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Block 3 > SFP: trachea, bronchi, lungs, pleura > Flashcards

SFP: trachea, bronchi, lungs, pleura Flashcards

1
Q

Where does the trachea begin?

A

Lower border of larynx at the cricoid cartilage at C6

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2
Q

Where does the trachea bifurcate?

A

At the sternal angle

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3
Q

The trachea bifurcates into ___

A

The right and left primary bronchi

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4
Q

Describe the general structure of the trachea

A

About ¾ of the diameter is composed of U-shaped bars of hyaline cartilage. The area not composed of cartilage is closed by the trachealis muscle.

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5
Q

What structures are anterior to the trachea?

A

Arch of aorta, brachiocephalic trunk, common carotid, left brachiocephalic vein, thymus

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6
Q

What structures are posterior to the trachea?

A

Right and left recurrent laryngeal nerves, esophagus, and vertebral column.

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7
Q

What is on the right side of the trachea?

A

Azygous vein, right vagus nerve, and pleura

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8
Q

What is on the left of the trachea?

A

Arch of aorta, left common carotid, left subclavian artery, left vagus nerve, left phrenic nerve, pleura

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9
Q

Compare the right and left primary bronchi

A

The right is wider, shorter, and more vertical; foreign objects are often aspirated into the right bronchus.

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10
Q

What is the carina?

A

Keel-shaped cartilage at tracheal bifurcation

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11
Q

The right primary bronchus divides ___ entering the hilum, while the left primary bronchus divides ___ entering the hilum

A

Before; after

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12
Q

The right primary bronchus branches into…

A

Superior secondary bronchus and intermediate bronchus

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13
Q

The left primary bronchus branches into…

A

The superior and inferior secondary bronchi

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14
Q

The intermediate bronchus divides into…

A

Middle and inferior secondary bronchus

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15
Q

Bronchi ultimately divide into ___

A

Terminal bronchioles

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16
Q

The lungs are separated by ___

A

The mediastinum

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17
Q

What are the lobes of the left lung?

A

Superior and inferior

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18
Q

The hilum of the lung allows for passage of…

A

Left pulmonary artery, left primary bronchus, and left pulmonary veins

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19
Q

What is the lingula?

A

Structure at lower tip of the superior lobe of the left lung

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20
Q

What are the lobes of the right lung?

A

Superior, middle, and inferior

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21
Q

What fissures are present in the right lung?

A

Oblique and horizontal

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22
Q

What is the difference between structures in the right and left lung in the hilum?

A

In the right lung, the pulmonary artery is anterior to the bronchus, while it is superior to the bronchus in the left lung. The primary bronchus divides before entering the hilum in the right lung and after entering the hilum in the left.

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23
Q

What makes bronchopulmonary segments anatomical units of the lung?

A

They each receive a branch of pulmonary artery, lymphatic vessels, and autonomic nerve supply.

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24
Q

What is the functional and surgical unit of the lung?

A

Bronchopulmonary segments

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25
Q

Bronchopulmonary segments are ventilated by ___

A

Tertiary bronchi

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26
Q

As we move along bronchi, what happens to cartilage rings?

A

They become cartilage plates

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27
Q

Describe cartilage in the bronchioles

A

It’s absent

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28
Q

What kind of epithelium is in the bronchioles?

A

Ciliated epithelium

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29
Q

What are the levels of bronchioles from most proximal to most distal?

A
  1. Terminal bronchiole 2. Respiratory bronchiole 3. Alveolar ducts
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30
Q

Where do alveoli first appear?

A

Respiratory bronchioles

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31
Q

Describe the flow of blood through the lungs

A
  1. Lungs receive deoxygenated blood from the right side of the heart through pulmonary artery
  2. Deoxygenated blood makes it to capillary beds at alveolar walls and gas exchange occurs
  3. Oxygenated blood enters pulmonary veins to be delivered to the left heart
32
Q

What supplies blood to the lung tissue itself?

A

Bronchial arteries that branch from the descending aorta

33
Q

What drains the lungs?

A

Bronchial veins

34
Q

Bronchial veins drain to ___ on the right and ___ on the left

A

Azygous vein; hemiazygos vein

35
Q

The superficial plexus in the lungs drains to ___ nodes

A

Bronchopulmonary

36
Q

Deep plexus lymphatic vessels in the lungs drain to __ nodes

A

Pulmonary then bronchopulmonary nodes

37
Q

After the hilar nodes, describe the drainage of lymph in the lungs

A
  1. Tracheobronchial nodes 2. Paratracheal nodes 3. Broncho mediastinal trunks 4. Brachiocephalic veins directly or indirectly
38
Q

How does the pleura come to be during development?

A

The lungs grow into a structure that will eventually have a visceral and parietal layer

39
Q

Where do the visceral and parietal pleura meet?

A

The hilum (root)

40
Q

Describe the visceral pleura

A

It covers the outer surfaces of the lung and extends into the interlobar fissures

41
Q

Describe the parietal pleura

A

Covers the thoracic wall, surface of mediastinum, and into the root of the lung

42
Q

What is the pleural reflection?

A

The point at the hilum of the lung where a pleural cuff forms (visceral and parietal pleura join)

43
Q

What is the pulmonary ligament?

A

Loose fold that hangs below the cuff and allows for movement of pulmonary vessels and bronchi during inspiration

44
Q

Describe the cervical pleura

A

Portion of parietal pleura that covers the apex and extends up into the neck

45
Q

Describe the costal pleura

A

Portion of the parietal pleura that lines the inner surface of the ribs, costal cartilages, intercostal spaces, sides of vertebral bodies, and back of the sternum

46
Q

Describe the diaphragmatic pleura

A

Portion of the parietal pleura that covers the thoracic surface of the diaphragm

47
Q

Describe the mediastinal pleura

A

Portion of the parietal pleura that covers the lateral border of the mediastinum

48
Q

What are recesses?

A

Portions where the pleura/lung extend into during inspiration; there is a Costodiaphragmatic recess and costomediastinal recess

49
Q

The pleura extends ___ rib levels lower than the lung

A

2

50
Q

At the mid-clavicular line, the lungs extend to the __ rib, and the pleura extends to the __ rib

A

6; 8

51
Q

At the mid-axillary line, the lung extends to the __ rib while the pleura extends to the __ rib

A

8; 10

52
Q

At the mid scapular line, the lung extends to the __ rib while the pleura extends to the __ rib

A

10; 12

53
Q

Where does the pulmonary nerve plexus distribute?

A

Trachealis muscle, mucous membrane of trachea and airways, and blood vessels

54
Q

What is the function of afferent fibers in the lungs?

A

They carry information from mucous membranes and alveolar stretch receptors to the CNS

55
Q

The parietal pleura is sensitive to…

A

Pain, temperature, touch, pressure

56
Q

The visceral pleura is sensitive to…

A

Stretch

57
Q

What are the main innervation methods of the parietal pleura?

A

Phrenic nerve and intercostal nerves

58
Q

Describe the phrenic nerve in relation to the pleura

A

Innervates the mediastinal pleura as well as the dome of the diaphragmatic pleura

59
Q

Describe the intercostal nerves in relation to the pleura

A

Segmental intercostal nerves innervate the costal pleura segmentally and the lower 6 intercostal nerves innervate the periphery of the diaphragm

60
Q

Describe the innervation of the visceral pleura

A

Autonomic innervation from pulmonary plexuses at the tracheal bifurcation and main bronchi

61
Q

Describe the phrenic nerves

A

They descend anterior to the root of the lungs between the pericardium and pleura. They’re distributed to the mediastinal pleura and dome of diaphragm

62
Q

Which nerves provide motor innervation to the diaphragm?

A

Phrenic nerve

63
Q

The right phrenic nerve descends to the right side of…

A

R brachiocephalic vein, SVC, R atrium, IVC

64
Q

The left phrenic nerve descends to the left side of…

A

The aortic arch

65
Q

The right vagus nerve is between ____

A

Brachiocephalic vein and brachiocephalic trunk

66
Q

The left vagus nerve runs across the ___

A

Left side of the aortic arch

67
Q

The vagus nerve runs ___ to the root of the lung, while the phrenic nerve runs ___ to the root of the lung

A

Posterior; anterior

68
Q

How do we increase thoracic volume during inspiration?

A

Raising the sternal ends of the ribs to increase anteroposterior diameter and raising the ribs at the costo-vertebral joints to increase the transverse diameter

69
Q

What happens to the diaphragm during inspiration?

A

It contracts, causing it to flatten

70
Q

What happens to the trachea during inspiration?

A

The bifurcation can move downward by 2 levels

71
Q

What is used during quiet inspiration?

A

Diaphragm and external intercostals

72
Q

What is used during forced inspiration?

A

SCM, scalene, muscles that stabilize the scapula

73
Q

What muscles are used in quiet expiration?

A

Passive; the muscles relax

74
Q

What muscles are used in forced expiration?

A

Internal intercostals, abdominal muscles, and quadratus lumborum

75
Q

When the patient holds their arms with their hands behind their heads, how does this show surface projections?

A

The scapula rotates superiorly, causing its medial border to be parallel to the oblique fissure from T4

76
Q

When the patients hold their arm straight up, how does this show surface projections?

A

The horizontal fissure will cross the 5th rib at the mid axillary line and cross the 4th intercostal space. The oblique fissure will be at the spine of 4th thoracic vertebra. As it descends toward the anterior portion of the body, it crosses the 4th rib, 4th intercostal, 5th intercostal and midaxillary line, and follows the 6th rib anteriorly

Block 3 (52 decks)

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