Trachea, Bronchial Tree and Lungs

Question 1

What is the length and average diameter of the trachea?

Answer 1

• 10-11cm lomg
• average 2.5cm wide

Question 2

What are the boundaries of the trachea?

Answer 2

• starts at C6
• ends at T4/5 (at the carina)

Question 3

What is the trachea composed of that keeps the lumen patent?

Answer 3

c-shaped hyaline cartilage rings

Question 4

What muscle alters the tracheal diameter?

Answer 4

trachealis muscle

Question 5

Where is the trachealis muscle located?

Answer 5

posteriorly between the ends of the tracheal cartilages

Question 6

Answer 6

Red = trachealis muscle

Question 7

In the cervical region what is the trachea related to?

Answer 7

• sternohyoid muscle
• sternothyroid muscle
• isthmus of thyroid gland
• inferior thyroid vessels
• carotid sheath
• brachiocephalic trunk
• jugular venous arch
• recurrent laryngeal nerve

Question 8

Where does the trachea enter the thoracic cavity?

Answer 8

through the thoracic inlet

Question 9

Where does the left recurrent laryngeal nerve lie?

Answer 9

in the groove between the trachea and the oesphagus

Question 10

At what level does the trachea divide into left and right principle bronchi?

Answer 10

T4/5 - sternal angle

Question 11

Answer 11

Red = left recurrent laryngeal nerve

Question 12

What areteries supply the trachea?

Answer 12

• inferior thyroid artery
• bronchial arteries
• tracheal branches of aorta
• mediastinal branches of internal thoracic artery

Question 13

What veins drain the trachea?

Answer 13

• inferior thyroid vein (plexus)
• bronchial veins

Question 14

What lymph nodes are related to the trachea?

Answer 14

• pre-tracheal lymph nodes
• paratracheal lymph nodes

Question 15

What is the neural supply of the trachea

Answer 15

SNS = sympathetic trunk

PSNS = vagus nerve

Question 16

How does the right main bronchus differ from the left? And why is this clinical important?

Answer 16

more verticle, shorter and wider

Foreign body aspiration

Question 17

What do the main bronchi divide into?

Answer 17

lobar bronchi

Question 18

How many lobar bronchi are there in each lung

Answer 18

LHS = 2

RHS = 3

Question 19

What do the lobar bronchi divide into?

Answer 19

segmental bronchi

Question 20

What do the segmantal bronchus pass to?

Answer 20

a broncho-pulmonary segment

Question 21

How do the segmental bronchi alter diameter?

Answer 21

bronchi divide like a tree decreasing the diameter

Question 22

What do segmental bronchi divide into?

Answer 22

terminal bronchioles

Question 23

What are terminal bronchioles connected to?

Answer 23

respiratory bronchioles

Question 24

How do bronchioles affect airflow?

Answer 24

cause the greatest resistance to air flow in the conducting passages

Question 25

How many pulmonary alveoli is each respiratory bronchiole connected to?

Answer 25

~2-11

Question 26

What do alveolar ducts open into?

Answer 26

alveolar sacs (clusters of pulmonary alveoli)

Question 27

How many alveoli does each alveolar duct connect to?

Answer 27

~5-6

Question 28

What is the main purpose of the alveoli?

Answer 28

large surface area for the diffusion and exchange of gases

Question 29

What are the 3 surfaces of the lungs?

Answer 29

costal, diaphragmatic and mediastinal

Question 30

What are the three margins of the lungs?

Answer 30

anterior, inferior and posterior

Question 31

What is another name for the apex of the lung?

Answer 31

cupula

Question 32

What feature is unique to the left lung

Answer 32

has a cardiac notch

Question 33

How does the right lung compare tho the left

Answer 33

shorter but wider

Question 34

How many lobes does each lung have?

Answer 34

Right = 3 Left = 2 + lingula

Question 35

Answer 35

Red = oblique fissure blue = horizontal fissure

Question 36

Answer 36

Question 37

Where does the phrenic nerve pass in relation to the lung roots?

Answer 37

anterior

Question 38

Where does the vagus nerve pass in relation to the lung roots?

Answer 38

posterior

Question 39

What is the root of the lung?

Answer 39

collection of structures that attach the lung structures in the mediastinum

Question 40

What is the root of the lung covered by?

Answer 40

a sleeve of mediastinal pleura that reflects on the surface of the lung

Question 41

What is contained within the root of the lung?

Answer 41

* pulmonary artery * 2 pulmonary veins * a main bronchis * bronchial vessles * nerves * lymphatics

Question 42

What is the function of the pulmonary ligament?

Answer 42

Allows the lungs to be mobile

Question 43

What is the smallest functionally and structurally independent unit of the lungs?

Answer 43

bronchopulmonary segemnts

Question 44

What does a bronchopulmonary segment have?

Answer 44

own branch of pulmonary artery, nerves and segmental (tertirary) bronchus

Question 45

Answer 45

Red = pulmonary artery green = segmental bronchus blue = pulmonaruy vein

Question 46

what are bronchopulmonary segments separated by?

Answer 46

Connective Tissue

Question 47

Is there anastomosis between neighbouring bronchopulmonary segments?

Answer 47

NO

Question 48

what shape are bronchopulmonary segments and what are they directed towards?

Answer 48

pyramid-shaped their apicies are directed towards the hilum

Question 49

Where do tributaries of the pulmonary vein and lymphatics tend to pass?

Answer 49

intersegmental septum

Question 50

How many segments does each lung have?

Answer 50

10

Question 51

What are the divisions of the right lung

Answer 51

Inferior = 5 Superior = 3 Middle = 2

Question 52

What segments are present in the superior section of the right lung?

Answer 52

Apical (superior) Anterior Posterior

Question 53

What segments are present in the middle section of the right lung?

Answer 53

Medial Lateral

Question 54

What segments are present in the inferior section of the right lung?

Answer 54

Apical (superior) Medial Lateral Anterior Posterior

Question 55

What segements are present in the superior section of the left lung?

Answer 55

Apical (superior) Anterior Posterior

Question 56

What segments are present in the lingula section of the left lung?

Answer 56

superior and inferior

Question 57

What segments are present in the inferior section of the left lung?

Answer 57

Apical (superior) Medial Lateral Anterior Posterior

Question 58

What is the only part of the left lung that makes contact with the diaphragm?

Answer 58

lingula

Question 59

What is the main constituent of bronchioles?

Answer 59

mainly smooth muscle little cartilage

Question 60

Where are goblet cells not present in the respiratory tract?

Answer 60

In and distal to respiratory bronchioles

Question 61

What is the function of type I alveolar cells?

Answer 61

permit diffusion

Question 62

what is the function of type II alveolar cells?

Answer 62

produce surfactant that reduces the tendency for pulmonary alveoli to collapse

Question 63

How many cells thick are each pulmonary alveolus? And what is the reason for this?

Answer 63

1 cell thick Increased diffusion rate

Question 64

What can cause of a distortion of the carina?

Answer 64

enlargement of tracheobronchial lymph nodes tumour

Question 65

What segment in which lobe is most prone to pneumonia and why?

Answer 65

apical segment of the inferior lobe drops of the bronchial tree posteriorly

Question 66

What is the lung tissue supplied by?

Answer 66

bronchial arteries

Question 67

How many bronchial arteries are on the RHS and where do they orginate from?

Answer 67

one bronchial artery on the right 3rd posterior intercostal artery or superior posterior intercostal artery

Question 68

How many bronchial arteries are on the LHS and where do they orginate from?

Answer 68

2 bronchial arteries on the left aorta

Question 69

what can pulmonary arerties anastomose with and where?

Answer 69

pulmonary arteries in the walls of the bronchioles

Question 70

What is the function of pulmonary arteries?

Answer 70

carry de-oxygenated blood to the lungs at low pressure

Question 71

Where do the pulmonary arteries arise from?

Answer 71

from the pulmonary trunk just below the sternal angle

Question 72

What is the tract of the right pulmonary artery?

Answer 72

Passes anterior to the right primary bronchus and posterior to the ascending aorta and SVC

Question 73

What two lymphatic organs drain into the pulmonary nodes?

Answer 73

* deep lymphatic pleuxs (running alongside the arteries and dividing bronchial tree) * Superficial (sub-pleural) lymphatic plexus

Question 74

where are the pulmonary nodes located?

Answer 74

in the hilum of the lung

Question 75

Give the passage of lymph drainage from the pulmonary nodes

Answer 75

Question 76

Answer 76

Black = left and right bronchomediastinal trunk red = superior tracheobronchial green = inferior tracheobronchial blue = paratracheal

Question 77

What is the nerve supply of the lungs?

Answer 77

supplied by the pulmonary plexuses around the main bronchi at the root of the lung

Question 78

Where do the parasympathetic fibres arise from and what is their action?

Answer 78

from vagus bronchoconstrictor, vasodilator and secretomotor

Question 79

Where do sympathetic fibres arise from and what is their function?

Answer 79

sympathetic trunk brnchodilator, vasocontrictor

Question 80

What are the three main reasons a tracheostemy would be needed?

Answer 80

1. laryngeal obstruction 2. evcuation of excessive secretions 3. Long-lasting artificial respiration

Question 81

What type of incision is made for a tracheostemy?

Answer 81

vertical incision is made downwards from the cricoid cartilage