bronchi, lungs, pleura and the diaphragm

Question 1

what does the bronchial tree consist of?

Answer 1

• trachea - primary bronchi - secondary bronchi - tertiary bronchi - bronchioli

Question 2

describe the trachea ?

Answer 2

• C shaped incomplete cartilage rings - the lowest tracheal ring is the carina

Question 3

where does the trachea start and end?

Answer 3

starts at C6 - ends at T4 this is where is biFOURCATES

Question 4

where is the primary bronchi?

Answer 4

T4/5

Question 5

compare the right and left bronchi?

Answer 5

the right is wider and vertical than the left also a bit shorter

Question 6

label a diagram of the trachea moving into the bronchi?

Answer 6

Question 7

where are the secondary bronchi and what do they supply?

Answer 7

they are formed within the lungs

• they supply the lobes

Question 8

how many lobes does the right and left lung have?

Answer 8

right = 3

left = 2

Question 9

what do the tertiary bronchi supply?

Answer 9

they supply the bronchopulmonary segments

• self contained independent units of lung tissue

Question 10

what are bronchopulmonary segments?

Answer 10

they are the smallest functionally independent regions of the lung

Question 11

how many bronchopulmonary segments do the right and left lung have?

Answer 11

right = 10

left = 8 or 9

Question 12

how do the compositions of substances change down the airway?

Answer 12

Question 13

Answer 13

Question 14

what is the pleura?

Answer 14

• a thin layer of flattened cells supported by connective tissue that lines each pleural cavity and covers the exterior the lungs

Question 15

what are the two types of pleura?

what do they do?

Answer 15

• the parietal pleura:

lines the inner surface of the chest walls

• the visceral pleura:

covers the surface of the lungs

it is shiny

Question 16

how do the pleura connect?

Answer 16

they are continuous with one another at the lung root = the hilum

Question 17

what is the pleural cavity?

Answer 17

• this is potential space between the visceral and parietal pleura
• this contains a thin layer of serous fluid
• this allows the lungs to glide

Question 18

what does the costodiaphragmatic recess of the pleura mean?

Answer 18

• this means the lung tissue is not normally present except on max inspiration
• this is where the fluid first accumulates

Question 19

what is the purpose of a chest drain?

what are the borders of a safe triangle?

Answer 19

• to collect fluid, air, blood from the pleural space
• the borders of the safe triangle are

—Posterior: latissimus dorsi

—Anterior: pectoralis major

—Superior: apex of axilla

—Inferior: 5th ICS at MAL

the needle will insert superior to the superior border of the rib to avoid the neuromuscular bundle

Question 20

label the lobes and the fissures on the lungs?

Answer 20

Question 21

what are some important surface land marks?

sternoclavicular joint

sternal angle

sternal border

oblique fissure

horizontal fissure

Answer 21

• 2-3cm above medial 3rd of the clavicle = sternoclavicular joint
• 2nd costal cartilage at the sternal angle
• 6th costal cartilage at sternal border

oblique fissure : from T3 posteriorly to 6th CC

horizontal fissure : from 4th CC on the right to meet oblique fissure at MAL

Question 22

what are the two circulations of the lungs?

Answer 22

• pulmonary

supplies the lung with deoxygenated blood needed to oxygenate it

• bronchial (systemic)

provides the lungs with oxygenated blood to meet its metabolic needs

Question 23

how are the lungs innervated?

by sympathetic and parasympathetic nerves?

Answer 23

PSNS: vagus nerve, increases secretions, contraction of the smooth muscle of the airways so that the airways are smaller and less air can come through

SNS: from the sympathetic trunks, relaxes the smooth muscle so more air flows through

Question 24

how does the lymphatic drainage of the lungs work?

Answer 24

• lymphatics of the lungs and the visceral pleura drain to the

bronchopulmonary lymph nodes –> tracheobronchial nodes

–>bronchomediastinal trunk

Question 25

what are the surfaces of the lungs?

Answer 25

- costal surface convex - mediastinal surface - diaphragmatic surface concave

Question 26

what does the margin of the diaphragm attach to?

Answer 26

- costal margin - xiphroid process - ribs 11/12 - lumbar vertebrae

Question 27

how far does the dome of the diaphragm extend?

Answer 27

- much higher than the costal margin - abdominal organs

Question 28

at what level is the IVC oesophagus aorta

Answer 28

IVC: T8 Esophagus: T10 Aorta: T12

Question 29

out of the IVC, oesophagus, aorta which pierces the diaphragm?

Answer 29

only the oesophagus and aorta are thick enough the pierce the diaphragm the IVC does not pierce the diaphragm

Question 30

what happens to the diaphragm, chest wall, intercostal muscles and lungs during inspiration?

Answer 30

intercostal muscles contract the diaphragm contracts the ribs move up and out the chest wall expands the pressure decreases

Question 31

what happens to diaphragm, chest wall, intercostal muscles and lungs during inspiration?

Answer 31

- the internal intercostal muscles contract - the external intercostal muscles relax - the ribs move in and downwards - the diaphragm relaxes - the chest cavity gets smaller - pressure increases

Question 32

what is the mechanism of breathing?

Answer 32

- pleural cavity expands during inhalation - elastic lungs also expand during inhalation —Reduced pressure inside lungs vs environment —Air flows in

Question 33

how do the ribs move during breathing?

Answer 33

—Ribs move in 2 directions with 2 ‘mechanisms’ - —Bucket handle: increases transverse diameter (lateral expansion) —Pump handle: increases antero-posterior diameter overall this increases the volume of the chest

Question 34

what does the contraction of the diaphragm result in?

Answer 34

—Diaphragm contraction increases volume of thoracic cavity —--\> Pressure on abdominal viscera further contraction causes the costal margin the raise - the increased thoracic capacity causes reduced intrapleural pressure

Question 35

what innervates the diaphragm? what supplies the diaphragm?

Answer 35

Innervated by phrenic nerve supplied by inferior phrenic arteries

Question 36

what does quiet expiration rely on?

Answer 36

- it is passive - it relies on the elastic recoil of the lungs elastic tissue and ribcage

Question 37

what does forced expiration rely on?

Answer 37

- abdominal wall muscles contract - this results in an increase in intra-abdominal pressure which forces diaphragm upwards - this also pulls the ribs down