Comprehensive Pulm Anatomy Functions Flashcards
(124 cards)
1
Q
What is the difference between visceral and parietal pleura?
A
Visceral covers the lungs; parietal lines the chest wall.
2
Q
What is the costodiaphragmatic recess?
A
A potential space between the diaphragm and ribs that may collect air or fluid.
3
Q
Why is the left lung taller than the right lung?
A
The heart depresses the left hemidiaphragm, elongating the lung.
4
Q
What anchors the diaphragm posteriorly?
A
Attachments to the lumbar vertebrae.
5
Q
How many lobes does the right lung have?
A
Three lobes, divided by horizontal and oblique fissures.
6
Q
How many lobes does the left lung have?
A
Two lobes, with one oblique fissure.
7
Q
How many bronchopulmonary segments are in each lung?
A
Right lung ~10; Left lung ~8.
8
Q
What is the role of the diaphragm in breathing?
A
Contracts to expand thoracic volume during inspiration.
9
Q
What do the scalene muscles do?
A
Stabilize the upper thorax during inspiration.
10
Q
What is the function of sternocleidomastoid in respiration?
A
Prevents rib cage collapse during deep inspiration.
11
Q
What do external intercostals do?
A
Aid inspiration by expanding the chest wall.
12
Q
What do internal intercostals do?
A
Aid forced expiration by compressing the thorax.
13
Q
How do abdominal muscles assist in breathing?
A
Force air out by pushing up on the diaphragm during active expiration.
14
Q
What is the role of pec minor in respiration?
A
Stabilizes the thorax for deeper inspiration when arms are fixed (leaning on something, tripod position)
15
Q
What are the three types of nasal turbinates?
A
Superior, middle, and inferior.
16
Q
What bones do the turbinates arise from?
A
Superior/middle = ethmoid bone; inferior = maxillary bone.
17
Q
What is the function of nasal turbinates?
A
Filter, humidify, and warm inspired air by creating turbulence.
18
Q
Why are the nasal bones fragile?
A
Their porous structure accommodates extensive blood supply.
19
Q
What is the preferred route for nasal intubation?
A
Along the floor of the nose to avoid damaging turbinates.
20
Q
What are the three parts of the pharynx?
A
Nasopharynx, oropharynx, laryngopharynx.
21
Q
What is the vallecula?
A
The space between the base of the tongue and epiglottis, useful for placing a curved blade during intubation.
22
Q
What is the narrowest part of the airway in neonates?
A
Cricoid cartilage.
23
Q
What is the narrowest part of the adult airway?
A
The transglottic space (vocal cord level).
24
Q
What is the Adam’s apple anatomically?
A
The laryngeal prominence of the thyroid cartilage.
25
What structure helps close the airway during swallowing?
The epiglottis.
26
What cartilage forms the anterior laryngeal wall?
The thyroid cartilage.
27
What cartilage is shaped like a ring and sits below the thyroid?
The cricoid cartilage.
28
What joint allows the thyroid cartilage to tilt and adjust vocal tension?
Cricothyroid joint.
29
What muscle tightens the vocal cords via the cricothyroid joint?
Cricothyroid muscle.
30
What nerve innervates most of the face and anterior pharynx?
Trigeminal nerve (CN V).
31
What nerve innervates the posterior tongue and oropharynx?
Glossopharyngeal nerve (CN IX).
32
What nerve innervates the larynx, trachea, and epiglottis?
Vagus nerve (CN X).
33
What cranial nerve provides taste to the anterior 2/3 of the tongue?
Facial nerve (CN VII).
34
What are the three main salivary glands?
Sublingual, submandibular, parotid.
35
Which salivary gland is most prone to swelling with trauma?
Parotid gland.
36
What are the three main types of tonsils?
Palatine (oropharynx), pharyngeal (nasopharynx), lingual (base of tongue).
37
What determines the pitch of your voice anatomically?
The length and tension of the vocal cords.
38
What causes men to have deeper voices than women?
A larger laryngeal prominence creates longer vocal cords, which produce lower-pitched sounds.
39
What joint allows the vocal cords to be stretched?
The cricothyroid joint.
40
Which muscle tightens the vocal cords by pulling the thyroid cartilage downward?
The cricothyroid muscle.
41
What cartilages control vocal cord movement?
Arytenoid cartilages (with corniculate cartilages sitting on top).
42
Where should the tip of a curved (Mac) blade be placed during intubation?
In the vallecula to lift the epiglottis indirectly.
43
How is a straight (Miller) blade used differently from a Mac blade?
It is advanced over the epiglottis to directly lift it.
44
What is the function of manipulating the epiglottis during intubation?
To expose the glottic opening for endotracheal tube placement.
45
What is the purpose of cricoid pressure during induction?
To prevent aspiration by occluding the esophagus.
46
What is a potential risk of excessive cricoid pressure?
Damage to the esophageal sphincter, especially during abdominal contractions.
47
Why is airway obstruction common in anesthetized patients?
Loss of muscle tone causes the tongue and pharyngeal structures to collapse posteriorly.
48
What airway structure is commonly occluded by a relaxed tongue?
The laryngeal inlet.
49
What position helps restore airway patency in anesthetized patients?
Head tilt and jaw thrust (or insertion of airway adjuncts).
50
Why are nasal intubations risky?
Turbinates are fragile and highly vascular, making them prone to bleeding.
51
What bone forms the roof of the nasal cavity and is involved in smell?
Cribiform plate of the ethmoid bone.
52
What part of the ethmoid bone houses olfactory receptors?
The cribriform plate.
53
Why is the nasal cavity a good route for drug absorption?
It has rich vascular supply and direct neural access to the brain.
54
What causes 'ice cream headaches'?
Cold stimulation of the roof of the confuses the brain into interpreting facial pain.
55
Which nerve is responsible for the 'brain freeze' phenomenon?
Trigeminal nerve (CN V), via its maxillary branch (V2).
56
What is the average length of the adult trachea?
About 10–13 cm long, with 4 cm extrathoracic and 10 cm intrathoracic.
57
How many cartilaginous rings support the adult trachea?
Approximately 20 C-shaped rings.
58
Why is the posterior trachea not rigid?
It lacks cartilage, allowing esophageal expansion during swallowing and aiding cough mechanics.
59
What is the carina?
The last tracheal cartilage at the bifurcation into the left and right mainstem bronchi.
60
How many bronchopulmonary segments does the right lung typically have?
Ten segments.
61
How many bronchopulmonary segments does the left lung typically have?
Eight segments, due to fusion during development.
62
Why is the right mainstem bronchus more prone to aspiration?
It's shorter, wider, and deviates from vertical by only ~25°.
63
What is the angle of bifurcation between the main bronchi?
Approximately 70° total (25° right, 45° left).
64
Which laryngeal cartilage forms a complete ring?
The cricoid cartilage.
65
What does the thyrohyoid membrane connect?
The thyroid cartilage to the hyoid bone.
66
What is the median cricothyroid ligament used for clinically?
Emergency cricothyrotomy access.
67
What landmark helps confirm correct placement of the ETT cuff?
Inflation is palpable at the sternal notch.
68
Why must air be humidified during invasive ventilation?
Because bypassing the upper airway eliminates natural humidification and warming.
69
How does head position affect tracheal intubation?
Extension lengthens and narrows the trachea; flexion shortens and widens it.
70
What is the narrowest part of the airway in adults?
The transglottic space (between the vocal cords).
71
What is the narrowest point of the airway in children under 10?
The cricoid cartilage.
72
What happens to the vocal cords during whispering?
They are too open to vibrate; no phonation occurs.
73
How do you confirm you're whispering?
Place your hand on your throat — no vibration = whispering.
74
What does the cricothyroid muscle do?
Tightens the vocal cords (no effect on opening or closing).
75
What does the vocalis muscle do?
Also tightens the cords without opening/closing them.
76
What does the thyroarytenoid muscle do?
Adducts the cords — closes the glottis.
77
What does the transverse arytenoid muscle do?
Adducts the cords — brings arytenoids together.
78
What does the posterior cricoarytenoid muscle do?
Abducts (opens) the cords — only muscle that opens the glottis.
79
What does the lateral cricoarytenoid muscle do?
Adducts (closes) the vocal cords.
80
What nerve innervates most laryngeal muscles?
Inferior laryngeal nerve, a branch of the recurrent laryngeal nerve.
81
What happens if one recurrent laryngeal nerve is damaged?
Phonation may still occur, but voice is hoarse or raspy.
82
Why can we still talk with one damaged laryngeal nerve?
Multiple muscles close the cords; phonation is preserved.
83
Why is the posterior cricoarytenoid muscle critical for breathing?
It’s the only muscle that opens the cords — essential for airway patency.
84
Why can a person still phonate with unilateral recurrent laryngeal nerve damage?
Because multiple muscles close the cords, and compensation allows cords to approximate enough for sound.
85
What makes the posterior cricoarytenoid muscle uniquely vital?
It is the only muscle that abducts the vocal cords, opening the airway for breathing.
86
How does head position affect the trachea during intubation?
Extension lengthens and narrows the trachea; flexion shortens and widens it — impacting ETT fit and resistance.
87
Where should you palpate to feel the endotracheal tube cuff inflate?
At the sternal notch — the cuff typically sits just below the larynx, near this landmark.
88
What structure allows the epiglottis to cover the airway during swallowing?
Suprahyoid muscles elevate the larynx, which passively causes the epiglottis to fold over the glottis.
89
Why is the cribriform plate of the ethmoid bone clinically important?
It's a route for olfactory nerve fibers but also a potential path for infection into the CNS.
90
# Suprahyoid
What does the digastric muscle do?
Elevates the hyoid and depresses the mandible.
91
# Suprahyoid
What does the mylohyoid muscle do?
Elevates the hyoid and floor of the mouth during swallowing.
92
# Suprahyoid
What does the geniohyoid muscle do?
Pulls the hyoid bone anteriorly and upward.
93
# Suprahyoid
What does the stylohyoid muscle do?
Elevates and retracts the hyoid bone.
94
# Infrahyoid Muscles
What does the sternohyoid muscle do?
Depresses the hyoid after it has been elevated.
95
# Infrahyoid Muscles
What does the omohyoid muscle do?
Depresses and stabilizes the hyoid; has superior and inferior bellies.
96
# Infrahyoid Muscles
What does the sternothyroid muscle do?
Depresses the thyroid cartilage.
97
# Infrahyoid Muscles
What does the thyrohyoid muscle do?
Depresses the hyoid and elevates the larynx.
98
What does the cricothyroid muscle do?
Tenses the vocal cords (increases pitch); no effect on cord opening or closing.
99
What does the vocalis muscle do?
Tenses the vocal cords (fine pitch control).
100
What does the thyroarytenoid muscle do?
Adducts the vocal cords (closes the glottis).
101
What does the transverse arytenoid muscle do?
Adducts the vocal cords (closes the glottis by bringing arytenoids together).
102
What does the posterior cricoarytenoid muscle do?
Abducts the vocal cords (opens the glottis); only muscle that opens the cords.
103
What does the lateral cricoarytenoid muscle do?
Adducts the vocal cords (closes the glottis).
104
What does the diaphragm do during breathing?
Contracts to increase thoracic volume, lowering intrathoracic pressure for inspiration.
105
What do the scalene muscles do?
Stabilize the upper thorax and elevate the first two ribs during inspiration.
106
What does the sternocleidomastoid muscle do in respiration?
Elevates the sternum and upper thorax; prevents rib cage collapse during deep breaths.
107
What do the external intercostals do?
Aid inspiration by expanding the rib cage.
108
What do the internal intercostals do?
Aid forced expiration by depressing the rib cage.
109
What do the abdominal muscles do in breathing?
Compress abdominal contents to force air out during active expiration.
110
What does the pectoralis minor muscle do (respiratory function)?
Stabilizes the scapula and thorax during deep inspiration when the arms are fixed.
111
What is the function of the thyrohyoid membrane?
Connects the thyroid cartilage to the hyoid bone; suspends the larynx.
112
What does the median cricothyroid ligament do clinically?
Provides access for emergency cricothyrotomy; connects thyroid and cricoid cartilage.
113
What are the annular ligaments of the trachea?
Connective tissue bands between tracheal cartilages; allow flexibility and prevent collapse.
114
What does lateral rotation of the arytenoids result in?
Vocal cord abduction (opening) — performed by the posterior cricoarytenoid.
115
What does medial rotation of the arytenoids cause?
Vocal cord adduction (closure) — done by lateral cricoarytenoid and thyroarytenoid.
116
What is the function of the transverse arytenoid muscle in arytenoid mechanics?
Pulls the arytenoid cartilages together, closing the posterior glottis.
117
What is the functional role of intrinsic laryngeal muscles?
Adjust vocal cord tension and position to regulate phonation and airway patency.
118
What is the role of extrinsic laryngeal muscles?
Move the entire larynx, typically to elevate or depress it during swallowing or speaking.
119
What is the function of the cricotracheal ligament?
Anchors the cricoid cartilage to the first tracheal ring — stabilizes the upper trachea.
120
What does the hyoepiglottic ligament do?
Connects the hyoid bone to the epiglottis and restores it to open position after swallowing.
121
How does the epiglottis prevent aspiration during swallowing?
It's passively folded over the glottis by laryngeal elevation (via suprahyoid muscles).
122
What is the epiglottis made of and why is it important?
Elastic cartilage — allows it to flex during swallowing and recoil to reopen the airway.
123
What do the superior, middle, and inferior pharyngeal constrictors do?
Sequentially contract to push food through the pharynx into the esophagus during swallowing.
124
Why are pharyngeal constrictors clinically important?
They help prevent aspiration and are vulnerable to injury during difficult intubation or trauma.
