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Year 1 HLB Respiratory > The Lungs and the Pleura > Flashcards

The Lungs and the Pleura Flashcards

1
Q

What is the mediastinum?

A
  • cavity surrounded by loose connective tissue
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2
Q

What components make up the mediastinal cavity?

A
  • lymph nodes and vessels - nerves - heart - trachea - thymus gland - great vessels
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3
Q

What does pleura mean?

A
  • greek for sides of the body
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4
Q

What is the visceral pleura?

A
  • visceral = organ
  • loose areolar connective tissue
  • on outside of the lungs
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5
Q

What is the pleural space? (some refer to this as pleural cavity)

A
  • space between the lungs (visceral pleura) and parietal space
  • connected to the parietal pleura
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6
Q

What is inside the pleural space?

A
  • pleural fluid
  • secreted by mesothelial cells
  • lubricates and allows movement of lungs
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7
Q

What is the parietal pleura?

A
  • parietal means wall of the body
  • covers the inside of the thoracic wall
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8
Q

What are the 2 large pleural cavities either side of the mediastinum called?

A
  • pleural cavities
  • contain left and right lungs
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9
Q

What is a lung root?

A
  • structures that emerge from the lungs, called the hilum
  • include principle bronchus, pulmonary arteries and veins
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10
Q

What is the lung apex?

A
  • the top of the lung
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11
Q

What is the base of the lung?

A
  • where the lungs meet the diaphragm - dome like appearance is due to domes of diaphragm - called the diaphragmatic
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12
Q

What is the costal surface of the lung?

A
  • the outside of the lung facing the ribs (costal)
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13
Q

What are the fissures of the lung?

A
  • fold of visceral pleura - separates the lobes of the lungs
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14
Q

How many lobes are in the left and right lungs?

A
  • right = 3 - upper, lower and medial lobes - left = 2 - upper and lower lobes
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15
Q

What is the hilum of the lungs?

A
  • interior/medial aspects of lungs
  • site of entry/exit of structures from an organ
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16
Q

Where is the best place to listen to the lung sounds of the apex of the lungs?

A
  • 2 fingers to the left/right of the sternal/jugular notch
  • above the clavicle
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17
Q

Can the middle lobe be listened to on the anterior aspect of the chest wall?

A
  • yes
  • ribs 4-6
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18
Q

in addition to the lung root, what other central component of the thoracic cavity can cause an impression on the inside of the lungs?

A
  • mediastinum
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19
Q

What fissures are present in the right lung?

A
  • oblique - horizontal
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20
Q

What do the oblique and horizontal fissures separate in the right lung?

A
  • oblique = separates upper and lower lobes - horizontal = separates upper and middle lobe
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21
Q

What does the oblique fissure separate in the left lung?

A
  • upper and lower lobes
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22
Q

When trying to identify which is left and right lung on the mediastinal surface of the lungs, what can you use to help you?

A
  • indents on the mediastinal surface - aortic arch - other blood vessels - lobes (3 in right and 2 left)
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23
Q

What is the name where the trachea bifurcates into left and right lungs located at the sternal angle/angle of louis?

A
  • carina
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24
Q

The primary bronchi bifurcates to provide the 3 main parts of the right lung. What are the 3 names of these?

A

1 - upper lobal bronchi 2 - middle lobar bronchi 3 - lower lobar bronchi

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25
Q

The primary bronchi bifurcates into 2 in the left lung, what are the names of these?

A

1 - upper lobal bronchi 2 - lower lobar bronchi

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26
Q

What is the basic organisation of the bronchial tree?

A
  • principle bronchi - lobar bronchi - primary - secondary - tertiary - terminal bronchioles - respiratory bronchioles (BP segments) - alveoli
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27
Q

What are the bronchopulmonary segments?

A
  • a specific segment of the lungs from the tertiary bronchi - receive their own blood supply - receive their own bronchi branch
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28
Q

Why are the bronchopulmonary segments important?

A
  • able to act independently - reduces risk each segment can impair another - in cancer for example
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29
Q

How many bronchopulmonary segments are there in the left and right lungs?

A
  • right lung = 10 - left lung = 8
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30
Q

What do the bronchopulmonary segments divide into?

A
  • lobules - divisions of the lungs
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31
Q

What are the 3 bronchopulmonary segments in the superior/upper lobe of the right and left lung?

A

1 - apical (meaning anex so top) 2 - posterior 3 - anterior

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32
Q

What are the 2 bronchopulmonary segments in the medial lobe of the right lung?

A

1 - lateral 2 - medial

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33
Q

What are the 5 bronchopulmonary segments in the inferior/lower lobe of the right and left lung?

A

1 - Superior 2 - Posterior Basal 3 - Anterior Basal 4 - Medial Basal 5 - Lateral Basal

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34
Q

What is the arrangement following the terminal bronchi?

A
  • respiratory bronchioles (BP segments) - alveolar ducts - alveolus - alveolar sacs - pores of kohn
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35
Q

Alveoli are made up of a single layer of epithelial cells, what are those cells?

A
  • simple squamous epithelial cells (Type I cells) - simple cuboidal epithelial cells (Type II cells)
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36
Q

Roughly how many alveoli are there in each lung?

A
  • 300-400
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37
Q

What is emphysema?

A
  • emphysema = latin for swelling
  • alveoli become damaged ⬇️ their elastic properties
  • alveoli sacs merge forming 1 large sac, ⬇️ surface area
38
Q

What does emphysema do to compliance and elasticity of the lungs?

A
  • lungs are able to expand but not recoil - ⬆️ compliance - ⬇️ elasticity
39
Q

What are the 2 most common symptom of emphysema?

A

1 - coughing 2 - shortness of breathe

40
Q

What is a bunch of alveoli called?

A
  • alveoli sac
41
Q

What surrounds each alveoli to ensure perfusion?

A
  • capillaries do assist with gas exchange
42
Q

Why are alveoli spherical and not flat in the respiratory tract?

A
  • increase surface area for gas exchange
43
Q

What is an obstructive respiratory disease?

A
  • disease causing damage to airways
  • lungs can expand but not recoil
  • difficult getting air out = ⬇️ FEV1
44
Q

Why is emphysema an example of obstructive respiratory disease?

A
  • damaged alveoli expand but do not recoil
  • compliance is ⬆️ meaning air can enter the lungs
  • elasticity is ⬇️ so it is difficult to get air out of the lungs
45
Q

What are a few examples of obstructive respiratory disease?

A
  • bronchitis - bronchiectasis (excess build up of mucus) - asthma
46
Q

What does COPD mean?

A
  • chronic obstructive pulmonary disorder - group of obstructive lung conditions
47
Q

What is an restrictive respiratory disease?

A
  • disease causing damage to airways - impacts lungs ability to get air in to the lungs
48
Q

What is a pleural recess?

A
  • space formed in pleural space
49
Q

What are the 2 pleural recess in the thoracic cavity?

A

1 - costodiaphragmatic recess (reflection between costal+diaphragmatic pleura)

2 - costomediastinal recess (reflection between costal+mediastinal pleura)

50
Q

What are the 4 regions of the parietal pleura around the lungs, given different names due to reflections?

A

1 - cervical (apex of lung) 2 - costal (facing the ribs) 3 - diaphragmatic 4 - mediastinal

51
Q

What determines when one part of the parietal pleura becomes another?

A
  • reflection of the parietal pleura - where one part of the pleura bends and becomes another
52
Q

What nerves innervate the costal and cervical pleura?

A
  • somatic supply so feel all sensations - intercostal nerves T1-T11
53
Q

What nerves innervate the mediastinal and diaphragmatic pleura?

A
  • phrenic nerve - somatic supply so feel all sensations
54
Q

What is the pulmonary ligament?

A
  • fusion of the parietal and visceral pleura - anchors lungs to superior mediastinal - NOT a true ligament
55
Q

What is the costal groove?

A
  • internal and inferior surface of the ribs
  • allows blood vessels and nerves to run along rib
56
Q

What is the purpose of the costal groove?

A
  • to create a cavity for vessels - VAN = veins, arteries and nerves
57
Q

What is tachypnoea?

A
  • abnormal rapid respiratory rate
  • short breathes
  • normal respiratory rate = 16-20b/min
58
Q

What is dyspnea?

A
  • shortness of breathe
59
Q

What is hyperpnea?

A
  • slow abnormal breathing - long and deep breathes
60
Q

What is pleuritis and/or pleural rub?

A
  • inflammation and/or swelling of pleural space - on stethoscope sounds like hands rubbing together
61
Q

What does pleural effusion mean?

A
  • build up of excess fluid in pleura
  • generally requires draining
  • symptoms (if any) progress slowly
62
Q

What does pneumothorax mean?

A
  • pneumo greek for air
  • thorax greek for thoracic
  • means liung collapse with rapid onset of symptoms
63
Q

What is pneumothorax?

A
  • filling of air in the pleural cavities of the lungs
64
Q

What is hemomothorax?

A
  • blood has leaked into the pleural cavities of the lungs
65
Q

What happens to intrapleural pressure if air, liquids or pus is able to enter the pleural space?

A
  • air, fluids etc… fill the space so volume ⬇️
  • intrapleural pressure will increase
  • Boyles law = ⬇️ volume = ⬆️ pressure
66
Q

What are the 3 different types of pneumothorax?

A

1 - closed 2 - open 3 - tension

67
Q

What is closed pneumothorax? (can be air, fluid or pus)

A
  • air has entered the pleural space from inside respiratory system
  • air compresses the lungs
  • air is eventually filtered out and lung returns to normal
68
Q

What is open pneumothorax? (can be air, fluid or pus)

A
  • air enters pleural space due to break in parietal pleura
  • air enters from outside of respiratory system
  • air compresses the lungs
  • break is repaired and air is filtered out and lung returns to normal
69
Q

What is tension pneumothorax? (can be air, fluid or pus)

A
  • break in parietal pleura and air enters the pleural space
  • creates one way valve so air cannot leave
  • air compresses the lungs and lung collapses
  • most dangerous of the 3
70
Q

What are the 2 types of circulation in the lungs?

A

1 - pulmonary arteries and veins (gas exchange)

2 - bronchial arteries (supply O2 and nutrients to lungs)

71
Q

What does the pulmonary circulation do in the lungs?

A
  • pulmonary arteries bring de-oxygenated blood - pulmonary veins leave with oxygenated blood
72
Q

What do the bronchial arteries do in the lungs?

A
  • blood supply of the lungs
73
Q

Where do the left and right bronchial arteries for the lungs originate?

A
  • left = descending aorta - right = 3rd post intercostal artery
74
Q

How do the pleural membranes of the respiratory tract receive blood?

A
  • anterior and posterior intercostals arteries - azygos and internal thoracic vein
75
Q

During hypoxic episodes what happens to the pulmonary and bronchial arteries?

A
  • pulmonary = vasoconstriction (opposite to systemic circulation)
  • bronchial = vasodilation
76
Q

What are the 3 main lymphatic drainage avenues for the lungs and thoracic cavity?

A

1 - Mediastinal 2 - Parasternal 3 - Tracheobronchial

77
Q

Where are the tracheobronhial lymph nodes located?

A
  • around the carina (trachea and bronchi)
78
Q

Where are the parasternal lymph nodes located?

A
  • parasternal lines - anterior ends of the intercostal spaces - side of the internal thoracic artery
79
Q

Where do the lymph nodes drain into?

A
  • right lymphatic duct - thoracic/left lymphatic duct
80
Q

How are the lungs innervated?

A
  • controlled by autonomic system - pulmonary plexus
81
Q

What are the main components of the pulmonary plexus that supply the lungs? I.e. what supplies sympathetic and para-sympathetic innervation?

A
  • parasympathetic = vagus nerve (10th cranial nerve) - sympathetic = sympathetic chain
82
Q

Where do the pulmonary plexus run in relation to the lungs?

A
  • anterior and posterior at site of carina
83
Q

What parts of the nervous system innervate the visceral and parietal pleura?

A
  • visceral pleura = autonomic so stretch sensitive only
  • parietal = somatic so feels all senses
84
Q

Why is it important to know the nerves that innervate the lungs?

A
  • clinical management will target nervous system
85
Q

In an emergency situation and someone is having an asthma attach what drug might be useful?

A
  • sympathetic drug (adrenoreceptors)
  • B2 Gas receptor will vasodilate bronchi
  • SABA - salbutamol high dose using nebuliser
86
Q

Why is the pleural space always lower than intrapulmonary and atmospheric pressure?

A
  • parietal pleural aim to move outwards
  • visceral pleural aim to move inwards
  • these movements increase the pleural space
  • Boyles law = ⬆️ volume = ⬇️ pressure ⬇️ volume = ⬆️ pressure
87
Q

What is the hilium of the lungs?

A
  • location on lungs where things can enter or leave
88
Q

What is the root of the lungs?

A
  • collection of structures connecting the lung to the mediastinum
89
Q

How does the diaphragm provide stability to the pericardium?

A
  • central tendon provides attachment to fibrous pericardium
90
Q

Which rib is the oblique fissure located at?

A
  • generally 6th rib

Year 1 HLB Respiratory (25 decks)

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