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MD3001 Respiratory > Trachea, Bronchial Tree and Lungs > Flashcards

Trachea, Bronchial Tree and Lungs Flashcards

1
Q

Where does the trachea run from?

A

C6 to T4/5 at the carina

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2
Q

What makes up the trachea?

A
  • C shaped hyaline cartilages (keep lumen patent)

- trachealis muscle: posteriorly between ends of tracheal cartilages (alters tracheal diameter)

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3
Q

What are the relations of the trachea?

A
  • sternohyoid muscle
  • stermothyroid muscle
  • isthmus of the thyroid gland
  • inferior thyroid vessels
  • carotid sheath
  • brachiocephalic trunk
  • jugular venous arch
  • recurrent laryngeal nerve
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4
Q

Describe how the trachea enters the thoracic cavity

A
  • enters through the thoracic inlet

- divides into left and right principal bronchi

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5
Q

Where does the left recurrent laryngeal nerve sit?

A

in the groove between the trachea and oesophagus

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6
Q

What arteries supply the trachea?

A
  • inferior thyroid artery
  • bronchial arteries
  • tracheal branches of aorta
  • mediastinal branches of ITA
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7
Q

What veins drain the trachea?

A
  • inferior thyroid vein

- bronchial veins

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8
Q

What nerves supply the trachea?

A
  • parasympathetics: vagus

- sympathetic trunks

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9
Q

What lymph nodes drain the trachea?

A
  • pretracheal lymph nodes

- paratracheal lymph nodes

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10
Q

Describe the morphology of the principal bronchi and the clinical relevance of this

A
  • right principal bronchi is more vertical, shorter and wider
  • more likely for foreign body to enter right principal bronchi
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11
Q

What does the main bronchi divide into?

A
  • lobar bronchi that subdivides into segmental bronchi

- segmental bronchus passes to a broncho-pulmonary segment

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12
Q

What do segmental bronchi lead to?

A
  • terminal bronchioles
  • connected to respiratory bronchioles
  • bronchioles cause the greatest resistance to air flow in conducting passages
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13
Q

What do bronchioles lead to?

A
  • connected to alveolar ducts
  • ducts open into alveolar sacs which are clusters of pulmonary alveoli
  • provides a very large surface area for diffusion of gases
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14
Q

What are the surfaces and margins of the lungs?

A

Surfaces:

  • costal
  • diaphragmatic
  • mediastinal

Margins:

  • anterior
  • posterior
  • inferior
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15
Q

What are the differences in shape between the right and left lung?

A

Right:

  • 3 lobes separated by an oblique and horizontal fissure
  • shorter but wider

Left:

  • 2 lobes separated by an oblique fissure
  • has a cardiac notch
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16
Q

What are the impressions for on the right lung?

A
  • oesophagus
  • SVC
  • right atrium
  • IVC
  • pulmonary ligament
17
Q

What are the impression for on the left lung?

A
  • subclavian artery
  • aortic arch
  • left ventricle
  • pulmonary ligament
18
Q

Where does the vagus nerve pass the lungs?

A

posterior to the lung roots

19
Q

What vessels are in the root of the lung?

A
  • a pulmonary artery
  • 2 pulmonary veins
  • a main bronchus
  • bronchial vessels
  • nerves
  • lymphatics
20
Q

Describe the arrangement of the vessels in the root of the lungs

A
  • main bronchi sit most posteriorly
  • pulmonary arteries superior
  • pulmonary veins inferior
21
Q

What are the bronchopulmonary segments?

A
  • sections of the lung with its own branch of pulmonary artery, nerves and segmental bronchus
  • pyramid shaped with apices directed towards hilum
  • separated by connective tissue
  • no anastomosis between segments
22
Q

Describe the divisions of the bronchopulmonary segments

A
  • 10 segments on each side
  • upper lobe: apical, anterior and posterior
  • middle/lingula: medial and lateral
  • lower lobe: apical, medial, lateral, anterior and posterior
23
Q

Describe the histological features of the lungs

A
  • little cartilage in bronchioles, mainly smooth muscle
  • no goblet cells in and distal to bronchioles
  • pseudostratified columnar epithelium in bronchi replaced by simple cuboidal epithelium in bronchioles
  • wall of pulmonary alevoli one cell thick (for diffusion)
24
Q

Type I and II alveolar cell

A
  • type I: permit diffusion

- type II: produce surfactant (lowers tension) that reduces tendency for pulmonary alveoli to collapse

25
Q

What can cause distortion of the carina seen in a bronchoscopy?

A

enlargement of the tracheobronchial lymph nodes

26
Q

Why is the segmental bronchi more susceptible to pneumonia?

A

It drops off the bronchial tree posteriorly making it easier for infection to spread there

27
Q

Describe the vascular supply of the lungs

A
  • bronchial arteries:
  • 1 on right from 3rd posterior IC artery/superior posterior IC artery
  • 2 on the left from the aorta
  • can anastomose with pulmonary arteries in walls of bronchioles
  • pulmonary arteries: carry deoxygenated blood to the lungs at low pressure
28
Q

Describe the vascular drainage of the lungs

A
  • bronchial veins to azygos system

- pulmonary veins

29
Q

Where does the right pulmonary artery sit?

A
  • anterior to the right primary bronchus

- posterior to ascending aorta and SVC

30
Q

Describe the lymph drainage of the lungs

A
  • deep and superficial lymphatic plexus
  • to pulmonary nodes
    (to bronchopulmonary, to inferior and superior tracheobronchia to paratracheal along with posterior mediastinal, to bronchomediastinal lymph trunk with parasternal and anterior mediastinal)
31
Q

Describe the nerve supply of the lungs

A
  • pulmonary plexuses around main bronchi at root of the lung
  • parasympathetic fibres: from vagus, synpase in plexus
  • postganglionic fibres to bronchoconstrictor, vasodilator and secretomotor
  • sympathetic fibres: from sympathetic trunk, synapse in sympathetic ganglia
  • post ganglionic fibres to bronchodilator and vasodilator
32
Q

In what 3 situations would you do a tracheostomy?

A
  • to bypass an obstructed upper airway
  • to clean and remove secretions from the airway
  • to more easily, and usually more safely, deliver oxygen to the lungs.

MD3001 Respiratory (38 decks)

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