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STRUCTURES - WEEK 2 > LEC 21: Lungs - 08.29.14 > Flashcards

LEC 21: Lungs - 08.29.14 Flashcards

(75 cards)

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1
Q

Gross Anatomy of the Lungs (Right, Left)

A

RIGHT:

  • 3 lobes
  • Right Upper [horizontal fissure], Right Middle [oblique fissure], Right Lower

LEFT:

  • 2 lobes
  • Left Upper [oblique fissure], Left Lower

NB: oblique fissure = major fissure

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2
Q

Front View of Lungs

(what is palpated with stethoscope)

A

RIGHT:

  • Right Upper and Right Middle equally apparent
  • Right Lower very small

LEFT:

  • Majority is Left Upper
  • Very small portion of Left Lower
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3
Q

Right Lateral View of Lungs

(what can you palpate)

A

RIGHT:

  • Right Upper (~1/3)
  • small portion of Right Middle
  • Significant portion of Right Lower
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4
Q

Left Lateral View of Lungs

(what can you palpate)

A

LEFT:

  • Left Upper
  • Left Lower
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5
Q

Back View of Lungs

A

RIGHT:

  • mostly Right Lower
  • small portion of Right Upper

LEFT:

  • mostly Left Lower
  • small portion of Left Upper
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6
Q

Describe this image from the lung

A

Lung lymphatics

  • white lines under shiny visceral surface
  • channel lymph toward hilum and to mediastinal lymph nodes
  • carbon (turns black) within visceral pleural lymphatic channels
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7
Q

What layer of pleura covers the lung

A

Visceral pleura

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8
Q

What is the layer of pleura against chest wall

A

Parietal pleura

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9
Q

What is the cellular composition of the pleura

A
  • single layer of mesothelial cells
  • mesothelial cells are a form of simple squamous epithelium
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10
Q

pleural cavity

A

Space between parietal and visceral layers of lungs = pleural cavity;

should not have anything between these layers except for a small amount of lubricating fluid

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11
Q

hemothorax

A

collection of blood in the space between the chest wall and the lung (the pleural cavity)

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12
Q

pneumothorax

A

collection of air in the space between the chest wall and the lung (the pleural cavity)

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13
Q

What is the result if there is a tear/puncture in the parietal pleura

A

AFFERENT NERVE: intercostal and phrenic

RESULT: GSA pain

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14
Q

What is the result if there is a tear/puncture in the visceral pleura

A

AFFERENT NERVE: vagus and sympathetics

RESULT: little/no pain

Gray’s: visceral pleura is innervated by visceral afferent nerves that accompany bronchial vessels, pain is generally not elicited from this tissue

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15
Q

What nerve senses everything but tear/puncture in the lung

A

the vagus nerve (CN X - cranial nerve 10)

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16
Q

Location of vagus nerve in the lung

A

vagus nerve runs posterior to hilum of lung

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17
Q

Location and function of phrenic nerve in the lung

A

Phrenic nerve (C3-C5) runs anterior to hilum of lung;

Phrenic nerves carry motor (GSE) fibers to diaphragm

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18
Q

hilum

A

also known as the root of the lung;

formed by bronchus, pulmonary artery, pulmonary vein, bronchial artiers/veins, pulmonary plexus of nerves, lymphatic vessels, bronchial lymph glands, and areolar tissue

hilum is also where the viseral and parietal pleura meet

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19
Q

Order of arteries/bronchus/veins in hilum of lung (Left/Right)

A

LEFT: (Are Brides Vain)

  • Artery, Bronchus, Vein

RIGHT: (Bride Are Vain)

  • Bronchus, Artery, Vein
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20
Q

Where do the visceral and parietal pleura meet (reflection of the pleura)

A

root of the lung (hilum)

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21
Q

Pulmonary arteries

A

Carry deoxygenated blood away from the heart to the lungs (where blood gets oxygenated)

NB: these arteries do not “supply” the lungs – the material they carry is not beneficial; lungs are supplied by bronchial arteries/intercostal arteries (aorta) or subclavian arteries

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22
Q

Pulmonary veins

A

carry oxygenated blood from the lungs back to the heart; blood enters at left atrium, flows to left ventricle where it will be circulated (aorta)

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23
Q

Impressions on the Left Lung

A

LEFT:

  • Left Subclavian Artery
  • Arch of Aorta
  • Brachiocephalic Vein
  • Left Ventricle

“LABL”

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24
Q

Impressions on the Right Lung

A

RIGHT:

  • Superior Vena Cava
  • Inferior Vena Cava
  • Azygos Vein
  • Brachiocephalic Trunk (Artery)
  • Esophagus
  • Right Atrium

“BRAISE”

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25
What blood vessels supply the lungs
* bronchial arteries (from aorta) * intercostal arteries (from aorta) * subclavian arteries NB: These are nutrient arteries that supply oxygenated blood to lung tissue; they enter at the hilum
26
How are capillaries formed
Pulmonary arteries follow bronchial trees to form capillaries around alveoli; pulmonary arteries carry **deoxygenated blood**
27
Bronchopulmonary segments
* lung sub-units corresponding to bronchial tree * no visible lines demarcating individual segments
28
Trace the tracheobronchial tree
* Trachea * Intrapulmonary bronchus * Main (1) * Lobar (2) * Segmental (3) * Bronchiole * Terminal Bronchiole * Respiratory Bronchiole * Alveolar Duct * Alveolar Sac * Alveolus
29
Carina
* cartilaginous ridge within trachea at site of tracheal bifurcation * bifurcation usually at T5 vertebrae, with the angle of Louis * lies more toward left side (foreign bodies most often aspirated into right side)
30
Histology of Trachea
C = cartilage M = mucosa T = trachealis muscle (smooth) L = longitudinal muscle (smooth)
31
Adventitia
connective tissue on outside of trachea
32
C-shaped rings
Trachea made up of C-shaped rings (hyaline cartilage, incomplete dorsally)
33
What are the smooth muscles of the trachea
* trachealis * longitudinal
34
What are the mucosal layers of the trachea
* **submucosa** * mucous and serous glands * **muscosa** * **epithelium** - pseudostratified ciliated columnar cells, goblet cells * **lamina propria** - connective tissue, elastic fibers
35
Label the parts of the slide
A. Mucosa - epithelium B. Mucosa - lamina propria C. Submucosa - serous glands D. Submucosa - mucous glands E. Perichondrium F. Hyaline cartilage
36
What type of epithelium is found in the respiratory tract
ciliated, pseudostratified columnar; nuclei are at different heights, but all cells are anchored to the basement membrane
37
Label this epithelium
ciliated, pseudostratified columnar ## Footnote A. Goblet cell B. Cilia
38
What other types of cells are present in respiratory epithelium
* **Endocrine (Kulchisky) cells** * **​**secrete serotonin, etc. * regulate airway reflexes (smooth muscle contraction) * **Basal cells (not columnar)** * **​**undifferentiated precursors
39
Differences between angles of mainstem bronchi
Right mainstem bronchus is more vertical than left; inhaled objects tend to lodge in the right mainstem bronchus so often
40
Intrapulmonary Bronchus
* usually next to branch of pulmonary artery * irregular cartilage plates * smooth muscle * goblet cells * **ciliated, pseudostratified columnar** epithelium * transitions to **ciliated simple columnar** as bronchi get smaller
41
Broncho-pulmonary segment
secondary/tertiary bronchi travel alongside, branch in parallel, with pulmonary arteries/arterioles
42
Bronchiole
* no cartilage * smooth muscle * very few goblet cells * epithelium transitions from **ciliated simple columnar** to **ciliated simple cuboidal**
43
pattern of epithelium as you move down bronchiole tree
TRACHEA (RESPIRATORY EPITHELIUM): ciciliated, pseudostratified columnar INTRAPULMONARY BRONCHUS: transitions to ciliated, simple columnar BRONCHIOLE: transitions to ciliated simple cuboidal
44
Sympathetic Nervous System
4 Fs: Fight Flight Fright Fuck
45
Autonomic Innervation of Bronchial Glands
**Sympathetic** = inhibitory (need air passageway high and dry to run away) **Parasympathetic (Vagus nerve)** = secretomotor
46
Autonomic Innervation of Bronchial Smooth Muscle
**Sympathetic** = bronchodilation **Parasympathetic (Vagus nerve)** = bronchoconstriction
47
Autonomic Innervation of Bronchial Vasculature
**Sympathetic** = vasoconstriction **Parasympathetic** = vasodilation (? - may have conflicting experimental evidence) NB: No gas exchange in bronchi or bronchioles, thus want large diameter lumen!
48
Autonomic Innervation of Alveolar Vasculature
**Sympathetic** = no effect **Parasympathetic (Vagus never)** = no effect
49
Sympathetic Nervous System in Respiratory Tract
* secretory inhibition * bronchodilation * vasoconstriction
50
Parasympathetic Nervous System in Respiratory Tract
* secretomotor * bronchoconstriction * vasodilation (?)
51
COPD / Asthma
may involve abnormally high parasympathetic discharge as well as inflammation
52
pulmonary plexus
* **sympathetic axons** * **parasympathetic axons** and **ganglia**
53
Name the divisions of the bronchiole
* terminal bronchiole * respiratory bronchiole * alveolar duct * alveolar sac * alveolus
54
Histology of the Terminal Bronchiole
* surrounded by layer of smooth muscle * no goblet cells * ciliated simple cuboidal epithelium * Clara cells
55
What do the green and purple arrows label (hint: terminal bronchiole)
GREEN: ciliated cuboidal cells PURPLE: Clara cells
56
Clara cell
* precursors of bronchiolar epithelial cells * detoxifies carcinogens * synthesizes a surfactant-like protein * secretes alpha-1-antitrypsin that inhibits digestion of elastin emphysema = elastic tissue breakdown
57
Alveolar Wall (what do arrows point to)
Alveolar Wall contains elastic tissue
58
Acinus
(plural = Acini) * functional subunit of the lung supplied by a single respiratory bronchiole
59
What are the divisions after the terminal bronchiole
* Terminal Bronchiole * Respiratory Bronchiole * Alveolar Duct * Alveolar Sac * Alveolus
60
Histology of the Respiratory Bronchiole
* simple cuboidal epithelium * wall punctuated by alveoli and smooth muscle * encircled by smooth muscle, interrupted by alveoli
61
What are A and B in this respiratory bronchiole
Respiratory bronchiole is encircled by smooth muscle, interrupted by alveoli A. Alveolus B. Smooth muscle
62
Histology of the Alveolar Duct
* wall punctuated by alveolar sacs and alveoli
63
Histology of the Alveolar Sac
terminal part of alveolar duct, alveolar clusters
64
Histology of the Alveolar Capillaries
end of tracheobronchial tree
65
What are the features of alveolar capillaries
* capillary walls protrude into lumen * provide more surface area * simple squamous epithelium
66
What are the (3) types of cells found in alveolar walls
1. Endothelial cells * thin, flat; gas exchange 2. Type I pneumocytes * thin, flat; gas exchange * only 40% of alveolar cells * cover 90% surface of alveoli 3. Type II pneumocytes * thick, protruding, "foamy" * 60% of alveolar cells * Replace damaged Type I cells * Secrete surfactant
67
What are the (3) types of alveolar cells (lining the alveoli)
Endothelial * thin, flat cells for gas exchange Type 1 pneumocytes * flat cells Type 2 pneumocytes * round, "foamy" cells
68
Lamellar bodies
* Type II pneumocytes store surfactant in lamellar bodies * gives foamy appearance on light microscopy * product surfactant in form of tubular myelin weaves
69
Surfactant
* found on alveolar surface * mix of phospholipids, cholesterol, carbohydrates, proteins * acts as detergent to decrease alveolar surface tension * keeps cell surface water layer thin, increasing gas exchange * increases compliance (stretchability) * prevents alveolar collapses
70
clinical sign of low surfactant levels
respiratory distress syndrome
71
Alveolar Pore (of Kohn)
Allow equalization of pressure between alveoli, facilitate flow between acini when bronchioles are blocked
72
Alveolar Pores (of Kohn) are sometimes partially obstructed by an accumulation of surfactant; how is extra surfactant removed
* Alveolar macrophages phagocytose extra surfactant * also called "dust cells" because they ingest inhaled particulate matter
73
Alveolar macrophages
* also called "dust cells" * phagocytose extra surfactant * ingest inhaled particulate matter
74
What might lots of alveolar macrophages signify
* infection/irritation * lungs can recruit ~1mm macrophages per hour
75
Smoker's Lungs
* excess carbon particles (trapped in macrophages) * **chronic bronchitis** (excess mucus from goblet cells) * increased risk of pneumonia * loss of elasticity (**emphysema**, **fibrosis**) * **cancer** * **metaplasia** (bronchi epithelium changes to stratified squamous) * **interstitial disease** (thickened alveolar walls)

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