Lower Respiratory Tract Flashcards

1
Q

What is the rough diameter of the bronchioles?

A

<1mm

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2
Q

What is the difference between the structure of the bronchioles and the bronchi?

A

Mostly smooth muscle, no glands, simple columnar or cuboidal epithelium, gradual decrease in goblet cells and cilia

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3
Q

What helps to support the alveoli structure?

A

Elastic fibres

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4
Q

What epithelium lines the alveoli?

A

Simple squamous

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5
Q

Which cells are involved in gas exchange in the alveoli?

A

Type I pneumocytes

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6
Q

What cells are there to provide immune defense in the alveoli?

A

Alveolar macrophages

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7
Q

Why are type II pneumocytes important?

A

Produce surfactant which reduces the surface tension and prevents alveolar collapse during expiration.

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8
Q

What separates the capillary endothelium from the alveolar epithelium?

A

Interstitium

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9
Q

What is the space between two alveoli called?

A

Alveolar septum

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10
Q

Where does the lower respiratory tract start?

A

Trachea

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11
Q

Describe the division of the trachea into bronchi

A

Trachea > principal bronchi > lobar bronchi > segmental bronchi

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12
Q

Which bronchi bifurcates first and is wider?

A

Right

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13
Q

The left main bronchus passes under what structure?

A

Arch of aorta

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14
Q

What lies posterior to the trachea?

A

Oesophegus

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15
Q

What is the conduction part of the respiratory system?

A

From the nose to the terminal bronchioles

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16
Q

What is the respiratory part of the respiratory system?

A

Respiratory bronchioles and alveoli

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17
Q

What is the significance of the broncho-pulmonary segments?

A

They are functionally separate and have their own arterial supply and segmental bronchi. This means they can be respected without affecting the surrounding segments.

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18
Q

How many segments does the left lung have?

A

Between 8-10

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19
Q

What are the superior and lingula segments of the left lung?

A

Superior apical, posterior, anterior, superior lingula and inferior lingula

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20
Q

What are the inferior segments of the left lung?

A

Apical basal, medial basal, anterior basal, lateral basal, posterior basal.

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21
Q

Which segments in the left lung can be combined in some patients?

A

Superior apical and posterior

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22
Q

Which segment in the left lung can be absent or small and what segment can it share it’s bronchi with?

A

Medial basal, anterior basal

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23
Q

Which two segments of the lungs are most likely to collect secretions and fluid in a patient who is supine?

A

Apical basal and posterior basal

24
Q

How many lobes does the right lung have?

A

3

25
Q

How many segments does the right lung have?

A

10

26
Q

What are the segments of the upper lobe of the right lung?

A

Apical, posterior, anterior

27
Q

What are the segments of the middle lobe of the right lung?

A

Lateral and medial

28
Q

What are the segments of the inferior lobe of the right lung?

A

Apical basal, medial basal, anterior basal, lateral basal, posterior basal

29
Q

What acronym can you use to remember the upper and lower lobes of the right lung respectively?

A

APALM, AMALP

30
Q

What does the horizontal fissure separate in the right lung?

A

Middle and superior lobe

31
Q

Which lung has the deepest cardiac impression?

A

Left

32
Q

The diaphragmatic surface of which lung is higher up? Why?

A

Right lung, liver

33
Q

What lies under the diaphragm on the left side?

A

Stomach

34
Q

What vessels make an impression on the left lung?

A

Aortic arch, descending aorta

35
Q

What vessels make an impression on the right lung?

A

Superior and inferior vena cava, arch of azygous veins

36
Q

What structures does the hilum provide a doorway into the lungs for?

A

Principle bronchus, bronchial arteries & veins, broncho-pulmonary lymph nodes, pulmonary artery, 2x pulmonary veins, pulmonary plexus.

37
Q

The branches of which nerves make up the pulmonary plexus?

A

CN X (Vagus) and ganglia from the sympathetic chain

38
Q

Describe the positions of the main structures entering the hilum?

A

Pulmonary artery lies superiorly, the two pulmonary veins lie inferiorly and posteriorly, the bronchus usually lies between the them.

39
Q

Where does the phrenic nerve arise and what does it supply?

A

C3-5, cervical plexus. Motor and sensory function to the diaphragm.

40
Q

Where does the phrenic nerve run in relation to the hilum?

A

Anterior

41
Q

Where does the Vagus nerve runs in relation to the hilum?

A

Posterior

42
Q

What delivers deoxygenated blood to the lungs and where does it arise from?

A

Pulmonary arteries -> pulmonary trunk -> right ventricle

43
Q

How many pulmonary veins are there in total?

A

4

44
Q

What carries oxygenated blood back to the heart?

A

Pulmonary veins

45
Q

Where do the bronchial arteries arise from?

A

Descending thoracic aorta

46
Q

Where does the right bronchial vein drain?

A

Azygous vein

47
Q

Where does the left bronchial vein drain?

A

Accessory hemi-azygous vein

48
Q

What supplies parasympathetic innervation to the lungs and what outcome does this have?

A

Vagus nerve (X), stimulate gland secretion, contraction of bronchial smooth muscle and vasodilation of pulmonary vessels

49
Q

What is the outcome of sympathetic innervation of the lungs?

A

Relaxation of bronchi smooth muscle and vasoconstriction of the pulmonary vessels

50
Q

What nerve carries pain signals from the lungs?

A

Visceral afferent nerve to the sensory ganglion of the Vagus (X)

51
Q

How many lymphatic plexuses are there?

A

2

52
Q

Which lymphatic plexus drains the lung parenchyma?

A

Superficial

53
Q

Which lymphatic plexus drains the lung root?

A

Deep

54
Q

What structures form the posterior peripheral attachment of the diaphragm, and what are these parts of the diaphragm called?

A

L1-L3, right and left crura

55
Q

What perforates the diaphragm and at what level?

A

IVC and right phrenic nerve, T8. Oesophagus and right/left Vagus nerve, T10. Aorta, thoracic duct and azygous vein, T12.

56
Q

What artery supplies the diaphragm and where does it arise from?

A

Inferior phrenic, abdominal aorta