Trachea, bronchial tree and lungs Flashcards

1
Q

structure of the trachea

A

 10-11 cm long, average 2,5 cm wide
 Starts at C6, ends at T4/5 at carina

 Composed of C-shaped hyaline cartilages
– Keep the lumen patent

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2
Q

what lies at the posterior aspect of the trachea

A

 Trachealis muscle (posteriorly, between the ends of the tracheal cartilages) alters tracheal diameter

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3
Q

relation to the left recurrent laryngeal nerve

A

nerve lies in the groove between the trachea and the oesophagus

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4
Q

arterial supply of the trachea

A
 Inferior thyroid artery
 Bronchial arteries
 Tracheal branches of aorta
 Mediastinal branches of
internal thoracic artery
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5
Q

venous supply of the trachea

A

 Inferior thyroid vein (plexus)

 Bronchial veins

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6
Q

lymph supply of the trachea

A

 Pretracheal lymph nodes

 Paratracheal lymph nodes

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7
Q

nervous supply of the trachea

A

 Parasympathetics: Vagus
 Sympathetics: Sympathetic
trunks

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8
Q

what is the significance of the right main bronchus

A

Right main bronchus is slightly more vertical, shorter and wider
so more susceptible to foreign body aspiration

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9
Q

The divisions of the trachea

A
  • become right and left main bronchi at t4/t5
  • then divide into lobar bronchi
  • then into segmental bronchi
  • these then pass into a broncho-pulmonary segment
  • then divide into terminal bronchioles
    t
  • these connect to respiratory bronchiloles
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10
Q

BRONCHIOLES

A

these cause the greatest resistance to air flow in the conducting passages

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11
Q

PULMONARY ALVEOLI

A

 Each respiratory bronchiole is connected to ~2 -11 alveolar ducts
 The alveolar ducts open into alveolar sacs, clusters of pulmonary
alveoli.
− Each alveolar duct is connected to ~5-6 alveoli
− Provides a very large surface area for the diffusion of gases

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12
Q

what are the three surfaces of the lungs

A

Costal, Diaphragmatic, Mediastinal

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13
Q

what are the three margins of the lungs

A

Anterior, posterior, inferior

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14
Q

what is the structural difference between the right and left lung

A

– Left lung has cardiac notch
– Right lung is shorter but wider

there is also three lobes in the right lung and two lobes in the left lung

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15
Q

what separates the lobes

A

– Oblique fissure

– Horizontal fissure (only in the right lung)

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16
Q

what is the contents of the root of the lung

A
− A pulmonary artery
− Two pulmonary veins 
− A main bronchus
− Bronchial vessels
− Nerves
− Lymphatics
Covered by a sleeve of mediastinal pleura that reflects onto the surface of the lung
17
Q

what is the rough structure of the hilum of the lung

A

the bronchi lie posteriorly and the pulmonary arteries lie superiorly and the pulmonary veins lie inferiorly anteriorly

18
Q

BRONCHOPULMONARY SEGMENTS

A
Section of lung with its own branch of pulmonary artery, nerves
and segmental (tertiary) bronchus

NO ANASTOMOSIS BETWEEN SEGMENTS
therefore safe from the spread of disease e

19
Q

tell me about the veins and lymphatics in the bronchopulmonary segments

A

Tributaries of the pulmonary vein and lymphatics tend to pass in the inter-segmental septum

20
Q

HISTOLOGICAL FEATURES of bronchioles

A

 There is little cartilage in the bronchioles, mainly smooth muscle
 No goblet cells in and distal to respiratory bronchioles
 The pseudostratified columnar epithelium of the bronchi is replaced by simple cuboidal epithelium of the bronchioles

21
Q

 Type I alveolar cell

A

permit diffusion

22
Q

Type II alveolar cell

A

Produce Surfactant that reduces the tendency for pulmonary alveoli to collapse.

23
Q

which segment is prone to pneumonia

A

The apical segment of the inferior lobe is inferolateral to the upper, posterior position of the oblique fissure. As its tertiary bronchus drops off the bronchial tree posteriorly

24
Q

BRONCHOGRAM

A

phenomenon of air-filled bronchi (dark) being made visible by the opacification of surrounding alveoli (grey/white). It is almost always caused by a pathologic airspace/alveolar process, in which something other than air fills the alveoli.

25
vascular supply of the lung tissue
bronchial arteries: x1 on the right, from 3rd posterior intercostal artery or superior posterior intercostal artery - x2 on the left, from the aorta these can anatomise with he pulmonary arteries in the walls of the bronchioles
26
where is the venous blood of the lung tissue drained by
Bronchial veins (into the azygos system) or by the pulmonary veins
27
position the pulmonary arteries
- Right PA passes anterior to the right primary bronchus and posterior to the ascending aorta and SVC - Left PA is shorter
28
lymph drainage of the lung tissue
deep (running alongside the arteries and dividing bronchial tree) and superficial (sub-pleural) lymphatic plexuses these both drain to the pulmonary lymph nodes which are buried in the hilum
29
lymph travel from the pulmonary lymph nodes
- pulmonary nodes - bronchiopulmonary nodes (around the man bronchi) - inferior and superior tracheobronchial nodes - paratracheal nodes • Left bronchomediastinal trunk • Right bronchomediastinal trunk • Thoracic duct • Right lymphatic duct
30
nerve supply of the trachea
supplied by the pulmonary plexuses around the main bronchi at the root of the lung
31
– Parasympathetic fibres
* From the vagus * Synapse in the plexuses * Postganglionic fibres resulting in bronchoconstrictor, vasodilator and secretomotor.
32
– Sympathetic fibres
• From sympathetic trunk • Synapse in the sympathetic ganglia • Postganglionic fibres resulting in bronchodilator, vasoconstrictor