Respiratory anatomy and histology Flashcards

1
Q

what are the three lines used to demarcate the topography of the lungs?

A

midclavicular
midaxillary
paravertebral

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2
Q

what are the locations of adhesion for the lung and visceral pleura?

A

midclavicular - rib 6
midaxillary - rib 8
paravertebral - rib 10

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3
Q

what are the locations of adhesion for the parietal pleura?

A

midclavicular - rib 8
midaxillary - rib 10
paravertebral - rib 12

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4
Q

what is the best access for removal of pleural effusion fluid?

A

posterior 7th / 8th / 9th intercostal spaces

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5
Q

what is the superior pulmonary sulcus? what is the clinical relevance?

A

posterior concave curvature / region of thoracic wall

pancoast tumor can migrate superiorly to this sulcus

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6
Q

which type of tumor can migrate superiorly to the superior pulmonary sulcus?

A

pancoast tumor

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7
Q

what are the involved structures in a pancoast tumor?

A

sympathetics
brachial plexus
subclavian vessels

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8
Q

what is the brachial plexus manifestation of a pancoast tumor?

A

intrinsic hand muscle deficits due to C8/T1 involvement

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9
Q

what are the stellate ganglion manifestations of a pancoast tumor?

A

horner syndrome (ptosis, myosis, anhydrosis)

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10
Q

the lingula is associated with which lobe / region?

A

superior lobe of left lung

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11
Q

how many bronchopulmonary segments does the right lung have?

A

10

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12
Q

how many bronchopulmonary segments does the left lung have?

A

8-10

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13
Q

what is the relationship of the pulmonary artery to the bronchi in the right lung?

A

anterior

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14
Q

what is the relationship of the pulmonary artery to the bronchi in the left lung?

A

superior

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15
Q

at which thoracic level does the trachea bifurcate?

A

T4 / T5

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16
Q

the trachea begins at what vertebral level?

A

C6

17
Q

what do segmental (tertiary) bronchi supply on the right and left sides?

A

right - 10 bronchopulmonary segments

left - 8 bronchopulmonary segments

18
Q

what are the four components of the respiratory airways?

A

respiratory bronchioles
alveolar ducts
alveolar sacs
alveoli

19
Q

the lamina propria of the vocal contains what structures?

A

vocal ligament

Reinke’s space

20
Q

what is Reinke’s space?

A

histological space contained in the lamina propria of the vocal fold adjacent to the vocal ligament

21
Q

what is the purpose of Reinke’s space?

A

fluid accumulation above and below (Reinke’s edema)

22
Q

what constitutes the epithelium on the inner aspect of the larynx?

A

ciliated, pseudostratified columnar with goblet cells

23
Q

what constitutes the epithelium on vocal folds, anterior surface of epiglottis, and external laryngeal surfaces?

A

non-keratinized stratified squamous

24
Q

what cell types are the drivers of mucociliary clearance?

A

ciliated columnar cells

25
Q

goblet cells span what regions of the respiratory tract?

A

trachea to primary bronchioles

26
Q

what are the neuroendocrine cells of Kulchitsky?

A

numerous in fetal lung - proliferate in certain diseases of pulmonary system

27
Q

where are smooth muscle bundles found in the respiratory tract?

A

interface of lamina propria and submucosa of intrapulmonary bronchi

28
Q

the glands in the submucosa of the intrapulmonary bronchus secrete what substances?

A
mucins 
lactoferrin 
lysozyme 
IgA 
a1-antitrypsin and other protease inhibitors
29
Q

75% of lung cancers originate in what bronchi?

A

1st, 2nd, and 3rd order bronchi

30
Q

what are the histologic changes seen in asthma?

A
increased mucus 
increased thickness of basal lamina 
increased thickness of lamina propria due to edema and emigration of inflammatory cells 
increased thickness of muscularis 
increased glands in submucosa
31
Q

what are the histological features of bronchioles?

A

lack cartilage
lack submucosa
goblet cells normally in large bronchiole
prominent muscle layer

32
Q

where are club cells seen?

A

terminal and respiratory bronchioles

33
Q

what is the function of club cells?

A

represent stem cell population

secrete surfactant

34
Q

which pneumocyte makes up over 90% of the surface area?

A

type I

35
Q

what are the functions of type I pneumocytes?

A

facilitate gas diffusion between blood and alveoli

36
Q

which pneumocyte secretes surfactant?

A

type II

37
Q

what are the functions of type II pneumocytes?

A

secrete surfactant

cell division

38
Q

where are alveolar macrophages seen?

A

alveolar lumen

39
Q

what forms the blood gas barrier?

A

type I pneumocytes with adluminal surfactant

fused basal laminae of type I pneumocyte and continuous capillary