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Respiratory System > Anatomy of Lungs/COPD Case Study Stuff/Self Studies Combined > Flashcards

Anatomy of Lungs/COPD Case Study Stuff/Self Studies Combined Flashcards

1
Q

What are the borders of the pleural cavity?

A

Superiorly: extends above the 1st rib
Inferiorly: extend just above level of the costal margin
Medially: the wall is the mediastinum

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2
Q

What difference is there in nerve fiber type is found in parietal and visceral pluera?

A

GSA in parietal

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3
Q

What is the cupola?

A

the dome of pleura lining the cervical extension of the pleural cavity

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4
Q

What is the root of the lung?

A

root of the lung refers to the tubular sleeve of mediatinal pleura that surrounds structures passing between the lungs and the mediastinum

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5
Q

Where are parietal and visceral pleura continuous?

A

hilum

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6
Q

What are the recesses of the lung we need to know? What do they do? What can happen to them during disease?

A

Costodiaphragmatic recess and costomediastinal recess

  • room for lungs to expand during forced inspiration
  • accumulate w/ fluid
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7
Q

How is the costomediastinal recess made? What is important to know about it

A

due to the fact the lung is smaller on the left side. ONly on the left side

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8
Q

When the anterior chest wall is removed, what is the first thing you see?

A

parietal pleura

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9
Q

Where does the phrenic nerve pass in relation to the lung?

A

anterior to the root of the lung

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10
Q

What are the structures in the hilum from top to bottom for the left and right lung?

A

Right: Bronchus, pulmonary artery, pulmonary veins
Left: Pulmonary artery, bronchus, pulmonary veins

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11
Q

What is an important physiological difference between the right and left main stem bronchi?

A

Right stem bronchus is a wider and straighter thus you are more likely to aspirate into this lung.

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12
Q

How many lobes are in each lung? Secondary bronchi?

A

Right: 3 lobes, 3 secondary bronchi
Left: 2 lobes, 2 secondary bronchi

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13
Q

What unique structure is found in the left lung but not the right lung?

A

lingula

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14
Q

What is a BP segment? Why are they important?

A

area of lung supplied by a semental bronchus and its accompanying pulmonary artery branch. It is the smallest functionally independent region of lung and the smallest area of lung that can be isolated and removed without affecting adjacent segments

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15
Q

How many BP segments are in each lung?

A

left: 8
right: 10

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16
Q

What BP segments are in the different lobes of the right lung?

A

Superior Lobe: Apical, posterior, anterior
Middle: Lateral, Medial
Inferior Lobe: Superior, Medial basal, anterior basal, lateral basal

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17
Q

What BP segments are in the different lobes of the left lung?

A

Superior Lobe: Apicoposterior, anterior, superior, inferior

Inferior Lobe: Superior, antero-medial basal, lateral basal, posterior basal

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18
Q

What pneumonic can you use to know the BP segments of the lung (which one is which)

A

APALMPALMS (right lung)

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19
Q

What do the bronchial arteries supply blood for? Origin?WHat provides for the left and right lung?

A
  • provide nutritive support for pulmonary tissues
  • thoracic aorta
  • Left: superior left bronchial artery
  • Right: right bronchial artery
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20
Q

Visceral pluera innervation? (include nerve fibers, through what system, and origin)

A
  • GVA, GVE
  • pulmonary plexus
  • vagus and sympathetic chain
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21
Q

What is an increased carina density indicative of?

A

lung disease due to tracheobronchial lymph node enlargement

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22
Q

The lung has a structure lymphatics drain into what? Right and left drain into what?

A
  • Lung: tracheobronchial nodes
  • Right lung: right bronchomediastinal nodes/trunks
  • left lung: left bronchomediatinal nodes/trunks, with the exception that the lower portion of the left lung drains into right bronchomediastinal nodes/trunk
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23
Q

What is true about the position of the right and left lung to the midline?

A

At the region of the lower sternum, the right lung is closer to the midline than the left lung because of the displacement of the left lung by the heart

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24
Q

Where is the recesses of the plueral cavities most evident?

A

anteriorly and inferiorly

25
Q

What costal areas does the left lung ascultation occur at?

A

Apex of left lung: Rib 1
Superior lobe of left lung: below rib 3
Inferior lobe of left lung: Between 8-9

26
Q

What is dyspnea?

A

SOB

27
Q

How will air trapping be heard on a stethoscope? What disease will you hear this in?

A

Hyperresonance due to be much area.

Empheysma

28
Q

What are some classic signs of right vs left heart failure?

A

Right: JVD, hepojugular reflex, hepatomegaly, leg edema
Left: crackles (rales)

29
Q

What is the definition of chronic bronchitis?

A

3 months in a row for 2 years of sputum production in the morning

30
Q

What cell types are involved in inflammation of small airways and lung parenchyma? Inflammatory mediators?

A
  • Cell types: neutrophils, macrophases, lymphocytes

- Inflammatory mediators: oxidative metabolites, growth factors, cytokines, chemokines, proteinases

31
Q

What leads to destruction of alveolar structure and function in COPD?

A
  • increased lung proteinase production/activity

- alveolar septal cell apoptosis by immune cells

32
Q

What are some consequences of chronic inflammation associated with COPD? (3)

A

lesions within the lung, loss of lung elastic recoil, fibrosis and narrowing of the small airways

33
Q

What immune cell type is found in greater amount in lung disease? 2nd most? 3rd?

A

first: macrophages
second: neutrophils
third: lymphoctyes (B, T cells)

34
Q

What do macrophage secrete that leads to tissue damage?

A

TNF alpha, interleukin 8, and monocyte chemotactic peptide (MCP-1)

35
Q

Where are neutrophils found in the diseased lung?

A

airway lumen and airway glands and lung tissue (only in tissue when disease is serious)

36
Q

What do t-cells recognize and react with?

A

major histocompatibility complex (MHC) molecules

37
Q

What do B cells recognize and react with?

A

immunoglobulins

38
Q

What do epithelial cells do in an immune response?

A

initiate cell infiltration and inflammation by production and release of chemokines and cytokines

39
Q

What are eosinophils and mast cells role in COPD?

A

None really unless disease is exacerbated

40
Q

What does TNF alpha do?

A

activates macrophages in lung and increases damage to epithelial layer

41
Q

What compounds are chemokines in the immune response to COPD? Function?

A

IL 8, CXCL1, and MCP1

recruit monocytes and neutrophils from blood to lung.

42
Q

What two things discussed in the self study influence increased airway and systemic inflammation?

A

smoking and chronic bacterial infection

43
Q

What is elevated in a bacterial infection? (5)

A

increased neutrophils, CXCL8, TNF alpha, proteases (such as MMP-9), neutrophil elastase

44
Q

What enzymes are secrted by alveolar macrophage? What regulates this?

A
  • metalloproteases 2,9,12
  • cathespsins K, L, and S
  • Regulation: NF-kB
45
Q

What is the effect of oxidation of alpha 1 protease?

A

Increase secretion of elastase

46
Q

What do elastase do in the body? (2 functions)

A
  • play a role in host defense

- break down elastin (conflicting functions because we need elastin in our structural components of lungs)

47
Q

What do neurtrophil elastase do? (3)

A

stimulate fibroblast contraction which narrow small airways, activation of epidermal growth factor, goblet cell metaplasia

48
Q

What T cell type carried out destruction of lung? What are its functions?

A

cytotoxic T cells (CTLs)
-when t receptor cell stimulates, CTLs released. Secret cytokines (for t cell profliferation and macrophage activation). Secrete t helper cells

49
Q

What do b cells do?

A

B cells differentiation to plasma cells and then antibodies.

50
Q

What are anti nuclear autoantibodies? Are they more/less/equally seen in COPD patient vs. healthy?

A

Antibodies to self most likely to DNA in nucleus.

-more prevalent

51
Q

What does the production of t helper cells contribute to? (3 things)

A
  1. development of b-cell lymphoid follicles
  2. immunoglobulin production
  3. production of elevated igG antibody levels in serum of COPD patients
52
Q

Where are the intercostal nerve/vein/artery found?

A

costal groove of the ribs

53
Q

Which ribs are true ribs? False? Floating?

A

True: 1-7
False: 8,9,10
Floating: 11,12

54
Q

Typical vs atypical? Which ones and why?

A 
Typical: 3-9
Atypical: 1: atypical shape, single facet on head
2: tuberosity of body
10-12: single facet
11-12: short, no neck, no tubercle
55
Q

What forms costal margin

A

7-10 ribs

56
Q

Where are the phrenic and vagus nerves w/ respect to the root of the lung? Azygos vein?

A

Phrenic: anteriorly
Vagus: superiorly and posteriorly
Azygos vein: superiorly and posteriorly

57
Q

Where is there continuity of the serous layers of the pleura?

A

at root of the lung

58
Q

What provides blood supply and innervation for parietal pleura?

A

Blood supply: arteries of the thoracic wall

Innervation: phrenic nerves and intercostal nerves

59
Q

What is a distinction between visceral and parietal pleura in nerve fiber types?**

A

partietal pleura receive GSA while visceral don’t

Respiratory System (5 decks)

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