Respiratory tract Flashcards
3 parts of the respiratory tract
Upper airways
Inferior airways
Organ of respiration
What is included in the upper airways?
Nasal cavity
Paranasal sinuses
(naso)pharynx
What is included in the inferior airways?
Larynx
Trachea
Bronchi
What is the organ of respiration?
The lungs
What 2 systems is the pharynx shared between?
The respiratory system
The digestive system
Where does the pharynx go from and to?
The outer part of the basil part of the occipital bone and C6
What is the pharynx?
A musculomembranous tube
What is the inner aspect of the pharynx covered by?
Mucosa
Where is the pharynx larger?
In the cranial part
What does the pharynx communicate with?
Nasal, oral and laryngeal cavities
What is the wall of the pharynx made of?
Skeletal muscles (voluntary)
3 parts of the pharynx
Nasopharynx
Oropharynx
Hypopharynx (laryngopharynx)
Where does the oesophagus start?
C6
Is the pharynx closed or open posteriorly?
Closed
What suspends the pharynx’s to the outer aspect of the base of the skull?
Pharyngobasilae fascia
What are the 3 circular constrictor muscles of the pharynx?
Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor
What is the connective part where the pharyngeal muscles connect called?
Pharyngeal raphe
3 elevator muscles of the pharynx
Stylopharyngeus muscle
Salpingopharyngeus muscle
Palatopharyngeus muscle
Where does the superior pharyngeal constrictor muscle originate?
The pterygomandibular raphe
Where does the middle pharyngeal constrictor muscle originate?
Greater horn of the hyoid bone
Where does the interior pharyngeal constrictor muscle originate?
Thyroid cartilage of the larynx (oblique line)
Where does the stylopharyngess muscle originate?
Styloid process
Where does the salpingopharyngeus muscle originate?
Cartilage of the auditory tube
Do the elevator muscles of the pharynx mix with the fibers of the constrictors?
Yes
Where does the palatopharyngeus muscle originate?
Soft palate
How many opening in the posterior of the pharynx?
3
Where is the nasopharynx located?
Posterior to the choanae
What is the posterior wall of the nasopharynx in touch with?
C1 and C2
What is found on the lateral walls of the nasopharynx?
The opening of the auditory tube
Which part of the nasopharynx os not rigid?
The soft palate (the floor)
Different name for auditory tube
Eustachian
What kind of structure is the auditory tube?
Cartilage
Is the opening of the auditory tube a real opening?
Yes, the air communicates with the middle ear
What kind of mucosa is found in the nasopharynx?
Respiratory mucosa
Where is the oropharynx located?
Posterior to the isthmus of the forsus
What does the laryngopharynx communicate with
Communicates with the larynx
What does the oropharynx communicate with?
The oral cavity
What kind of mucosa is found in the oropharynx
Continuation of mucosa of the oral cavity
Squamous stratified non keratinised epithelium
What is the larynx?
An air passage
A sphincter
Organ of phonation (production of sound)
Where does the larynx extend from and to?
The root of the tongue to the trachea
Where does the laryngopharynx go from and to?
C3-C6
Proper term for Adam’s apple
Laryngeal prominence
What envelopes the larynx?
The visceral pretracheal fascia
Where does the visceral pre tracheal fascia covers the larynx?
Anteriorly, laterally and posteriorly
Where does the laryngeal prominence fit between?
The infra hyoid muscles
What suspends the thyroid cartilage to the hyoid bone?
The thyrohyoid membrane
What is the skeletal framework of the larynx?
Different articulated cartilage connected by membrane and moved by muscles
3 single laryngeal cartilages
Thyroid
Cricoid
Epiglottic cartilages
What are the 4 paired laryngeal cartilage?
Arytenoid
Corniculate
Cuneiform
Tritiated
What kind of cartilage are the laryngeal cartilage?
Hyaline cartilage
Elastic cartilage
What is the anterior process of the arytenoid cartilage called?
The vocal process
What is the posterior process of the arytenoid cartilage called?
Muscular process
Where does the stalk of the epiglottis attach to? and through what?
The inner surface of the thyroid cartilage through the thyroepiglottic ligament
What 2 types of movement does the circa-aryhtenoid joint allow for?
Rotation
Gliding movement
What does the lateral rotation of the arytenoid cartilage do to the vocal folds/ligaments?
Abduction
What does the medial rotation of the arytenoid cartilage do to the vocal folds/ligaments?
Adduction
Different name for vestibular ligament
Fasle vocal folds
What forms the true vocal folds?
The vocal ligament
Why are the false vocal folds called so?
Because they are not involved in formation of sound
What does the contraction of the thyroarytenoid muscle do?
Draws the arytenoid cartilages anteriorly and thus relaxes the vocal ligament
What sound does the relaxing of the vocal ligaments give?
Low pitch
What is found lateral to the vocal ligaments?
The vocals muscles (most medial part of the thyroarytenoid muscle)
What is the space (recess) between the vestibular and the vocal folds?
Ventricle of larynx/vestibule
What kind of epithelium are the vocal folds covered in?
Squamous stratified epithelium
2 types of innervation in the larynx
Sensory innervation of the mucosa
Motor innervation of the muscles producing sound
What nerve does the laryngeal nerve branch from?
The vagus nerve
Where does the trachea go from and to?
C6-T4
What is the trachea made from?
Cartilagous rings (up to 20), hyaline cartilage
Where does the trachea bifurcate?
T4
Length of trachea
10-12cm
Which bronchus is longer?
Left
Which bronchus has a larger diameter?
Right
Which bronchus forms a higher degree angle from the midline?
The left
What is the right bronchus in close relationship with?
The azygos vein
What is the left bronchus in close relationship with?
The aorta
4 sections of the lungs
Apex
Base
3 borders
2 surfaces
Name of the 2 surfaces of the lungs
Mediastinum surface
Costal surface
Name of the serous membrane covering the lungs
Pleura
How many layers of the pleura?
2
Name of the 2 layers of the pleura
Visceral pleura (attached to lung)
Pariteal pleura (attached to the chest wall)
What is the name of the cavity between the 2 layers of the pleura?
Pleural cavity
Are the 2 layers of the pleura made from the same membrane?
Yes
4 sections of the pariteal pleura
Cervical part
Costal part
Diaphragmatic part
Mediastinal part
Name of the notch of the left lung
Cardiac notch
Which lung is bigger?
Right
How many fissure on the right lung?
2
How many fissures on the left lung?
1
How many lobes on the right lung?
3
How many lobes on the left lung?
2
Name of the fissures of the right lung
Oblique
Horizontal
Name of the fissure of the left lung
Oblique
How many segmental bronchus of each bronchi in each lung?
10
How many lobar bronchus does the bronchi in each lung?
Right:3
Left:2
Names of the 3 lobes of the right lung
Superior
Middle
Inferior
Names of the 2 lobes of the left lung
Superior
Inferior
What are the cartilage rings replaced with when moving towards the bronchioles?
Incomplete runs, irregular sports of cartilage
What marks the transition from bronchi to bronchioles?
The stopping of cartilage
Do bronchioles have cartilage?
No
2 parts of the lobule
Terminal bronchiole
Acinus
What does the Clara cells produce?
Surfactant lipoprotein
What do neuroendocrine cells produce?
Hormones
Which is the main artery supplying the pharynx?
The pharyngeal artery
How are the veins in the pharynx organised?
Superficial pharyngeal venous plexus
Deep pharyngeal venous plexus
What is the inner layer of the pharynx made up of?
Mucosa
What is the outer layer of the pharynx made up of?
Skeletal muscle and pre vertebral fascia
What does the palatopharyngeal arch consist of?
Muscle covered by mucosa
Which structure of the nasopharynx is the only one that is not rigid?
The floor
What raises and lowers the floor of the nasopharynx?
The soft palate
Deglutition meaning
The action or process of swallowing
When is the larynx mobile?
During degulition (swallowing)
Where does the larynx project?
Ventrally between the great vessels of the neck
What is the larynx covered by anteriorly?
Skin
Fasciae
The hyoid depressor muscles
What makes the larynx an organ of phonation?
The vocal points
What cartilage of the larynx is hyaline cartilage?
Arytenoid
Thyroid
Tritiate
Cricoid
What cartilage of the larynx is elastic cartilage?
Vocal process of the arytheonoids
Epiglottis
Corniculate
Cuneiform cartilage
3 joints of the larynx
Cricothyroid joint
Cricoarytenoid joint
Arycorniculate joint
What cartilage of the larynx has the shape of a shield?
The thyroid
Where on the thyroid cartilage does the true vocal folds attach?
The thyroid notch
Where on the thyroid cartilage does the fasle vocal folds attach?
Laterally to the true vocal folds
What cartilage of the larynx has the shape of a ring?
Cricoid cartilage
What does the cricoid cartilage have a similar shape to?
The rings of the trachea
Which margin of the cricoid cartilage of the pharynx articulates with arytenoid cartilage?
Posteriorly on the superior margin
What is the primary movement at the circo-thyroid joint?
Rotation around a transverse axis
What does the movement of the circo-thyroid joint do?
Brings together the lamina of the thyroid cartilage and the arch of the cricoid cartilage (closing the visor)
Lengthens the vocal ligament
What effect does the lengthening of the vocal ligament have?
Increase vocal fold tension
What does the rotation of the circo-arythtenoid do?
Makes each vocal process swing laterally (increasing width of the rima glottidis) or medially (decreasing width of the rima glottidis)
What does the gliding of the circo-arythtenoid do?
Adduction or abduction of the vocal folds
What does the medial gliding of the circo-arythtenoid do? and when does it occur
Adduction
Occurs with medial rotation
What does the lateral gliding of the circo-arythtenoid do? and when does it occur
Abduction
Occurs with lateral rotation
Where does the fibroelastic membran of the larynx lie?
Within the cartilaginous skeleton of the larynx, beneath the laryngeal mucosa
What does the laryngeal muscles do?
Move laryngeal cartilages relative to one another
What does the moving of the laryngeal cartilages do?
Affects the tension/position of the vocal folds
Origin and insertion of the cricothyroid muscle?
Origin: nterolateral part of cricoid cartilage
Insertion of oblique part: inferior horn of thyroid cartilage
Insertion of straight part: Inferior margin of thyroid cartilage
Action of the cricothyroid muscle
Draws thyroid cartilage anteroinferiorly
Lengthens and tenses vocal ligament (high pitch sound)
Which laryngeal muscle creates and adduction of the muscular processes?
Posterior cricoarythenoid muscle
What does the adduction of the muscular processes do?
Abduction of vocal process
Opening of rima glottidis
What does the abduction of the muscular processes do?
Adduction of vocal process
Closing of rima glottidis
Which laryngeal muscle creates and abduction of the muscular processes?
Lateral cricoarythenoid
What do the transverse and oblique interarythenoid muscles do?
Medial gliding of aryhenoids and blocking
Adduction of vocal processes, closing rima glottidis
Which muscle of the larynx makes a low pitched voice?
Thyroarytenoid muscle
What is the default position of the rima glottidis?
Open
Where is the apex of the rima glottidis?
Anterior
Where is the base of the rima glottidis?
Posterior
Why is the rima glottidis redish?
Because of respiratory mucosa
What happens to the rima glottidis during forced respiration?
It is widened and vocal cords are fully abducted to increase airway
How many layers does the lamina propia of the vocal folds consist of?
3 layers
What does the most superficial layer of the lamina propia of the vocal folds consist of?
Loose collagen and elastic fibers
What does the intermediate layer of the lamina propia of the vocal folds consist of?
Elastic fibers
What does the deep layer of the lamina propia of the vocal folds consist of?
Collagen fibers
Which layers of the lamina propia of the vocal folds form the vocal ligament?
The intermediate and the deep layer
Which theory explains the mechanism underlying the vocal fold vibrations?
Aerodynamic-myoelastic theory
When are vocal sounds produced?
When forced exhalation creates pressurised airflow that collides with the vocal folds resulting in their vibration
Where does the superior thyroid artery originate from?
Common carotid artery
Where does the inferior laryngeal artery originate from?
Thyrocervical trunk
What does the right recurrent laryngeal nerve wrap around?
Brachiocephalic trunk
Where does the left recurrent laryngeal nerve wrap around?
The aortic arch
Is the right recurrent laryngeal nerve sensory or motor?
Exclusively motor
Which innervation produces sound?
Motor innervation
After the bifurcation of the trachea, which side is longest before it bifurcates again?
Left
What is the innermost layer of the trachea?
Epithelium
Which 2 nerves innervate the parietal pleura of the lungs?
Intercostal nerves
Phrenic nerve
Which nerves innervates the visceral pleura?
Autonomic nerves
What is pneumothorax?
Abnormal collection of air in pleural space
Collapsed lung
How many more ribs than the lung does the pleura project on?
2 more
So the lung project anterior on the 6th rib and the pleura on the 8th
Which rib does the lung project on anteriorly?
6th
Which rib does the lung project on posteriorly?
10th
How many segments of each lung?
10
Which lung segments are found in the superior lobe of the right lung?
1-3
Which lung segments are found in the middle lobe of the right lung?
4 and 5
Which lung segments are found in the inferior lobe of the right lung?
6-10
Which lung segments are found in the superior lobe of the left lung?
1-5
Which lung segments are found in the inferior lobe of the left lung?
6-10
What does the pulmonary ligament surround?
Hilum of the lung:
Bronchus
Pulmonary artery
Pulmonary veins
Does the bronchioli have glands nad cartilage in the wall?
No
Function of bronchioli and bronchioli terminales
Conductive
What is the function of the bronchioli respiratorii?
Respiratory (gas exchange)
What are the conductive airways lined internally by?
Mucosa
Submucosa
Where in the lungs is cartilage present?
Fron trachea to smallest bronchi
Where in the lungs is cartilage absent?
Bronchioles
Where in the lungs is the smooth muscle and respiratory surface largest?
Alveolar
What is the extra pulmonary and larger intrapulmonary passages lined by? (epithelium)
Respiratory epithelium
What is respiratory epithelium?
Pseudostratified
Ciliated
Mucous secreting goblet cells
6 types of epithelial cells in the conducting airways
Ciliated columnar
Goblet
Clara
Basal
Brush
Neuroendocrine
What does BALT stand for
Bronchus
Associated
Lymphoyd
Tissue
What are the capillary endothelial cells?
Single layer of a flat cell
What is the alveolar epithelium?
Single layer mosaic of types 1 and 2 pneumocytes
Which cells form over 90% of the alveolar area?
Type 1 pneumocytes (simple squamous epithelial cells)
What about the type 1 pneumocytes facilitates gas diffusion?
Their thin cytoplasm
What joins type 1 pneumocyte?
Thight junctions
What creates the blood-air barrier?
The tight junctions of type 1 pneumocytes
Do type 1 pneumocyte divide?
No
What happens if type 1 pneumocytes are damaged?
They are replaced by type 2 cells which proliferate and differentiate into type 1
What are type 2 pneumocytes the precursor of?
Alveolar surfactants which helps reduce surface tension
What do alveolar macrophages do?
Clear the respiratory spaces of inhaled particles small enough to reach the alveoli
What does principle of La Place say?
Surfactants create less surface tension and equal pressure in 2 alveolar of different sizes
How many pulmonary veins per lung?
2
Where does the pulmonary trunk bifurcate?
Below the aortic arch
How does the right main pulmonary artery divide?
It trifurcates into 3 lobar arteries which divide into segmental arteries and then into sub segmental arteries
How does the left main pulmonary artery divide?
Bifurcates into 2 lobar arteries
