Respiratory II

Question 1

3 portions of respiratory system

Answer 1

air conducting = conditions inspired air
respiratory = gas exchange
ventilation = insp/exp thoracic cage

Question 2

air conduction portion

Answer 2

warmed by venous plexus and hoisted by secretions of seromucous glands in GOBLET cells

Question 3

nasal conchae

Answer 3

turbulence to help warm and moisten air

Question 4

pharynx, where does it begin and end

Answer 4

begin: base of skull
end: inferior cricoid cartilage C6

Question 5

3 parts of pharynx

Answer 5

nasopharynx
oropharynx
laryngopharynx

Question 6

larynx

Answer 6

anterior neck, windpipe

Question 7

functions of larynx

Answer 7

phonation, cough reflex, protect lower respiratory tract

Question 8

3 parts of larynx

Answer 8

supra glottis
glottis
subglottis

Question 9

supra glottis

Answer 9

epiglottis to false VC (vestibular folds)

Question 10

glottis

Answer 10

VCs and 1cm below

Question 11

rima glottidis

Answer 11

opening between VCs

Question 12

subglottis

Answer 12

inferior glottis to inferior cricoid cartilage

Question 13

epiglottis

Answer 13

flap of cartilage behind tongue, at top of larynx

Question 14

clinical relevance of larynx

Answer 14

emergency intubation, apply cricoid pressure to cricoid of larynx to occlude esophagus and prevent regurgitation of gastric contents

Question 15

laryngeal muscles

Answer 15

phonation and breathing

Question 16

3 UNPAIRED cartilages

Answer 16

epi, thy, cri

Question 17

3 paired cartilages

Answer 17

arytenoid
corniculate
cuneiform

Question 18

is the larynx continuous with the trachea?

Answer 18

yes, opens superiorly into trachea

Question 19

cricothyroid muscle: innervated by what

Answer 19

external laryngeal nerve (CN X)

Question 20

posterior cricoarytenoid muscle

Answer 20

abducts vocal folds, sole opener of vocal folds

Question 21

clinical relevance = vocal cord paralysis. what is the movement of VC controlled by?
what is it innervated by?

Answer 21

movement of VC is controlled by intrinsic muscles of larynx
innervated by: RECURRENT LARYNGEAL NERVE
(motor innervation to all laryngeal except cricothyroid)

Question 22

Recurrent laryngeal nerve (RLN) palsy: causes

Answer 22

thyroid cancer
apical lung tumor
aortic aneurysm

Question 23

unilateral RLN palsy

Answer 23

one VC, speech not affected

hoarseness

Question 24

bilateral RLN palsy

Answer 24

both VCs paralyzed
breathing impaired
no phonation
if rima glottidis closes –> emergency

Question 25

what are the trachea and bronchi supported by

Answer 25

C-shaped rings

Question 26

what does the trachea bifurcate into

Answer 26

main bronchi (primary, mainstem)

Question 27

right mainstem bronchi

Answer 27

shorter & wider | develops week 4 with laryngeal diverticulum

Question 28

primary R and L bronchi

Answer 28

R and L lungs

Question 29

carina

Answer 29

separates right and left primary bronchi

Question 30

secondary/lobar bronchi

Answer 30

``` # of lobes R=3, L=2 ```

Question 31

What are the right and left lungs separated by

Answer 31

middle mediastinum = heart and great vessels

Question 32

right lung

Answer 32

horizontal and oblique fissure | larger, shorter, wider

Question 33

surface impressions on R lung

Answer 33

``` azygous R brachiocephalic SVC esophagus heart ```

Question 34

what does horizontal fissure separate on R lung

Answer 34

upper and middle lobe

Question 35

what does oblique fissure separate on R lung

Answer 35

lower from upper and middle

Question 36

left lung, what are the 2 unique features

Answer 36

oblique fissure 2 unique features: 1. cardiac notch on upper lobe 2. lingula (analogous to middle lobe of R lung)

Question 37

what does oblique fissure separate on L lung

Answer 37

lower and upper

Question 38

surface impressions on L lung

Answer 38

esophagus thoracic aorta L SC heart

Question 39

hilum of lung

Answer 39

doorway; area where structure forming the root of the lung actually touches lung tissue

Question 40

main primary bronchi

Answer 40

C-shaped rings R = wider and more vertical than left, 2-3cm ASPIRATED OBJECTS LODGE MORE R THAN L L = narrower and more horizontal, 5cm

Question 41

lobar secondary bronchi

Answer 41

crescent shaped rings | = # of lobes

Question 42

tertiary segmental bronchi

Answer 42

cresent shaped rings R = 10 L = 8 bronchopulmonary segment = unit of lung tissue

Question 43

blood supply: lungs

Answer 43

Lungs supplied with DE-OX via paired pulm arteries | once OX, leaves lungs via 4 pulm veins

Question 44

blood supply: bronchi/roots/tissues

Answer 44

bronchial arteries, descending aorta

Question 45

innervation: lungs parasympathetic sympathetic visceral afferent/sensory

Answer 45

derived pulmonary plexuses PARA = vagus = vasoD, secretion, contract bronchial sm. m SYMPATHETIC = sympathetic trunks (cardiopulmonary, thoracic splanchnic = relax sm. m, vasoC VISCERAL = conduct pain impulse to sensory ganglia of vagus (REFLEX)

Question 46

lymphatic drainage: lungs

Answer 46

lymph --> pulm nodes --> bronchopulmonary nodes (hilum) --> tracheobronchial nodes --> L/R bronchomediastinal trunks

Question 47

visceral pleura of lungs: function blood supply veins nerve supply

Answer 47

=covers lungs blood supply = bronchial artery veins = azygous/hemiazygous v. nerve supply = NONE

Question 48

parietal pleura of lungs: function blood supply veins nerve supply

Answer 48

= covers internal surface of thoracic cavity blood supply = 1. cervical, costal = intercostal 2. diaphragmatic = intercostal (peripheral), pericardiacophrenic (central tendon) 3. mediastinal = pericardiacophrenic veins: drain companion veins of arterial supply nerve:

Question 49

pleural cavity

Answer 49

between visceral and parietal layer

Question 50

pleural recesses

Answer 50

where parietal pleurae can oppose | occupied by lungs only on forced/deep inspiration

Question 51

why are the pleural recesses important

Answer 51

fluid collects in disease areas for aspiration and or drain fluid

Question 52

costomediastinal recess

Answer 52

between costal and mediastinal pleurae, ant. border of lung | deep insp

Question 53

costodiaphragmatic recess

Answer 53

between costal and diaphragmatic pleurae, along inf. border of lung deep insp