Pulmonary System

Question 1

Types of Pleura in the lungs

Answer 1

Visceral pleura: lines the lungs themselves

Parietal pleura: lines the pulmonary cavities

Question 2

Pleural cavity

Answer 2

Space between pleura layers. Contains serous pleural fluid lubricating pleural surfaces.

Question 3

4 parts of the parietal pleura

Answer 3

Costal

Mediastinal

Diaphragmatic

Cervical pleura (cupula)

Question 4

Suprapleural membrane

Answer 4

Also called sibson fascia

• fibrous extension of endothoracic fascia that reinforces cervical pleura and prevents distortion of superior thoracic aperture.
• attaches to rib 1 and transverse process of C7

Question 5

Apex of lung

Answer 5

Superior end ascends slightly above 1st rib into the root of the neck

• covered by cervical pleura

Question 6

Base of lung

Answer 6

Inferior surface of lung resting on the diaphragm.

Question 7

Right lung has how many lobes and fissures

Answer 7

3 lobes, 2 fissures (oblique and horizontal)

Question 8

Left lung has how many lobes and fissures

Answer 8

2 lobes, 1 fissure (only oblique)

Question 9

Main bronchi

Answer 9

Most superior portion of the bronchi tree. Segments off the larynx at the sternal angle.

Right bronchi: shorter and wider with a more vertical pathway

Left bronchi: longer and runs more inferolaterally

• most often the right bronchi is lodged when blockage is possible.

Question 10

Lobar bronchi (secondary)

Answer 10

2nd branch off the main bronchi

• 2 on the left primary
• 3 on the right primary

Each 2nd branch correlates with a lobe of that respective lung.

Question 11

Segmental bronchi (tertiary)

Answer 11

3rd branch off lobar bronchi

• contains several branches off the lobar bronchi
• supply bronchopulmonary segments which are the smallest sections of lungs that can be individually incised out.
• 10 in the right
• 8-10 in the left

Question 12

Levels of bronchioles from largest to smallest

Answer 12

Conducting

Terminal

Respiratory

Question 13

Alveolar sacs

Answer 13

Found at the ends of respiratory bronchioles.

Unit of respiratory exchange of gases

Question 14

Right and left pulmonary arteries

Answer 14

Arise from the pulmonary trunk at the level of the sternal angle.

Carry venous blood to the lungs.

• segment into lobar arteries, 1 for each lobe of the respective lungs.

Question 15

Superior and inferior pulmonary veins

Answer 15

Found on both lungs and named after the lobe they reside in.

Carry oxygen rich blood to the heart.

• right lung also has middle lobe vein

Question 16

Bronchial arteries

Answer 16

Supply blood to the lung tissues. Arise from the aorta.

Question 17

Trachea

Answer 17

Inferior portion of the larynx beginning at C4 and running to T4/5.

Supported by C-shaped rings of hyaline cartilage

Question 18

Trachealis muscle

Answer 18

Smooth muscle within the posterior tracheal wall.

Provides limited constriction of the airway when it contracts.

Question 19

Carina

Answer 19

T4 ridge of cartilage that signals the splitting into two primary bronchi.

Question 20

Lymphatic drainage of the lungs

Answer 20

Moves from distal to proximal with proximal being the hilum of the lungs.

• right lung and inferior left lobe of left lung drain into the right lymphatic duct
• superior left lobe of the left lung drain into the thoracic duct

Question 21

Sympathetic efferent fiber pathways to the lungs

Answer 21

Consists of presynpatic fibers of T1-5 that synapse onto the sympathetic trunk

Postsynpatic fibers leave sympathetic trunk via splanchnic nerves to the pulmonary plexuses

Question 22

Actions of sympathetic efferent fibers in the lungs

Answer 22

Bronchodilator

Vasoconstriction

Secretory reduction (inhibits alveolar glands of bronchi tree)

Question 23

Parasympathetic efferent fiber pathways to the lungs

Answer 23

Presynaptic fibers travel via vagus nerves directly to the pulmonary plexuses and synapse on the branches of the bronchial tree

Question 24

Parasympathetic efferent fiber actions on the lungs

Answer 24

Bronchoconstriction

Vasodilation

Secretomotor (stimulates secretions of alveolar glands)

Question 25

Visceral afferent fibers

Answer 25

Either reflexive of nociception responses.

Reflexive: take the same path as parasympathetic

Nociceptive: excluding trachea, follow the sympathetic route. (Trachea follows parasympathetic)

Question 26

Reflexive afferent fibers include what types of stimuli?

Answer 26

Stretch, tactile and chemo and pressure (baro).

Question 27

Phrenic nerve

Answer 27

Carries both somatic afferent and efferent fibers from C3-5

Somatic efferent fibers: stimulate contraction of diaphragm

Somatic afferent fibers: transmit stimuli from mediastinal and diaphragmatic pleura

Question 28

Intercostal nerves

Answer 28

Transmit somatic afferent fibers from peripheral regions of the costal pleura

Question 29

Pulmonary collapse

Answer 29

Caused by penetration of the thoracic wall or surface of lungs

• causes air to be sucked into the pleural cavity via negative pressure, breaking the surface tension adhering visceral to parietal pleura.
• causes lung to collapse and deflate causing major empty space.

Question 30

Radiographic representation of collapse lung

Answer 30

Elevated diaphragm on the collapsed side.

Reduction of plural cavity

Displacement of the mediastinum towards the collapsed side.

Collapsed lung appears more white surrounded by deeper blackness

Question 31

Pneumothorax

Hydrothorax

Hemothorax

Answer 31

Air, Fluid, blood filling of the pleural cavity.

Blood usually only occurs via major vessels being torn

Question 32

Radiological representation of the thoraxes

Answer 32

Lung is collapsed and appears whiter with either black (pneumothorax) or gray (hemothorax or hydrothorax) background

If air and fluid are present in the lung, a sharp horizontal line of different opaqueness will be present.

Question 33

Pleuritis

Answer 33

Inflammation of pleura.

Distinguishable by crackling, friction like sounds via auscultation of the lungs.

Usually accompanied by sharp pain while breathing, especially on exertion, and increase in overall rate of respiration.

Question 34

Segmental atelectasis and its radiological appearance

Answer 34

Collapsing of lung segment via blockage of the respective segmental bronchi.

Causes mediastinal shift in radiographs. Can also cause enlarged segments of the lung to counteract lost segment.

Question 35

Pulmonary embolism

Answer 35

Blockage of a pulmonary artery often seen via a fat globule, air bubble or thrombus from a leg vein.

Can cause acute respiratory distress (complete loss of oxygenated blood usually via embolism)

Can cause pulmonary infarction (necrotic region of lung tissue via hypoxia).

Question 36

Pleural pain

Answer 36

Parietal pleura irritation can cause referred pain to dermatomes supplied via C1-C5