner surface of chest wall, diaphragm & lateral surface of mediastinum)
How thick is the fluid between the two layers of the pleura
0.002mm thick
When the cavity is intact it has ____ intrapleural pressure, creating ____ space
Negative, potential
What can easily destroy the adherence of the pleural layers
Air or fluid
What is the pleural recess
Space in the pleural cavity where the lungs may not fill during quiet respiration
Describe the right & left costadiaphragmatic recess
The outer part of the pleural cavity above the diaphragm close to the costal walls where small pleural effusions may occur d/t gravity & someone standing/sitting
What is the thorax
The bony structure that forms part of an air-tight box around the lungs
What are the boundaries of the thorax
- Superiorly: thoracic inlet
- Laterally: ribs
- Anteriorly: sternum & ribs
- Posteriorly: ribs, thoracic vertebrae (spine)
- Posteriorly: ribs, thoracic vertebrae
- Inferiorly: diaphragm
What is the significance of the thoracic inlet
The opening marks the boundary between the neck & thorax
What are the 3 main parts to the thoracic cavity
The right & left pleural cavities & the mediastinum
What does the mediastinum contain
The heart, trachea & esophagus
