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CP Exam I COPY > Lower Respiratory Tract > Flashcards

Lower Respiratory Tract Flashcards

1
Q

What are the main components of the lower respiratory tract?

A

Trachea
Main stem of bronchi
Bronchial tubes
Lungs (alveoli)

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2
Q

What type of epithelium lines the trachea, bronchi, and bronchial tubes?

What are these structures contained in?

A

Pseudostratified columnar ciliated epithelium

Contained in a mucous membrane

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3
Q

What is the purpose of the cilia on the pseudostratified columnar ciliated epithelium lining the lower respiratory tract?

A

Cilia move a layer of mucous toward the laryngopharynx where it can be swallowed or coughed up

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4
Q

What midline structure is continuous with the larynx from the neck into the superior mediastinum?

A

Trachea

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5
Q

The trachea extends from _____ vertebrae to the ______ angle (the junction of the manubrium to the sternal body) at the same level as ______

A

C6
Sternal
T4

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6
Q

The ________ _________ plane passes through the sternal angle to intersect the intervertebral disc between the T4-T5 verebrae. This plane intersects the trachea in the midline where it bifurcates into 2 main bronchi.

A

Transverse thoracic

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7
Q

Describe the diameter and length of the trachea in adults

A

3/4” diameter

3.5-5” long

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8
Q

Describe the composition of the trachea

A

20 U-shaped hyaline cartilage rings

Smooth muscle - found in elastic posterior wall next to esophagus

Mucous glands - keep surface of epithelium coated

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9
Q

What arteries supply the trachea?

A

Superior and inferior thyroid aa.

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10
Q

What veins drain the trachea?

A

Superior, middle, and inferior thyroid veins

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11
Q

Compare/contrast the right main bronchus with the left main bronchus

A

Right main bronchus:
Larger diameter
More vertical
Shorter length

Left main bronchus:
Smaller diameter
Less vertical
Longer length

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12
Q

The secondary (lobar) bronchi go to the lobes of the lungs. Describe the lobar bronchi in the right vs. left lung

A

Right lung = 3 lobar bronchi (because 3 lobes)

Left lung = 2 lobar bronchi (because 2 lobes)

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13
Q

The _________ ___________ refer to the largest subdivisions of a lobe of a lung. They are pyramidal shaped segments with their apices facing the lung root and their bases at the pleural surface.

A

Bronchopulmonary segments

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14
Q

The bronchopulmonary segments refer to the largest subdivisions of a lobe of a lung. They are pyramidal shaped segments with their apices facing the lung root and their bases at the pleural surface.

They are separated from adjacent segments by connective tissue ________.

They are supplied independently by a __________ bronchus and tertiary branch of a _________ artery

A

Septa

Segmental; pulmonary

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15
Q

Bronchopulmonary segments are named according to segmental bronchi supplying them. They are supplied independently by a segmental bronchus and a tertiary branch of a pulmonary artery. What drains the bronchopulmonary segments?

A

Intersegmental parts of pulmonary veins that lie in connective tissue between and drain adjacent segments

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16
Q

What do the tertiary (segmental) bronchi supply?

A

The bronchopulmonary segments - which are the largest subdivisions of a lobe (pyramidal shaped segments of the lung with their apices facing the lung root and their bases at the pleural surface)

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17
Q

How many segments/segmental bronchi are associated with each lung?

A

Right lung = 10 segments, 10 segmental bronchi

Left lung = 8 segments, 8 segmental bronchi

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18
Q

What is the next level of branching below the tertiary (segmental) bronchi?

A

Beyond tertiary segmental bonchi, there are 20-25 generations of branching conducting bronchioles that eventually end as terminal bronchioles

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19
Q

What are the overall levels of branching of the lower respiratory tract from the trachea to the alveoli?

A 
Trachea
Primary/main bronchi
Secondary/lobar bronchi
Tertiary/segmental bronchi
Terminal bronchioles
Respiratory bronchioles
Alveoli
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20
Q

What are the smallest conducting bronchioles? Describe their characteristics

A

Terminal bronchioles

Lack cartilage in their walls
Transport air but lack glands or alveoli
Give rise to respiratory bronchioles

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21
Q

In which division of the lower respiratory tract do alveoli first appear?

A

Respiratory bronchioles

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22
Q

Respiratory bronchioles are characterized by scattered, thin walled outpocketings called ______ that extend from their lumens.

A

Alveoli

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23
Q

What are the 2 primary functions of respiratory bronchioles?

A

Transport air

Gas exchange

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24
Q

Each respiratory bronchiole gives rise to 2-11 _______ _______

A

Alveolar ducts

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25
Q

Each respiratory bronchiole gives rise to 2-11 alveolar ducts

Each alveolar duct gives rise to 5-6 ______ _______, into which clusters of alveoli open

A

Alveolar sacs

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26
Q

Alveoli have a ______ ______ thickness

They are organized in ________ and are surrounded by a dense _______ network

A

Single-celled

Clusters; capillary

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27
Q

What arteries supply the bronchi but not the alveoli?

A

3 bronchial arteries (2 left, 1 right)

[these supply the bronchial tubes but not the alveoli because they are not part of pulmonary circulation]

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28
Q

The 3 bronchial arteries (2 left and 1 right) are responsible for supplying the bronchial tubes. What do these branch from?

A

The descending aorta

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29
Q

Describe venous drainage of the bronchi

A

Bronchial veins drain to the azygous veins, which are tributaries to the superior vena cava

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30
Q

What general structures are associated with the surface anatomy of the lungs?

A 
Fissures
Cardiac notch
Lingula
Apex
Base
Hilum
Visceral pleura
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31
Q

What fissure(s) is/are found in the left lung and what do these divide?

A

Oblique fissure only - divides the upper and lower lobes

32
Q

What fissure(s) is/are found in the right lung and what do these divide?

A

Oblique fissure - divides middle lobe from lower lobe and upper lobe from lower lobe

Horizontal fissure - divides upper lobe from middle lobe

33
Q

Which of the following is found only in the right lung?

A. Cardiac notch
B. Lingula
C. Oblique fissure
D. Horizontal fissure
E. Hilum
A

D. Horizontal fissure

34
Q

Where is the cardiac notch located?

A

In the upper lobe of the left lung, adjacent to the heart

35
Q

What surface anatomy structure of the lung is found in the upper lobe of the left lung, adjacent to the cardiac notch?

A

Lingula

36
Q

What constitutes the apex of the lung? What is another term for apex of the lung?

A

Apex = area above first ribs

Cupola = apex

37
Q

What is the term for the area of the lungs adjacent to the respiratory diaphragm?

A

Base

38
Q

What is the term for the lung structures containing other structures entering and exiting the lungs like bronchi, pulmonary vessels, pulmonary nerves, lymphatic vessels, and bronchial vessels?

A

Hilum

39
Q

What is the difference between pulmonary and systemic circulation?

A

Pulmonary circulation moves blood between the heart and lungs (deoxygenated blood from heart goes to lungs, then returns to heart as oxygenated blood)

Systemic circulation moves blood between the heart and other body systems (oxygenated blood from heart goes to body, then returns to heart as deoxygenated blood)

40
Q

Vessels associated with pulmonary circulation include:

Pulmonary trunk
Pulmonary arteries
Alveolar capillary network
Pulmonary veins

What does the pulmonary trunk itself emerge from?

A

The right ventricle

41
Q

Vessels associated with pulmonary circulation include:

Pulmonary trunk
Pulmonary arteries
Alveolar capillary network
Pulmonary veins

Which of the above have right and left divisions, and have a branching pattern similar to bronchi?

A

Pulmonary arteries

42
Q

Vessels associated with pulmonary circulation include:

Pulmonary trunk
Pulmonary arteries
Alveolar capillary network
Pulmonary veins

Which of the above constitutes the functional part of pulmonary circulation?

A

Alveolar capillary network - serves function of gas exchange

[note that total surface area must be equal in size to all combined capillaries in all organs in the body]

43
Q

Vessels associated with pulmonary circulation include:

Pulmonary trunk
Pulmonary arteries
Alveolar capillary network
Pulmonary veins

What is the purpose of the pulmonary veins?

A

Collect blood from alveoli and return to the left atrium

44
Q

General visceral afferent fibers supply what type of innervation to the lungs?

A

Sensory

45
Q

Sensory (general visceral afferent) fibers supplying the lungs are contained in the ______ nerve

A

Vagus (CN X)

46
Q

Sensory (general visceral afferent fibers) supplying the lungs are contained in the vagus nerve. What are the 5 types of receptors are associated with these fibers?

A 
Stretch receptors
Irritant receptors
Tactile receptors
Baroreceptors
Chemoreceptors
47
Q

Sensory (general visceral afferent fibers) supplying the lungs are contained in the vagus nerve. These are associated with 5 types of receptors:

Stretch receptors
Irritant receptors
Tactile receptors
Baroreceptors
Chemoreceptors

Which of the above are found in pulmonary arteries?

A

Baroreceptors

48
Q

Sensory (general visceral afferent fibers) supplying the lungs are contained in the vagus nerve. These are associated with 5 types of receptors:

Stretch receptors
Irritant receptors
Tactile receptors
Baroreceptors
Chemoreceptors

Which of the above are found in respiratory epithelium?

A

Irritant receptors

49
Q

Sensory (general visceral afferent fibers) supplying the lungs are contained in the vagus nerve. These are associated with 5 types of receptors:

Stretch receptors
Irritant receptors
Tactile receptors
Baroreceptors
Chemoreceptors

Which of the above are found in alveoli and smooth muscle?

A

Stretch receptors

50
Q

Sensory (general visceral afferent fibers) supplying the lungs are contained in the vagus nerve. These are associated with 5 types of receptors:

Stretch receptors
Irritant receptors
Tactile receptors
Baroreceptors
Chemoreceptors

Which of the above are found in pulmonary veins?

A

Chemoreceptors (these detect blood gases)

51
Q

Sensory (general visceral afferent fibers) supplying the lungs are contained in the vagus nerve. These are associated with 5 types of receptors:

Stretch receptors
Irritant receptors
Tactile receptors
Baroreceptors
Chemoreceptors

Which of the above are associated with the cough reflex?

A

Tactile receptors

52
Q

General visceral efferent fibers are associated with what type of innervation in the lungs?

A

Motor

53
Q

Motor (general visceral efferent) fibers supplying the lungs are autonomic fibers that are contained in the _______ _______ plexus

A

Pulmonary nerve

54
Q

Motor (general visceral efferent) fibers supplying the lungs are autonomic fibers that are contained in the pulmonary nerve plexus. What are the 2 divisions of these motor fibers and what aspects of the lung do they supply innervation to specifically?

A

Sympathetic (post-ganglionic) fibers

Parasympathetic nerve fibers

Both supply smooth muscle and glands

55
Q

Motor (general visceral efferent) fibers supplying the lungs are autonomic fibers that are contained in the pulmonary nerve plexus. Both sympathetic (post-ganglionic) fibers and parasympathetic nerve fibers supply smooth muscle and glands.

What are the functions of the sympathetic division in terms of their effects on glandular secretion, bronchial vessels, and bronchial tubes?

A

Inhibit glandular secretion

Induce vasoconstriction of bronchial vessels

Dilate bronchial tubes

56
Q

Motor (general visceral efferent) fibers supplying the lungs are autonomic fibers that are contained in the pulmonary nerve plexus. Both sympathetic (post-ganglionic) fibers and parasympathetic nerve fibers supply smooth muscle and glands.

What are the functions of the parasympathetic division in terms of their effects on glandular secretion, bronchial vessels, and bronchial tubes?

A

Increase glandular secretion

Induce vasodilation of bronchial vessels

Constrict bronchial tubes

57
Q

Describe course of parasympathetic fibers in association with the lungs

A

Pre-ganglionic parasympathetics come to pulmonary nerve plexus by vagal nerves

They synapse with post-ganglionic parasympathetics on surfaces of bronchial tubes and vessels

58
Q

What are the 2 lymphatic plexuses associated with the lungs? Where are these found?

A

Superficial plexus - deep to visceral pleura

Deep plexus - located in substance of bronchi

59
Q

The superficial lymph plexus is found deep to the visceral pleura. Where does this plexus drain FROM and TO?

A

Drains lymph FROM visceral pleura and lung parenchyma TO bronchopulmonary lymph nodes in the hilum

60
Q

The deep lymph plexus is located in the substance of the bronchi. Where does this plexus drain lymph FROM and TO?

A

Drains lymph FROM bronchi TO pulmonary lymph nodes near the hilum, THEN goes to bronchopulmonary nodes in the hilum

61
Q

Name the 4 groups of lymph nodes associated with the lungs in sequence of their lymphatic drainage

A

Pulmonary nodes
Bronchopulmonary (hilar) nodes
Tracheobronchial nodes
Tracheal nodes

62
Q

What group of lymph nodes would you find in the hilum?

A

Bronchopulmonary (hilar) nodes

63
Q

What group of lymph nodes would you find in the lungs at the bifurcation of larger bronchi?

A

Pulmonary nodes

64
Q

What group of lymph nodes would you find at the bifurcation of the trachea?

A

Tracheobronchial nodes

65
Q

What group of lymph nodes would you find on the lateral surfaces of the trachea?

A

Tracheal nodes

66
Q

What are the 2 lymph trunks associated with the respiratory tract?

A

Right bronchomediastinal lymph trunk

Left bronchomediastinal lymph trunk

67
Q

What does the right bronchomediastinal lymph trunk drain FROM and TO?

A

Drains lymph from right side of trachea to right lymphatic duct

68
Q

What does the left bronchomediastinal lymph trunk drain FROM and TO?

A

Drains from left side of trachea to the thoracic duct

69
Q

Both the superficial and deep lymph plexuses eventually drain into the bronchopulmonary (hilar) lymph nodes.

The right lung drains primarily through the consecutive sets of nodes on the _____ side. The superior lobe of the left lung drains primarily through corresponding nodes on the ____ side.

Many, but not all, lymphatics from the lower lobe of the left lung drain to the _____ superior tracheobronchial nodes; the lymph then continues to follow the ___ side pathway

A

Right; left

Right; right

70
Q

The bronchomediastinal lymph turnks are major lymph conduits draining the thoracic viscera. Where do the right and left bronchomediastinal lymph trunks usually terminate?

A

On each side at venous angles = junctions of the subclavian and internal jugular veins

[however, the right bronchomediastinal trunk may first merge with other lymphatic trunks converging ehre to form the short right lymphatic duct; and the left bronchomediastinal trunk may terminate in the thoracic duct]

71
Q

Lymph from parietal pleura drains into what 4 groups of lymph nodes of the thoracic wall?

A

Intercostal nodes
Parasternal nodes
Mediastinal nodes
Phrenic nodes

[note that a few lymph vessels from the cervical parietal pleura may drain into axillary nodes]

72
Q

At what spinal level does the trachea bifurcate into primary bronchi?

A

T4-T5 (midline at the level of the areola)

73
Q

If a child were to aspirate a foreign body while standing/sitting upright, where are you most likely to see it on an imaging study?

A

Right lower lobe

74
Q

If a child were to aspirate a foreign body while laying supine, where are you most likely to see it on an imaging study?

A

Right upper lobe

75
Q

Cardiomegaly (enlargement of the heart tissue) may lead to pulmonary complaints such as shortness of breath due to irritation of what structure?

A

Lingula - located on left lung adjacent to the cardiac notch

76
Q

Describe the pathway of lymph nodes from pulmonary to tracheal

A

Pulmonary –> hilar –> tracheobronchial –> tracheal

CP Exam I COPY (18 decks)

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