Anatomy Of The Lower Respiratory System

Question 1

Where does the trachea commence?

Answer 1

Lower border of the larynx at cricoid cartilage C6

Question 2

What is the trachea anterior to?

Answer 2

The oesophagus

Question 3

Where does the trachea lie?

Answer 3

Within a visceral compartment of the neck, surrounded by a pre-tracheal layer of fascia
Extends medically in front of carotid sheath

Question 4

Where does the trachea bifurcate?

Answer 4

At T5-carina

Right and left bronchi

Question 5

What plane does the trachea lie in?

Answer 5

Oblique plane and is tilted anterosuperiorly

Question 6

When the trachea enters the superior thoracic aperture, what does it connect?

Answer 6

The root of the neck with the thorax

Question 7

Where do the superior aspects of the pleural cavities, which surround the lungs, lie?

Answer 7

On either side of the entrance to the mediastinum

Question 8

In comparison to structures entering the thorax from the upper limb, how do the structures entering from the head and neck enter?

Answer 8

More vertically

Question 9

Where does the superior mediastinum end?

Answer 9

T4/T5

Question 10

Where is the sternal angle?

Answer 10

T4/T5

Question 11

Where does the trachea divide into left and right bronchi?

Answer 11

Level of sternal angle

T4/T5

Question 12

What is the treacherous kept patent by?

Answer 12

The fibroelastic tube is kept patent by U shaped bars (rings) of hyaline cartilage

Question 13

What are the posterior free ends of the trachea connected by?

Answer 13

Smooth muscle : trachealis

Question 14

What are the 2 cartilages in the larynx?

Answer 14

Thyroid and cricoid

Question 15

What are the 4 layers of the trachea?

Answer 15

Mucosa (goblet cells - mucin)
Submucosa
Fibrocartilage
Adventita

Question 16

What is the mucosa of the trachea made of?

Answer 16

Goblet cells (mucin)

Question 17

What is the role of the adventitia in the trachea?

Answer 17

Binds trachea to adjacent structures in the neck and mediastinum

Question 18

What protects the alveoli from desiccation?

Answer 18

Secretions of mucous and serous glands moisten the air, protecting the alveoli from desiccation

Question 19

What are the characteristics of the right main bronchus?

Answer 19

Wider and shorter (2.5cm length)

Question 20

What are the characteristics of the left main bronchus?

Answer 20

Harrowers, longer and more horizontal (5cm length)

Question 21

Where is the inhalation of foreign bodies more likely to enter?

Answer 21

Right bronchus, passing into middle or lower lobe bronchi

Question 22

What does bronchoscopy enable examination of?

Answer 22

Trachea to carina
Permits view of lobar and segmental bronchi
Can be used for biopsy of mucous membrane and removal of foreign bodies

Question 23

Where does bifurcation of the trachea occur?

Answer 23

Behind the arch of the aorta into left and right principle bronchi

Question 24

What do respiratory bronchioles divide into?

Answer 24

2-11 alveolar ducts that enter alveolar sacs

Question 25

How does the bronchial tree divide?

Answer 25

``` Left/right man bronchus Lobar bronchus Segmental bronchus Terminal bronchus Bronchioles Terminal bronchiole Respiratory bronchiole Alveolar Alveolar duct Alveolar sacs ```

Question 26

What is the pulmonary ligament?

Answer 26

Fold of pleura that projects inferiorly from root of lung

Question 27

What is the role of the pulmonary ligament?

Answer 27

Stabilises the inferior long | Permits movement during respiration

Question 28

Where do the vagus nerve pass at hilum of the lung?

Answer 28

Pass immediately posterior to lung root and phrenic nerves immediately anterior

Question 29

What artery branches off the arch of the aorta on the hilum of the left lung?

Answer 29

Left subclavian artery

Question 30

What is in the hila of the lungs?

Answer 30

Right/left main bronchus - posterior Bronchial arteries Pulmonary arteries - superior Pulmonary veins - inferior

Question 31

How many lobes does the right lung have?

Answer 31

3 lobes Superior Middle Inferior

Question 32

How many lobes does the left lung have?

Answer 32

2 lobes | Superior and inferior

Question 33

What is the fissure on the left lung?

Answer 33

Oblique fissure between superior and inferior lobe

Question 34

What is the fissure on the right lung between the superior and middle lobe?

Answer 34

Horizontal fissure

Question 35

What is the fissure on the right lobe between the middle and inferior lobe?

Answer 35

Oblique fissure

Question 36

What is the notch on the left lung called?

Answer 36

Cardiac notch | Lingula is below

Question 37

What does the inferior border of the lung do?

Answer 37

Separates base from costal and mediastinal surfaces

Question 38

What does the anterior and posterior border of the lungs do?

Answer 38

Separates the costal and mediastinal surfaces anteriorly and posteriorly

Question 39

What is a bronchopulmonary segment?

Answer 39

An area of lung supplied by a segmental bronchus and accompanying pulmonary artery branch Smallest, functionally independent until of a lung and smallest area that can be isolated and removed without affecting adjacent regions

Question 40

What are bronchopulmonary segments shaped like?

Answer 40

An irregular cone with an apex facing the lung root and base at the pleural surface

Question 41

What is a principal function of the thoracic wall and the diaphragm?

Answer 41

To alter the volume of the thoracic cavity | Dimensions may change in vertical, transverse, and anteroposterior directions

Question 42

What significantly alters the vertical dimensions of the thorax?

Answer 42

Elevation and depression of the diaphragm

Question 43

What alters the anteroposterior dimensions of the thorax?

Answer 43

Elevation and depression of the ribs

Question 44

What is the innervation of the diaphragm?

Answer 44

``` Phrenic nerve (C3-C5) Peripheral T5-T12 (intercostal) ```

Question 45

Where do the IVC, Oesophagus and Aorta pass through the diaphragm?

Answer 45

IVC - T8 Oesophagus - T10 Aorta - T12

Question 46

Where is the sternocostal attachment of the diaphragm?

Answer 46

Posterior xiphoid process | Deep surface of lower 6 ribs

Question 47

Where is the vertebral attatchment of the diaphragm?

Answer 47

Crura and arcuate ligaments

Question 48

Where does the right crus attach?

Answer 48

L1-L3

Question 49

Where does the left crus attach?

Answer 49

L1-L2

Question 50

What kind of membrane is the pleura?

Answer 50

Serous membrane

Question 51

What is the pleura?

Answer 51

Smooth membrane which secretes serous fluid 2 membranes of epithelial cells Line and enclose body cavities One continuous layer in each cavity

Question 52

How many membranes of epithelial cells is the pleura?

Answer 52

2 membranes of epithelial cells

Question 53

What layers of pleura lines body walls?

Answer 53

Parietal

Question 54

What layers of pleura lines organs or viscera?

Answer 54

Visceral

Question 55

What do reflections of serous membranes in the pleura form?

Answer 55

Potential spaces

Question 56

What are the divisions of the parietal pleura?

Answer 56

1. Cervical 2. Costal 3. Diaphragmatic 4. Mediastinal 5. Pulmonary ligament - allows increased mobility during respiration

Question 57

Where does he visceral pleura extend?

Answer 57

Extends into the interlobar fissures Parietal and visceral pleura are continuous around the hilum of the lung Between parietal and visceral layers is the pleural cavity

Question 58

What kind of nerve supply does parietal pleura have?

Answer 58

Somatic nerve supply

Question 59

What are the costal and peripheral pleura innervated by?

Answer 59

Intercostal nerves

Question 60

What are mediastinal and central diaphragmatic pleura innervated by?

Answer 60

Phrenic nerve C3,C4,C5

Question 61

What is the parietal pleura sensitive to?

Answer 61

Touch, temperature and pressure (PAIN)

Question 62

What is the innervation of the visceral pleura?

Answer 62

AUTONOMIC nervous system Pulmonary plexus From the sympathetic trunk and VAGUS nerve Response to distension Not sensitive to touch, temperature or pressure

Question 63

What is the difference in pressure in intrapleural and atmospheric pressure?

Answer 63

Normally intrapleural pressure is < atmospheric pressure : negative pressure Due to recoil of chest wall and lungs away from each other Keeps the lungs inflated

Question 64

What happens if intrapleural pressure becomes equal to or exceeds atmospheric pressure?

Answer 64

Lungs will collapse - pleural effusion - pneumothorax

Question 65

What is pleural effusion?

Answer 65

Excess fluid in the pleural cavity | Limits breathing as it hinders expansion of the lung

Question 66

What are the main causes of pleural effusion?

Answer 66

Injection or inflammation of pleura or left ventricular heart failure