RS Lecture 1 and 2 - Why is lung disease important? & Structure of the airways Flashcards Preview

LSS 1 - Thorax anatomy, Respiratory and Circulatory system > RS Lecture 1 and 2 - Why is lung disease important? & Structure of the airways > Flashcards

Flashcards in RS Lecture 1 and 2 - Why is lung disease important? & Structure of the airways Deck (69)
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1
Q

<p>What is the partial pressure of O2 and CO2 in arteriole blood?</p>

A

<p>PAO2: 13.3 kPa

| PACO2: 5.3 kPa</p>

2
Q

<p>What is the partial pressure of O2 and CO2 in atmospheric air?</p>

A

<p>O2: 0.209 (20.9%)

| CO2: 0.0004 (0.04%)</p>

3
Q

<p>What does disease burden and relative rankings depend on?</p>

A

<p>The parameter studied and the population studied - mortality, morbidity (either hospital admissions OR years lived with disability), uniformity across world/country</p>

4
Q

<p>What is the UK's leading disease burden vs the leading actual killer?</p>

A

<p>Low back pain vs Ischemic heart disease</p>

5
Q

<p>What is the mortality rate of respiratory diseases? </p>

A

<p>1 in 5 die in the UK</p>

6
Q

<p>What has happened to the death rate of COPD in recent years?</p>

A

<p>It has risen dramatically, predicted to be in top 3 causes of mortality by 2020</p>

7
Q

<p>What is the biggest cancer killer in the UK?</p>

A

<p>Lung cancer - more women die from lung cancer than from breast cancer</p>

8
Q

<p>Some facts about lung cancer in UK:</p>

A

<p>45,000 new cases per year, </p>

9
Q

<p>What is happening to the prevalence of smoking?</p>

A

<p>It is decreasing but more women are smoking now - 21% men and 16.5% women smoke</p>

10
Q

<p>What are the 4 things to consider when diagnosing a patient with a resp disease?</p>

A

<p>1. Infectious 2. Pulmonary vascular disorder 3. Small lung disorders 4. Airways diseases</p>

11
Q

<p>Give me an example of an infectious resp disease</p>

A

<p>TB - rates have been rising again especially in London</p>

12
Q

<p>Give me an example of a pulmonary vascular disorder </p>

A

<p>Pulmonary emboli - clots from legs/pelvis can complicate mobility and become fatal - single biggest cause of maternal death associated with childbirth</p>

13
Q

<p>Give me 2 examples of a small lung disorder due to disease outside of lung</p>

A

<p>Mesothelioma caused by Asbestos - increasing rapidly, with peak in 10ish years
Obesity - ^ resp workload and resp dysfunction and associated with ^ risk of asthma and sleep related breathing disorders</p>

14
Q

<p>Give me an example of an airways disease with a localised obstruction:</p>

A

<p>Sleep apnoea - leads to six times normal risk of having a road accident - can't breath for 45 out of 60s during sleeping, so wake up and get unrestful sleep</p>

15
Q

<p>Some facts about COPD:</p>

A

<p>920 admitted to hospital - 10.4% died, 19.1% readmitted after discharge within a month, 34.2% too breathless to leave the house</p>

16
Q

<p>Give me an example of a small lung disorder due to disease within the lungs:</p>

A

<p>Idiopathic Pulmonary Fibrosis - median survival rate is 3 years, 35% increase in diagnosis</p>

17
Q

<p>What is the main issue with resp diseases?</p>

A

<p>Most of them aren't diagnosed well enough, if at all</p>

18
Q

<p>What are the main symptoms that reflect lung disease?</p>

A

<p>Breathlessness, coughing, sputum production, chest discomfort, hoarseness, etc</p>

19
Q

<p>What is the problem with lung disease symptoms?</p>

A

<p>Could be due to many reasons - eg: Breathlessness: Lung/heart/pulmonary vascular/neuromuscular disease, systemic disorders etc</p>

20
Q

<p>What are the main processes that are debilitated by these illnesses?</p>

A

<p>Function of lungs is gas exchange - resting adult needs 250ml O2/min which is more than acquired by diffusion</p>

21
Q

<p>How do different diseases interfere with gas exchange? </p>

A

<p>COPD: toxic effect paralyses cilia so can't sweep mucus and secretions interfere with calibre of airway</p>

22
Q

<p>How can the calibre of the airway be changed?</p>

A

<p>Mucus isn't swept away so builds up, thickening of membrane, thinning of membrane and loss of supportive tissue around airway</p>

23
Q

<p>Why are spirometers important?</p>

A

<p>Can determine what kind of lung disease - between small lung disease vs obstructive disorders</p>

24
Q

<p>What are the main structure of the resp system?</p>

A

<p>Nasal cavities, sinuses, pharynx, larynx, tracheobronchial tree, lungs, diaphragm</p>

25
Q

<p>What is the role of the nasal cavity?</p>

A

<p>To warm and moisten the air that we breathe in</p>

26
Q

<p>How is the nasal cavity innervated?</p>

A

<p>By 2 types of innervation - 1) sensory/somatic from CNV: Lower half by maxillary divison and upper half by ophthalmic division
2) olfactory nerves that lie above the nasal cavity, close to the brain</p>

27
Q

<p>What are the names of the three major ridges in the sinuses?</p>

A

<p>Inferior, Middle and Superior Concha, with inf being the biggest</p>

28
Q

<p>What are the 4 sinuses?</p>

A

<p>Frontal (between the eyebrows), Ethmoidal (between the eyes - air cells), Sphenoidal (under the pituitary), Maxillary (under the eyes - largest and main ones)</p>

29
Q

<p>What is the debilitating factor of the maxillary sinus and why is it a problem?</p>

A

<p>The drainage opening is at the top of the sinus, so drainage of mucus is difficult, hence infections can occur more easily</p>

30
Q

<p>Why do dentists have to be careful when removing teeth?</p>

A

<p>There is very little space between the root of the tooth and the maxillary sinus, so erosion of the layer could cause a hole in the maxillary sinus</p>

31
Q

<p>What do the ethmoidal sinuses and the separation between the brain and nose do?</p>

A

<p>It acts as an insulation layer, to keep the brain and the eyes from experiencing any sudden change in temp from the air inhaled</p>

32
Q

<p>What is the nasal septum?</p>

A

<p>Its the bone and cartilage that separates the nostrils </p>

33
Q

<p>What are the 3 sections of the pharynx?</p>

A

<p>Nasopharynx, Oropharynx, Laryngopharynx</p>

34
Q

<p>Where is the nasopharynx section? </p>

A

<p>Extends from back of nasal cavity to bottom of the tongue</p>

35
Q

<p>Where is the oropharynx?</p>

A

<p>From below the tongue to the epiglottis</p>

36
Q

<p>Where is the laryngopharynx?</p>

A

<p>From the epiglottis to the beginning of the oesophagus/entrance to larynx</p>

37
Q

<p>What is the larynx?</p>

A

<p>The voice box - holds the vocal cords </p>

38
Q

<p>What is the structure of the larynx?</p>

A

<p>Hyoid bone, thyrohyoid membrane, thyroid cartilage, cricothyroid ligament, cricoid cartilage</p>

39
Q

<p>Where is the larynx situated?</p>

A

<p>Anterior of the neck, can feel it as 'Adam's apple'</p>

40
Q

<p>Where is the opening of the larynx?</p>

A

<p>Situated posteriorly to the thyroid cartilage</p>

41
Q

<p>How is the thyroid bone adapted for its function?</p>

A

<p>It is open at the back, so it is c-shaped up until the cricoid cartilage which goes all the way around</p>

42
Q

<p>What are the vocal ligaments and what do they do?</p>

A

<p>They are infoldings of the membrane and they open when we breathe and close when we talk, so air passes through, phonating the air</p>

43
Q

<p>What is the difference between phonation and vocalisation?</p>

A

<p>Phonation is done by the larynx and changes pitch and volume of the air
Vocalisation is the movement of tongue, cheeks, mouth to make words</p>

44
Q

<p>What is the structure of the trachea?</p>

A

<p>C-shaped cartilage ring with epithelium on the inside. Between trachea and oesophagus exists the Trachealis muscle</p>

45
Q

<p>Where does the tracheobronchial tree begin?</p>

A

<p>Bifurication is at T4-5 around the sternal angle</p>

46
Q

<p>What kind of bifurcation is it?</p>

A

<p>It's asymmetrical, with RHS straighter and shorter than left as it moves to the right due to aortic arch</p>

47
Q

<p>How does the bronchial tree separate?</p>

A

<p>Primary, lobar, segmental bronchi - all have cartilage but it decreases as it goes down the levels</p>

48
Q

<p>What's after the segmental bronchi?</p>

A

<p>Bronchioles which are made from smooth muscle (no cartilage)</p>

49
Q

<p>Where do bronchioles terminate?</p>

A

<p>In the alveoli</p>

50
Q

<p>Where do the viscera and parietal pleura meet?</p>

A

<p>At root of lung and they are kept lubricated by surfactant</p>

51
Q

<p>Where do the lungs and the pleura reach on the body?</p>

A

<p>The pleura reaches 2 ribs below, so 6 and 8th respectively on midclavicular line</p>

52
Q

<p>Why is there more space for the pleura below the lungs?</p>

A

<p>To allow space for lungs to expand if needed</p>

53
Q

<p>What is the pulmonary ligament?</p>

A

<p>An extension of the pleura, allowing space for expansion</p>

54
Q

<p>What grooves are present on the left lung?</p>

A

<p>Left subclavian artery (top closest to apex), left brachiocephalic vein, descending aorta (and arch), cardiac impression and oesophagus (in front of aorta)</p>

55
Q

<p>What grooves are present on the right lung?</p>

A

<p>Subclavian artery, subclavian vein, svc, ivc, azygos vein (arches round) and oesophagus</p>

56
Q

<p>What 6 things are present in the hilum?</p>

A

<p>Pulmonary arteries (deO2), veins (O2), lymph nodes, bronchi, pulmonary plexus and arterioles</p>

57
Q

<p>What are bronchopulmonary segments?</p>

A

<p>The smallest bit of the lungs that can function independently, as it has its own blood supply, air supply and innervation</p>

58
Q

<p>What drives oxygen across the blood-air barrier?</p>

A

<p>Partial pressures - PO2 Air = 100 mmHg, PO2 blood = 40 mmHg </p>

59
Q

<p>Why is a lymphatic system important for the lungs?</p>

A

<p>The lungs are in contact with the outside air, so need fast access to immune system</p>

60
Q

<p>Where is the diaphragm positioned?</p>

A

<p>Lower edge attached at costal margin, centre of dome bulges up due to pressure difference between abdomen and pleural cavities up to 5th intercostal space</p>

61
Q

<p>What is the structure of the diaphragm?</p>

A

<p>Tendon sheet in the middle, with muscle surrounding it</p>

62
Q

<p>How does the diaphragm contract?</p>

A

<p>The outer muscle contracts, stretching the tendinous sheet, also attached to pericardium, so heart moves along with it</p>

63
Q

<p>What are the three tubes that pass through the diaphragm and where do they pass through?</p>

A

<p>IVC - through the tendinous tissue at T8, Oesophagus through muscular folding at T10, aorta between diaphragm and spine at T12</p>

64
Q

<p>What is the mnemonic for the 3 hiatuses of the diaphragm?</p>

A

<p>I 8 10 E A 12 "I ate 10 eggs at 12" - IVC at T8, Oesophagus T10, Aorta T12</p>

65
Q

<p>Where does the phrenic nerve originate?</p>

A

<p>C3-5</p>

66
Q

<p>What does the phrenic do?</p>

A

<p>Motor to diaphragm, so causes contraction</p>

67
Q

<p>How do you tell the difference between vagus and phrenic nerve?</p>

A

<p>Vagus is posterior to hilum, Phrenic anterior</p>

68
Q

<p>How do the ribs move when breathing?</p>

A

<p>Ribs expand like a bucket handle, so up - and like a water pump, so out, by turning the sternum outwards</p>

69
Q

<p>What other important muscles are used in breathing?</p>

A

<p>The abdominals and the pelvic diaphragm</p>

Decks in LSS 1 - Thorax anatomy, Respiratory and Circulatory system Class (27):