Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gross Anatomy > The Lungs > Flashcards

The Lungs Flashcards

1
Q

Which insults may cause inadvertent damage to the pleura?

A
  1. Surgical posterior approach to the kidney.
  2. Abdominal incision at the right infrasternal angle.
  3. Stellate ganglion nerve block.
  4. Brachial plexus nerve block.
  5. Knife wounds to the chest wall above the clavicle.
  6. Fracture of lower ribs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a chylothorax?

A

Occurs when lymph accumulates in the pleural cavity due to surgery or trauma that injures the thoracic duct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a hemothorax?

A

Occurs when blood enters the pleural cavity as a result of trauma or rupture of a blood vessel (e.g., a dissecting aneurysm of the aorta).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is an empyema?

A

Occurs when a thick pus accumulates in the pleural cavity. Empyema is a variant of pyothorax whereby a turbid effusion containing many neutrophils accumulates in the pleural cavity, usually as a result of bacterial pneumonia that extends into the pleural surface.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is pleuritis?

A

Pleuritis is inflammation of the pleura. Pleuritis involving only visceral pleura will be associated with no pain since the visceral pleura receives no nerve fibers of general sensation. Pleuritis involving the parietal pleura will be associated with sharp local pain and referred pain. Since parietal pleura is innervated by intercostal nerves and the phrenic nerve (C3, C4, and C5), pain may be referred to the thoracic wall and root of the neck, respectively.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What constitutes an open pneumothorax?

A

An open pneumothorax occurs when the parietal pleura is pierced and the pleural cavity is opened to the outside atmosphere. Upon inspiration, air is sucked into the pleural cavity and results in a collapsed lung. Most common causes include chest trauma (e.g., knife wound) and iatrogenic etiology (e.g., thoracocentesis, transthoracic lung biopsy, mechanical ventilation, central line insertion).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a spontaneous pneumothorax?

A

Occurs when air enters the pleural cavity usually due to a ruptured bleb (bulla) of a diseased lung. Results in a loss of negative intrapleural pressure and a collapsed lung.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common site for a spontaneous pneumothorax to occur?

A

In the visceral pleura of the upper lobe of the lung.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some typical clinical findings associated with spontaneous pneumothorax?

A

Clinical findings include chest pain, cough, and mild to severe dyspnea; spontaneous pneumothorax most commonly occurs in young, tall males.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a tension pneumothorax?

A

May occur as a sequela to an open pneumothorax if the inspired air cannot leave the pleural cavity through the wound upon expiration (check-valve mechanism). Results in a collapsed lung on the wounded side and a compressed lung on the opposite side due to a deflected mediastinum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which clinical findings are associated with tension pneumothorax?

A

Clinical findings include chest pain, shortness of breath, deviated trachea, absent breath sounds on the affected side, and hypotension since the mediastinal shift compresses the SVC and IVC, thereby obstructing venous return. Tension pneumothorax may cause sudden death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many U-shaped hyaline cartilages are found in the trachea?

A

16-20.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

At which vertebral levels does the trachea begin and end?

A

The trachea begins just inferior to the cricoid cartilage (C6 vertebral level) and ends at the sternal angle (T4 vertebral level), where it bifurcates into the right main bronchus and the left main bronchus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the carina?

A

The last tracheal cartilage at the bifurcation of the trachea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The right main bronchus is shorter and wider and turns to the right at a shallower angle than the left main bronchus. True or false?

A

True.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Into how many lobar and segmental bronchi does the right main bronchus branch?

A

The right main bronchus branches into 3 lobar bronchi (upper, middle, and lower) and finally into 10 segmental bronchi.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Into how many lobar and segmental bronchi does the left main bronchus branch?

A

The left main bronchus branches into 2 lobar bronchi (upper and lower) and finally into 8-10 segmental bronchi, the branching of which corresponds to the bronchopulmonary segments of the lung.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can cause compression of the trachea?

A

Compression of the trachea may be due to an enlargement of the thyroid gland or due to an aortic arch aneurysm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What may distortions in the position of the carina indicate?

A

Distortions in the position of the carina may indicate metastasis of bronchogenic carcinoma into the tracheobronchial lymph nodes that surround the tracheal bifurcation or may indicate enlargement of the left atrium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Into which portion of the lungs does aspirated material most commonly enter when a person is sitting or standing?

A

Aspirated material most commonly enters the right lower lobar bronchus and lodges within the posterior basal bronchopulmonary segment (no. 10) of the right lower lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Into which portion of the lungs does aspirated material most commonly enter when a person is supine?

A

Aspirated material most commonly enters the right lower lobar bronchus and lodges within the superior bronchopulmonary segment (no. 6) of the right lower lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Into which portion of the lungs does aspirated material most commonly enter when a person is lying on the right side?

A

Aspirated material most commonly enters the right upper lobar bronchus and lodges within the posterior bronchopulmonary segment (no. 2) of the right upper lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Into which portion of the lungs does aspirated material most commonly enter when a person is lying on the left side?

A

Aspirated material most commonly enters the left upper lobar bronchus and lodges within the inferior lingular (no. 5) bronchopulmonary segment of the left upper lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the course of the horizontal fissure of the right lung.

A

The horizontal fissure runs at the level of costal cartilage 4 and meets the oblique fissure at the midaxillary line.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe the distinctive anatomic features of the left lung.

A

The left upper lobe contains the cardiac notch, where the left ventricle and pericardial sac abut the lung. The lingula (which is the embryologic counterpart to the right middle lobe) lies just beneath the cardiac notch.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What defines a bronchopulmonary segment?

A

A bronchopulmonary segment contains a segmental bronchus, a branch of the pulmonary artery, and a branch of the bronchial artery, which run together through the central part of the segment.

27
Q

Why is it important to know that the tributaries of the pulmonary vein are found at the periphery of each bronchopulmonary segment, between two adjacent segments?

A

These veins form surgical landmarks during segmental resection of the lung.

28
Q

Name the bronchopulmonary segments within each lobe of the right lung.

A

Upper lobe: Apical (no. 1), Posterior (no. 2), and Anterior (no. 3)

Middle lobe: Lateral (no. 4), Medial (no. 5)

Lower lobe: Superior (no. 6), Medial Basal (no. 7), Anterior Basal (no. 8), Lateral Basal (no. 9), Posterior Basal (no. 10)

29
Q

Name the bronchopulmonary segments within each lobe of the left lung.

A

Upper lobe: Apical (no. 1), Posterior (no. 2), Anterior (no. 3), Superior Lingular (no. 4), Inferior Lingular (no. 5)

Lower lobe: Superior (no. 6), Anterior Basal (no. 8), Lateral Basal (no. 9), Posterior Basal (no. 10); note that no. 7 is absent

30
Q

Where can breath sounds from the upper lobe of each lung be auscultated?

A

On the anterior-superior aspect of the thorax.

31
Q

Where can breath sounds from the lower lobe of each lung be auscultated?

A

On the posterior-inferior aspect of the thorax.

32
Q

Where can breath sounds from the middle lobe of the right lung be auscultated?

A

On the anterior thorax near the sternum just inferior to intercostal space no. 4.

33
Q

Describe the course of the right pulmonary artery.

A

The right pulmonary artery run horizontally toward the hilus beneath the arch of the aorta; posterior to the ascending aorta and SVC; and anterior to the right main bronchus.

34
Q

What are some key differences between the right and left pulmonary arteries?

A

The left pulmonary artery is shorter and narrower than the right pulmonary artery and is connected to the arch of the aorta by the ligamentum arteriosum.

35
Q

From which artery does the right bronchial artery arise?

A

The right bronchial artery is a branch of a posterior intercostal artery.

36
Q

The two left bronchial arteries branch from which artery?

A

The two left bronchial arteries are branches of the thoracic aorta.

37
Q

What percentage of bronchial blood drains into the pulmonary capillary plexus versus the bronchial veins?

A

70% of bronchial blood drains into the pulmonary capillary plexus, while 30% of bronchial blood drains into the bronchial veins.

38
Q

What do the pulmonary veins carry?

A

The pulmonary veins carry oxygenated blood from the pulmonary capillary plexus and deoxygenated bronchial blood to the left atrium.

39
Q

How many pulmonary veins are there?

A

There are five pulmonary veins that drain each lobe of the lungs. However, the pulmonary veins from the right upper and middle lobes generally join so that only four pulmonary veins open into the posterior aspect of the left atrium.

40
Q

Into which vein do the right bronchial veins drain?

A

Into the azygos vein.

41
Q

Into which vein do the left bronchial veins drain?

A

Into the accessory hemiazygos vein.

42
Q

Describe the parasympathetic motor innervation of the lungs.

A

Preganglionic neuronal cell bodies are located in the dorsal nucleus of the vagus and nucleus ambiguus of the medulla. Preganglionic axons run in the vagus nerve (CN X). Postganglionic neuronal cell bodies are located in the pulmonary plexuses and within the lung along the bronchial airways.

43
Q

What are the effects of parasympathetic motor innervation of the lungs?

A

Postganglionic parasympathetic axons terminate on smooth muscle of the bronchial tree, causing bronchoconstriction, and seromucous glands, causing increased glandular secretion.

44
Q

Describe the parasympathetic sensory innervation of the lungs.

A

The neuronal cell bodies are located in the inferior (nodose) ganglia of CN X. These neurons send a peripheral process to the lung via CN X and a central process to the solitary nucleus in the brain. These neurons transmit touch and stretch sensation.

45
Q

Describe the sympathetic motor innervation of the lungs.

A

Preganglionic neuronal cell bodies are located in the intermediolateral cell column of the spinal cord. Preganglionic axons enter the paravertebral ganglia. Postganglionic neuronal cell bodies are located in the paravertebral ganglia at the cervical (superior, middle, and inferior ganglia) and thoracic (T1-T4) levels. Postganglionic sympathetic axons terminate on smooth muscle of blood vessels within the lung, causing vasoconstriction. Postganglionic sympathetic axons also terminate on postganglionic parasympathetic neurons and modulate their bronchoconstriction activity (thereby causing bronchodilation).

46
Q

How does epinephrine produce bronchodilation?

A

Circulating epinephrine from the adrenal medulla acts directly on bronchial smooth muscle to cause bronchodilation.

47
Q

Describe the sympathetic sensory innervation of the lungs.

A

The neuronal cell bodies are located in the dorsal root ganglia at about C7-C8 and T1-T4 spinal cord levels. These neurons send a peripheral process to the lung via the sympathetics and a central process to the spinal cord. These neurons transmit pain sensation.

48
Q

What is atelectasis?

A

Incomplete expansion of alveoli (in neonates) or collapse of alveoli in adults.

49
Q

What causes neonatal respiratory distress syndrome (NRDS)?

A

NRDS is caused by a deficiency of surfactant, which may occur due to prolonged intrauterine asphyxia, in premature infants, or in infants of diabetic mothers.

50
Q

How is lung maturation assessed in utero?

A

Lung maturation is assessed by the lecithin-to-sphingomyelin ratio in amniotic fluid (a ratio > 2:1 = maturity).

51
Q

Which clinical and pathological findings are common in NRDS?

A

Pathologic findings include hemorrhagic edema within the lung, atelectasis, and hyaline membrane disease characterized by eosinophilic material consisting of proteinaceous fluid (fibrin, plasma) and necrotic cells. Clinical findings include hypoxemia, which causes pulmonary vasoconstriction, pulmonary hypoperfusion, and capillary endothelium damage.

52
Q

What is adult respiratory distress syndrome (ARDS)?

A

ARDS is defined as a secondary surfactant deficiency due to other primary pathologies that damage either alveolar cells or capillary endothelial cells in the lung. ARDS is a clinical term for diffuse alveolar damage leading to respiratory failure.

53
Q

List the causes of ARDS.

A
  1. Inhalation of toxic gases (e.g., 9/11 rescue workers), water (as in a near drowning), or extremely hot air
  2. Left ventricular failure resulting in cardiogenic pulmonary edema
  3. Illicit drugs (e.g., heroin)
  4. Metabolic disorders (e.g., uremia, acidosis, acute pancreatitis)
  5. Severe trauma (e.g., car accident with multiple fractures)
  6. Shock (e.g., endotoxins or ischemia can damage cells)
54
Q

Define pulmonary embolism (PE).

A

PE is the occlusion of the pulmonary arteries or their branches by an embolic blood clot originating from a deep vein thrombosis (DVT) in the leg or pelvic area.

55
Q

What is a “saddle embolus” and how does it commonly present?

A

A large embolus may occlude the main pulmonary artery or lodge at the bifurcation as a “saddle embolus”, which may cause sudden death with symptoms easily confused with myocardial infarction (i.e., chest pain, severe dyspnea, shock, increased serum lactate dehydrogenase [LDH] levels).

56
Q

A medium-sized embolism may occlude segmental arteries and may produce a pulmonary infarction, which is wedge-shaped and usually occurs in the lower lobes. True or false?

A

True.

57
Q

In the context of PE, what are “emboli showers”?

A

A group of small emboli (“emboli showers”) may occlude smaller peripheral branches of the pulmonary artery and cause pulmonary hypertension over time.

58
Q

Describe a typical PE case.

A

A typical clinical scenario involves a postsurgical, bedridden patient who develops sudden shortness of breath.

59
Q

List some major PE risk factors.

A
  1. Obesity
  2. Cancer
  3. Pregnancy
  4. Oral contraceptives
  5. Hypercoagulability
  6. Multiple bone fractures
  7. Burns
  8. Prior DVT
60
Q

What is bronchiectasis and what are some common causes?

A

Bronchiectasis is the abnormal, permanent dilatation of bronchi due to chronic necrotizing infection (e.g., Staphylococcus, Streptococcus, Haemophilus influenzae), bronchial obstruction (e.g., foreign body, mucous plugs, or tumors), or congenital conditions (e.g., Kartagener syndrome, cystic fibrosis [CF], immunodeficiency disorders).

61
Q

How does bronchiectasis appear on bronchogram and how does this condition manifest clinically?

A

The lower lobes of the lung are predominately affected and the affected bronchi have a saccular appearance. Clinical findings include cough, fever, and expectoration of large amounts of foul-smelling purulent sputum.

62
Q

What is the difference between obstructive and restrictive lung disease?

A

Obstructive lung disease is characterized by an increase in airway resistance (particularly expiratory airflow), while restrictive lung disease is characterized by a decrease in compliance (i.e., the distensibility of the lung is restricted).

63
Q

What is obstructive ventilatory impairment?

A

It is impairment of airflow during expiration with concomitant air trapping and hyperinflation.

64
Q

What are some causes of obstructive lung disease?

A

The increase in airway resistance (due to narrowing of the airway lumen) seen in obstructive lung disease can be caused by conditions in the wall of the airway, where smooth muscle hypertrophy may cause airway narrowing (e.g., asthma); outside the airway, where destruction of lung parenchyma may cause airway narrowing upon expiration due to loss of radial traction (e.g., emphysema); and in the lumen of the airway, where increased mucus production may cause airway narrowing (e.g.,

Gross Anatomy (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions