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):

What is the partial pressure of O2 and CO2 in arteriole blood?

PAO2: 13.3 kPa
PACO2: 5.3 kPa


What is the partial pressure of O2 and CO2 in atmospheric air?

O2: 0.209 (20.9%)
CO2: 0.0004 (0.04%)


What does disease burden and relative rankings depend on?

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


What is the UK's leading disease burden vs the leading actual killer?

Low back pain vs Ischemic heart disease


What is the mortality rate of respiratory diseases?

1 in 5 die in the UK


What has happened to the death rate of COPD in recent years?

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


What is the biggest cancer killer in the UK?

Lung cancer - more women die from lung cancer than from breast cancer


Some facts about lung cancer in UK:

45,000 new cases per year,


What is happening to the prevalence of smoking?

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


What are the 4 things to consider when diagnosing a patient with a resp disease?

1. Infectious 2. Pulmonary vascular disorder 3. Small lung disorders 4. Airways diseases


Give me an example of an infectious resp disease

TB - rates have been rising again especially in London


Give me an example of a pulmonary vascular disorder

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


Give me 2 examples of a small lung disorder due to disease outside of lung

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


Give me an example of an airways disease with a localised obstruction:

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


Some facts about COPD:

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


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

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


What is the main issue with resp diseases?

Most of them aren't diagnosed well enough, if at all


What are the main symptoms that reflect lung disease?

Breathlessness, coughing, sputum production, chest discomfort, hoarseness, etc


What is the problem with lung disease symptoms?

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


What are the main processes that are debilitated by these illnesses?

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


How do different diseases interfere with gas exchange?

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


How can the calibre of the airway be changed?

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


Why are spirometers important?

Can determine what kind of lung disease - between small lung disease vs obstructive disorders


What are the main structure of the resp system?

Nasal cavities, sinuses, pharynx, larynx, tracheobronchial tree, lungs, diaphragm


What is the role of the nasal cavity?

To warm and moisten the air that we breathe in


How is the nasal cavity innervated?

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


What are the names of the three major ridges in the sinuses?

Inferior, Middle and Superior Concha, with inf being the biggest


What are the 4 sinuses?

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


What is the debilitating factor of the maxillary sinus and why is it a problem?

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


Why do dentists have to be careful when removing teeth?

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


What do the ethmoidal sinuses and the separation between the brain and nose do?

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


What is the nasal septum?

Its the bone and cartilage that separates the nostrils


What are the 3 sections of the pharynx?

Nasopharynx, Oropharynx, Laryngopharynx


Where is the nasopharynx section?

Extends from back of nasal cavity to bottom of the tongue


Where is the oropharynx?

From below the tongue to the epiglottis


Where is the laryngopharynx?

From the epiglottis to the beginning of the oesophagus/entrance to larynx


What is the larynx?

The voice box - holds the vocal cords


What is the structure of the larynx?

Hyoid bone, thyrohyoid membrane, thyroid cartilage, cricothyroid ligament, cricoid cartilage


Where is the larynx situated?

Anterior of the neck, can feel it as 'Adam's apple'


Where is the opening of the larynx?

Situated posteriorly to the thyroid cartilage


How is the thyroid bone adapted for its function?

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


What are the vocal ligaments and what do they do?

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


What is the difference between phonation and vocalisation?

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


What is the structure of the trachea?

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


Where does the tracheobronchial tree begin?

Bifurication is at T4-5 around the sternal angle


What kind of bifurcation is it?

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


How does the bronchial tree separate?

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


What's after the segmental bronchi?

Bronchioles which are made from smooth muscle (no cartilage)


Where do bronchioles terminate?

In the alveoli


Where do the viscera and parietal pleura meet?

At root of lung and they are kept lubricated by surfactant


Where do the lungs and the pleura reach on the body?

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


Why is there more space for the pleura below the lungs?

To allow space for lungs to expand if needed


What is the pulmonary ligament?

An extension of the pleura, allowing space for expansion


What grooves are present on the left lung?

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


What grooves are present on the right lung?

Subclavian artery, subclavian vein, svc, ivc, azygos vein (arches round) and oesophagus


What 6 things are present in the hilum?

Pulmonary arteries (deO2), veins (O2), lymph nodes, bronchi, pulmonary plexus and arterioles


What are bronchopulmonary segments?

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


What drives oxygen across the blood-air barrier?

Partial pressures - PO2 Air = 100 mmHg, PO2 blood = 40 mmHg


Why is a lymphatic system important for the lungs?

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


Where is the diaphragm positioned?

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


What is the structure of the diaphragm?

Tendon sheet in the middle, with muscle surrounding it


How does the diaphragm contract?

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


What are the three tubes that pass through the diaphragm and where do they pass through?

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


What is the mnemonic for the 3 hiatuses of the diaphragm?

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


Where does the phrenic nerve originate?



What does the phrenic do?

Motor to diaphragm, so causes contraction


How do you tell the difference between vagus and phrenic nerve?

Vagus is posterior to hilum, Phrenic anterior


How do the ribs move when breathing?

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


What other important muscles are used in breathing?

The abdominals and the pelvic diaphragm

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