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Anatomy > Respiratory System I-II > Flashcards

Respiratory System I-II Flashcards

1
Q

What are the classifications of the respiratory system?

A

Conducting portion

Respiratory portion

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2
Q

What parts of the respiratory portion of the respiratory system?

A

Respiratory bronchiole, alveolar duct, alveolar sac and alveoli

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3
Q

What is the conducting portion of the respiratory system?

A

Nose, pharynx, larynx, trachea, bronchi, bronchioles, terminal bronchioles

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4
Q

What are the boundaries of the nasal cavities?

A

Boundaries: roof, floor, medial & lateral walls

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5
Q

What are the nasal cavities comprised of?

A
  1. Nasal vestibule: lined by hairy squamous epithelium

2. Nasal cavity proper: lined by mucosa which is either respiratory (lower 2/3) or olfactory (upper 1/3)

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6
Q

Describe nasal cavities (conducting)

A
  • extend from the nares to the choanae which are the entrances to the nasopharynx
  • Separated by a bony/cartilaginous nasal septum
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7
Q

Describe (in detail) nasal cavities

A

Roof: formed by nasal, frontal, ethmoid, & sphenoid bones from anterior to posterior

Floor: maxilla & palatine bone

Medial: septal cartilage, vomer & ethmoid bones from anterior to posterior

Lateral: formed by three “scroll/shell-like” nasal conchae or turbinates: superior, middle & inferior, which curve downwards to form meat uses, behind these are the ethmoid air cells & the maxillary sinuses

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8
Q

Describe olfaction (conducting)

A

Possible through the presence of olfactory mucosa in the superior 1/3 of the nasal cavity

Hair like projections from the olfactory bulb(CN I) pass from the cranial cavity through holes in the ethmoid bones: cruciform plate

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9
Q

Describe Paranasal sinuses(conducting)

A
  • Numerous sinuses exist in the bones that surround the nasal cavities
  • Small at birth and increase in size until puberty.
  • Act to lighten the skull & increase resonance of the voice
  • Named according to the bone that they are situated

May be sites of infection

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10
Q

Describe the frontal para nasal sinuses

A

Frontal

  • Lies anterior to cranial cavity superior to the orbits
  • Opens into the middle meatus
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11
Q

Describe maxillary sinuses

A
  • Largest of the sinuses, lateral to the nasal cavity, inferior to the orbit, superior to the oral cavity: root of the molar teeth project into it
  • Opens into the middle meatus
  • Most prone to infection due to drainage against gravity
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12
Q

Describe the ethmoid paranasal sinus

A
  • Form a paper thin wall between the orbit & the nasal cavity
  • Opens into the superior & middle meatus
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13
Q

Describe the sphenoid paranasal sinuses

A
  • Like how the sellaturcica and posteriorly above the nasal cavity
  • Drain into the sphenoid-ethmoid also recess above the superiorconcha/ turninate
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14
Q

Describe the nasal passages

A

The THREE nasal conchae/turbinates split the nasal cavity into FOUR passage ways:

  1. Sphenoethmoidal recess: above the superior concha: drains the sphenoid sinus
  2. Superior meatus: drains the posterior ethmoid
  3. Middle meatus: drains the maxillary, middle ethmoidal & frontal
  4. Inferior meatus: drains the nasolacrimal duct
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15
Q

What are the pharynx?

A

Starts at internal nares and extends to cricoid cartilage of larynx

-Contraction of skeletal muscles assist in deglutition

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16
Q

What is the function of pharynx?

A
  • Passage way for air and food
  • Resonating chamber
  • Houses tonsils
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17
Q

What are the 3 anatomical regions of the pharynx?

A
  • Nasopharynx
  • Oropharynx
  • Laryngopharynx
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18
Q

Where is the larynx(conducting) located?

A

From C3: hyoid bone- C6: circoid cartilage

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19
Q

Describe the larynx

A

Respiratory passage between pharynx and the trachea

Related to the thyroid gland anteriorly & the esophagus posteriorly

  • Formed of the unpaired: thyroid, cricoid, & epiglottis & the paired: arytenoids
  • Connected by joints, membranes/ligaments
  • Functional anatomy: phantom & swallowing
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20
Q

What is phonation ?

A

Articulation at the synovial cricothyroid & cricoarytenoid joints alters the length, tension & position of the true vocal cords

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21
Q

What is swallowing?

A

Involves the raising of the larynx to meet the bonus in the pharynx and the depression of the epiglottis towards the artenoid cartilage

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22
Q

What does phonation & swallowing do?

A

This is mainly a passive processs due to passage of the bolus

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23
Q

Describe phonation in detail

A

Forwards tilting of the thyroid cartilage in relation to the cricoid cartilage lengthens the vocal cords producing a higher pitch

-The cricothyroid muscle brings this about while the thyroartenoid

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24
Q

Describe the functional anatomy involved in breathing

A
  • Lateral rotation of the arytenoid cartilages on the cricoid cartilage separates the vocal cords, opening the airway
  • The posterior cricoarytenoid muscles bring this about while the lateral cricarytenoid
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25
Q

Explain the clinical correlate laryngitis

A
  • An inflammation of the larynx
  • Most often caused by a respiratory infection or irritants such as cigarette smoke
  • Inflammation of the vocal folds causes hoarseness or loss of voice by interfering with the contraction of the folds or by causing them to swell to the point where they cannot vibrate freely
  • Many long-term smokers acquire a permanent hoarseness from the damage
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26
Q

Describe trachea

A
  • Extends from larynx to superior border of T5
    - divides into right and left pulmonary bronchi

4 layers

  • mucosa
  • submucosa
  • hyaline cartilage
  • adventitia
  • 16-20 C-shaped rings of hyaline cartilage
    - Open part faces oesophagus
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27
Q

Describe Bronchi(conducting)

A
  • Right and left primary bronchus goes to right lung
  • Carina - internal bridge
    - Most sensitive area for triggering cough reflex
  • Divide to form bronchial tree
    - secondary lobar bronchi (one for each lobe), tertiary (segmental) bronchi, bronchioles, terminal bronchioles
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28
Q

Describe the structural, changes of branching in the bronchi

A

Mucous membrane changes

-Incomplete rings become plates and then disappear

  • As cartilage decreases, smooth muscle increases
    - sympathetic ANS: relaxation/dilation
    - parasympathetic ANS: contraction/constriction
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29
Q

Outline the branching of the bronchial tree

A

Trachea—> primary bronchi—> secondary bronchi—> tertiary bronchi—> bronchioles—>terminal bronchioles

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30
Q

Describe the respiratory membrane of the alveolus

A
  • Alveolar wall - type 1 and type 2 alveolar cells
  • Epithelial basement membrane
  • Capillary basement membrane
  • Capillary endothelium
  • Very thin- only 0.5 um thick to allow rapid diffusion of gases
31
Q

Where do the lungs receive blood from ?

A
  • Pulmonary artery - deoxygenated blood

- Bronchial arteries - oxygenated blood to profuse muscular walls of bronchi and bronchioles

32
Q

Describe the alveoli

A

Cup-shaped outpouching

-Alveolar sac- 2 or more alveoli sharing a common opening

33
Q

What are the types of Alveolar epithelial cells?

A
  • Type 1 alveolar cells- form nearly continuous lining, more numerous than type 2, main site of gas exchange
  • Type 2 alveolar cells(septal cells)- free surfaces contain microvilli, secrete alveolar fluid (surfactant reduces tendency to collapse)
34
Q

Describe the lungs

A

Separated from each other by the heart and other structures in the mediastinum

Each lung enclosed by double-layered pleural membrane

- Parietal pleura- lines wall of thoracic cavity 
- Visceral pleura- covers lungs themselves
35
Q

What is a pleural cavity?

A

Pleural cavity is space between layers

-Pleural fluid reduces friction, produces surface tension (stock together)

36
Q

What is the cardiac notch?

A

Heart makes left lung 10% smaller than right

37
Q

Describe the anatomy of the lungs

A

Lobes- each lung divides by 1 or 2 fissures
-Each lobe receives it own secondary(lobar) bronchus that branch into tertiary (segmental) bronchi

Lobules wrapped in elastic connective tissue and contains a lymphatic vessel, arterioles, venue and branch from terminal bronchiole

Terminal bronchioles branch into respiratory bronchioles which divide into alveolar ducts

About 25 orders of branching

38
Q

Describe the thoracic cage

A

Conical shaped, bony/ cartilaginous skeleton

Functional anatomy: protects thoracic AND abdominal organs

39
Q

What are the boundaries of the thoracic wall/cage?

A
  1. Superior: thoracic inlet
  2. Inferior: diaphragm
  3. Lateral: ribs
  4. Anterior: manubrium & sternum
  5. Posterior: thoracic vertebrae
40
Q

Describe thoracic inlet /superior boundary of thoracic wall

A

Transmits oesophagus, trachea & great vessels of the head/neck

10 cm wide & 5 cm deep

Slopes downwards from posterior to anterior

  • Bounded by T1 posteriorly, 1st rib laterally & upper border of the msnubrium anteriorly
  • Applied anatomy: confusingly named thoracic outlet syndromes
41
Q

Describe the anterior boundary of the thoracic cage

A

Manubrium: Suprasternal notch, Articular facets

Sternal angle (of Louis): T4/5 & 2nd rib

Sternum: costal cartilages from 2nd to 10th ribs

-Xiphisternum

42
Q

Describe the typical rib

A
  • Has a head, neck, tubercle and a body

- Costal groove marks pathway of blood returning to the heart

43
Q

Briefly describe ribs

A
  • Ribs 1-7 are attached to vertebrae (“true ribs”)
  • 8-10 are attached to the cartilage of the 7th rib (“false ribs”)
  • 11-12 are floating ribs
44
Q

Describe the diaphragm

A

Muscular dura (s. crus) & central tendon

  1. Vertebral & sternal origin of L & R crus
  2. Trefoil (parachute) shaped central tendon: continuous with pericardium

T8, T10(O/E), T12(A)

Important muscle of respiration

45
Q

What is the innervation of the diaphragm?

A

C3, 4, 5- phrenic

46
Q

Describe inhalation

A

Inhalation is active- contraction of :

  • diaphragm - most important muscle of inhalation
    • flattens, lowering dome when contracted
    • responsible for 75% of air entering lungs during normal quiet breathing
  • external intercostal:
    • Contraction elevates the ribs
    • 25% of air entering lungs during normal quiet breathing

-Accessory muscles for deep, forceful inhalation

47
Q

What is the role of the thorax in inhalation?

A
  • When thorax expands , parietal and visceral plurae adhere tightly due to sub atmospheric pressure and surface tension- pulled along with expanding thorax
  • As lung volume increases, alveolar (intrapulmonic) pressure drops
48
Q

Describe exhalation/expiration

A

-Pressure in lungs greater than atmospheric pressure

  • Normally passive - muscle relax instead of contract
    • Based on elastic recoil of chest wall and lungs from elastic fibers and surface tension of alveolar fluid
    • Diaphragm relaxes and become dome shaped
    • External intercostals relax and ribs drop down

Exhalation only active during forceful breathing

49
Q

What is the pneumothorax?

A

Air in pleural cavities

-Most commonly introduced in a surgical opening of the chest or as a result of a stab or gunshot wound, may cause the lungs to collapse atelectasis

50
Q

What is haemothorax?

A

Blood in the pleural cavities

51
Q

How are pneumothorax and hemothorax treated?

A

The goal of treatment is the evacuation of air (or blood) from the pleural space, which allows the lung to reinforce. A small pneumothorax may resolve on its own, but it is often necessary to insert a chest tube to assist in evacuation

52
Q

How are thoracocentesis & chest drains?

A
  • Drainage of air (pneumothorax) or fluid (pleural effusion)
  • 5th intercostal space, anterior axillary line

Structures the needle passes through:

-Skin, superficial fascia, serratus anterior, external intercostal muscle, internal intercostal muscle, parietal pleura

53
Q

What is emohysema?

A

A disorder characterized by destruction of the walls of the alveoli
-Abnormally large air spaces that remain filled with air during exhalation

54
Q

Explain the impact of emphysema

A

With less surface area for gas exchange! Oxygen diffusion across the damaged respiratory membrane is reduced. Blood oxygen level is somewhat lowered, and any mild exercise that raises the oxygen requirements of the cells leaves the patient breathless. As increasing numbers of alveolar walls are damaged, lung elastic recoil decreases due to loss of elastic fibers, and an increasing amount of air becomes trapped in the lungs at the end of exhaustion

Over several years, added exertion during inhalation increases the size of the chest cage, resulting in a “barrel chest”

55
Q

What generally causes Emphysema?

A

Generally caused by a long-term irritation

Cigarette smoke, air pollution, and occupational exposure to industrial dust are the most common irritants. Some destruction of alveolar sacs may be caused by an enzyme imbalance. Treatment consists of cessation of smoking, removal of other environmental irritants, exercise training under careful medical supervision, breathing exercises, use of bromchodilators, and oxygen therapy

56
Q

What is asthma ?

A

Chronic airway inflammation, airway hypersensitivity to a variety of stimuli and airway obstruction
-Due to smooth muscle spams in the walls of smaller bronchi and bronchioles, oedema of the mucosa of the airways, increased mucus secretion, and/or damage to the epithelium of the airway

57
Q

What triggers asthma?

A

-Allergen (pollen, house dust mites, molds, or a particular fold). Other common triggers of asthma attacks are emotional upset, aspirin, sulphating agents( used in wine and beer and to keep greens fresh salad bars), exercise and breathing cold air or cigarette smoke

58
Q

What are the acute and chronic responses of the asthma?

A

Acute response: smooth muscle spasm is accompanied by excessive secretion of mucus that may clog the bronchi and bronchioles and worsen the attack

Chronic response: inflammation, fibrosis, edema, and necrosis(death) of bronchial epithelial cells

59
Q

What are the symptoms of asthma?

A

Difficulty breathing, coughing, wheezing, ch3st tightness, tachycardia, fatigue, moist skin, and anxiety

60
Q

Describe treatment of asthma

A
  • Acute attack: drugs that mimics the effect of sympathetic stimulation- causes bronchiodilation
  • Long term therapy of asthma strives to suppress the underlying inflammation
61
Q

Outline the global changes of support

A

C shapes cartilage rings(trachea) —> plates of cartilage —> smooth muscle—> reticular and elastic fibers

62
Q

Outline the global changes to epithelium

A

Respiratory (bronchi)—> Ciliated simple columnar with goblet cells(smaller bronchioles)—> non ciliated simple cuboidal (terminal bronchioles) —> simple squamous

63
Q

Summarize the stages of lung development

A
  1. Glandular (weeks 6-16): cuboidal epithelium
  2. Canalicular (weeks 16-26): respiratory bronchioles form
  3. Terminal sac (week 26 to birth): flat type 1 and cuboidal type 2 pneumocystes form
  4. Alveolar (32 weeks to 8 years): Alveolar ducts and alveoli form
64
Q

Describe pseudoglandular and Canalicular period

A

Up to seventh prenatal month, the bronchioles divide continuously into more and smaller canals (canalicular phase)

  • Respiration not possible in pseudoglandular phase (6-16 weeks)
  • Respiration is possible towards the end: Canalicular (16-26 weeks)
65
Q

Describe terminal sac and alveolar period

A

-Respiration becomes possible when type 1 pneumocytes become thinner so that surrounding capillaries protrude into the alveolar sacs- creating the blood-air barrier

Respiration is possible

66
Q

Describe surfactant

A
  • At the end of the 6th month type 2 pneumocytes develop producing surfactant
  • Surfactant lowers surface tension at the air-alveolar interfere
  • Before birth the lungs are filled with fluid-surfactant levels increase during the last 2 weeks before birth
  • When respiration begins at birth most of the lung fluid is resorbed by the capillaries and some expelled EXCEPT for the surfactant
    - without surfactant the alveoli would collapse
67
Q

What happens when alveoli doesn’t have surfactant?

A

Atelectasis , the complete or partial collapse of the entire lung or area(lobe) of the lung

Occurs when tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.

68
Q

What is respiratory distress syndrome?

A

Deficiency of surfactant released by type 2 pneumocytes

  • More common among premature and low birth weight infants
  • Surfactant production is suppressed by asphyxia and increased by thyroxin and cortisol
  • Clinical picture: A newborn in respiratory distress and cyanosis due to collapsed alveoli
69
Q

How is Respiratory Distress Syndrome treated?

A

Treatment:

  • Steriids (betamethasome) to mother before mature delivery to accelerate fetal lung maturity
  • Mechanical ventilation and artificial surfactant
70
Q

What are the respiratory embryological derivatives?

A

Endoderm of respiratory diverticula may
-epithelium & glands of the trachea, bronchi and alveoli

Somatic mesoderm

  • Associated connective tissue, cartilage and smooth muscle
  • Parietal pleura

Splanchnic mesoderm
-Visceral pleura

71
Q

Describe the epithelium of the nose vestibule

A

Nonkeratinized stratified squamous with no cilia nor goblet cells

Contains numerous hairs

72
Q

Describe the epithelium of the respiratory region of the nose

A

Pseudostratified ciliated columnar, with both goblet cells and cilia

Contains conchae and meatuses

73
Q

Describe the epithelium of the olfactory region of the nose

A

Olfactory epithelium (olfactory receptors) with cilia but no goblet cells

Functions in olfaction

Anatomy (29 decks)

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