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Respiratory system > Tracheobronchial tree and larynx > Flashcards

Tracheobronchial tree and larynx Flashcards

1
Q

Is there cartilage on posterior trachea

A

No - tracheal muscle instead

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2
Q

What is the trachea?

A

Fibrocartilagenous tube supported by c-shaped cartilage rings
Extends from larynx to C5/6

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3
Q

What is the hilum?

A

Root of the lung - blood vessels and bronchi enter

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4
Q

Layers of trachea

A

Mucosa: pseudostratified ciliated columnar epithelium

Submucosa: aerolar connective tissue with seromucosou glands and ducts

C-shaped ring of hyaline cartilage

Adventitia - aerolar connective tissue

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5
Q

Bronchial tree

A
  • Trachea bifurcates at carina
  • Main bronchi enters lungs at hilum
  • Right: wider, shorter, more vertical
  • Left: inferior to aortic arch, anterior to eosophagus and descending thoracic aorta
  • Caught object is in in right main bronchus
  • Left bronchi splits into 2 lobar bronchi and right splits into 3
  • All separated by connective tissue
  • Segmental bronchi are tertiary
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6
Q

Where does trachea bifurcate?

A

Carina

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7
Q

What do main bronchi form?

A

Lobar bronchi

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8
Q

How many lobes are on left?

A

2

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9
Q

How many lobes on right?

A

3

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10
Q

Bronchial tree

A

Main bronchi - lobar bronchi - segmental bronchi - bronchopulmonary segments

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11
Q

Segmental bronchi

A
  • Divide into conducting bronchioles that end as terminal bronchioles
  • Transport air, no alveoli
  • Bronchioles lack cartilage
  • Terminal bronchioles divide into respiratory bronchioles which divide into alveolar ducts
  • These give rise to alveolar sacs
  • Outpouchings (alveoli) structural units of gas exchange
  • 300 million alveoli
  • No surfactant means lungs collapse
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12
Q

Secondary bronchi

A

Hyaline cartilage

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13
Q

Tertiary bronchi

A

Pseudostratified ciliated columnar epithelium

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14
Q

Terminal bronchioles

A

Initially ciliated then simple columnar epithelium
No cartilage but smooth muscle
No goblet cells

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15
Q

Respiratory bronchioles

A

Simple squamous epithelium

Surfactant producing

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16
Q

Alveoli

A

Single cell layer of pneumocytes

17
Q

Acute asthma

A
  • Allergen causes sudden inflammation and contraction of bronchiole smooth muscle (bronchospasm), narrowing airways causing breathing difficulties and wheezing
  • Salbutamol given to relax airways, steroids
18
Q

Cystic fibrosis

A
  • Autosomal recessive
  • Deranged atransport of chloride and other ions alters viscocity of mucous, making patient more prone to infections, damaging bronchi amnd resulting in bronchiectasis
  • Bronchiectasis: permanent dilation of central and medium sized airways - can’t clear secretions
19
Q

COPD

A
  • Long term exposure to particles damages lung lining
  • Chronic bronchitis
  • Emphysema (tissue destruction)
  • Bronchiolitis (small airway inflammation and fibrosis)
  • Resistance to airflow in small airways increased compliance of lungs, air trapping
20
Q

Blood supply

A

Bronchial arteries supply blood to nutrition to lungs, structures of root of lungs and visceral pleura
Two left bronchial arteries (thoracic aorta)
Single right bronchial artery

21
Q

Larynx

A
  • Anterior neck
  • Functions: phonation, cough reflex, protection of lower respiratory tract
  • Structure: primarily cartilaginous skeleton
  • Ligaments and membranes
  • Laryngeal muscles move larynx for phonation and breathing
  • Suspended from hyoid
  • C3-6
  • Superiorly is pharynx
  • Inferiorly is trachea
  • Anteriorly is infra-hyoid muscles
  • Laterally is thyroid gland
  • Posteriorly is oesophagus
  • Supra-glottis: inferior surface of epiglottis to vestibular folds
  • Glottis: vocal apparatus, contains vocal cords
  • Subglottis/infra-glottis: vocal folds to trachea
22
Q

Laryngeal cartilage unpaired

A

Epiglottis, thyroid and cricoid

23
Q

How to artificially close oesophagus

A

Put pressure on cricoid cartilage

24
Q

Paired laryngeal cartilage

A

Arytenoid cartilage (attaches to vocal ligament)
Corniculate
Cuneiform

25
Q

Arytenoid cartilage

A

Anterior vocal process - attaches to vocal ligament
Apex attaches to aryepiglottic folds
Crico-arytenoid joints - approximate, tense and relax vocal folds

26
Q

True vocal cords

A

Non-keratonised stratified squamous epithelium
Contains Reinke’s space to allow vibration of epithelium
Rima glottidis = space between vocal folds

27
Q

False vocal cords

A

Vestibular ligament covered by mucous membrane

Provide protection to larynx

28
Q

Superior laryngeal nerve

A

Internal branch provides sensory innervation to supra glottis
External branch provides motor innervation to cricothyroid muscle

29
Q

Inferior laryngeal nerve

A

Continuation of recurrent laryngeal nerve
Sensory innervation to infraglottis
Motor innervation to internal muscles of larynx except cricothyroid

30
Q

Damage to nerve can be caused by

A 
Apical lung tumour 
Thyroid cancer 
Aortic aneurysm 
Cervical lymphadenopathy 
Iatrogenic causes
31
Q

Unilateral RLN palsy

A

Hoarseness
Increased risk of aspiration
Bovine cough

32
Q

Bilateral RLN palsy

A

Cords adducted
Breathing impaired (stridor, snoring)
Phonation can’t occur

33
Q

extrinsic muscles

A

Move larynx superiorly and inferiorly - supra hyoid and infra hyoid and stylopharyngess
Supra- and infra hyoid muscle groups attach to hyoid - bound to larynx by strong ligaments
Suprahyoid muscles and stylopharyngeus elevate larynx , infra hyoid muscles depress larynx

34
Q

Extrinsic laryngeal ligaments

A

Thyrohyoid membrane hyo-epiglottoic ligaments - connects hyoid bone to anterior aspect of epiglottis
Cricotracheal ligament
Median cricothyroid ligament

35
Q

Intrinsic laryngeal ligaments

A

Cricothyroid ligament

Quadrangular ligament

36
Q

Cricothyroidotomy

A

Temporary airway in situations where larynx is obstructed

37
Q

Superior laryngeal artery

A

Branch of superior thyroid artery - supplies internal surface larynx

38
Q

Inferior laryngeal artery

A

Branch of inferior thyroid artery - supplies mucous membrane and muscles of inferior larynx

39
Q

venous drainage

A

Superior and inferior laryngeal veins
Superior laryngeal veins drain to internal jugular vein via superior thyroid
Inferior laryngeal vein drains to left brachiocephalic vein via inferior thyroid vein

Respiratory system (23 decks)

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