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anatomy psc2018 > respiratory system > Flashcards

respiratory system Flashcards

1
Q

what can the respiratory system by divided into?

A
  • upper respiratory tract
  • lower respiratory tract
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2
Q

what does the upper respiratory tract include?

A
  • Nadal cavity
  • paranasal sinuses
  • pharynx
  • larynx (above level of vocal folds)
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3
Q

what is the purpose of the upper respiratory system?

A
  • to condition inspired air before reaching the lungs
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4
Q

what happens to air before reaching lungs?

A
  • warmed to body temperate
  • humidified
  • filtered for particulates
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5
Q

what does the lower respiratory tract include?

A
  • larynx (below level of vocal folds)
  • trachea
  • bronchi
  • bronchioles
  • lungs
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6
Q

what is the lower respiratory tract concerned with?

A
  • gas exchange
  • conducts inspired air to tissues involved in gas exchange
  • traps and removes particulates
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7
Q

what do the lungs contain?

A
  • bronchioles
  • alveolar ducts
  • alveolar sacs
  • alveoli
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8
Q

what controls the rhythm of breathing?

A
  • respiratory centres of the brainstem
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9
Q

where is the respiratory centre located?

A
  • lower part of brainstem
  • in medulla oblongata
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10
Q

what are inspiratory neurones?

A
  • active during inspiration
  • inactive during expiration
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11
Q

what are the neurones active during expiration called?

A
  • expiratory neurones
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12
Q

what do the neurones automatically maintain?

A
  • rhythmic cycling pattern of inspiration and expiration
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13
Q

what is the automatic rhythm modified by?

A
  • afferent information
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14
Q

where does afferent information come from?

A
  • chemoreceptors
  • the brain
  • receptors in the lungs
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15
Q

what is the main function of the lungs?

A
  • to oxygenate blood by bringing inspired air into close relation with deoxygenated blood in pulmonary circulation
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16
Q

what is the appearance of lungs?

A
  • light, soft and spongy
  • can see dark/black deposits as result of breathing polluted air
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17
Q

which lung is usually larger?

A
  • right lung
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18
Q

why is this lung larger?

A
  • middle mediastinum (containing the heart) bulges more to the left than the right
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19
Q

what is the location of the lungs?

A
  • left and right of thorax
  • separated by mediastinum
  • surrounded by pleural cavities
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20
Q

where does air enter and leave the lungs?

A
  • main bronchi (branches of trachea)
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21
Q

what do pulmonary arteries deliver?

A
  • deoxygenated blood to lungs from right ventricle
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22
Q

where does oxygenated blood return?

A
  • to left atrium
  • via the pulmonary veins
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23
Q

what 3 surfaces do the lungs have?

A
  • costal surface
  • mediastinal surface
  • diaphragmatic surface
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24
Q

what is the location of costal surface?

A
  • close to ribs/ costal cartilages and intercostal spaces
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25
Q

what is the location of mediastinal?

A
  • close to the mediastinum arteriorly and vertebral column posteriorly
  • contains hilum of lung
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26
Q

what is the diaphragmatic surface location?

A
  • sits on diaphragm
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27
Q

what are the three borders of the lung?

A
  1. inferior
  2. anterior
  3. posterior
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28
Q

what does the inferior border separate?

A
  • base from the costal surface
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29
Q

what does the anterior base separate?

A
  • costal surface from mediastinal surface
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30
Q

what is the difference between the anterior border of left and right lung?

A
  • right is relatively straight
  • left has deep cardiac notch
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31
Q

what does the posterior border separate?

A
  • costal surface from mediastinal surface
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32
Q

what is the shape of the posterior border?

A
  • smooth and rounded
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33
Q

what structures leave impressions in the spongy surface of lung?

A
  • mediastinal
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34
Q

what are the impressions on the right lung?

A
  • groove for superior vena cava
  • groove for azygous vein
  • groove for oesophagus
  • groove for inferior vena cava
  • cardiac impression
  • diaphragmatic impression
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35
Q

what are the impressions on the left lung?

A
  • groove for descending aorta
  • groove for aortic arch
  • cardiac impression
  • diaphragmatic impression
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36
Q

what are the lungs made up of?

A
  • lobes
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37
Q

what are the lobes separated by?

A
  • fissures
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38
Q

which side of the lungs has the most lobes?

A

right lung (larger as presence of heart projects to the left)

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39
Q

how many lobes and fissures does the right lung have?

A
  • 3 lobes
  • 2 fissures
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40
Q

how many lobes and fissures does the left lung have?

A
  • 2 lobes
  • 1 fissure
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41
Q

what are the two types of fissures that divide the lungs into lobes?

A
  • horizontal
  • oblique
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42
Q

what does the oblique fissure separate?

A
  • inferior lobe from superior and middle lobe
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43
Q

what does the horizontal fissure separate?

A
  • superior lobe from middle lobe
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44
Q

what are the 3 lobes in the right lung?

A
  • superior (upper)
  • middle
  • inferior
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45
Q

what is the superior lobe in contact with?

A
  • anterior thoracic wall
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46
Q

where does the superior lobe project into?

A
  • root of the neck
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47
Q

what is the middle lobe in contact with?

A
  • anterior and lateral thoracic wall
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48
Q

what is the inferior lobe in contact with?

A
  • posterior and inferior thoracic wall
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49
Q

why is the position of the lobes important?

A
  • dictates where a stethoscope should be placed to listen to each lobe of lung
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50
Q

what lobes does the left lung have?

A
  • superior (upper)
  • inferior (lower)
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51
Q

what is the superior lobe in contact with?

A
  • upper part of the anterior and lateral thoracic wall
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52
Q

where does the superior lobe project into?

A
  • root of the neck
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53
Q

what is the inferior lobe mostly in contact with?

A
  • posterior and inferior part of thoracic wall
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54
Q

what does the oblique fissure separate?

A
  • inferior and superior lobe
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55
Q

where is the lingula found?

A
  • left lung
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56
Q

what is the lingula?

A
  • tongue like projection that extends over the anterior surface of the heart
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57
Q

what are the roots of the lungs?

A
  • where the lungs attach to the heart and tracheae
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58
Q

what is the hilum of the lung?

A
  • where structures that make up the root of lung enter and leave
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59
Q

what structures make up the root of the lung?

A
  • pulmonary artery
  • two pulmonary veins
  • a main bronchus
  • bronchial vessels
  • nerves
  • lymphatics
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60
Q

what does the visceral pleura become at the hilum?

A
  • parietal pleura
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61
Q

what are the characteristics of bronchi?

A
  • thickest, strongest walls
  • strong
  • cartilaginous
  • don’t compress or collapse easily
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62
Q

what are the characteristics of pulmonary arteries?

A
  • thinner walls
  • elastic walls
  • elastic recoil when compressed
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63
Q

what are the characteristics of pulmonary veins?

A
  • thin walls
  • easily collapsible
  • not elastic
  • don’t retain their tubular shape
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64
Q

what is the position of the structures at the hilum?

A
  • pulmonary artery = superior
  • pulmonary vein = inferior
  • bronchi = posterior
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65
Q

where does the apex of the lung lie?

A
  • just above first rib
  • level with T1
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66
Q

what is the inferior aspect of the lung in contact with?

A
  • diaphragm
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67
Q

what happens in quiet respiration?

A
  • inferior margin flung travels around thoracic wall
    -follows rib 6 down to rib 8 from vertebral level T10 posteriorly
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68
Q

what is posterior oblique fissure?

A
  • in midline
  • near spine of vertebra T4
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69
Q

what is lateral oblique fissure?

A
  • descends diagonally
  • crosses 4th and 5th intercostal space to reach rib 6
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70
Q

what is anterior oblique fissure?

A
  • follows rib 6 and its costal cartilage
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71
Q

what is the horizontal fissure?

A
  • lies anteriorly
  • follows contour of rib 4
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72
Q

what is the pleura?

A
  • thin membrane enclosing the lungs
  • also lines walls of thoracic cavity
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73
Q

what is the parietal pleura?

A
  • associated with walls of cavity
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74
Q

what does the parietal pleura line?

A
  • pulmonary cavities
  • adherent to thoracic wall, mediastinum and diaphragm
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75
Q

what is the pleura associated with lungs called?

A
  • visceral pleura
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76
Q

what is the purpose of the visceral pleura?

A
  • covers lungs
  • is adherent to all its surfaces
  • cant be separated from the lungs
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77
Q

are the layers of pleura continuous with each other?

A
  • yes
  • they are one giant membrane folding to cover all
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78
Q

where is the point of continuum of the pleura?

A
  • the root of the lungs
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79
Q

what is the space between the pluera layers called?

A
  • pleural cavity
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80
Q

what is potential space?

A
  • cavity that doesn’t normally exist in healthy people
  • present when two membranes are packed closely together
  • has potential to become a space in illness or injury
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81
Q

what type of membrane is the pluera?

A
  • serous
  • produces serous fluid (lubricating fluid between the layers)
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82
Q

what is the function of the pleura and serous fluid?

A
  • allows smooth movement of lungs as they expand and collapse
  • provides surface tension keeping contact with thoracic wall
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83
Q

what is the parietal pleura divided into?

A
  • costal pleura
  • mediastinal pleura
  • diaphragmatic pleura
  • cervical pleura
84
Q

what does the costal pleura cover?

A
  • internal surfaces of thoracic wall
85
Q

what does the mediastinal pleura cover?

A
  • lateral aspects of mediastinum
86
Q

what does the diaphragmatic pleura cover?

A
  • superior aspect of diaphragm on each side of mediastinum
87
Q

what does the cervical pleura cover?

A
  • extends through superior thoracic aperture forming dome over apex
88
Q

what’s costomediastinal recess?

A

costal pleura is opposed to mediastinal pleura

89
Q

what is costodiaphragmatic recess?

A
  • costal pleura is opposed to diaphragmatic pleura
  • largest and most clinically important recess
  • deepest after forced expiration and shallowest after forced inspiration
90
Q

what is a real space?

A
  • when significant amount of air or fluid enters the pleural cavity
  • causes lung to collapse due to elastic nature of the lung tissue
91
Q

what is a common cause of lung space?

A
  • puncture wound to the thorax
92
Q

what is a pneumothorax?

A
  • air rushing into the pleural cavity
93
Q

what is a hydrothorax?

A
  • accumulation of fluid in the pleural cavity
  • may result from pleural effusion (escape of fluid into pleural cavity)
94
Q

what is a haemothorax?

A
  • when blood enters the pleural cavity
95
Q

what causes haemothorax?

A
  • result of injury to major intercostal vessels (usually by fractured rib)
96
Q

how is the lung reinflated?

A
  • by draining fluid from pleural cavity using chest drain
97
Q

what do the bones of the thorax consist of?

A
  • sternum
  • 12 pairs of ribs
  • costal cartilages
  • 12 thoracic vertebra (T1-T12)
98
Q

what do these bones provide?

A
  • attachment points for muscles of respiration
  • move to facilitate breathing
  • provide protection for vulnerable organs within thorax
99
Q

what does the sternum consist of?

A
  • manubrium
  • sternal body
  • xiphoid process
100
Q

what do the ribs articulate posteriorly with?

A
  • thoracic vertebra
101
Q

where do the ribs end anteriorly?

A
  • costal cartilage
102
Q

which ribs are true ribs?

A

ribs 1 -7

103
Q

what does true ribs mean?

A
  • they articulate directly with sternum anteriorly
  • has own costal cartilage
104
Q

what are the false ribs?

A

ribs 8 - 12

105
Q

what does false ribs mean?

A
  • articulate indirectly with sternum anteriorly
  • attach to sternum via longer, shared costal cartilages
106
Q

what are the floating ribs?

A
  • ribs 11 and 12
107
Q

what are floating ribs?

A
  • don’t articulate with sternum anteriorly
  • shorter and pointier
108
Q

what do the thoracic vertebra make up?

A
  • posterior element of thoracic cage
  • articulate with ribs and with each other
109
Q

what muscles are involved with ventilation?

A
  • skeletal muscles
110
Q

what is the diaphragm?

A
  • thin, musculotendinous, dome shape muscle
111
Q

what does the diaphragm separate?

A
  • thorax from the abdomen
112
Q

what are the features of the diaphragm?

A
  • large, flat central tendon
  • attached to lower ribs and vertebral column
  • innervated by right and left phrenic nerves (C3,4,5)
113
Q

where does blood supply to diaphragm originate from?

A
  • intercostal arteries
114
Q

where does venous drainage go to?

A
  • inferior vena cava
115
Q

what 3 major structures travel through the diaphragm?

A
  • aorta
  • inferior vena cava
  • oesophagus
116
Q

wha does contraction of the diaphragm do?

A
  • flattens it
  • increases volume of thorax
  • aids inspiration
  • rib margins lift and move out
117
Q

video on inspiration and expiration

A
118
Q

how much does the apex move during quiet breathing?

A

1-2cm

119
Q

how much does the diaphragm move during deep breathing?

A

10cm

120
Q

where are the intercostal muscles located?

A
  • in between ribs
121
Q

where are external intercostal muscles located?

A
  • superficially to the internal intercostals
122
Q

where does the blood supply come from?

A
  • intercostal arteries
123
Q

what does venous drain occur via?

A
  • intercostal veins
124
Q

what are they innervated by?

A
  • intercostal nerves
125
Q

what 3 structures travel together in intercostal space?

A
  • intercostal artery, vein and nerve
126
Q

what is the function of external intercostal muscles in inspiration?

A
  • pull ribs upwards and forwards
  • cause increase in lateral and anteroposterior diameters of thorax
127
Q

what are the properties of external intercostals?

A
  • fibres run obliquely anteroinferiorly (diagonally forward and down)
  • contraction of external intercostals pulls ribs up and out
128
Q

what are the properties of internal intercostals?

A
  • fibres run obliquely posteroinferiorly (diagonally backwards and down)
  • contraction of external intercostals pulls ribs down and inward
129
Q

what movement happens in internal intercostals during active respiration?

A
  • pull ribs down and inwards
130
Q

what are the innermost intercostals?

A
  • incomplete and variable
  • pass from rib to rib deep to the internal intercostals
  • separated from internal by bundle of intercostal blood vessels and nerves
131
Q

what are the accessory muscles of respiration?

A
  • sternocleidomastoid
  • pectoralis minor
  • scalene muscles
132
Q

what is the function of the accessory muscles?

A
  • assist in expansion of thoracic cavity in forced expiration
  • maximise respiratory efficiency
133
Q

what planes do the ribs move in during breathing?

A
  • anteroposterior (forwards and backwards)
  • laterally
134
Q

what are the tree like structures embedded in lung tissue?

A
  • vascular tree
  • airway tree
135
Q

what is the vascular tree composed of?

A
  • arteries, veins and capillaries
136
Q

what is the function of the vascular tree?

A
  • conducts poorly oxygenated blood to the lungs and returns highly oxygenated blood to the heart
137
Q

what does the airway tree consist of?

A
  • air filled branching tubes
138
Q

what is the function of the airway tree?

A
  • conduct new atmospheric air to the gas exchange surfaces
  • return used air to environment
139
Q

what is pulmonary oedema?

A
  • build up of fluid in interstitial space in lungs
  • increases diffusion distances of gases between blood and alveoli
140
Q

what is pulmonary oedema usually secondary to?

A
  • left heart failure
  • renal failure
  • pneumonia
  • cirrhosis of liver
141
Q

what does the increased diffusion distance lead to?

A
  • hypoxia
  • as the blood loads with less oxygen
142
Q

what are early symptoms of pulmonary oedema?

A
  • shortness of breath
  • cough
  • disrupted rate and rhythm of breathing
143
Q

what are later symptoms of pulmonary oedema?

A
  • cyanosis
  • cough with red foaming sputum
144
Q

what is the initial treatment?

A
  • treating hypoxia with 100% oxygen
145
Q

what is later treatment?

A
  • addresses the underlying cause
146
Q

what is the trachea?

A
  • widest conducting airway
  • has smallest cross sectional area
  • responsible for most airway resistance
147
Q

how is collapsing prevented?

A
  • by rigs of hyaline cartilage
148
Q

what does the trachea bifurcate into?

A
  • two primary or main bronchi which enter the lung
149
Q

where does the bifurcation of trachea occur?

A
  • vertebral level T4
150
Q

what is vertebral level T4?

A
  • level of sternal angle (angle between manubrium and body of sternum)
  • level where trachea bifurcate into 2 main bronchi
  • level of arch of aorta
  • where second rib articulates with the sternum
151
Q

how does the structure of right and left bronchus differ?

A
  • right = wider, shorter, runs vertically
  • left = more horizontal, runs inferior to arch of aorta
152
Q

what do the primary bronchi form?

A
  • trunks of each of the lungs
153
Q

how many times do the bronchi divide?

A

11 times

154
Q

what do the main bronchi first divide into?

A
  • secondary/lobar bronchi (one per lobe of each lung)
155
Q

what do these then divide into?

A
  • tertiary/segmental bronchi (each supplies different segment of lung)
156
Q

what do the first 17 generations of airway form?

A
  • conducting zone of lower respiratory system
157
Q

where are the bronchioles found?

A
  • around 12th division of the bronchi
158
Q

what are bronchioles?

A
  • small, collapsible passageways with smooth muscle walls
159
Q

what’re respiratory bronchioles?

A
  • transition between conducting airways and gas exchanging tissues of the lungs
160
Q

where do the respiratory bronchioles terminate?

A
  • at alveolar ducts which lead to alveoli
161
Q

what do the structures from respiratory bronchioles to alveoli form?

A
  • respiratory zone of lower respiratory system
162
Q

what does each tertiary bronchus supply?

A
  • a different bronchopulmonary segment of lung
163
Q

what are the alveoli?

A
  • primary site of base exchange
  • small out pockets that greatly increase the SA for gas exchange
164
Q

how are the alveoli arranged?

A
  • in long lobules (cluster of alveoli surrounded by elastic fibres and network of capillaries)
165
Q

what is a lung lobule?

A
  • cluster of alveoli supplied by a single respiratory bronchiole
  • surrounded by connective tissue of the lung
166
Q

what are the properties of the alveoli?

A
  • thin walls (one cell thick)
  • basement pentanes fused to endothelium of capillaries surrounding
167
Q

what is the apical surface covered in?

A
  • surfactant
  • where the gases dissolve to aid their diffusion
168
Q

what is emphysema?

A
  • condition largely associated with smoking
  • where lungs are unable to expel all the air (overinflated usually)
169
Q

what is emphysema caused by?

A
  • gradual damage to alveoli
  • usually by irritants or infection
  • makes them loose their natural elasticity
170
Q

what are the symptoms?

A
  • chronic hypoxia
  • fatigue
  • weight loss
  • breathlessness
171
Q

what can complicate the disease?

A
  • chronic bronchitis (lungs unable to clear mucus)
172
Q

what is the combination of emphysema and chronic bronchitis called?

A
  • chronic obstructive pulmonary disease (COPD)
173
Q

what are the treatments for emphysema?

A
  • no cure
  • early symptoms controlled with bronchodilators
174
Q

what is asthma?

A
  • most common chronic airway disease
175
Q

what happens in asthma?

A
  • conducting airways become restricted as diameter reduces
176
Q

what sort of disease is asthma thought to be?

A
  • immunological
  • caused by immune system over-reacting to an antigen that would normally be overlooked
177
Q

what is the inducer for asthma?

A
  • original antigen that elicited an immune response
  • acts as allergen
178
Q

what happens in response to this inducer?

A
  • immune system gives inappropriate response resulting in over-reaction
  • causes swelling of airways and recruitment of eosinophils
179
Q

what is status asthmaticus?

A
  • an acute asthma attack
180
Q

what triggers status asthmaticus?

A
  • an irritant
181
Q

what is an irritant?

A
  • causes varying degrees of bronchoconstriction
182
Q

what treatment is used for acute asthma attacks?

A
  • bronchodilators like salbutamol (Ventolin)
  • prophylactic inhaled steroids (BDP)
183
Q

what are the properties of the upper respiratory tract?

A
  • designed with large SA to warm and moisten inhaled air
184
Q

what are the cavities lined with?

A
  • pseudostratified columnar epithelium
185
Q

what cells do columnar cells have on their surface?

A
  • cilia
186
Q

what is the pseduostratified columnar known as?

A

respiratory type epithelium

187
Q

what are the walls of trachea and large bronchi supported by?

A
  • rings of hyaline cartilage
  • incomplete smooth muscle support
188
Q

what are the cartilage rings replaced with as the airways become smaller?

A
  • cartilage plates
  • eventually smooth muscle. becomes the major support
189
Q

what is the bronchial tree lined with?

A
  • respiratory type epithelium in the larger bronchi
190
Q

what are the bronchioles lined with?

A
  • simple ciliated columnar epithelium
  • goblet cells are sparse
191
Q

what are bronchioles?

A
  • distal airways
  • located between cartilage walled bronchi and where ciliated epithelium ceases
192
Q

what is the site of gas exchange?

A
  • distal respiratory tract
193
Q

what are the most proximal components of the lower respiratory tract?

A
  • respiratory bronchioles
    (lined with cuboidal ciliated epithelium)
194
Q

what are the alveolar ducts lined with?

A
  • flattened epithelium
195
Q

what do the alveoli consist of?

A
  • type 1 and 2 pneumocytes
    (lie on basement membrane)
195
Q

what does the alveolar wall consist of lots of?

A
  • elastin
196
Q

what does the elastin allow?

A
  • lungs to stretch to accommodate inspired air
  • recoil to original shape
  • allows air to be expelled
  • support
197
Q

what are type 1 pneumocytes?

A
  • thin cells
  • allow gaseous diffusion
  • flattened cells with flattened nuclei
  • joined by tight junctions
  • few organelles
198
Q

what do type 1 pneumocytes cover?

A
  • basement membrane
199
Q

what are type 2 pneumocytes?

A
  • secrete surfactant
  • rounded
  • contain mitochondria
200
Q

what is the purpose of surfactant?

A
  • acts as detergent
  • reduces alveolar surface tension
  • prevents collapse of alveoli during expiration
  • facilitates inspirational expansion
201
Q

what can some type 2 pneuomcytes act as?

A
  • precursor stem cells for type 1 pneumocytes
202
Q

what are alveolar macrophages?

A
  • patrol alveolar air spaces and inter-alveolar septa (walls of alveoli)
  • can pass freely between
203
Q

what do alveolar macrophages do?

A
  • phagocytose inhaled debris and pathogens
204
Q

what happens after phagocytosis?

A
  • pass into lymphatic system or adhere to mucous coated ciliated epithelium
  • continue up mucociliary escalator to trachea where cleared by coughing

anatomy psc2018 (8 decks)

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