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Anatomy of Systems > The Upper Respiratory Tract > Flashcards

The Upper Respiratory Tract Flashcards

1
Q

Why is the upper respiratory tract important

A

Often get infections here (rhinitis, laryngitis, bronchitis)

Generally less severe than lower resp tract where infections here can kill (pneumonia :( )

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2
Q

Describe the structure of the nasal cavities

What is the function of the nasal cavity and the structures inside

A

Ant nares => Vestibule with vibrisae => Nasal cavity => Post nares

Warms the air
Keeps it moist, both ensure that the moisture in the lungs is 100% saturated with O2

Vibrisae, filters inspired air

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3
Q

Describe the general structure of the whole pharynx

A

Muscular tube made up of nasal pharynx, oropharynx and hypopharynx

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4
Q

Where can the nasal pharynx be found

A

Extends from the base of the skull to the upper surface of the soft palate

Opening of auditory tube found here

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5
Q

Where can the oral pharynx be found

A

Between the soft a palate and superior border of the epiglottis

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6
Q

Where can the hypopharynx be found

A

Where the pharynx splits into the larynx and oesophagus

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7
Q

Describe the structure and function of the larynx

A

Made up of hyaline and elastic cartilage

Predominantly a sphincter for the airway, prevent food and fluids entering the lungs
Voice box also found here but not its main role

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8
Q

What is the function of the oesophagus

A

Food and fluids enter here => GBS

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9
Q

Describe the structure and function of the trachea

A

20C shaped cartilage rings, keeps airway open

Leads to carina (bifurcation of trachea => 2 bronchi at T4)

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10
Q

How does the bronchus divide and what changes as a result?

A

Pulmonary bronchus => Lobar bronchus => Segmentary bronchus => etc

23 divisions in total
As you divide, amount of hyaline cartilage decreases, amount of smooth muscle increases, amount of connective tissue increases

Epithelium transitions from ciliates pseudostratified columnar => simple squamous

Start to lose smooth muscle and connective tissue as you approach alveoli, site of gas exchange

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11
Q

Describe the pulmonary circulation (pulmonary arteries, veins, bronchial arteries and veins)

A

Pulmonary arteries branch along bronchiole very closely
Forms a plexus around alveoli with pulmonary vein capillaries
O2 in solution diffuses across 2nm
Pulmonary vein normally further away from bronchioles
Alveoli don’t need a blood supply, get their O2 from diffusion

Thoracic aorta => bronchial arteries => veins => pulmonary veins, azygos

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12
Q

What are the protective mechanisms of the upper respiratory tract

A 
Mechanical (mucus and hairs)
Goblet cells and serous glands
Mucociliary escalator and cilia
Macrophages
WBCs
Mast cells and histamine release
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13
Q

How does mechanical protection (mucus and hairs) protect the URT

A

Moistens air and traps pathogens

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14
Q

How do the goblet cells and serous glands protect the URT

A

Watery submucosal antibacteriocidal secretions

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15
Q

How does the mucociliary escalator and cilia protect the URT

A

On top of pseudocolumnar cells, wafts mucus up to oesophagus => stomach from bronchi

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16
Q

How do macrophages help protect the URT
How do WBCs help protect the URT
How do mast cells help protect the URT

A

Digests unwanted pathogens, travel up to pharynx to dispose of them
Aids in immune response
Mast cells release histamine, decreases lumen in airway, prevent pathogens from entering the lumen

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17
Q

Describe how airflow is directed from the nasal cavity to the nasopharynx

A

Upper, middle and lower conchae directs air flow to post nares
Warm because heat from blood vessels is close enough to the wall

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18
Q

Describe the 5 ways that ventilation is controlled

A 
Peripheral and central chemoreceptors
Proprioception
Irritant/C receptors
Stretch receptors
Hypothalamus (pain, emotion)
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19
Q

How do peripheral and central chemoreceptors change ventilation

A

+ve

Conc of gases in blood (PO2, PCO2) altered by increased ventilation rate

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20
Q

How does proprioception change the rate of ventilation

A

+ve
When muscles move more, increased O2 needed
Ventilation rate increased

21
Q

How do irritant/C receptors change the rate of ventilation

A

-ve

Causes a change in breathing pattern, reduces ventilation rate to remove source

22
Q

How do stretch receptors change ventilation

A

-ve

Tells you when to stop inspiring and start expiring

23
Q

How does the hypothalamus alter the rate of ventilation

A

+-ve

Pain and emotion affects the way we breathe

24
Q

What controls our afferent responses to ventilation?

A

Pons/respiratory centres of medulla oblongata

25
Q

How does the cough reflex change as the irritation goes down the resp tract

A

If irritation in upper tract, violent reaction

If irritation in lower tract, less of a reaction

26
Q

What receptors trigger the cough reflex

A

Rapidly adapting irritant receptors

Non myelinated C fibres

27
Q

What afferent reflexes are triggered as a result of the afferent receptors being triggered

A

Bronchial submucosal glands produce more mucus to trap irritation

28
Q

What nerve do the sensory afferents go up in the cough reflex

A

Ipsilateral vagus

29
Q

Where is the cough center

A

Integration of afferent fibres in medulla, separate to breathing centres

30
Q

What are the efferent nerves in the cough reflex and what do they trigger

A

Via phrenic and other somatic nerves, stimulates breath and sudden chest wall mv

Recurrent laryngeal vagal efferents to bronchial tree

31
Q

What muscles are effected by the nervous efferents from the cough center

A

Expiration muscles
Larynx
Trachealis
Bronchial SM

32
Q

What can stimulate the cough reflex

A 
Sinusitis
Asthma
Laryngotracheatis
Tuberculosis
Emphysema
Foreign body
33
Q

Describe the structures in the larynx

A

Larynx, behind the tongue
Oesophagus, most posterior

Aryepiglottic fold surrounds epiglottis
False/vestibular fold => true vocal fold => glottis
Arytenoid cartilage found at the bottom of the aryepiglottic fold

34
Q

What structures are found in the aryepiglottic folds and what is the function

A

Aryepiglottic muscles found in aryepiglottic folds, acts as sphincter of airway, prevents foods from going down lung

35
Q

How can the glottis be altered

A

Glottis diameter can be altered by rotation of artenoid cartilage => abduction and addiction of the vocal folds

36
Q

How do the different positions of the glottis affect the possible range of functions

A

When arytenoid cartilages adduct => vocal folds come together => glottis closed
For swallowing food, prevent food from falling into lung

Arytenoid cartilage rotated => vocal folds separate => glottis open
For breathing

Arytenoid cartilage rotated and abducted => vocal folds separate => glottis really open
For deep breathing

Arytenoid cartilage abducted only, no rotation => vocal folds closed => glottis open
For whispering

37
Q

Describe the structure of the larynx

A

Hyoid bone
Thyrohyoid membrane between hyoid and thyroid cartilage. Membrane has opening for vagus to enter
Thyroid cartilage
Muscles between thyroid and cricoid cartilage
Cricothyroid membrane
Trachea

38
Q

How is the cricoid cartilage different from the tracheal cartilage

A

Cricoid, complete cartilage ring, thicker at the back

Tracheal, C shaped cartilage rig

39
Q

Where are the false folds, laryngeal ventricles and true folds in relation to the larynx in a coronal section

A

All at level of thyroid cartilage
False fold
Laryngeal ventricle
True fold

40
Q

How to do an emergency laryngotomy and what to watch out for

A

Target cricothyroid membrane
However, some people have a pyramidal 3rd thyroid lobe covering this membrane, don’t puncture the artery here
If they do have a 3rd lobe, move it out of the way before puncturing membrane

41
Q

When would you do a tracheotomy and why

A

Opening made in trachea in surgery

Keep the airways open

42
Q

What nerves innervate the larynx

A

From inf vagal ganglion => sup laryngeal
Sup laryngeal branches into int and ext laryngeal

Inf vagal ganglion => L vagus => L recurrent laryngeal
Inf vagal ganglion => R vagus => R recurrent laryngeal

43
Q

What is innervated by the int laryngeal

A

Thyrohyoid membrane => sensory above vocal folds

44
Q

What is innervated by the ext laryngeal

A

Cricothyroid muscle

45
Q

Describe the route of the L vagus

What does it innervate

A

L vagus => through superior thoracic aperture => chest => branch comes off the bottom and passes up groove between trachea and oesophagus (L recurrent laryngeal)

Sensory to lower half of larynx, below vocal folds and supply muscles

46
Q

Describe the route of the R vagus

Describe the innervations of the R vagus

A

From inf vagal ganglion => passes in front of and behind R subclavian artery => larynx

Supplies trachea and oesophagus on route
Sensory to lower half of larynx, below vocal folds to supply muscles

47
Q

Describe the relative structures of the R and L bronchi and the importance of this

A

R bronchi = straighter and wider than L

Foreign objects more likely to fall down into R

48
Q

What is the level of the cricoid cartilage and the carina

A

Cricoid C6

Carina T4-5

49
Q

Describe the structure of a cross section of the trachea

Function of each section

A

C shaped cartilage
Submucus glands
Trachealis muscle between cartilage and oesophagus

Trachealis muscle innervated by PNS vagus
Submucus gland release mucus for protection

Anatomy of Systems (11 decks)

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