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[OS 205] 1st Exam > [USMLE] Sternum, Mediastinum, Trachea, Lungs, Bronchopulmo, Respiration > Flashcards

[USMLE] Sternum, Mediastinum, Trachea, Lungs, Bronchopulmo, Respiration Flashcards

1
Q

Is a flat, elongated, dagger-shaped bone and consists of the manubrium, the body, and the xiphoid process.

A

sternum (broad above, narrow below)

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2
Q

the sternum is relatively _____ and _____ in the female

slopes ________

A

shorter; thinner

downward and forward

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3
Q

the body of the sternum is more than twice as long as the _____ in the male but is usually less in the female

A

manubrium

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4
Q

The sternum: is a common site for bone marrow biopsy because

A

it possesses hematopoietic marrow

throughout life and because of its breadth and subcutaneous position

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5
Q

It may be split in the _____ to allow the surgeon to gain easy access to the lungs, heart, and great
vessels.

A

median plane (median sternotomy)

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6
Q

It has a superior margin, the jugular notch, which can be readily palpated at the root of the neck.

A

manubrium

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7
Q

the manubrium aas a clavicular notch on each side for articulation with the

A

clavicle

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8
Q

the manubrium also articulates with the

A

cartilage of the first rib, the upper half of the second rib, and the body of the sternum at the manubriosternal joint, or sternal angle

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9
Q

the junction between the manubrium and the body of the sternum; most reliable surface landmark of chest

A

Sternal angle (angle of Louis)

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10
Q

Is located at the level where:
The ______ ribs articulate with the sternum.
The aortic arch begins and ends.
The trachea bifurcates into the right and left bronchi at the _____.
The inferior border of the superior mediastinum is demarcated.
A transverse plane can pass through the intervertebral disk between ____ and ____.

A

2nd;
carina;
T4 and T5

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11
Q

Body of the sternum articulates with the

A

2nd to 7th costal cartilages

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12
Q

the body of the sternum also articulates with the _____ at the xiphisternal joint, which is level with the _____ thoracic vertebra.

A

xiphoid process;

9th

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13
Q

the Xiphoid process is a ____, __________ at birth that ossifies slowly from the central core and unites with the body of the sternum after middle age. it is _____ shaped

A

flat, cartilaginous process;

sword

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14
Q

The xiphoid process lies at the level of _____, and the xiphisternal joint lies at the level of the T9 vertebral body,
which marks the lower limit of the thoracic cavity in front, the upper surface of the liver, diaphragm, and
lower border of the heart.

A

T10 vertebra

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15
Q

the xiphoid process can be palpated in the epigastrium and is attached via its pointed caudal end to the

A

linea alba

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16
Q

the ribs consists of

A

12 pairs of bones that form the main part of the thoracic cage, extending from the vertebrae
to or toward the sternum

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17
Q

the ribs _____ the anteroposterior and transverse diameters of the thorax by their movements

A

increase

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18
Q

Typical ribs characteristics

A

ribs 3 through 9, each of which has a head, neck, tubercle, and body (shaft)

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19
Q

The _____ of the ribs articulates with the corresponding vertebral bodies and intervertebral disks and supra-adjacent vertebral bodies.

A

head

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20
Q

The _____ is thin and flat and turns sharply anteriorly at the angle and has a costal groove that follows the inferior and internal surface of a rib and lodges the intercostal vessels and nerves.

A

body (shaft) of the ribs

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21
Q

The tubercle of the ribs articulates with the _____ of the corresponding vertebrae, with the exception
of _____.

A

transverse processes;

ribs 11 and 12

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22
Q

true ribs

A

the first seven ribs (ribs 1 to 7)

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23
Q

true ribs are attached to the sternum by their

A

costal cartilages

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24
Q

false ribs

A

the lower five ribs (ribs 8 to 12)

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25
Q

ribs 8 to 10 are connected to the costal cartilages immediately above them to form the _____

A

anterior costal margin

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26
Q

Are the last two ribs (ribs 11 and 12) , which are connected only to the vertebrae.

A

floating ribs

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27
Q

bony thorax (skeleton) consists of

A

TICS

thoracic vertebrae, intervertebral discs, cartilages, sternum

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28
Q

superior thoracic aperture (thoracic inlet)

A

small, kidney-shaped, oblique

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29
Q

thoracic inlet boundaries

A

1st pair of ribs and cartilages

front: manubrium

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30
Q

inferior thoracic aperture (thoracic outlet)

A

large, irregular, oblique

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31
Q

thoracic outlet boundaries

A 
T12 vertebra
12th rib behind
sides cartilage of ribs 7-12
front- xiphisternal junction
closed by diaphragm
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32
Q

is the compression of neurovascular structures in the thoracic outlet (a space between the clavicle and the first rib), causing a combination of pain, numbness, tingling, or weakness and fatigue in the upper limb caused by pressure on the brachial plexus (lower trunk or C8
and T1 nerve roots) by a cervical rib (mesenchymal or cartilaginous elongation of the transverse
process of the seventh cervical vertebra).

A

Thoracic outlet syndrome

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33
Q

a loss of stability of the thoracic cage that occurs when a segment of the anterior or lateral thoracic wall moves freely because of multiple rib fractures; an extremely painful injury and impairs ventilation, thereby affecting oxygenation of the blood and causing respiratory failure

A

Flail chest

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34
Q

Fracture of the first rib may injure the _____ and _____

A

brachial plexus and subclavian vessels

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35
Q

are most commonly fractured and usually result from direct blows or crushing injuries

A

middle ribs

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36
Q

broken ends of ribs may cause ______ and lung or spleen injury

A

pneumothorax

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37
Q

Lower rib fractures may tear

the diaphragm, resulting in a

A

diaphragmatic hernia

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38
Q

First rib is the

A

broadest and shortest of the true ribs

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39
Q

first rib has a

A

single articular facet on its head

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40
Q

first rib articulates with the

A

first thoracic vertebra

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41
Q

first rib has a _____ and _____

A

scalene tubercle - for the insertion of the anterior scalene muscle
two grooves - for the subclavian artery and vein

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42
Q

Second rib

A

Has two articular facets on its head, which articulate with the bodies of the first and second thoracic
vertebrae.

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43
Q

first vs second rib (in length)

A

second rib is about twice as long as the first rib

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44
Q

Tenth rib

A

Has a single articular facet on its head, which articulates with the tenth thoracic vertebra

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45
Q

Eleventh and twelfth ribs

A

Have a single articular facet on their heads; Have no neck or tubercle

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46
Q

the only bony attachment between the appendicular and axial skeletons

A

Sternoclavicular joint

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47
Q

Sternoclavicular joint has a _____ and contains ______

A

fibrocartilaginous articular surface;

two separate synovial cavities

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48
Q

The sternoclavicular joint is a saddle-type synovial joint but has the movements of a

A

ball-and-socket joint

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49
Q

Are synchondroses in which the sternum articulates with the first seven costal cartilages

A

Sternocostal (sternochondral) joints

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50
Q

Are synchondroses in which the ribs articulate with their respective costal cartilages

A

Costochondral joints

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51
Q

ext. intercostal

A

eleven in number; occupy ICS;

from rib tubercle behind to costochondral junction anteriorly

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52
Q

ext. intercostal {origin, insertion, innervation}

A

origin: lower border of the rib below
insertion: upper border of the rib (below)
innervation: branches of the IC nerve

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53
Q

int. intercostal

A

eleven in number; occupy ICS; extend medialward

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54
Q

anterior primary rami of the first 11 thoracic spinal nerves.

A

intercostal nerves

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55
Q

The anterior primary ramus of the twelfth thoracic spinal nerve is the

A

subcostal nerve - runs beneath the 12th rib

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56
Q

intercostal nerves run between

A

the internal and innermost layers of muscles, with the intercostal veins and arteries above
(Veins, Arteries, Nerves [VAN ]).

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57
Q

intercostal nerves are lodged

A

in the costal grooves on the inferior surface of the ribs

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58
Q

Gives rise to two anterior intercostal arteries in each of the upper six intercostal spaces and terminates
at the 6th intercostal space by dividing into the musculophrenic and superior epigastric arteries

A

Internal thoracic artery

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59
Q

Internal thoracic artery usually arises from the

A

first part of the subclavian artery

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60
Q

Internal thoracic artery descends directly behind the

A

first six costal cartilages, just lateral to the sternum

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61
Q

Accompanies the phrenic nerve between the pleura and the pericardium to the diaphragm.

A

Pericardiophrenic artery

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62
Q

Pericardiophrenic artery supplies the

A

pleura, pericardium, and diaphragm (upper surface)

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63
Q

Anterior intercostal arteries

A

12 small arteries

2 in each of the upper six intercostal spaces that run laterally, 1 each at the upper and lower borders of each space

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64
Q

The upper artery in each intercostal space anastomoses

A

posterior intercostal artery

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65
Q

lower artery in each intercostal space joins the

A

collateral branch of the posterior intercostal artery

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66
Q

the anterior intercostal arteries provide muscular branches to the

A

intercostal, serratus anterior, and pectoral muscles

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67
Q

Provide the medial mammary branches (second, third, and fourth branches).

A

Anterior perforating branches

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68
Q

Anterior perforating branches supply the

A

pectoralis major muscle and the skin and

subcutaneous tissue over it

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69
Q

Gives rise to two anterior arteries in the seventh, eighth, and ninth spaces; perforates the diaphragm;
and ends in the tenth intercostal space

A

Musculophrenic artery

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70
Q

the musculophrenic artery anastomoses with the

A

deep circumflex iliac artery

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71
Q

the musculophrenic artery supplies the

A

pericardium, diaphragm, and muscles of the abdominal wall

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72
Q

Descends on the deep surface of the rectus abdominis muscle within the rectus sheath; supplies this
muscle

A

Superior epigastric artery

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73
Q

Superior epigastric artery anastosomes with

A

inferior epigastric artery

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74
Q

Superior epigastric artery supplies the

A

diaphragm, peritoneum, and anterior abdominal wall

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75
Q

Is formed by the confluence of the superior epigastric and musculophrenic veins, ascends on the medial
side of the artery, receives the upper six anterior intercostal and pericardiacophrenic veins, and ends in
the brachiocephalic vein.

A

Internal thoracic vein

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76
Q

Is a venous connection between the lateral thoracic vein and the superficial epigastric vein

A

Thoracoepigastric vein

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77
Q

Are placed along the internal thoracic artery

A

Sternal or parasternal (internal thoracic) nodes

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78
Q

Sternal or parasternal (internal thoracic) nodes drain into the junction of the _____ and ______

A

internal jugular and subclavian veins

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79
Q

Sternal or parasternal (internal thoracic) nodes receive lymph from the _____ portion of the breast, intercostal spaces, diaphragm, and supraumbilical
region of the abdominal wall.

A

medial

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80
Q

Lie near the heads of the ribs

A

Intercostal nodes

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81
Q

Intercostal nodes receive lymph from the

A

intercostal spaces and the pleura

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82
Q

Intercostal nodes drain into the

A

cisterna chyli or the thoracic duct

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83
Q

Lie on the thoracic surface of the diaphragm.

A

Phrenic nodes

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84
Q

Phrenic nodes receive lymph from the

A

pericardium, diaphragm, and liver

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85
Q

Phrenic nodes drain into the

A

sternal and posterior mediastinal nodes

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86
Q

Mediastinum is an interpleural space (area between the pleural cavities) in the thorax and is bounded:

A

laterally by the pleural cavities;
anteriorly by the sternum and the transversus thoracis muscles; and
posteriorly by the vertebral column (does not contain the lungs)

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87
Q

Mediastinum consists of the

A

superior mediastinum above the pericardium and the three lower divisions: anterior,
middle, and posterior

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88
Q

Superior mediastinum boundaries

A

superiorly by the oblique plane of the 1st rib; and inferiorly by the imaginary line running from
the sternal angle to the intervertebral disk between the 4th and 5th thoracic vertebrae (T3-T4 on the SIM);
laterally by the parietal pleura

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89
Q

Superior mediastinum contains the

A

superior vena cava (SVC), brachiocephalic veins, arch of the aorta , thoracic duct, trachea, esophagus, vagus nerve, left recurrent laryngeal nerve, and phrenic nerve

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90
Q

is the site at which immature lymphocytes develop
into T lymphocytes; and secretes thymic hormones, which cause T lymphocytes to gain immunocompetence. It begins involution after puberty.

A

thymus, a lymphoid organ

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91
Q

pericardium is loosely bound to manubrium by fibrous tissue which constitutes the

A

superior sternopericardial ligament

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92
Q

Lies anterior to the pericardium and posterior to the sternum and the transverse thoracic muscles.

A

Anterior mediastinum

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93
Q

Anterior mediastinum contains the remnants of the

A

thymus gland, lymph nodes, fat, and connective tissue

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94
Q

Anterior mediastinum consists largely of

A

areolar tissue

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95
Q

Lies between the right and left pleural cavities.

A

Middle mediastinum

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96
Q

Middle mediastinum contains the

A

pericardium, heart and great vessels, bronchi, comp of root of lungs, arch of azygos vein, phrenic vein

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97
Q

Lies posterior to the pericardium between the mediastinal pleurae.

A

Posterior mediastinum

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98
Q

Posterior mediastinum contains

A

esophagus, thoracic aorta, azygos and hemiazygos veins, thoracic duct, vagus nerves,
sympathetic trunk, and splanchnic nerves

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99
Q

trachea pathway

A

Begins at the inferior border of the cricoid cartilage (C6) as a continuation of the larynx and ends by
bifurcating into the right and left main stem bronchi at the level of the sternal angle (junction of T4 and
T5).

location: sup mediastinum

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100
Q

trachea length

A

about 9 to 15 cm in length (12 cm long, 2 cm wide according to SIM)

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101
Q

trachea has _____ that open posteriorly toward the esophagus and prevent the trachea from collapsing.

A

16 to 20 incomplete hyaline cartilaginous rings

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102
Q

carina

A

a downward and backward projection of the last tracheal cartilage

103
Q

lies at the level of the sternal angle and forms a keel-like ridge separating the openings of the right and left main
bronchi

A

carina

104
Q

may be compressed by an aortic arch aneurysm, a goiter, or thyroid tumors, causing
dyspnea

A

trachea

105
Q

may be examined with a bronchoscope and may be distorted, widened posteriorly, and
immobile in the presence of a bronchogenic carcinoma. The mucous membrane over the carina is one
of the most sensitive areas of the tracheobronchial tree and is associated with the cough reflex.

A

carina

106
Q

right vs left main bronchus

A

right main bronchus is shorter, wider , and more vertical than the left main bronchus

107
Q

right main(primary) bronchus pathway

A

Runs under the arch of the azygos vein and divides into three lobar or secondary (superior, middle ,
and inferior ) bronchi and finally into 10 segmental bronchi

108
Q

The right superior lobar (secondary) bronchus is known as the _______ because it passes above the level of the pulmonary artery. All others are the hyparterial bronchi.

A

eparterial (above the artery) bronchus

109
Q

Left main (primary) bronchus pathway

A

Runs inferolaterally inferior to the arch of the aorta , crosses anterior to the esophagus and thoracic
aorta, and divides into two lobar or secondary bronchi , the upper and lower, and finally into 8 to 10
segmental bronchi.

110
Q

Left main (primary) bronchus is also crossed superiorly by the _______ over its proximal part and by the _______ over its distal part.

A

arch of the aorta;

left pulmonary artery

111
Q

Left main (primary) bronchus dilates its lumen by

A

sympathetic nerves

112
Q

Left main (primary) bronchus constricts by

A

parasympathetic stimulation

113
Q

is a group of lung diseases associated with chronic
obstruction of airflow through the airways and lungs. It includes chronic bronchitis and emphysema ,
which are the most common forms and is caused primarily by cigarette smoking.

A

COPD

114
Q

is an inflammation or irritation of the airways, and excessive mucus production
plugs up the airways, causing a cough and breathing difficulty.

A

chronic bronchitis

115
Q

is an accumulation of air in the terminal bronchioles and alveolar sacs (air is trapped
in the lungs) due to destruction of the alveolar walls, reducing the surface area available for the
exchange of oxygen and carbon dioxide and thereby reducing oxygen absorption

A

emphysema

116
Q

is an airway obstruction and is characterized by dyspnea (difficulty in breathing) and cough
with wheezing because of spasmodic contraction of smooth muscles in the bronchioles, which narrows
the airways particularly during expiration

A

asthma

117
Q

is a chronic dilation of bronchi and bronchioles resulting from destruction of
bronchial elastic and muscular elements, which may cause collapse of the bronchioles

A

Bronchiectasis

118
Q

pleura

A

thin serous membrane

119
Q

pleura consists of

A

a parietal pleura and a visceral pleura

120
Q

Lines the inner surface of the thoracic wall and the mediastinum and has costal, diaphragmatic,
mediastinal, and cervical parts

A

parietal pleura

121
Q

is the dome of the pleura, projecting into

the neck above the neck of the first rib.

A

cervical pleura (cupula)

122
Q

a suprapleural membrane, which is a thickened portion of the endothoracic fascia , and is attached to the first rib and the transverse process of the seventh cervical vertebra

A

Sibson’s fascia

123
Q

endothoracic fascia

A

extrapleural fascial sheet lining the thoracic wall.

124
Q

parietal pleura is innervated by the

A

intercostal nerves and the phrenic nervesal pleu

125
Q

parietal pleura is very sensitive to

A

pain

126
Q

parietal pleura is supplied by

A

branches of the internal thoracic, superior phrenic, posterior intercostal, and superior
intercostal arteries

127
Q

visceral pleura is supplied by

A

bronchial arteries

128
Q

pulmonary ligament

A

two-layered vertical fold of mediastinal pleura

129
Q

pulmonary ligament runs along mediastinal surface of each lung from

A

hilus to the base

130
Q

Intimately invests the lungs and dips into all of the fissures

A

visceral pleura

131
Q

visceral pleura is supplied by

A

bronchial arteries

132
Q

visceral pleura’s venous blood is drained by

A

pulmonary veins

133
Q

visceral pleura Is insensitive to pain but is sensitive to

A

stretch

134
Q

visceral pleura contains

A

vasomotor fibers and sensory endings of

vagal origin

135
Q

is an inflammation of the pleura with exudation (escape of fluid from blood vessels) into its cavity, causing the pleural surfaces to be roughened

A

Pleurisy (pleuritis)

136
Q

Is a potential space between the parietal and visceral pleurae.

A

pleural cavity

137
Q

pleural cavity

A

Represents a closed sac with no communication between right and left parts

138
Q

pleural cavity contains

A

a film of fluid that lubricates the surface of the pleurae and facilitates the movement of the
lungs

139
Q

Can accumulate fluid when in the erect position.

Allow the lungs to be pulled in and expanded during inspiration.

A

Costodiaphragmatic recesses

140
Q

Costodiaphragmatic recesses

A

Are the pleural recesses formed by the reflection of the costal and diaphragmatic pleurae

141
Q

Costomediastinal recesses

A

Are part of the pleural cavity where the costal and mediastinal pleurae meet.

142
Q

is an accumulation of air in the pleural cavity, and thus, the lung collapses because the negative pressure necessary to keep the lung expanded has been eliminated. It results from an injury to the thoracic wall or the lung.

A

Pneumothorax

143
Q

a life-threatening pneumothorax in

which air enters during inspiration and is trapped during expiration

A

Tension pneumothorax

144
Q

an abnormal accumulation of excess fluid in the pleural space

A

Pleural effusion:

145
Q

(type of pleural effusion) clear watery fluid

A

transudate

146
Q

(type of pleural effusion) cloudy viscous fluid

A

exudate

147
Q

An accumulation of fluid (water) in the pleural cavity

A

hydrothorax

148
Q

An accumulation of fluid (blood) in the pleural cavity

A

hemothorax

149
Q

An accumulation of fluid (lymph) in the pleural cavity

A

chylothorax

150
Q

An accumulation of fluid (pus) in the pleural cavity

A

pyothorax

151
Q

Are the essential organs of respiration

A

lungs

152
Q

lungs are attached to the heart and trachea by their roots and the

A

pulmonary ligaments

153
Q

lungs contain

A

nonrespiratory tissues

154
Q

lungs are are nourished by the

A

bronchial arteries

155
Q

drained by the

A

bronchial veins for the larger subdivisions of the bronchi and by the pulmonary veins for the smaller
subdivisions of the bronchial tree

156
Q

lungs have bases that rest on the convex surface of the diaphragm, descend during _____, and ascend
during _____.

A

inspiration;

expiration

157
Q

Has an apex that projects into the neck and a concave base that sits on the diaphragm

A

Right lung

158
Q

right lung vs left lung

A

right lung is larger and heavier than the left lung, but is shorter and wider because of the higher right dome of the diaphragm and the inclination of the heart to the left

159
Q

right lung is divided into upper, middle, and lower lobes by the

A

oblique and horizontal (accessory) fissures

160
Q

The oblique fissure usually begins at the head of the fifth rib and follows roughly the line of the

A

6th rib

161
Q

The horizontal fissure runs from the oblique fissure in the

midaxillary line at the 6th rib level and extends forward to the

A

4th costal cartilage level

162
Q

right lung has

A

3 lobar (secondary) bronchi and 10 segmental (tertiary) bronchi

163
Q

Has grooves for

A

SVC, arch of azygos vein, esophagus

164
Q

left lung is divided into upper and lower lobes by an

A

oblique fissure

165
Q

lingula

A

a tongue-shaped portion of the upper lobe that corresponds to the middle lobe of the right lung. (contained in the left lung)

166
Q

left lung contains

A

a cardiac impression , a cardiac notch (a deep indentation of the anterior border of the
superior lobe of the left lung), and grooves for various structures (e.g., aortic arch, descending aorta,
left subclavian artery).

167
Q

left lung has

A

has 2 lobar (secondary) bronchi and 8 to 10 segmental bronchi

168
Q

is an inflammation of the lungs, which is of bacterial, viral, and mycoplasmal origin. Symptoms are usually cough, fever, sputum production, chest pain, and dyspnea. It
can be treated by administering antibiotics and antimicrobial drugs for initial therapy.

A

Pneumonia (pneumonitis)

169
Q

is an infectious lung disease caused by the bacterium Mycobacterium tuberculosis and is characterized by the formation of tubercles that can undergo caseous necrosis. Its symptoms are cough, fever, sweats, tiredness, and emaciation. TB is spread by coughing and mainly enters the body
in inhaled air and can be treated with very effective drugs.

A

Tuberculosis (TB)

170
Q

causes severe pain radiating toward the shoulder and along the medial aspect of the arm and atrophy of the
muscles of the forearm and hand)

A

lower trunk brachial plexopathy

171
Q

is a malignant neoplasm of the lung apex and

causes Pancoast’s syndrome

A

Pancoast’s or superior pulmonary sulcus tumor:

172
Q

is a deep vertical groove in the posterior wall of the thoracic cavity on
either side of the vertebral column formed by the posterior curvature of the ribs, lodging the posterior
bulky portion of the lung

A

Superior pulmonary sulcus

173
Q

is an inherited multisystem disease that has widespread dysfunction of the exocrine glands.

A

Cystic fibrosis (CF)

174
Q

involves fluid accumulation and swelling in the lungs caused by lung toxins (causing altered capillary permeability), mitral stenosis, or left ventricular failure that results in increased pressure in the pulmonary veins.

A

Pulmonary edema

175
Q

As pressure in the pulmonary veins rises, fluid is pushed

into the _____ and becomes a barrier to normal oxygen exchange, resulting in _____.

A

alveoli;

shortness of breath

176
Q

is a condition of permanent deposition of substantial amounts of particles in the
lungs, usually of occupational or environmental origin.

A

Pneumoconiosis

177
Q

is a form of pneumoconiosis caused by accumulation of carbon from inhaled smoke or coal dusts in the lungs

A

Anthracosis

178
Q

is caused by inhalation of crystalline silica dusts from rocks and sands, which are collected in terminal airways.

A

Silicosis

179
Q

is caused by inhalation of asbestos fibers, and accumulated particles and fibers in the lungs can cause irritation and inflammation, leading to a breathing disorder, cough, chest pains, and a high risk of lung cancer

A

Asbestosis

180
Q

Is the anatomic, functional, and surgical unit (subdivision) of the lungs

A

Bronchopulmonary segment

181
Q

Bronchopulmonary segment consists of

A 
a segmental (tertiary or lobular) bronchus, a segmental branch of the pulmonary artery, and a
segment of the lung tissue, surrounded by a delicate connective tissue septum (intersegmental septum
182
Q

Bronchopulmonary segment is drained by

A

intersegmental part of the pulmonary vein

183
Q

Bronchopulmonary segment refers to the portion of the lung supplied by each segmental bronchus and segmental artery. The pulmonary veins are said to be

A

intersegmental

184
Q

Bronchopulmonary segment is clinically important because the intersegmental pulmonary veins form surgical landmarks; thus, a surgeon CAN remove a bronchopulmonary segment without seriously disrupting the surrounding _____

A

lung tissue and major blood vessels

185
Q

is the collapse of a lung by blockage of the air passages or by very shallow breathing because of anesthesia or prolonged bedrest. It is caused by mucus secretions that plug the airway, foreign bodies in the airway, and tumors that compress or obstruct the airway.

A

Atelectasis

186
Q

Lung cancer has three types:

A

squamous cell carcinoma , adenocarcinoma , and

small-cell carcinoma

187
Q

arises in the epithelium of the larger bronchi and tends to form masses

A

squamous cell carcinoma

188
Q

originates in the peripheral areas of the

lung as solitary nodules that develop from bronchial mucous glands and alveolar epithelial cells

A

adenocarcinoma

189
Q

contains small epithelial cells that originate in the main bronchi and grow
aggressively in cords of grapelike clusters

A

small-cell carcinoma

190
Q

is the surgical removal of an entire lung and is usually performed as a treatment for lung cancer. It consists of either a traditional pneumonectomy, in which only the diseased lung is removed, or an extrapleural pneumonectomy, in which the lung, the parietal pleura, and a part of the diaphragm are removed.

A

Pneumonectomy

191
Q

Conducting portion (airway) includes the

A

nasal cavity, nasopharynx, larynx, trachea, bronchi, bronchioles (possess no cartilage), and terminal bronchioles

192
Q

respiratory portion includes the

A

respiratory bronchioles, alveolar

ducts, atria, and alveolar sacs

193
Q

takes place across the wall (blood-air barrier) of lung alveoli and pulmonary capillaries

A

Oxygen and carbon dioxide exchange

194
Q

Is the vital exchange of oxygen and carbon dioxide that occurs in the

A

respiration

195
Q

the airborne barrier of respiration consists of

A

alveolar type I cells, basal lamina, and capillary endothelial cells.

196
Q

The alveolar type II cells secrete

A

surfactant

197
Q

Occurs when the ribs and sternum (or thoracic cage) are elevated by the following muscles: the
diaphragm; external, internal (interchondral part), and innermost intercostal muscles;
sternocleidomastoid; levator costarum; serratus anterior; scalenus; pectoralis major and minor; levator
costarum; and serratus posterior superior muscles.

A

inspiration

198
Q

inspiration involves the following processes

A

Contraction of the diaphragm, Enlargement of the pleural cavities and lungs, Forced inspiration

199
Q

Pulls the dome inferiorly into the abdomen, thereby increasing the vertical diameter of the thorax.

A

Contraction of the diaphragm

200
Q

Reduces the intrapulmonary pressure (creates a negative pressure ), thus allowing air to rush into the
lungs passively because of atmospheric pressure.

A

Enlargement of the pleural cavities and lungs

201
Q

Involves contraction of the intercostal muscles and elevation of the ribs (superolateral movement),
with the sternum moving anteriorly like a bucket handle . (When the handle is raised, the convexity
moves laterally.)

A

Forced inspiration

202
Q

Involves the following muscles: the muscles of the anterior abdominal wall, internal intercostal
(costal part) muscles , and serratus posterior inferior muscles.

A

expiration

203
Q

expiration involves the following processes

A

Overall process,Elastic recoil of the lungs, Forced expiration

204
Q

Involves relaxation of the diaphragm, the internal intercostal muscles (costal part), and other muscles;
decrease in thoracic volume; and increase in the intrathoracic pressure.

A

Overall process

205
Q

what happens to the ribs and abdominal pressure in overall process?

A

The abdominal pressure is

decreased , and the ribs are depressed.

206
Q

Elastic recoil of the lungs produces what in the pleural cavities

A

a subatmospheric pressure

207
Q

expiration is a

A

passive process caused by the elastic recoil of the lungs

208
Q

quiet inspiration results from

A

contraction of the diaphragm

209
Q

Requires contraction of the anterior abdominal muscles and the internal intercostals (costal part).

A

Forced expiration

210
Q

Lymphatic Vessels of the Lung drain the

A

bronchial tree, pulmonary vessels, and connective tissue septa

211
Q

Lymphatic Vessels of the Lung pathway

A

Run along the bronchiole and bronchi toward the hilus, where they drain to the pulmonary
(intrapulmonary) and then bronchopulmonary nodes, which in turn drain to the inferior (carinal) and
superior tracheobronchial nodes, the tracheal (paratracheal) nodes, bronchomediastinal nodes and
trunks, and eventually to the thoracic duct on the left and right lymphatic duct on the right.

212
Q

Pulmonary trunk circulation

A

Extends upward from the conus arteriosus of the right ventricle of the heart and carries poorly
oxygenated blood to the lungs for oxygenation.

213
Q

Pulmonary trunk pathway

A

Passes superiorly and posteriorly from the front of the ascending aorta to its left side for about 5 cm and
bifurcates into the right and left pulmonary arteries within the concavity of the aortic arch at the level of
the sternal angle.

214
Q

pulmonary trunk vs aorta

A

Has much lower blood pressure than that in the aorta

215
Q

pulmonary trunk is contained where?

A

within the fibrous pericardium

216
Q

left vs right pulmonary artery

A

left pulmonary artery is shorter and narrower than the right pulmonary artery, and

217
Q

left pulmonary artery pathway

A

arches OVER the left primary bronchus.

218
Q

left pulmonary artery Is connected to the arch of the aorta by the

A

ligamentum arteriosum , the fibrous remains of the ductus arteriosus.

219
Q

right pulmonary artery

A

Runs horizontally toward the hilus of the right lung under the arch of the aorta behind the ascending
aorta and SVC and anterior to the right bronchus.

220
Q

is an obstruction of the pulmonary artery or
one of its branches by an embolus (air, blood clot, fat, tumor cells, or other foreign material), which
arises in the deep veins of the lower limbs or in the pelvic veins or occurs following an operation or
after a fracture of a long bone with fatty marrow.

A

Pulmonary embolism (pulmonary thromboembolism)

221
Q

Pulmonary veins are _____ in drainage

A

intersegmental (do not accompany the bronchi or the segmental artery within the
parenchyma of the lungs).

222
Q

pulmonary veins leave the lung as

A

five pulmonary veins, one from each lobe of the lungs. However, the right upper and
middle veins usually join so that only four veins enter the left atrium.

223
Q

pulmonary veins circulation

A

Carry oxygenated blood from the respiratory part (alveoli) of the lung and deoxygenated blood from the
visceral pleura and from a part of the bronchioles to the left atrium of the heart. (Gas exchange occurs
between the walls of alveoli and pulmonary capillaries, and the newly oxygenated blood enters venules
and then pulmonary veins.)

224
Q

Bronchial arteries arise from the

A

thoracic aorta; usually there is one artery for the right lung and two for the left lung.

225
Q

Bronchial arteries supply oxygenated blood to the

A

nonrespiratory conducting tissues of the lungs and the visceral pleura

226
Q

Anastomoses of the bronchial arteries occur between the

A

capillaries of the bronchial and pulmonary systems

227
Q

bronchial veins receive blood from the and

A

bronchi

228
Q

bronchial veins empty into the

A

azygos vein on the right and into the accessory hemiazygos vein or the superior intercostal vein on the left.

229
Q

bronchial veins may receive twigs (small vessels) from the

A

tracheobronchial lymph nodes

230
Q

Receives afferent and efferent (parasympathetic preganglionic) fibers from the vagus nerve, joined by
branches (sympathetic postganglionic fibers) from the sympathetic trunk and cardiac plexus.

A

pulmonary plexus

231
Q

pulmonary plexus is divided into the

A

anterior pulmonary plexus , which lies in front of the root of the lung, and the
posterior pulmonary plexus , which lies behind the root of the lung

232
Q

pulmonary plexus has sympathetic nerve fibers that

A

dilate the lumina of the bronchi and constrict the pulmonary vessels

233
Q

pulmonary plexus has parasympathetic fibers

A

constrict the lumina , dilate the pulmonary vessels, and increase glandular secretion

234
Q

phrenic nerve arises and lies where?

A

Arises from the third through fifth cervical nerves (C3–C5) and lies in front of the anterior scalene
muscle.

235
Q

phrenic nerve enters the thorax by passing

A

deep to the subclavian vein and superficial to the subclavian arteries

236
Q

phrenic nerve runs

A

anterior to the root of the lung

237
Q

vagus nerve runs

A

posterior to the root of the lung

238
Q

phrenic nerve is accompanied by the

A

pericardiophrenic vessels of the internal thoracic vessels

239
Q

phrenic nerve descends

A

between the mediastinal pleura and the pericardium

240
Q

phrenic nerve innervates the

A

fibrous pericardium, the mediastinal and diaphragmatic pleurae, and the diaphragm for motor and its central tendon for sensory

241
Q

Lesion of the phrenic nerve: may or may not produce complete paralysis of the corresponding half of
the diaphragm because

A

the accessory phrenic nerve , derived from the fifth cervical nerve as a branch
of the nerve to the subclavius, usually joins the phrenic nerve in the root of the neck or in the upper
part of the thorax

242
Q

is an involuntary spasmodic sharp contraction of the diaphragm , accompanied by the
approximation of the vocal folds and closure of the glottis of the larynx. It may occur as a result of the
stimulation of nerve endings in the digestive tract or the diaphragm. When chronic, it can be stopped by
sectioning or crushing the phrenic nerve.

A

Hiccup

243
Q

Primordium for the lower respiratory system appears as

A

a laryngotracheal groove in the floor of the

pharyngeal foregut.

244
Q

forms from the laryngotracheal groove in the ventral wall of the foregut
.

A

Laryngotracheal (respiratory) diverticulum

245
Q

the diverticulum is separated from the foregut proper by the formation of a

A

tracheoesophageal septum

246
Q

Tracheoesophageal septum divides the foregut into a

A

ventral portion, the laryngotracheal tube
(primordium of the larynx, trachea, bronchi, and lungs), and a dorsal portion (primordium of the
oropharynx and esophagus)

247
Q

develop at the distal end of the laryngotracheal diverticulum

A

lung buds

248
Q

Epithelium and glands in the trachea and bronchi are derived from the

A

endoderm

249
Q

is derived from visceral mesoderm covering the outside of the bronchi

A

Visceral pleura

250
Q

is derived from somatic mesoderm covering the inside of the body wall.

A

parietal pleura

251
Q

The conducting (airway) system through the terminal bronchioles develops. Respiration is not possible.

A

Glandular period (prenatal weeks 5 to 17)

252
Q

Luminal diameter of the conducting system increases, and respiratory bronchioles , alveolar ducts, and
terminal sacs begin to appear. Premature fetuses born before week 20 rarely survive.

A

Canalicular period (prenatal weeks 13 to 25)

253
Q

More terminal sacs form, and alveolar type I cells and surfactant producing alveolar type II cells develop. Respiration is possible, and premature infants can survive with intensive care.

A

Terminal sac period (prenatal weeks 24 to birth)

254
Q

Respiratory bronchioles, terminal sacs, alveolar ducts , and alveoli increase in number.

A

Alveolar period (late fetal stage to 8 years)

[OS 205] 1st Exam (6 decks)

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