Flashcards in Anatomy and Histology Deck (69):
Where do the apices of the lung lie in relation to the surface anatomy?
2.5 cm above the medial 1/3 of the clavicle
2.5 cm lateral to the spine of C7
What are the three vertical axes with respect to the lungs? Where is the edge of the lung at each of these points?
Where are the edges of the parietal pleura with respect to the three vertical axes of the thorax?
Where is the middle lobe of the lung located?
4th intercostal space, midclavicular line
Where is the appropriate site for a thoracocentesis?
Between the 7th, 8th, or 9th intercostal space posteriorly
Why should you go posteriorly for a thoracocentesis?
-Posterior gutter is deeper (diaphragm)
-Intercostal spaces are wider
-Neurovascular bundle is closer to the inferior margin of the rib above
What is a pleural effusion?
Fluid accumulation between the visceral and parietal pleura of the lung
What is the pulmonary sulcus? What is its significance?
Posterior curvature of the thoracic wall
Location of a pancoast tumor
When a pancoast tumor grows superiorly, what may it eventually involve?
may impact the brachial plexus
What muscles weakness may be the first sign of a pancoast tumor?
Intrinsic muscles of the hand
What is the syndrome that may develop with a pancoast tumor?
Horner's syndrome (ptosis, miosis, anhidrosis)
What vessels may be obstructed with a pancoast tumor?
Which lung is larger?
What are the two fissures of the right lung?
What is the single fissure of the left lung?
What is the depression on the medial surface of the left lung?
How many bronchopulmonary segments are there in the right lung? Left?
Right = 10
Left = 8
True or false: bronchopulmonary segments are interdependent in their blood/venous/air supply, thus you cannot resect a single segment
False-- fully independent
What sits superiorly in the hilum of the right lung? Inferiorly? Anteriorly between the two?
Bronchi on top
Pulmonary artery anterior between
What sits superiorly in the hilum of the left lung? Inferiorly? Posteriorly between the two?
Superiorly = pulmonary artery
Posteriorly = bronchus
Inferiorly = pulmonary vein
What is the RALS mnemonic for remembering where the pulmonary artery sits relative to the bronchus?
What spinal level does the trachea begin? Where does it bifurcate?
How long is the trachea?
Which pulmonary bronchus is more vertically directed?
How many lobar bronchi are there is each lung?
Same as the number of lobes for each
What is the branching order of the bronchi in each lung?
How many segmental bronchi are there in each lung?
10 in the right, 8 in the left
Where do the respiratory airways begin?
At the level of the Respiratory bronchioles
What are the four division of the respiratory bronchioles?
What is the epithelium that lines the vocal cords?
What are the divisions of the mucosa of the larynx?
What is the epithelial type of most of the larynx?
ciliated pseudostratified columnar cells
The vocalis muscle is an element of what larger muscle?
What is Reinke's space?
Area between the vocal ligament and the epithelium of the vocal cord
(a potential space between the vocal ligament and the overlying mucosa)
What is Reinke's edema?
Fluid between the vocal ligament and its overlying mucosa, causing edema of the vocal cords
What is the general rule of cellular diversity as you progress down the airway?
Less diverse the lower you go
What are the two types of cells that are present in the alveoli?
Type I and II pneumocytes
What are the 6 cell types in the bronchial airways?
-Ciliated columnar cells
-Seromucous gland cells
Where is the stopping point of goblet cells?
Level of the lobar bronchioles
What is the effect of smoking on goblet cells?
What are the cells in the bronchi that are the stem cells?
What is the role of the neuroendocrine cells in the bronchi?
Development, but may become cancerous
What is the role of the brush cells in the bronchi?
Cells with a well developed brush border--
What are the 6 layers of the trachea?
What is the secretory product of goblet cells?
What happens to the basement membrane of the trachea with chronic insult?
Where is the smooth muscles found in the trachea? (histologically)
Interface between the lamina propria and submucosa of the intrapulmonary bronchi
What happens to the smooth muscle layer of the trachea/bronchi as you progress down the airway?
Increases in thickness
What is the role of the glands in the submucosa of the trachea? (5)
Contains seromucous glands that are responsible for secreting:
Why is it that the submucosal glands secrete but do not produce IgA?
Plasma cells produces IgA, then transport it to the submucosal glands for secretion
75% of lung cancers originate from what order bronchi?
1 2 3
what are the histological changes that occur with asthma? (5)
-increased thickness of the BL
-Increased thickness of the lamina propria
-Increased thickness of the muscularis
-Increased glands in the submucosa
What causes the increased thickness of the lamina propria in the bronchial wall with asthma?
Emigration of inflammatory cells
What is the Reid index used for? What is it?
Determines whether someone has bronchitis
length of BM to mucus glands / glands to cartilage
What is the normal Reid index value? What indicates chronic bronchitis?
Normal less than 0.4
Chronic bronchitis greater than 0.5
What is bronchiectasis?
dilated bronchi due to tissues damage
What is the thickness of bronchioles?
Less than 1 mm
True or false: bronchioles lack cartilage
True or false: bronchioles lack a submucosa
True or false: all bronchioles lack goblet cells
False--large ones have them
What are club cells, and what do they do?
cells found in the terminal and respiratory bronchioles that secrete surfactant
What is the role of type I alveolar cells? can these divide?
Form the wall of the alveoli, where gas exchange occurs
What is the role of type II alveolar cells? can these divide?
Secrete surfactant, and are stem cells
Found along the borders of the alveoli
What are heart failure cells?
macrophages with hemosiderin d/t RBC breakdown
What is the signature histological feature of type II alveolar cells?
Presence of lamellar bodies, which contain its secretory product, pulmonary surfactant
What are the two divisions of the lung circulation?
Pulmonary and bronchial (which supply the O2 and stuff)
What forms the blood gas barrier?
Type I alveolar cells, fused with the basal lamina of the capillary
What is contained within the intra-alveolar septum?
type III collagen and/or elastin