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SA respiratory > S1) Anatomy of the Respiratory System > Flashcards

S1) Anatomy of the Respiratory System Flashcards

1
Q

How does the respiratory system develop?

A
  • Develops as a ‘diverticulum’ from the pharynx on the anterior side of the primitive gut tube.
  • This elongates, bifurcates and branches to form the respiratory system
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2
Q

Identify 5 functions of the nasal cavity

A
  • Induce turbulent flow (nasal conchae)
  • Warm and moisten inspired air
  • Recover water from expired air
  • Speech production (phonation)
  • Olfaction
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3
Q

Briefly describe the purpose of the paranasal sinuses

A
  • made up of the larynx and the pharynx

Complement the function of the nasal cavity

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4
Q

What are the three divisions of the pharynx? and the overall role of the pharynx

A
  • Nasopharynx
  • Oropharynx
  • Laryngopharynx
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5
Q

Explain the relationship between the pharynx and larynx

A

The pharynx and larynx work together to ensure that food and air enter the oesophagus and trachea respectively

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6
Q

How does the larynx protect the airway during swallowing?

A

The epiglottis is a flap made of elastic cartilage attached to the entrance of the larynx which projects obliquely upwards to prevent the aspiration of food/liquids during swallowing and blocks the trachea

→ laryngeal inlet becomes narrowed when epiglottis folds, vocal chords adduct and shut

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7
Q

Identify the 6 structures in the conducting zone of the respiratory system

A
  • Trachea
  • Primary (main) bronchi
  • Secondary (lobar) bronchi
  • Tertiary (segmental) bronchi
  • Bronchioles
  • Terminal bronchioles
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8
Q

Identify the 3 structures in the respiratory zone of the respiratory system

A
  • Respiratory bronchiole
  • Alveolar duct
  • Alveolus
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9
Q

Identify 2 functions of the cartilage in the trachea

A
  • Keeps airway open (patency)
  • Enables movement during breathing
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10
Q

Why is the tracheal cartilage C-shaped?

A

The cartilage opens at the esophagus and is replaced by connective tissue and muscle allowing the bolus to press against the trachea and be swallowed easily

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11
Q

Which parts of the body do the superior and inferior thoracic aperture communicate with respectively?

A
  • Superior thoracic aperture communicates with the neck
  • Inferior thoracic aperture communicates with the abdomen
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12
Q

Which specific nerves innervate the diaphragm?

A

Left and right phrenic nerves

C3, C4, C5 keep the diaphragm alive

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13
Q

Which segment of the nervous system innervates the diaphragm?

A

The diaphragm is a somatically innervated skeletal muscle (voluntary control)

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14
Q

How do we ventilate the lungs?

A
  • Increase the volume of the thoracic cavity
  • Reducing the alveolar pressure
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15
Q

What are the three layers of intercostal muscles connecting the ribs together?

A
  • External intercostal muscle
  • Internal intercostal muscle
  • Innermost intercostal muscle
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16
Q

What is the primary function of the external intercostals?

A

Assist inhalation

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17
Q

Internal intercostals are antagonists to external intercostals.

Thus, state their function

A

Assists exhalation (especially forced exhalation)

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18
Q

What is the location of the main neurovascular bundle for the intercostals?

A

Below the rib, hence entry during pleural aspiration or insertion of chest drain is always made above the rib

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19
Q

Which three structures pass through the diaphragm?

A
  • Vena Cava
  • Oesophagus
  • Aorta
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20
Q

At what vertebral levels do the three structures pass through the diaphragm?

A
  • Vena cava (T8)
  • Aortic hiatus (T12)
  • Oesophagus (T10)

Levels correspond to the number of letters in each structure

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21
Q

What are the components of the intercostal neurovascular bundle?

A
  • Intercostal nerve
  • Intercostal vein
  • Intercostal artery
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22
Q

What is the azygos vein and what does it do?

A

The azygos vein is a vein running up the side of the thoracic vertebral column draining itself towards the superior vena cava.

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23
Q

What are the articulating points of the rib cage?

A
  • The ribs articulate with the vertebral column posteriorly
  • The ribs terminate anteriorly as cartilage (costal cartilage)
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24
Q

The typical rib consists of three components.

Identify them

A
  • Head
  • Neck
  • Body
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25
Q

Describe the shape of the head of a typical rib

A

The head is wedge shaped and has two articular facets separated by a wedge of bone

  • forms the costovertberal joints
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26
Q

Identify the different articulation points of the head of the rib

A
  • One facet articulates with the numerically corresponding vertebrae
  • The other articulates with the vertebrae above
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27
Q

Describe the articulation points of the neck of a typical rib

A

Where the neck meets the body there is a roughed tubercle which articulates with the transverse process of corresponding vertebrae

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28
Q

Describe the structure and function of the body/shaft of the rib

A
  • Structure: flat and curved
  • Function: internal surface of the shaft has a groove for the neurovascular supply of the thorax, protecting them from damage
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29
Q

What are the four characteristic features of the thoracic vertebrae?

A
  • Vertebral body is heart shaped
  • Demi-facets on each side of vertebral body
  • Costal-facets on transverse process
  • Spinous processes are long and slanted inferiorly
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30
Q

Explain why hoarseness of the voice may be a sign of intrathoracic disease

A
  • Hoarseness is a symptom not a disease
  • It is related to swelling, inflammation and an upper respiratory tract infection
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31
Q

Describe the rib movements during inhalation and exhalation

A
  • Inhalation

I. Chest cavity enlarges

II. Rib cage moves upward and outward

  • Exhalation

I. Chest cavity reduces

II. Rib cage moves downward and inward

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32
Q

Describe the anatomical position of the lungs

A
  • The lungs lie on either side of the mediastinum, within the thoracic cavity
  • Each lung is surrounded by a pleural cavity
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33
Q

Which 4 structures does the mediastinal surface of the left lung lie in close proximity to?

A
  • Heart
  • Arch of aorta
  • Thoracic aorta
  • Oesophagus
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34
Q

Which 5 structures does the mediastinal surface of the right lung lie in close proximity to?

A
  • Oesophagus
  • Heart
  • Inferior vena cava
  • Superior vena cava
  • Azygos vein
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35
Q

Briefly describe the structure of the lungs

A

Each lung consists of:

  • An apex
  • Base
  • Lobes
  • Three surfaces
  • Three borders
36
Q

What are the three surfaces of the lungs?

A
  • Costal (faces internal surface of chest wall, smooth)
  • Mediastinal (lateral aspect of middle mediastinum)
  • Diaphragmatic (concave)
37
Q

Which lung is smaller?

A

The left lung is slightly smaller than the right due to the presence of the heart

  • adjacent to the heart, aortic arch, descending aorta, oesophagus, left phrenic nerve, vagus nerve and left recurrent layrngeal nerve
38
Q

Distinguish the lobular structure of the left and right lungs

A
  • The right lung has three lobes (superior, middle and inferior) separated by oblique and horizontal fissures
  • The left lung has two lobes (superior and inferior) separated by a similar oblique fissure
39
Q

What is the lung root?

A

The lung root is a collection of structures that suspends the lung from the mediastinum

40
Q

Identify the contents of each lung root

A
  • Bronchus
  • Pulmonary artery
  • 2 pulmonary veins
  • Lymphatic vessels
  • Pulmonary plexus of nerves
41
Q

All the structures in the lung root enter/leave via the hilum.

What is this?

A

The hilum is a wedge shaped area on the mediastinal surface of the lung

42
Q

Briefly describe the arterial supply and venous drainage of the lungs

A
  • The lungs are supplied with deoxygenated blood by the paired pulmonary arteries
  • Once the blood receives oxygenation, it leaves the lungs via the four pulmonary veins only a small amount of blood leaves via the bronchial veins
43
Q

Describe the venous drainage and arterial supply of the bronchi, lung roots and visceral pleura

A
  • Arterial supply via the bronchial arteries which arise from the descending aorta
  • Venous drainage via the bronchial veins:

I. Right - drains into azygos vein

II. Left - drains into accessory hemiazygos vein

44
Q

The nerves of the lungs are derived from pulmonary plexuses.

Describe the parasympathetic and sympathetic supply of the lungs

A
  • Parasympathetic: derived from the vagus nerve
  • Sympathetic: derived from the sympathetic trunks

sympathetic efferent fibres are bronchodilators and vasoconstrictor

45
Q

There are two pleurae in the body, consisting of a serous membrane.

How can the pleura be divided into two parts?

A
  • Visceral pleura which covers the lungs
  • Parietal pleura which covers the internal surface of the thoracic cavity, extends into the costo-diaphragmatic recess
46
Q

The parietal pleura is the thicker pleura and can be subdivided into 4 parts.

Identify and describe these

A
  • Mediastinal pleura lines lateral aspect of mediastinum
  • Cervical pleura lines neck extension of pleural cavity

- Costal pleura covers inner aspect of ribs, etc

  • Diaphragmatic pleura covers surface of diaphragm
47
Q

Describe the structure of the visceral pleura

A
  • Covers outer surface of lungs
  • Extends into interlobar fissures
  • Continuous with the parietal pleura at hilum of each lung
48
Q

What is the pleural cavity?

A

The pleural cavity is a potential space between the parietal and visceral pleura which contains a small volume of serous fluid

49
Q

What are the two functions of the parietal pleura?

A
  • Lubricates the pleural surfaces, allowing friction-free movement
  • Produces surface tension, pulling the pleurae together and ensuring the lungs expand during inspiration
50
Q

What are recesses?

A
  • The pleural cavity is not completely filled by the lungs anteriorly and posteroinferiorly.
  • It gives rise to recesses, which are potential spaces where opposing surfaces of the parietal pleura touch
51
Q

There are two recesses in each pleural cavity.

Identify and describe their location

A
  • Costodiaphragmatic: located between the costal pleurae and the diaphragmatic pleura
  • Costomediastinal: located between the costal pleurae and the mediastinal pleurae, behind the sternum
52
Q

What happens when fluid collects in the pleural recesses?

A
53
Q

Compare and contrast the vascular supply of the parietal and visceral pleura

A
  • Parietal: intercostal arteries
  • Visceral: internal thoracic arteries
54
Q

Compare and contrast the innervation of the visceral and parietal pleura

A
  • Visceral: pulmonary plexus – sensitive to distension only
  • Parietal: phrenic and intercostal nerves – sensitive to pressure, pain and temperature
55
Q

What is pneumothorax?

A
  • Pneumothorax is a condition which occurs when air or gas is present within the pleural space
  • This removes surface tension of the serous fluid in the space and reduces lung extension
56
Q

What is the sternal angle?

A

The sternal angle is a joint formed by the articulation of the manubrium and the body of the sternum, a transverse ridge

57
Q

How can one find the sternal angle?

A
  • Find the sternal notch
  • Walk your fingers down the manubrium a few centimetres
  • Feel for a distinct bony ridge
58
Q

The costal cartilages of which rib articulate with the sternum at the level of the sternal angle?

A

The second rib

59
Q

difference between the structure of a bronchus and bronchiole

A
  • bronchus has very little cartilage so can easily collapse and so needs support of the alveoli to maintain the shape
60
Q

how does the bronchus keep open

A
  • radial traction
  • alveoli form an outward pressure away from the bronchus and creates tension
61
Q

what is the upper respiratory tract made up of? and how is it conductive to warming, humidifying and filtering air particles?

A

– nose

– pharynx and larynx (paranasal sinuses)

  • warming → air heated on passage through nose, water vapour added
  • humidified → transudation of fluid via epithelium
  • filtering → via cilia trapping large particles in air
62
Q

what is the role of the larynx?

A
  • connects the pharynx to the trachea
  • contains the vocal chords which are the entrance to the trachea
63
Q

which muscles and nerves innervate the vocal chords?

A
  • intrinsic laryngeal muscles
  • the recurrent laryngeal nerves (has a long course on the left side so is susceptible to compression during intra thoracic disease => hoarse voice)
64
Q

explain how the cough reflex works

A
  • closing of vocal chords build up the intra thoracic pressure
  • this is followed by the sudden opening of the vocal chord
  • air is expelled out
65
Q

describe the reason for airway obstruction

A
  • opening between vocal chords can present as airway obstruction → difficult to breathe
66
Q

what is the sternum made of?

A
67
Q

how do the internal intercostal muscles aid chest expansion? what direction are their fibres

A
  • fibres run down and posteriorly
  • pull ribs down
  • active only during FORCED expiration
  • work closely with the innermost intercostal muscles
68
Q

how do external intercostal muscles aid chest expansion? what direction are the fibres

A
  • fibres run down anteriorly and down from inferior to superior margins of rib
  • contribute to 30% chest expansion
  • elevates the ribs
69
Q

how much chest expansion is the diagram responsible for

A

70%

70
Q

where does the trachea start and end

A
  • starts at the lower border of the cricoid cartilage
  • terminates at level of sternal angle
71
Q

what is the angle between the left and right bronchi called

A

carina

72
Q

what is the angle between the left and right bronchi called

A

carina

73
Q

why are foreign bodies most likely to get trapped in the right main bronchus?

A
  • right main bronchus is shorter and more vertical than the left
  • found in middle lobe
74
Q

how many bronchi divide on the left and how many divide on the right

A
  • 3 lobar bronchi on the right for the superior, middle and inferior lobe
  • 2 lobar bronchi on the left for the superior and inferior lobe
75
Q

what is a segmental bronchi

A
  • division of the lobar bronchi
76
Q

what is a bronchopulmonary segment and what is its clinical relevance

A

→ area of lung supplied by segmental bronchus

→ pulmonary artery

→ drained by segmental vein

→pyramid shaped

→ Clinical relevance: bronchoscopy, so you can isolate separate segment

77
Q

Which divisions of the bronchioles are known as the conducting zones

A

1-16

78
Q

which parts of the lungs make up the respiratory zone?

A
  • respiratory bronchioles → have occasional alveoli
  • alveolar ducts → lined with alveoli
  • alveolar sac → composite airspace with numerous alveoli open
79
Q

what is the right lung adjacent to?

A

superior vena cava, azygous vein, right atrium, oesophagus, right phrenic nerve, vagus nerve and sympathetic trunk

80
Q

what can damage to the phrenic nerve cause?

A
  • it can paralyse the diaphragm and cause breathlessness
81
Q

what can damage to the left recurred pharyngeal nerve cause?

A
  • paralysis intrinsic laryngeal muscle
  • vocal cord paralysis
  • voice becomes hoarse
82
Q

briefly describe the lymphatic drainage of the lungs

A
  • hilar nodes (bronchopulmonary nodes)
  • these nodes can turn into tracheobronchial nodes which can widen the angle of the carina
83
Q

which fissure seperates the left lung lobes?

A
  • oblique → separates upper and lower and extends from T2\
84
Q

Which fissure in the right lung separates the right upper and middle lobes

A
  • horizontal fissure
85
Q

what is the extent of the pleural cavity?

A
  • the pleural cavity lies lower 2 ribs lower than the lung
86
Q

what type of blood does pulmonary arteries carry

A

deoxygenated

87
Q

what is the structural comparison between a bronchus and a bronchiole?

A
  • bronchus has areas of cartilage around it
  • bronchiole has no cartilage
  • bronchus has small glands in the submucosa
  • bronchiole has no glands

SA respiratory (23 decks)

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