Respiratory anatomy Flashcards
(109 cards)
1
Q
what is respiration?
A
the transport of oxygen from the atmosphere to the tissues and the release of carbon dioxide
2
Q
what is the pleura?
A
a thin, double layered, serous membrane
3
Q
what are the two layers of the pleura?
A
parietal pleura, visceral pleura
4
Q
what is the parietal pleura?
A
the outer layer of the pluera. lines the thoracic wall and diaphragm
5
Q
what is the visceral pleura?
A
the inner layer of the pleura. lines the surface of the lungs and fissures
6
Q
what is the pleural cavity
A
the space between the two layers of the pleura
7
Q
what is the thoracic cage made up of? (dorsally, laterally, anteriorly)
A
thoracic vertebra (dorsally)
ribs (laterally)
sternum and costal cartilages (anteriorly)
8
Q
what are the functions of the thoracic cage?
A
protective**
movement
support (scapula and upper limbs)
muscle attachment points
9
Q
how many pairs of ribs are there?
A
12
10
Q
which are the true ribs and where do they attach?
A
ribs 1-7, directly to the sternum with their own costal cartilage
11
Q
which are the false ribs and where do they attach?
A
ribs 8-10, indirectly to sternum via costal cartilage of ribs above
12
Q
which are the floating ribs and where do they attach?
A
ribs 11 and 12, no anterior attachment
13
Q
what happens to the length of the ribs?
A
1-7 increase in length
8-12 decrease in length
14
Q
where do the costovertebral joints attach?
A
head of rib to vertebral body (e.g. rib 6 with T6 and T7)
15
Q
where do the costotransverse joints attach?
A
rib tubercle to transverse process (e.g. rib 6 with T 7)
16
Q
what happens to ribs 1-5 during respiration?
A
move in a pump handle fashion to increase AP diameter
17
Q
what happens to ribs 8-10 during respiration?
A
move in a bucket handle fashion to increase lateral diameter
18
Q
what happens to ribs 6 and 7 during respiration?
A
move in a pump handle and bucket handle fashion
19
Q
what happens to ribs 11 and 12 during respiration?
A
dont contribute to rib movement
20
Q
what are the respiratory muscles of inspiration?
A
diaphragm, external intercostals
21
Q
what are the accessory muscles of inspiration?
A
scalenes and sternocleidomastoid
22
Q
what are the respiratory muscles of forced expiration?
A
abdominals, internal intercostals
23
Q
where does the diaphragm sit and what shape is it?
A
musculotendinous sheet separating the thorax and abdomen
large, dome shaped muscle, lower posteriorly than anteriorly
24
Q
what are the 3 sets of fibres in the diaphragm?
A
sternal, costal (majority) and lumbar (crural)
25
where do the sternal fibres of the diaphragm run?
posterior surface of xiphoid process of sternum to anterior border of central tendon
26
where do the costal fibres of the diaphragm run?
inner surface of lower 6 ribs and costal cartilages to anterolateral part of the central tendon
27
where do the crural fibres (right crus) of the diaphragm run?
from the anterolateral aspects of the bodies and intervening discs of L1 - L3
28
where do the crural fibres (left crus) of the diaphragm run?
from the bodies and discs of L1 and L2
29
what are the ligaments of the diaphragm?
medial arcuate, lateral arcuate, median arcuate
30
where does the medial arcuate ligament run?
from side of body of L2 to the tip of transverse process of L1
31
where does the lateral arcuate ligament run?
from the transverse process of L1 to the tip of 12th rib
32
where does the median arcuate ligament of the diaphragm run?
tendinous bond connecting the two crura
33
what are the three openings of the diaphragm?
venal caval opening
oesophageal opening
aortic opening
34
what are the actions of the diaphragm
inspiration
35
which hemidiaphragm is higher and why?
right - has the liver underneath
36
where is the central tendon of the diaphragm at rest and during quiet inspiration?
at rest, opposite T8
during quiet inspiration, descends to T9
37
what covers the superior surface of the diaphragm?
parietal pleura
38
what nerve is the diaphragm innervated by and what are its nerve roots?
phrenic nerve, C3,4,5
39
where do the intercostal muscles run and how many are there?
between adjacent ribs - inferior border of rib above to superior border of rib below
11 pairs between ribs 1-12
40
what are the outer, middle and deep layer of intercostals called?
outer - external
middle - internal
deep - inner most
41
how do the accessory muscles help with inspiration?
by lifting up the rib cage
42
what happens during forced expiration?
contraction of abdominal muscles causes the abdominal viscera to push up against the diaphragm reducing the vertical diameter of the pleura
43
what is respiratory pressure?
pressure of air inside lungs and airways
described relative to atmospheric pressure
44
what are the gases and percentages that make up air?
21% oxygen, 78% nitrogen
45
what is intrapulmonary pressure?
pressure within the alveoli
rises and falls with different phases of breathing
always eventually equalises with atmospheric pressure
46
what is intrapleural pressure?
pressure within the pleural cavity
47
what is intrapleural pressure vs intrapulmonary pressure?
intrapleural pressure is always negative relative to intrapulmonary pressure
48
why is the intrapleural pressure always negative?
the 2 opposing forces - tendency of chest wall the expand and lungs to recoil, pulls the visceral pleura away from the parietal pleura
49
what keeps the 2 pleura layers locked together
pleural fluid
50
what is transpulmonary pressure?
the difference between intrapulmonary and intrapleural pressures
51
what happens if the transpulmonary pressure is 0mmHg?
the lungs will collapse
52
what is ventilation?
the movement of air in and out of the lungs
53
what is inspiration?
air flow into the lungs
54
what is expiraiton?
gases exit the lungs
55
what happens to the pressure as the volume increases?
decreases
56
how do gases flow?
from high to low pressures - down pressure gradient
57
what happens to thoracic and lung volumes when respiratory muscles contract?
increase
58
what happens to intrapulmonary pressure when respiratory muscles contract?
decreases
59
when does air flow into the lungs stop?
when intrapulmonary pressure = atmospheric pressure
60
what initiates quiet expiration?
inspiratory muscles relax and lungs recoil
61
what happens to thoracic and lung volumes in quiet expiration?
reduced
62
what happens to intrapulmonary pressure during quiet expiration?
increases
63
when does gas flow out of the lungs stop in quiet expiration?
when intrapulmonary pressure is 0
64
how is forced inspiration initiated?
recruitment of accessory muscles
65
how is forced expiration initiated?
contraction of abdominals and internal intercostals
66
why is forced expiration required during exercise?
breathe faster to provide more oxygen to remove carbon dioxide quicker. no time for elastic recoil
67
what are the functions of the nose?
moistens, warms and filters the air
houses old factory receptors (for smell)
promotes resonance chamber for speech
68
what is the nasopharynx and what does it do?
superior throat, deals with air
69
what is the orapharynx and what does it do?
part of throat after mouth, deals with hot drinks and spicy food
70
what is the laryngopharynx?
bifurcation where pharynx joins larynx
anteriorly trachea - lungs
posteriorly oesophagus
71
what is the larynx?
vocal cords
72
what is the epiglottis and what dose it do?
protective flap, stops unwanted substances (food and drink) going down into your lungs
73
what are vibriassae and what do they do?
fine hairs in nostrils that help filter out large particles from air
74
what are nasal turbinates?
inside nasal cavity
inferior, middle and superior
pertrude medially from each lateral wall of the nasal cavity
75
what do the nasal turbinates do?
slow down airflow to allow time for the nose to filter, warm and humidify air
76
what helps the mucus humidify and moisten inhaled air?
high water content
77
what is mucosa?
the lining of the airways of the URT
78
what happens to the mucosa if there is a build up of irritants (dust, pollen) within the nose?
leads to irritation of the sensory nerve endings and a sneeze
79
what happens in the conducting zone?
gas conducted into our alveoli (no gas exchange)
80
what happens in the respiratory zone?
gas exchange takes place. part airway, part alveoli
81
what are the alveoli?
air sacks where gas exchange takes place
oxygen enters blood stream, carbon dioxide enters alveoli
82
how many lobes are there in the left and right lung?
left - 2 (smaller to make room for the heart)
right - 3
83
what are the bronchopulmonary segments?
anatomically separate unit of lung surrounded by its own connective tissue septa. has its own artery, vein, segmental bronchus
84
what is mucociliary transport?
defence mechanism of the lungs
85
what three things make up mucociliary transport?
ciliated epithelial cells (bristles)
aqueous / sol layer (water)
gel / sputum layer (toothpaste)
86
what is the function of the cilia?
act in unison with other cilia to cause movement of cell or surrounding medium
87
what is the aqueous/sol layer and what is its function?
layer of fluid that bathes cilia
offers very little resistance to movement (actually facilitates)
88
how much mucus do normal individuals produce per day?
10-100mls
89
whats the function of the gel/sputum layer?
acts like fly paper - sticky mucus on top of cilia traps any foreign bodies, microbes, cellular debris and the cilia will sweep the trapped particles towards the mouth and out of the lungs
90
what happens if mucus is retained in the lungs?
warm, wet environment, good breeding ground for microbes -> repeated chest infections
91
what is pulmonary oedema?
build up of fluid in the lungs
92
how quick does the cilia move?
20 cycles per second
93
what rate does cilia move mucus to mouth?
2cm / minute
94
what happens to the excess mucus?
build up around carina -> cough
swallowed into oesophagus
95
what happens to cilia function in cold air?
reduced cilia beat frequency
dont clear mucus effectively down into pharynx to be swallowed so runny nose
96
what is primary cilia dyskinesia?
genetic abnormality where patients are born with a structural defect to their cilia which means the cilia are dyskinetic (abnormal movement of cilia)
97
what is situs invertus?
thoracic and abdominal organs are inverted. Doesnt cause problems for patients but confusing on xrays
98
what happens to cilia function with anaesthetic?
stop cilia from beating normally during the oepration and will be sluggish for a while after.
after a long operation, there will be a significant build up of mucus in the lungs. if patient has pain post op that stops them coughing and clearing mucus, it could lead to a chest infection
99
what happens to cilia function in elderly people?
age reduces cilia beat frequency
more structural abnormalities
risk of post op chest infection increased
100
what happens to cilia function with infection / inflammation?
virus and bacteria can attack cilia affecting cilia function
inflammatory response causes more mucus to be produced by goblet cells which will further impair cilia function
101
what happens to cilia function with smoking?
whilst patient is inhaling smoke, causes ciliary akinesia (cilia stops beating). once they have stopped smoking, the cilia starts moving again
102
what happens to cilia function with smoking long term?
cilia gets burnt off the epithelium
build up of sputum in the lungs (less cilia)
smoke contains irritants and those will cause goblet cells to produce more mucus
cilia do recover if you give up smoking, however, soon after the cilia has to work harder so you cough more
103
what are the three collateral channels in the lungs?
channels of lambert
channels of martin
pores of kohn
104
what are the pores of kohn?
alveolar septa have small fenestrations that provide communications between neighbouring alveoli, around 10 per alveoli, develop at ~1 year old
105
how do you increase airflow through the collateral channels?
make them bigger by taking a bigger breath (doing exercise)
106
where are the anterior, lateral and posterior borders of the lungs?
anterior - rib 6
lateral - rib 8
posterior - rib 10
107
what are the anterior, lateral and posterior borders of the pleura?
anterior - rib 8
lateral - rib 10
posterior - rib 12
108
where is the horizontal fissure?
from rib 4 anteriorly then horizontally to meet oblique fissure
109
