Sesh 10: The Respiratory System & Breast

Question 1

What structure attaches at the sternal angle?

Answer 1

The 2nd rib.

Question 2

Why is the inferior aspect of each lung curved upwards?

Answer 2

Because the domed diaphragm is beneath them.

Question 3

Is the diaphragm higher on the right or left, and why?

Answer 3

On the right due to the liver.

Question 4

What are the names of the resulting conditions when the pleural cavity fills with:

1. Air
2. Blood
3. Pus
4. Watery transudate or exudate

Answer 4

1. Pneumothorax
2. Haemothorax
3. Empyema
4. Pleural effusion

Question 5

Which intercostal space is a needle usually inserted into, to drain fluid from the pleural cavity?

Answer 5

7th, posteriorly.

Above the superior border of the lower rib to avoid vessels and nerves.

Question 6

The intercostal nerves and vessels run along the _______ aspect of each rib.

Answer 6

Inferior, in the costal groove.

So needles are inserted above the superior border of lower rib to avoid this.

Question 7

The conducting portion of the respiratory tract runs from the __________ to the _________.

Answer 7

1. Nasal cavity

2. Terminal bronchioles

Question 8

The nasal cavity to the largest bronchioles are lined with _____________ epithelium.

Answer 8

Pseudostratified

Question 9

Simple columnar epithelium lines which part of the respiratory tract?

Answer 9

Terminal bronchioles.

Question 10

The respiratory bronchioles and alveolar ducts are lined by what type of epithelium?

Answer 10

Simple cuboidal.

Question 11

Which part of the respiratory tract is lined by simple squamous epithelium?

Answer 11

Alveoli.

Question 12

The epithelium of the olfactory region of the nasal cavity is lacking what type of cell?

Answer 12

Goblet cells.

Question 13

What is different about the cilia in the olfactory region of the nasal cavity?

Answer 13

They are non-motile.

Question 14

What are Bowman’s glands?

Answer 14

Serous glands in the olfactory region of the nasal cavity that produce a watery secretion, to flush odorants from the epithelial surface.

Question 15

Each vocal cord of the larynx contains:
1.
2.

Answer 15

1. A vocal ligament (elastic fibres)

2. A vocalis muscle (skeletal muscle)

Question 16

How does the histology of the primary bronchi differ from that of the trachea?

Answer 16

The cartilage completely encircles the bronchi lumen, but forms C-shaped rings in the trachea.

Question 17

Which bronchus are foreign objects more likely to lodge within, and why?

Answer 17

The right, as its path is more vertical than the left.

Question 18

What classification of epithelium is termed ‘respiratory epithelium’?

Answer 18

Pseudostratified ciliad epithelium, as this lines most of the upper respiratory tract, but gas exchange doesn’t occur here.

Question 19

In COPD, there is:

• __________ cell hyperplasia
• reduced no’s of __________ cells
• hypertrophy of the __________ _________

Answer 19

1. Goblet
2. Ciliated
3. Submucous
4. Glands
   (So get more mucus with less cilia to move it)

Question 20

How does the histology of secondary and tertiary bronchi differ from the primary bronchi?

Answer 20

Cartilage is arranged as irregular crescent plates rather than the rings seen in primary bronchi.

Question 21

How are bronchiole walls held open?

Answer 21

By the elasticity of the alveolar walls.

Question 22

Why do asthmatic patients have more difficulty expiring that inspiring?

Answer 22

In expiration, bronchial walls aren’t held open by alveoli, so they tend to collapse due to the pressure decrease.

Question 23

Where are Clara cells found?

Answer 23

Between bronchiolar ciliated epithelial cells, from the terminal bronchioles to the alveolar ducts.

Question 24

What do Clara cells secrete?

Answer 24

A surfactant lipoprotein and Clara cell protein (CC16).

Question 25

Raised levels of CC16 in the serum indicates.....?

Answer 25

Leakage across the air-blood barrier.

Question 26

Lowered CC16 levels in bronchoalveolar lavage fluid indicates.......?

Answer 26

Lung damage.

Question 27

What's the function of surfactant lipoprotein secreted by Clara cells?

Answer 27

Prevents bronchiolar walls sticking together in expiration.

Question 28

Alveolar walls are supported by a basketwork of_______ and __________ fibres.

Answer 28

1. Elastic | 2. Reticular

Question 29

Type I pneumocytes are ___________ in shape, and cover ____% of the alveolar surface area.

Answer 29

1. Squamous | 2. 90

Question 30

Type II pneumocytes are ______ in shape and produce _________.

Answer 30

1. Cuboidal | 2. Surfactant

Question 31

Name a hallmark sign of emphysema.

Answer 31

Pursed-lip breathing.

Question 32

What happens to alveolar walls in emphysema?

Answer 32

They are destroyed, meaning bronchioles collapse, making expiration difficult.

Question 33

What is pneumonia?

Answer 33

Lung inflammation caused by bacteria. | Alveoli fill with inflammatory cells, and the lung consolidates.

Question 34

What cells, apart from type I and II pneumocytes, are found in the alveolar walls?

Answer 34

Macrophages- phagocytose microbes and dust.

Question 35

What are the 2 functions of pleural fluid?

Answer 35

1. Reduces friction between pleura during breathing | 2. Provides surface tension, preventing the lungs recoiling and collapsing

Question 36

The pressure in the intrapleural space during inspiration is_____cmH2O, and ______cmH2O during expiration.

Answer 36

1. -8 | 2. -4

Question 37

When does intrapulmonary pressure equalise with atmospheric pressure?

Answer 37

At the end of exhalation.

Question 38

The intrapleural pressure is usually ___cmH2O lower than intrapulmonary pressure, which keeps the ______ adherent to the ________.

Answer 38

1. 4 2. Lungs 3. Chest wall/ pleura

Question 39

During expiration, surfactant molecules move_________, to reduce ________ __________, and equalise the pressure within different sized alveoli.

Answer 39

1. Together 2. Surface 3. Tension

Question 40

What is a pancoast tumour?

Answer 40

A tumour of the apex of the lung

Question 41

What plexus can a pancoast tumour impinge upon?

Answer 41

Brachial plexus

Question 42

How might Horner's syndrome be caused?

Answer 42

By a pancoast tumour causing pressure on the sympathetic trunk. But can have other benign causes.

Question 43

What can be a sign of a pulmonary tumour impinging on the recurrent laryngeal nerve?

Answer 43

Patient may have a hoarse voice.

Question 44

How many lobes do the right and left lung have respectively?

Answer 44

Right- 3 lobes | Left- 2 lobes

Question 45

What type of gland is the breast?

Answer 45

A modified apocrine sweat gland.

Question 46

When does the final maturation of breasts occur?

Answer 46

During 1st pregnancy.

Question 47

At what point in foetal life do the breast buds form, in both sexes?

Answer 47

6th-9th week

Question 48

Where can accessory breast tissue present?

Answer 48

Anywhere along the course of the embryologic mammary streak (axilla to inguinal region).

Question 49

What is Poland syndrome?

Answer 49

A rare birth defect characterised by underdevelopment of the pectoralis major muscle on 1 side of the body, and webbed fingers (cutaneous syndactyly) on the ipsilateral side. More common in men.

Question 50

Which ribs are the breasts found between?

Answer 50

2nd-6th rib (sternal edge to anterior axillary line)

Question 51

What is the name of the ligaments that support the breasts?

Answer 51

Cooper's suspensory ligaments.

Question 52

Which 3 vessels provide arterial supply to the breast?

Answer 52

1. External mammary artery 2. Internal mammary arteries 3. Intercostal arteries

Question 53

Name 2 factors that can decrease the risk of breast cancer.

Answer 53

1. 1st pregnancy before 30 yrs 2. Breast feeding 3. Exercise

Question 54

Name 2 types of adjuvant therapy for breast cancer.

Answer 54

1. Chemotherapy 2. Hormonal therapy 3. Biological 4. DXT

Question 55

Name 2 actions of oxytocin following suckling.

Answer 55

1. Stimulates myoepithelial cells in mammary glands to contract and cause lactation 2. Causes uterine contraction

Question 56

Why do you need to investigate unusually fractures in someone with/ previously treated for breast cancer?

Answer 56

Bone is one of the most common sites of metastasis from breast cancer, so it could be due to a secondary tumour.

Question 57

What is apocrine secretion?

Answer 57

The apical plasma membrane of the gland pinches off, containing the vesicle to be secreted, and is secreted via a duct (exocrine).

Question 58

Where are Clara cells found?

Answer 58

Between the ciliated epithelial cells of the bronchioles.