Respiratory System

Question 1

Why is the inferior aspect of each lung curved upwards?

Answer 1

Because it lies on top of the domed diaphragm

Question 2

True or false: the respiratory system only contains serous membranes

Answer 2

FALSE - it contains a mucous membrane too

Question 3

What does the mucous membrane in the respiratory system line?

Answer 3

Conducting portion of the respiratory tract and it bears mucus-secreting cells to varying degrees

Question 4

What do the serous membranes line?

Answer 4

Pleural sacs which envelope each lung

Question 5

What can the pleural cavity fill with? (4)

Answer 5

1. Air (pneumothorax)
2. Blood (haemothorax)
3. Pus (empyema)
4. Watery transudate or exudate (pleural effusion)

Question 6

How can fluid be drained from the pleural cavity?

Answer 6

By inserting a wide-bore needle through an intercostal space (now done under ultrasound guidance).

Question 7

What is the danger of inserting the needle below the 7th intercostal space?

Answer 7

Diaphragm could be penetrated

Question 8

Complete the sentence:

Intercostal nerves and vessels run in the ______ ______ along the inferior body of each rib.

Answer 8

Costal groove

Question 9

Complete the sentence:

Cancer of the lung can cause a __________ of one side of the diaphragm if tumour impinges on the left or right _______ nerve.

Answer 9

Paralysis

Phrenic

Question 10

What two things can cancer in the apex of the lung impinge on and what can this cause?

Answer 10

Brachial plexus and can cause wasting of muscles in the lower arm 
Sympathetic trunk (nerves), giving rise to Horner's syndrome

Question 11

What are the characteristics of Horner’s syndrome? (3)

Answer 11

Miosis (constricted pupil)
Ptosis (weak, droopy upper eyelid)
Apparent anhidrosis (localised, decreased sweating)

Question 12

What causes a hoarse voice in lung cancer?

Answer 12

Impingement on the left recurrent laryngeal nerve or aneurysm of the aorta

Question 13

What constitutes as part of the conducting portion of the respiratory tract? (8)

Answer 13

Nasal cavity 
Pharynx 
Larynx
Trachea
Primary bronchi
Secondary bronchi
Bronchioles 
Terminal bronchioles

Question 14

What constitutes as the respiratory portion of the respiratory tract? (3)

Answer 14

Respiratory bronchioles
Alveolar ducts
Alveoli

Question 15

True or false: the walls of the passageways become thicker going down the order of the conducting and respiratory portions of the respiratory tract

Answer 15

FALSE - become thinner as their lumens decrease in diameter

Question 16

Which type of epithelium lines the airways from the nasal cavity to the largest bronchioles?

Answer 16

Pseudostratified epithelium with cilia and goblet cells

Question 17

Which type of epithelium lines the terminal bronchioles?

Answer 17

Simple columnar with cilia and Clara cells but no goblet cells

Question 18

Which type of epithelium lines the respiratory bronchioles and alveolar ducts?

Answer 18

Simple cuboidal with Clara cells and few sparsely scattered cilia

Question 19

Which type of epithelium lines the alveoli?

Answer 19

Simple squamous

Question 20

What allows us to detect odours?

Answer 20

Olfactory mucosa

Question 21

What are the two types of nasal cavities?

Answer 21

Non-olfactory regions

Olfactory regions

Question 22

What type of epithelium is present in the non-olfactory nasal regions?

Answer 22

Pseudostratified ciliated epithelium

Question 23

What type of epithelium is present in olfactory nasal regions?

Answer 23

Thick pseudostratified columnar epithelium without goblet cells

Question 24

What do serous glands do and what are they called in the olfactory region?

Answer 24

Flush out odourants from the epithelial surface, called Bowman’s glands

Question 25

Which type of epithelium are the ventricular folds of the larynx lined with?

Answer 25

Pseudostratified with mucous glands and numerous lymph nodules

Question 26

Which type of epithelium lines the vocal cords of the larynx?

Answer 26

Stratified squamous

Question 27

What do the vocal cords of the larynx contain? (2)

Answer 27

1. Vocal ligament (elastic fibres) | 2. Vocalis muscle (skeletal muscle)

Question 28

What do the vocal cords do?

Answer 28

Stop foreign objects from reaching the lungs by closing to build up pressure when coughing is required

Question 29

What is the difference between the trachea and the primary bronchi?

Answer 29

Cartilage rings and spiral muscle of primary bronchi completely encircle the lumen

Question 30

What do the secretions from the epithelium and submucosal glands of the trachea and bronchi contain? (6)

Answer 30

``` Mucins Water Serum proteins Lysozyme Antiproteases Immunoglobulins ```

Question 31

Complete the sentence: In COPD, there is goblet cell _____________, a smaller proportion of ciliated cells and ____________ of the submucous glands

Answer 31

Hyperplasia | Hypertrophy

Question 32

What is not present in the apical membranes of the epithelial cells of cystic fibrosis (CF) sufferers?

Answer 32

Cystic fibrosis transmembrane regulator (CFTR)

Question 33

What happens in CF as a result of the ion channel molecule not being present?

Answer 33

Water doesn't leave the epithelium in sufficient quantities to adequately hydrate mucus, mucus becomes viscous and can less readily be moved to the oropharynx for swallowing

Question 34

Complete the sentence: Absence of _________ in walls of bronchioles allows these passages to constrict and almost close down when smooth muscle contraction becomes excessive. Such __________________ can become excessive in asthma and cause more difficulty with ____________ than ___________.

Answer 34

Cartilage Bronchoconstriction Expiration Inspiration

Question 35

Why is expiration harder than inspiration for asthma patients?

Answer 35

During expiration, the bronchial walls are no longer held open by the surrounding alveoli

Question 36

True or false: as bronchioles get smaller, goblet cells give way to Clara cells

Answer 36

TRUE

Question 37

What do Clara cells secrete? (2)

Answer 37

Surfactant lipoprotein which prevents the walls sticking together during expiration Clara cell protein (CC16)

Question 38

What does CC16 protein do? (2)

Answer 38

Measurable marker in bronchoalveolar lavage fluid (if lowered then lung damage) Measurable marker in serum (if raised then leakage across air-blood barrier)

Question 39

Why is the absence of goblet cells in terminal bronchioles important?

Answer 39

To prevent individuals from 'drowning' in their own mucus

Question 40

What can alveoli open into? (4)

Answer 40

1. Respiratory bronchioles 2. Alveolar duct 3. Alveolar sac 4. Another alveolus

Question 41

Describe the properties of alveolar walls (4)

Answer 41

1. Have abundant capillaries 2. Supported by basketwork of elastic and reticular fibres 3. Have a covering composed of type I pneumocytes 4. Have scattering of intervening type II pneumocytes

Question 42

What causes emphysema?

Answer 42

Destruction of alveolar walls and permanent enlargement of air spaces which can result from smoking or alpha1-antitrypsin deficiency

Question 43

What is the hallmark sign of emphysema?

Answer 43

Pursed-lip breathing

Question 44

What happens when alveolar walls are damaged?

Answer 44

Bronchioles collapse, making it difficult for lungs to empty so air becomes trapped in alveoli

Question 45

What causes pneumonia?

Answer 45

Inflammation of the lung caused by bacteria (Streptococcus pneumoniae is most common)