Trachea, Bronnchial Tree and Lungs

Question 1

What is the size of the trachea?

Answer 1

• 10-11 cm long

- Average 2, 5 cm wide

Question 2

Where does the trachea start and end?

Answer 2

• Starts at C6

- Ends at T4/5 at carina

Question 3

Describe the cartilages of the trachea?

Answer 3

C-shaped hyaline cartilages

Question 4

What do the cartilages do?

Answer 4

They keep the lumen apart - stop the trachea from closing

Question 5

What muscle alters tracheal diameter (only slightly)?

Answer 5

The trachealis muscle

Question 6

What end of the trachea contains the trachealis muscle?

Answer 6

Posterior side

Question 7

What muscles is the trachea related to?

Answer 7

• Sternohyoid

- Sternothyroid

Question 8

What is the isthmus?

Answer 8

A part of the thyroid gland that bridges the right and left lobes

Question 9

What does the recurrent laryngeal nerve lie between in the neck?

Answer 9

In the groove between the trachea and oesophagus

Question 10

What does the trachea divide into?

Answer 10

The two main/principle bronchi

Question 11

What are the differences between right and left main bronchi?

Answer 11

• Right main bronchus is shorter, wider and more vertical

Question 12

What principle bronchi is a foreign body more likely to fall into?

Answer 12

The right principle bronchus

Question 13

What lung has 3 lobur bronchi?

Answer 13

The right lung (as it has 3 lobes)

Question 14

Describe how the trachea divides all the way into alveoli?

Answer 14

• Trachea
• Main bronchi
• Lobar (secondary) bronchi
• Segmental (tertiary) bronchi
• Subsegmental bronchi
• Conducting bronchiole
• Terminal bronchiole (conducting system)
• Respiratory bronchiole (respiratory system)
• Alveolar duct
• Alveolar sac
• Alveolus

Question 15

What causes the greatest resistance to air flow in the conducting passages?

Answer 15

The bronchioles

Question 16

How many alveolar ducts are each respiratory bronchioles connected to?

Answer 16

2 - 11 alveolar ducts

Question 17

`What are the three surfaces of the lungs?

Answer 17

• Costal
• Diaphragmatic
• Mediastinal

Question 18

What are the three margins of the lung?

Answer 18

• Anterior
• Posterior
• Inferior

Question 19

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

Answer 19

• Left lung has the cardiac notch

- Right lung is shorter but wider

Question 20

What fissure is present on both lungs?

Answer 20

The oblique fissure

Question 21

What does the horizontal fissure divide?

Answer 21

The upper and middle lobes of the right lung

Question 22

Lung impressions

Answer 22

LEARN

Question 23

What does the root of the lung contain?

Answer 23

• A pulmonary artery
• Two pulmonary veins
• A main bronchus
• Bronchial vessels
• Nerves
• Lymphatics

Question 24

What arteries bring oxygenated blood to the lungs?

Answer 24

Bronchial arteries

Question 25

What lies posterior in the lung hilum?

Answer 25

The bronchi

Question 26

What is the pulmonary ligament?

Answer 26

- It allows some movement for the lungs - Part of the pleura - Not a true ligament but rather the reflection of the mediastinal parietal pleura - Lies below the lung root on each side

Question 27

What are bronchopulmonary segments?

Answer 27

- Smallest functionally and structurally independant unit - Section of lung with its own branch of pulmonary artery, nerves and segmental (tertiary) bronchus - Pyramid shaped, with their apices directed towwards the hilum - Seperated by connective tissue - No anastomosis between neighbouring segments - Easier for surgical excision and makes spread of disease hard

Question 28

Where are tributaries of the pulmonary veins and lymphatics usually present?

Answer 28

The inter-segmental septum (between bronchopulmonary segments)

Question 29

What part of the left superior lobe touches the diaphragm?

Answer 29

The lingula

Question 30

How many bronchopulmonary segments are there?

Answer 30

20 (10 on both sides) | some of them may be fused in the left lung

Question 31

Where are the bronchopulmonary segments located on the left lung?

Answer 31

Each lobe has 5 segments

Question 32

Where are the bronchopulmonary segments located on the right lung?

Answer 32

- Inferior lobe has 5 segments - Superior 3 segments - Middle 2 segments

Question 33

What does a distortion of the carina mean?

Answer 33

Enlargement of lymph node or tumour

Question 34

What segment is prone to pneumonia?

Answer 34

- Apical segment of lower lobe. | - Its tertiary bronchus drops off the bronchial tree posteriorly

Question 35

What does the right bronchial artery branch off from?

Answer 35

3rd posterior intercostal artery or superior posterior intercostal artery

Question 36

What do the 2 left bronchial arteries branch off from?

Answer 36

The aorta

Question 37

Where may the bronchial arteries anastamose with the pulmonary arteries?

Answer 37

The walls of the bronchioles

Question 38

How is venous blood from the lung tissue drained?

Answer 38

Drained by bronchial veins into azygos system or by the pulmonary veins

Question 39

What lymph plexuses drain into the pulmonary node?

Answer 39

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

Question 40

Where are the pulmonary nodes located?

Answer 40

The hilum

Question 41

What does the left bronchomediastinal trunk drain into

Answer 41

The thoracic duct

Question 42

Where are the pulmonary plexuses located?

Answer 42

The main bronchi wt the root of the lung

Question 43

Where do parasympathetic fibres synapse?

Answer 43

In the plexuses

Question 44

What effect do the parasympethetic fibres have on the lung?

Answer 44

- Bronchoconstrict - VAsodilate - Secretomotor effects

Question 45

Where do sympathetic fibres to lung synapse?

Answer 45

The sympathetic trunk

Question 46

What happens if a tumour impinges on the sympathetic trunk?

Answer 46

Horner's syndrome

Question 47

what happens if a tumour impinges upon the aorticopulmonary window?

Answer 47

Left recurrent laryngeal nerve injury -> hoarsness of the voice

Question 48

Why would you need to performa tracheostomy?

Answer 48

- Laryngeal obstruction (diptheria, tumours, inhaled foreign bodies) - Evacuation of excessive secretions (severe postoperative chest infection in a patient who is too weak to cough adequately) - For long-lasting artificial respiration (poliomyelitis, severe chest injuries)

Question 49

What direction is the incision in a tracheostomy and why?

Answer 49

Vertical and to avoid anterior jugular veins

Question 50

What can the disadvantage of a vertical incision be?

Answer 50

Langer's lines

Question 51

Where is a transverse incision in a tracheostomy made?

Answer 51

Halfway between the cricoid and suprasternal notch

Question 52

Where is a needle inserted when relieving pneumothorax

Answer 52

At the 2nd or 3rd intercostal space at the midclavicular line

Question 53

Where is a catheter inserted in pneumothorax?

Answer 53

4th or 5th intercostal space at the midaxillary line