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CardioPulmonary Class > Structure and Function of the Lung Lecture 1 > Flashcards

Structure and Function of the Lung Lecture 1 Flashcards

1
Q

Discuss the dimensions of the trachea and main bronchi

A
  • Adult trachea diameter is 1.8 - 2.5 cm, length 11-13 cm
  • Supported by “U” shaped cartilages joined posteriorly by smooth muscle bands
  • External pressure of 40 cm H20 is sufficient to compress the trachea
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2
Q

Identify clinical significance of the dimensions for the trachea and bronchi

A
  • Trachea
    • 18mm
  • Main Bronchi
    • 12 mm
  • Lobar Bronchi
    • 5-8 mm
  • Segmental Bronchi
    • 4 mm
  • Small Bronchi
    • 1-3 mm
  • Terminal Bronchioles
    • 0.7-1 mm
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3
Q

List three factors affecting upper airway tone

A
  1. Mouth
  2. Nose
  3. Oropharynx
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4
Q

Identify the three areas from teeth to bronchi with the smallest cross-sectional area

A

Trachea

  • 2.54 cm2

Bronchi 1

  • 2.33 cm2

Bronchi 2

  • 2.13 cm2

Bronchi 3

  • 2.0 cm2
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5
Q

Describe the anatomy of the laryngeal cavity and vocal cords

A

Abductors

  • Posterior crycoarytenoids

Adductors

  • Lateral Crycoarytenoids

Regulators of tension

  • Cricothyroid
  • Thyroarytenoid
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6
Q

Larynx and Vocal Cords

A
  • Larynx extends from the epiglottis to cricoid
  • True vocal cords attatch anteriorly to thyroid and posteriorly to the arytenoids
  • Larynx has poor lymphatic drainage, prone to edema
  • Triangular fissure between cords is the glottic opening.
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7
Q

Abductors

A

Posterior Crycoarytenoids

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8
Q

Adductors

A

Lateral Crycoarytenoids

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9
Q

Regulators of tension

A
  • Cricothyroid
  • Thyroarytenoid
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10
Q

Identify the most narrow portion of thelower airway in adults

A
  • Glottis is the most narrowest part of the lower airway in adult
  • Epiglottis is a life threatening condition (Supraglottic croup)
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11
Q

Discuss the effects of recurrent laryngeal nerve damage

A
  • Provides sensation below the cords
  • Damage may cause vocal cord palsy (Intermediate position between abducted and adducted state)
  • Occurs with radical neck dissection, paroridetomy, and thyroidectomy
  • NO muscle relaxant use
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12
Q

What occurs during superior laryngeal nerve damage?

A
  • Provides sensation above the cords and to cricothyroid
  • Stimulation may provoke larnygospasm
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13
Q

Descrive the mucosa of the nasopharnx and the trachea

A
  • Trachea
    • columnar ciliated epithelium
  • Small bronchi
    • columnar ciliated epithelium
  • Terminal Bronchioles
    • cuboidal
  • Respiratory Bronchioles
    • cubodal between the alveoli
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14
Q

Discuss the intrathoracic section of the trachea and its significance

A
  • Trachea bifurcated assymetically, the right bronchus being wider, shorter, and making a smaller angle, the left being thing and longer
  • Foreign bodies tend to enter the right main stem bronchus
  • Generations 1-4 have full cartilaginous support
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15
Q

Tracheal Dimensions

A
  • Teeth to cords 13 cm, adult trachea 11 - 13 cm
  • Orifice of RUL 1-2.5 cm from the carina, while that of the LUL is 5cm distal
  • Right bronchus 25 degrees, left bronchus 45 degrees
  • Diameter is 1.8 - 2.5 cm
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16
Q

What are the conducting zones

A
  • Generations 0-16
  • Trachea, left and right mainstem bronchi, lobar bronchi, segmental bronchi, terminal broncioles, comprise an anatomic dead space fo 150 ml
17
Q

What are the respiratory zones

A
  • Generations 17- 23
  • Respiratory bronchioles
  • Alevelolar ducts and alveoli
18
Q

Compare and Contrast Epithelium and cartilage in different generations of the lung

A
  • Pseudofied columnar ciliated epithelium
    • From nasal cavity to bronchioles
    • Mucous is propelled forward by ciliated epithelial cells
  • Cuboidal epithelium
    • Bronchioles to alveolus
  • Goblet cells
    • Produce mucous that lines all airways (increased in asthma and cystic fibrosis)
  • Other cells found in the respiratory epithelium include basal, mast, nonciliated bronchiolar epithelial, and APUD cells
19
Q

Epithelium Generation 1-11

A

Columnar ciliated epithelium

20
Q

Epithelium Generation 12-18

A

Cuboidal

21
Q

Epithelium level 19-23

A

Cuboidal between alveoli

22
Q

Identify which bronchus generations have cartilaginous support

A
  • Trachea - U shaped cartilage
  • Main Bronchi - U Shaped cartilage
  • Lobar Bronchi - Irregular shaped cartilage
  • Segemental Bronchi - Irregular shaped cartilage
  • Small bronchi - Irregular shaped cartilage
  • Terminal Bronchi - NO CARRTILAGE
23
Q

At what level does the cartilage become absent

A

Terminal bronchioles

  • last site with cartilage are the small bronchi
24
Q

Identify the cells reponsible for bronchospasm in asthmatics

A

Mast cells

  • Activation is the main cause of immediate bronchospasm seen in allergen induced asthma
25
Q

Identify the mechansim responsible for maintaining patency of generations 5-11

A

Patency relies partially on some cartilage in walls and postive transmural pressure gradient

  • pressure gradient must exist between pleural space and airway or airway collapse occurs.
26
Q

Identify the generation of bronchioles where the transition from conduction to respiration occurs.

A

Generations 17-18

  • Transition from conduction to gas exchange occurs here
  • gradual increase in nubmer of alveoli in walls of bronchioles
  • tremendous increase in cross- sectional area.
27
Q

Describe the approximate number of alveoli

A

Total number 2 million to 8 million, depending on height

28
Q

Describe the amount of surface area available for gas exchange.

A

On one side of the alveolar wall the capillary endothelium and alveolar epithelium are closely opposed

  • Total distance from gas to blood is 0.3 micrometers, where gas exchange is more efficient
  • This is known as the active side.
29
Q

Define Pores of Kohn and their significance

A
  • Small holes in the walls of adjoining alveoli (Alveolar septa)
  • Between 3 to 14 u in diameter
  • Formation of pores may be due to
    • Dequamation due to disease
    • Normal degeneration due to aging
    • Movement of macrophages leaving holes
30
Q

Aleveolar Septa “Service Side”

A
  • The other side of the capillary “service side” is usually more than 1-2 mm thick
  • Sizeable interstitial space containing elastin, collagen, nerve endings, and macrophages
  • Service side is more affected by edema and firbous tissue
31
Q

Alveolar Septa “Active Side”

A

One side of alveolar wall where capillary endothelium and alveolar epithelium are closely opposed

  • Total distance form gas to blood is 0.3 mm, where gas exhagne is more efficient.
32
Q

Differentiate between Type I and Type II alveolar

A
  • Alveolar Type 1
    • 95% of the alveolar surface is made up of squamous pneumocyte cells
    • Between 0.1 U and 0.5 U thick
    • major site of gas exchange
  • Alveolar Type 2
    • 5% of surface of alveoli composed of granular pneumocyte cells
    • cubodal in shape with microvilli
    • primary source of pulmonary surfactant
    • involved with reabsorption of fluid in the dry, alveolar spaces.
33
Q

Discuss the primary funciton of surfactant

A
  • Acts as a detergent to decrease surface tension
  • Pulmonary compliance is increased and work of breathing is reduced
  • Permits alveolar stability by keeping smaller alveoli from collapsing into large alveoli
34
Q

List four functions of the lungs

A
  1. Allow oxygen and carbon dioxide exhange
  2. Maintain/ regulate pH
  3. Metabolizes/ synthesizes/ converts compounds
  4. Filters unwanted materials from the circulation
  5. Acts as a reservoir for blood
  6. Defense against environment.
35
Q

Describe the difference between the parietal pleura and visceral pleura and their function

A
  • Parietal pleura lines the thoracic wall
  • Visceral pleura covers the lung surface
36
Q

Compare the role of the sympathetic and parasympathetic nervous system in regulating bronchial tone

A
  • Parasympatetic motor fibers (predominate)
    • constrict the bronchi
    • affected by medication, mechanical
  • Sympathetic (weak)
    • dilate the bronchi
    • affected by medication, agents.
37
Q

Identify the most important muscle in respiration and its innervation

A
  • Muscles of pharynx and larynx control upper airway resistance
  • Diaphragm, ribcage, spine, and neck muscles control inspiration
  • Muscles of the abdominal wall, ribcage and spine are utilized for active expiration
  • The most important muscle of inspiration is the diaphragm (75%)
  • Innervation is solely from the phrenic nerves (C3, C4, C5)
38
Q

List three metabolic functions of the lungs

A
  1. Conversion of angiotensin I to angiotensin II
  2. Complete or partial inactivation of vasoactive substances (bradykinin, serotonin, prostaglandins)
  3. Metabolism of several vasoactive and bronchoactive compounds such as arachidonic acid metabolites (Leukotrienes, prostaglandins, prostacyclin)
  4. Plays a major role in clotting mechanism (mast cells contain heparin) and immune system (IgA production)

CardioPulmonary Class (6 decks)

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