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Flashcards in Anatomy and Histology Deck (69):
1

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

2

What are the three vertical axes with respect to the lungs? Where is the edge of the lung at each of these points?

Midclavicular 6
Midaxillary 8
Paravertebral 10

3

Where are the edges of the parietal pleura with respect to the three vertical axes of the thorax?

Midclavicular 8
Midaxillary 10
Paravertebral 12

4

Where is the middle lobe of the lung located?

4th intercostal space, midclavicular line

5

Where is the appropriate site for a thoracocentesis?

Between the 7th, 8th, or 9th intercostal space posteriorly

6

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

7

What is a pleural effusion?

Fluid accumulation between the visceral and parietal pleura of the lung

8

What is the pulmonary sulcus? What is its significance?

Posterior curvature of the thoracic wall

Location of a pancoast tumor

9

When a pancoast tumor grows superiorly, what may it eventually involve?

may impact the brachial plexus

10

What muscles weakness may be the first sign of a pancoast tumor?

Intrinsic muscles of the hand

11

What is the syndrome that may develop with a pancoast tumor?

Horner's syndrome (ptosis, miosis, anhidrosis)

12

What vessels may be obstructed with a pancoast tumor?

Subclavian

13

Which lung is larger?

Right

14

What are the two fissures of the right lung?

Oblique
horizontal

15

What is the single fissure of the left lung?

Oblique

16

What is the depression on the medial surface of the left lung?

Cardiac notch

17

How many bronchopulmonary segments are there in the right lung? Left?

Right = 10
Left = 8

18

True or false: bronchopulmonary segments are interdependent in their blood/venous/air supply, thus you cannot resect a single segment

False-- fully independent

19

What sits superiorly in the hilum of the right lung? Inferiorly? Anteriorly between the two?

Bronchi on top
Pulmonary artery anterior between
Vein inferiorly

20

What sits superiorly in the hilum of the left lung? Inferiorly? Posteriorly between the two?

Superiorly = pulmonary artery
Posteriorly = bronchus
Inferiorly = pulmonary vein

21

What is the RALS mnemonic for remembering where the pulmonary artery sits relative to the bronchus?

Right anterior
left superior

22

What spinal level does the trachea begin? Where does it bifurcate?

C6
T4/5

23

How long is the trachea?

10-11 cm

24

Which pulmonary bronchus is more vertically directed?

Right

25

How many lobar bronchi are there is each lung?

Same as the number of lobes for each

26

What is the branching order of the bronchi in each lung?

Lobar
Segmental
Lobular
Terminal

27

How many segmental bronchi are there in each lung?

10 in the right, 8 in the left

28

Where do the respiratory airways begin?

At the level of the Respiratory bronchioles

29

What are the four division of the respiratory bronchioles?

Respiratory bronchioles
Alveolar ducts
Alveolar sacs
Alveoli

30

What is the epithelium that lines the vocal cords?

Stratified squamous

31

What are the divisions of the mucosa of the larynx?

Epithelium
Basal lamina
lamina propria

32

What is the epithelial type of most of the larynx?

ciliated pseudostratified columnar cells

33

The vocalis muscle is an element of what larger muscle?

Thyroarytenoid muscle

34

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)

35

What is Reinke's edema?

Fluid between the vocal ligament and its overlying mucosa, causing edema of the vocal cords

36

What is the general rule of cellular diversity as you progress down the airway?

Less diverse the lower you go

37

What are the two types of cells that are present in the alveoli?

Type I and II pneumocytes

38

What are the 6 cell types in the bronchial airways?

-Ciliated columnar cells
-Goblet cells
-Basal cells
-Seromucous gland cells
-Neuroendocrine cells
-Brush cells

39

Where is the stopping point of goblet cells?

Level of the lobar bronchioles

40

What is the effect of smoking on goblet cells?

Proliferate downward

41

What are the cells in the bronchi that are the stem cells?

basal cells

42

What is the role of the neuroendocrine cells in the bronchi?

Development, but may become cancerous

43

What is the role of the brush cells in the bronchi?

Cells with a well developed brush border--
Sensory cells

44

What are the 6 layers of the trachea?

-Respiratory epithelium
-Basal lamina
-Submucosa
-Perichondrium
-Hyaline cartilage

45

What is the secretory product of goblet cells?

Mucin

46

What happens to the basement membrane of the trachea with chronic insult?

thickens

47

Where is the smooth muscles found in the trachea? (histologically)

Interface between the lamina propria and submucosa of the intrapulmonary bronchi

48

What happens to the smooth muscle layer of the trachea/bronchi as you progress down the airway?

Increases in thickness

49

What is the role of the glands in the submucosa of the trachea? (5)

Contains seromucous glands that are responsible for secreting:
-mucins
-lactoferrin
-lysozyme
-IgA
-alpha-1-antitrypsin

50

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

51

75% of lung cancers originate from what order bronchi?

1 2 3

52

what are the histological changes that occur with asthma? (5)

-increased mucus
-increased thickness of the BL
-Increased thickness of the lamina propria
-Increased thickness of the muscularis
-Increased glands in the submucosa

53

What causes the increased thickness of the lamina propria in the bronchial wall with asthma?

Emigration of inflammatory cells

54

What is the Reid index used for? What is it?

Determines whether someone has bronchitis

length of BM to mucus glands / glands to cartilage

55

What is the normal Reid index value? What indicates chronic bronchitis?

Normal less than 0.4
Chronic bronchitis greater than 0.5

56

What is bronchiectasis?

dilated bronchi due to tissues damage

57

What is the thickness of bronchioles?

Less than 1 mm

58

True or false: bronchioles lack cartilage

True

59

True or false: bronchioles lack a submucosa

True

60

True or false: all bronchioles lack goblet cells

False--large ones have them

61

What are club cells, and what do they do?

cells found in the terminal and respiratory bronchioles that secrete surfactant

62

What is the role of type I alveolar cells? can these divide?

Form the wall of the alveoli, where gas exchange occurs

cannot divide

63

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

64

What are heart failure cells?

macrophages with hemosiderin d/t RBC breakdown

65

What is the signature histological feature of type II alveolar cells?

Presence of lamellar bodies, which contain its secretory product, pulmonary surfactant

66

What are the two divisions of the lung circulation?

Pulmonary and bronchial (which supply the O2 and stuff)

67

What forms the blood gas barrier?

Type I alveolar cells, fused with the basal lamina of the capillary

68

What is contained within the intra-alveolar septum?

type III collagen and/or elastin

69

Where are macrophages found in the alveoli?

Alveolar lumen and migrate of the epithelial surface