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Respiratory > The tracheobronchial tree and larynx > Flashcards

The tracheobronchial tree and larynx Flashcards

1
Q

At the lower border of what cartilage does the trachea arise

A

cricoid cartilage - ring of hyaline that site inferior to the thyroid gland

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2
Q

at what vertebral level does the larynx lie

A

C3-C6

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3
Q

at what level does the trachea bifurcate

A

T4-T5 - level of the sternal angle

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4
Q

The thyroid cartilage is the largest of the laryngeal cartilages. It is formed by a right and a left lamina that are separated posteriorly and joined together at an acute angle in the anterior midline forming what prominence known as the Adams apple

A

laryngeal prominence

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5
Q

At what vertebral level is the thyroid cartilage found

A

C4-C5

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6
Q

what cells line the tracheal lumen

A

ciliated pseudostratified columnar and goblet cells that create the tracheal mucosa

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7
Q

what nerve innervates the trachealis muscle ( that allows the trachea to constrict and dilate

A

recurrent laryngeal nerve/ inferior laryngeal nerve ( same thing) branch of the vagus nerve

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8
Q

what vertebral level does the trachea extend from

A

C6-T4/T5

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9
Q

In a tension pneumothorax tracheal deviation can occur and the mediastinum to shift to the other side- compressing the vena cava and opposite lung - what major problem can occur if this goes untreated

A

cardiac arrest

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10
Q

Sx of pneumothorax

A

none
sudden onset dyspnoea ( difficulty or laboured breathing)
pleuritic chest pain
asymmetrical chest expansion

Tnesion P - can look blue or ashen skin anxiety and rapid hr

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11
Q

what is pleuritic chest pain

A

Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. It is exacerbated by deep breathing, coughing, sneezing, or laughing.

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12
Q

what is the difference between a pneumothorax and a tension pneumothorax

A

Pneumothorax (air in the pleural cavity) is classified as open (external wound) or closed. The pleural pressure equilibrates with atmospheric pressure, resulting in lung collapse. Tension pneumothorax develops when air continuously enters the chest without evacuation ( valve)

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13
Q

if inserting an IV canula into the lungs to drain fluid where do you insert it

A

2nd intercostal space ( above or below) in mid clavicular line - audible hiss

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14
Q

what are the two arteries that supply the trachea in the neck and chest region respectively

A

neck - inferior thyroid arteries

chest- branches of bronchial arteries

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15
Q

what vein drains the trachea

A

brachiocephalic vein

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16
Q

where both the pleura connect and where vessels are airways can only enter the lungs - what is this point called and at what vertebral level

A

hilum

T5-T7

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17
Q

the trachea bifurcates into the right and left bronchus - following the right lung the bronchus bifurcates into the superior lobar bronchus and the what ? that leads on to split into the middle and inferior lobar bronchi

A

bronchus intermedius

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18
Q

why is the left lung lower than the right

A

The left lung is a little smaller than the right lung because it shares space in the left side of the chest with the heart.

cardiac notch

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19
Q

the main bronchi branch into the lobar bronchi then the segmental bronchi
the lobar bronchi supply what generically

A

lobes of the lung

3 on right 2 on left

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20
Q

what do each of the tertiary bronchi supply

A 
bronchopulmonary segment ( separated by connective tissue) 
10 in right 8 in left ish
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21
Q

what can be found within each bronchopulmonary segment

A 
lobules of lungs 
segmental bronchus 
segmental branches from pulmonary arteries 
branches of bronchial artery 
pulmonary vein and lymphatic margin
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22
Q

what are club cells

A

major secretory cell in the small airway epithelium occupying anywhere between 5% and 20% of total cells and secrete an array of bioactive compounds into the airway surface liquid (ASL) that protect the epithelium from damage

surfactant lipoprotein

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23
Q

bronchioles –> conducting bronchioles –> terminal –> respiratory –> alveolar duct –> alveolar sacs –> ?

A

alveoli

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24
Q

what cells make up respiratory bronchioles

A

simple squamous

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25
Q

in acute asthma allergen causes constriction of what vessels

A

bronchioles - through bronchospasm

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26
Q

What is bronchitis and what are the Sx

A 
Bronchitis is an infection of the bronchi, causing them to become irritated and inflamed. 
mucus hyper secretion 
Sx
Cough
yellow-grey mucus (phlegm) 
sore throat 
wheezing

Rx COPD

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27
Q

what is bronchiolitis

A

much like bronchitis but affects the bronchioles and more common in younger children

a high temperature (fever)
a dry and persistent raspy cough.
difficulty feeding.
difficulty breathing or fast breathing.
noisy breathing (wheezing)
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28
Q

can exercise increase bronchodilation and why

A

increased sympathetic activity so adrenaline released which relaxes smooth muscle in the bronchioles

29
Q

the bronchial arteries supply the roof of the lungs and visceral pleura the 1 right bronchial artery comes from the thoracic aorta where does the 2 left bronchia arteries come from

A

thoracic artery

30
Q

what does the prefix para mean

A

alongside or adjacent to

31
Q

what does the prefix pre mean

A

before or infront of

32
Q

bronchopulmonary nodes to trachea bronchial nodes to paratracheal nodes to bronchomediastinal lymph trunk tp the thoracic duct

true or false

A

true

33
Q

functions of the larynx

A

phonation
cough reflex
protection of LRT

34
Q

the internal cavity of the larynx is divided into 3 what are these called

A

supra glottis - unstoppable inferior epiglottis
glottis - contains vocal cords
subglottis - vocal folds to the trachea

35
Q

what is the opening between the vocal cords called?

A

rima glottis

36
Q

the epiglottis is the posterior root of the tongue and flattens during swallowing to close the larynx - what gland does it attach to

A

thyroid

37
Q

The thyroid cartilage -two hyaline laminae from Adams apple - connect to hyoid bone and circoid cartilage - but at what vertebral level can you find the thyroid cartilage

A

C4-C5

38
Q

croup causes a characteristic barking cough - epiglottis can be infected by bacteria what are the 4Ds

A

dysphagia, dysphonia, drooling, and distress

39
Q

the cricoid cartilage is found just inferior to the thyroid at what level can you find this

A

C6

40
Q

the arytenoid cartilage attaches to the vocal ligaments and the aryepiglottic fold true or false ( cuniform Cartilage is within this )

A

true

41
Q

where do you find the corniculate cartilage

A

apex of arytenoid cartilages

42
Q

what nerve is sensory to the supra glottis and motor to the cricothyroid muscles

A

superior laryngeal nerve

43
Q

the inferior laryngeal nerve is sensory to the infra glottis and motor to all the internal muscles of the larynx except what

A

cricothyroid

44
Q

what structure does the right recurrent laryngeal nerve ( branch of right vagus ) loop under

A

right subclavian artery

45
Q

what structure does the left recurrent laryngeal nerve loop under

A

arch of the aorta

46
Q

How can damage be causes to the laryngeal nerves and what is more prone

A

left more prone as longer course

due to surgery to remove apical lung tumours , thyroid cancers or aortic aneurysms

47
Q

Sx of unilateral nerve palsy

A

hoarseness and increased risk of aspiration

A breathy quality to the voice.
Hoarseness.
Noisy breathing.
Loss of vocal pitch.
Choking or coughing while swallowing food, drink or saliva.
The need to take frequent breaths while speaking.
Inability to speak loudly.
Loss of your gag reflex.

Bilateral more cords adducted and stridor and phonation cannot occur

48
Q

what intrinsic laryngeal ligament terminates superior and forms the vocal ligaments

A

cricothyroid ligaments

49
Q

what ligament/membrane spans from the arytenoid cartilage to epiglottis and lower margin of the vestibular ligaments.folds

A

quadrangular membrane

extrinsic - external
intrinsic hold cartilages together

50
Q

what happens in a cricothyroidectomy

A

depression below thyroid cartilage can be palpated - incision made here and an ET tube is inserted into the airway

51
Q

what artery supplies the internal surface of the larynx

A

superior laryngeal artery ( sup thyroid then external carotid)

52
Q

what after supplies the mucous membranes and muscles of inferior larynx

A

inferior laryngeal artery ( inf thyroid then thyrocervical trunk)

53
Q

do the veins follow the arteries and what do the veins drain into

A

yes

sup and inf laryngeal veins - internal jug on right and left goes into brachiocephalic vein via inferior thyroid

54
Q

what sets of lymph nodes drain the larynx and where do they travel to

A

superior of the vocal cords you find the superior deep cervical lymph nodes
and inferior to the vocal cords you find the pretacheal-para and inferior deep cervical lymph nodes

55
Q

what is a temporary nasopharyngeal airway called

A

airway adjust

56
Q

what is a temporary orophayngeal airway called

A

guedel and also LMA

57
Q

what do the extrinsic laryngeal muscles do

A

elevate or depress the larynx and involved in swallowing - split into supra hyoid ( above) and stylopharyngeus - elevate - and infra hyoid( below) - depress

58
Q

what do the intrinsic laryngeal muscles do

A

involved in breathing and phonation and control the shape of the rim glottis.

59
Q

tongue and lips are secondary closure sites of airspace and produce constant sound

A

true

60
Q

the cricothyroid muscle ( intrinsic) attaches to cricoid cartilage and thyroid cartilage what nerve innervates it and what does it do

A

the external laryngeal nerve - branch of sup. laryngeal nerve

61
Q

the posterior ( I) cricoarytenoid muscle attaches to cricoid cartilage and arytenoid cartilage and is the only muscle to do what? and what nerve innervates it?

A

abduct the vocal cords

inferior laryngeal nerve

62
Q

the arytenoid muscle(I) is composed of transverse and oblique fibres attach to opposite ends of the arytenoid and do what and innervated by what nerve

A

adduct the arytenoid cartilages/ vocal folds and narrow the rima glottis

inferior laryngeal nerve

lateral cricoarytenoid also does this

63
Q

which intrinsic muscle attached to thyroid cartilage and arytenoid cartilage relaxes the vocal ligaments and is innervated by the inferior laryngeal nerve

A

thyroarytenoid muscle ( intrinsic as well )

64
Q

the stylohyoid muscle attaches to the styloid process and hyoid bone what nerve innervates this muscle and what is it function

A

facial nerve

elevates and retracts the hyoid bone

65
Q

what muscle attaches to the manubrium and medial end of clavicle and the body of the hyoid bone and depresses the hyoid bone and larynx after swallowing

A

sternohyoid

C1-C3 ansa cervicalis

66
Q

the sternothyroid connects to manubirum and thyroid lamina ( C2-C3 innervation- ansa cervicalis) what does it do

A

depresses the larynx and thyroid cartilage during swallowing

67
Q

what muscle attaches to the manubirum and the medial third of clavicle and inserts on the mastoid process of occipital bone

A

sternocleidomastoid

68
Q

what innervates the sternocleidomastoid muscle

A

Cranial nerve 11

and C2-3 spinal root

69
Q

what is the main action of the sternocleidomastoid

A

tilts head to one Side i.e. laterally flexes and rotates head so face turned to opposite side

Respiratory (22 decks)

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