Anatomy of the Respiratory system

Question 1

What is in the upper respiratory tract?

Answer 1

The nostrils to the lower border of the cricoid cartilage of the larynx - contains the nose, paranasal sinuses, pharynx and larynx

Question 2

What are the functions of the nasal cavity?

Answer 2

• induce turbulent flow
• warm and moisten inspired air
• recover water from expired air
• speech production
• olfaction

Question 3

What names are given to the paranasal sinuses?

Answer 3

• ethmoidal
• frontal
• maxillary
• spheroidal

Question 4

What are the paranasal sinuses lined with?

Answer 4

respiratory epithelium - pseudo stratified ciliated columnar epithelium

Question 5

How is a large surface area in the nasal cavity created and why is it important?

Answer 5

The turbinates (conchae) increase the surface area and as it is lined by vascular muscle, allows the inhaled air to be warmed and humidified

Question 6

Why does the inhaled air need to be warmed and humidified?

Answer 6

increases the amount of water vapour entering the lungs to help keep the air entering from drying out the lungs etc

Question 7

How is humidification achieved?

Answer 7

mucous secretion and transduation of fluid through the epithelium

Question 8

How do the conchae help achieve moistened air and humidifciation

Answer 8

They slow down the airflow increasing time available for warming and humidification

Question 9

What else is the nostril lined with?

Answer 9

coarse hair to trap large particle in inhaled air

Question 10

What cells is mucus secreted from?

Answer 10

goblet cells

Question 11

What do the cilia do to foreign particles?

Answer 11

waft the mucus (containing the forge in particles) to the oropharynx where it s either swallowed or coughed out

Question 12

What is aspiration?

Answer 12

When something enters your airway or lungs

Question 13

How does aspiration occur.?

Answer 13

If the larynx and vocal cords are dysfunctional, the trachea may not be properly closed off during swallowing

Question 14

What is the sternal angle?

Answer 14

the junction of the manubirum and body of sternum - the sternal angle identifies the 2nd rib

Question 15

What is the costal groove and where is it found?

Answer 15

it is where the intercostal vessels and nerves runs - it is near the lower border of the rib

Question 16

Where would you insert a chest drain or do cannulas in the thoracic cavity?

Answer 16

Directly above the rib to ensure you don’t hit any of the neurovasculature

Question 17

What are the costocertebral joints?

Answer 17

synovial joints which connect the rib with the thoracic vertebra

Question 18

What do the intercostal arteries, veins and nerves supply?

Answer 18

intercostal muscles, parietal pleura and overlying skin

Question 19

What are the intercostal muscles?

Answer 19

each intercostal space contains 3 muscles - external, internal and innermost (similar to internal ones but less developed)

Question 20

What are the external intercostal muscles?

Answer 20

the fibres run down and anteriorly (hand in pocket)

-responsible for 30% of chest expansion in quiet respiration

Question 21

What type of movement for the external intercostal muscles do?

Answer 21

muscle contraction causes elevation of the ribs and increases the lateral and inter-posterior diameters of the chest (BUCKET HANDLE)

Question 22

What are the internal intercostal muscles?

Answer 22

The fibres run downward and posteriorly from the rib above to the rib below (PUMP HANDLE MOVEMENT)

Question 23

What type of movement does the internal intercostal muscle do?

Answer 23

the contraction of these muscles pulls the ribs down from position of chest expansion

Question 24

When do internal intercostal muscles become active?

Answer 24

During forced expiratrion - quiet inspiration is passive so requires nothign

Question 25

What is another function of the paranasal sinuses?

Answer 25

minimises the weight of the head

Question 26

What is important about the diaphragm?

Answer 26

It is the main muscle of inspiration and responsible for more than 70% of chest expansion in quiet respiration

Question 27

Where does the diaphragm lie (what are the landmarks)?

Answer 27

Right dome - 5th rib (landmark for liver) | Left done - 5th intercostal space

Question 28

What is the diaphragm innervated by?

Answer 28

the phrenic nerve (C3,4,5)

Question 29

What is the movement of the diaphragm in inspiration?

Answer 29

The diaphragm contracts and flattens (moves downwards) to increase the vertical diameter of the thoracic cavity

Question 30

How many lobes are in each lung?

Answer 30

3 in the right 2 in the left

Question 31

What are the components of the lower respiratory tract?

Answer 31

lower trachea, bronchi, lobar bronchi, segmental bronchi, bronchioles, terming bronchioles

Question 32

What is special about the upper 7 ribs?

Answer 32

articulate anteriorly through their costal cartilages with the sternum

Question 33

What is special about the 8th 9th and 10th ribas?

Answer 33

they articulate with the costal cartilage of the 7th rib

Question 34

What is special about the 11th and 12th rib?

Answer 34

They are "floating ribs"

Question 35

What is the mediastinum?

Answer 35

situated in the midline and lies between the 2 lungs

Question 36

What does the mediastinum contain?

Answer 36

heart and great vessels, trachea and oesophagus, phrenic and vagus nerves, lymbph nodes

Question 37

What should the pressure be in the alveoli for air to enter?

Answer 37

The pressure in the alveoli must be less than atm pressure for air to enter

Question 38

What happens in the phrenic nerve is damaged? How does it present on a chest x-ray?

Answer 38

causes paralyse of the affected side of the diaphragm - presents as an elevated semi-diaphragm

Question 39

Where are the openings in the diaphragm and what are they for?

Answer 39

Inferior VENA CAVA - T8 OESOPHAGUS - T10 AORTIC HIATUS - T12 (count the letters)

Question 40

What is the clinical relevance anatomically of a lower chest injury?

Answer 40

could damage abdominal organs like spleen, liver, stomach and upper kidneys

Question 41

What are the 2 types of pleura and what are their differences?

Answer 41

visceral and parietal - visceral lines the surface of the lungs and parietal lines the thoracic wall and diaphragm

Question 42

What innervation does the pleura have?

Answer 42

visceral - somatic innervation | parietal - autonomic innervation

Question 43

What fissures are in the lungs?

Answer 43

oblique and horizontal fissures (right lung has both, left just has oblique) - the visceral pleura extends between lobes of the lung into the depts of the fissures

Question 44

What is the potential space between the pleura known as?

Answer 44

pleural cavity - thin film of fluid contained here to allow pleurae to slip over each other reducing friction during breathing

Question 45

What is the costodiaphragmatic recess?

Answer 45

a small space created by the folding of the pleura that is not filled with lung tissue

Question 46

What does the pleural seal refer to?

Answer 46

the surface tension forces between the molecules of pleural fluid creates a seal ensuring that when the thorax expands in respiration, the lungs move with it

Question 47

Where does the trachea commence?

Answer 47

lower border of cricoid cartilage of the larynx and terminates at the sternal angle

Question 48

What occurs are the sternal angle?

Answer 48

bifurcation of the trachea into the right and left bronchi

Question 49

What is the carina?

Answer 49

the angle between the right and left main bronchi

Question 50

Why are small foreign objects and food more likely to lodge in the right lung?

Answer 50

the right main bronchus is wider, shorter and more vertical than the left

Question 51

What is a bronchopulmonary segment (don't need to know much)?

Answer 51

an area of lunch supplied by a segmental bronchus - surgically important as can be isolated and removed without much bleeding, air leakage or damage to the rest of lung

Question 52

Where is the apex of the lung found?

Answer 52

extends above the level of the 1rs rib into the root of the neck

Question 53

Why would you get neurological and vascular problems in the upper limb with an apex tumour?

Answer 53

the apex is closely related to the subclavian vessels and the brachial plexus

Question 54

What blood supply do the lungs have?

Answer 54

dual blood supply - from bronchial arteries and the pulmonary arteries

Question 55

What does the bronchial arteries carry and supply?

Answer 55

Supply the bronchial tree (but NOT alveoli) and the visceral pleura with oxygenated blood

Question 56

Where does the blood return to?

Answer 56

via the pulmonary veins rather than the bronchial veins - the small amount of blood returning from the bronchial veins drain via azygous vein into the SVC

Question 57

What does the pulmonary artery carry?

Answer 57

the entire output of the right ventricle to the lungs for gas exchange

Question 58

What are anastomoses between the bronchial and pulmonary arteries function?

Answer 58

maintain some blood supply to the lung parenchyma in patients with pulmonary embolism

Question 59

What do pulmonary veins do?

Answer 59

return oxygenated blood to the left hear - 2 leave each hilum (drains upper and lower lobes)

Question 60

What is the lymphatics drainage of the lungs?

Answer 60

-hilar nodes (bronchopulmonary nodes)

Question 61

What is the nerve supply to the lungs?

Answer 61

right and left vagus nerves and the sympathetic trunk

Question 62

What does the parasympathetic efferent fibres from the vagus nerve do?

Answer 62

they are motor to the bronchial smooth muscle and secretomotor to the mucous gland

Question 63

What do the vagal afferent fibres of the lungs do?

Answer 63

the cough reflex

Question 64

What does the sympathetic efferent fibres do?

Answer 64

bronchodilator and vasoconstrictor

Question 65

What nerve curves under the arch of the aorta?

Answer 65

the recurrent laryngeal nerve to return to the larynx

Question 66

What happens if the recurrent laryngeal nerve is damaged?

Answer 66

causes paralyse of the intrinsic laryngeal muscles causing vocal cord paralysis and hoarseness of voices

Question 67

How are bronchioles kept open?

Answer 67

radial traction - elastin in the walls of alveoli exert traction on the walls of the bronchioles which keeps them open