Session 1 (and BL recap)

Question 1

How many ribs are there in total?

Answer 1

24

Question 2

Which ribs are directly attached to the sternum via their costal cartilage?

Answer 2

The first 7
- Ribs 8 to 12 are known as false ribs (3 of which share a common cartilagenous connection to sternum and last 2 are floating)

Question 3

Pleural sacs are comprised of 2 layers. Name them:

Answer 3

Parietal and visceral serosa

Question 4

Fluid can be drained from the pleural cavity via use of a wide bore needle. What needs to be avoided when doing this?

Answer 4

The neurovascular bundle that runs under each rib

Question 5

The respiratory tract is made up of a conducting and respiratory portion. What is the conducting portion comprised of?

Answer 5

Nasal cavity, pharynx, larynx, trachea, primary bronchi, secondary bronchi, bronchioles, terminal bronchioles

Question 6

The respiratory tract is made up of a conducting and respiratory portion. What is the respiratory portion comprised of?

Answer 6

Respiratory bronchioles, alveolar ducts, alveoli

Question 7

What epithelia line the nasal cavity to the secondary bronchi?

Answer 7

Pseudostratified ciliated columnar, with presence of goblet cells

Question 8

What epithelia line the bronchioles and terminal bronchioles?

Answer 8

Simple columnar epithelium with cilia and Clara cells, no goblet cells

Question 9

What epithelia line the respiratory bronchioles and alveolar ducts?

Answer 9

Simple cuboidal epithelium with Clara cells

Question 10

What epithelia line the alveoli?

Answer 10

Simple squamous

Question 11

Does the cartilage of trachea completely surround lumen?

Answer 11

No it is C shaped - allows for the oesophagus to expand.

Question 12

How is the cartilage of primary bronchi arranged?

Answer 12

Ring structure

Question 13

The secondary bronchi down to bronchioles have irregular crescent plates of cartilage. True or false?

Answer 13

True

Question 14

Bronchioles have no cartilage or glands. True or false?

Answer 14

True

Question 15

What keeps bronchioles open?

Answer 15

Surrounding alveoli

Question 16

What do Clara cells secrete?

Answer 16

A surfactant lipoprotein - prevents walls of bronchioles sticking together during expiration

Question 17

CF sufferers do not have the ion channel molecule CFTR - what impact does this have?

Answer 17

Chloride ion transport across membrane compromised, water does not leave epithelium to hydrate mucus -> viscous mucus less readily removed

Question 18

What type of fibres surround alveoli?

Answer 18

Elastic

Question 19

Alveolar cells are…

Answer 19

Type I pneumocytes, type II pneumocytes

Question 20

What is the role of type I pneumocytes?

Answer 20

permit gas exchange with capillaries, predom cell type (90%)

Question 21

What is role of type II pneumocytes?

Answer 21

Produce surfactant

Question 22

What is emphysema?

Answer 22

Destruction of alveolar walls, permanent enlargement of air spaces. Alveolar walls hold bronchioles open, allowing air to leave in expiration. If damaged, difficult for lungs to empty

Question 23

What is the major factor that influences the volume of thorax?

Answer 23

Movement of diaphragm

Question 24

During inspiration, what happens to diaphragm?

Answer 24

Contracts and flattens, increasing vertical diameter of thoracic cavity -> pressure in cavity decreases and air drawn in

Question 25

What innervates the diaphragm?

Answer 25

Phrenic nerve C3, C4, C5

Question 26

Describe the movement of the chest wall during breathing, in relation to the ribs

Answer 26

1) Bucket handle movement: ribs move up to increase lateral dimension of thorax
2) Pump handle movement: sternum moves anteriorly and up

Question 27

What are the 3 layers of intercostal muscles?

Answer 27

External, internal and innermost

Question 28

Where is the external intercostal muscle deficient?

Answer 28

Anteriorly

Question 29

Where are the internal intercostals deficient?

Answer 29

Posteriorly

Question 30

Where are the innermost intercostal muscles mostly present?

Answer 30

Lateral aspect

Question 31

Are intercostals important in normal tidal breathing?

Answer 31

No, mainly for forced ventilation

Question 32

In what direction do the external intercostal fibres run, how do they impact ribs?

Answer 32

Run infero-medially (hands in pockets). When contract they pull ribs up
-> muscles for inhalation (forced)

Question 33

In what direction do the internal and innermost intercostal fibres run, how do they impact ribs?

Answer 33

Run at right angles to external (supero-medially to insert on rib above). Pull ribs down and backwards.
-> muscles for expiration (forced)

Question 34

There are 3 main structures that pass through diaphragm. What are they and at what level do they pass through?

Answer 34

1) Vena cava T8
2) Oesophagus T10
3) Aortic hiatus T12

Question 35

An inhaled foreign body will usually go down which bronchus?

Answer 35

The right - more vertical and wider

Question 36

How many lobes does the right lung have?

Answer 36

3

Question 37

The intercostal neurovascular bundle runs between what layers of intercostal muscles?

Answer 37

Internal and innermost

Question 38

Blood from the intercostal spaces is drained into what system?

Answer 38

Azygos venous system - drains into SVC