Where would you find the upper respiratory tract and what does it consist of?
Nostrils--> lower border of cricoid cartilage of larynx
- Paranasal sinuses
- Pharynx (acts as 3 way valve)
The nasal cavity contains 4 paranasal sinuses. Identify the names of them on the following diagram:
- Frontal sinus
- Ethmoid sinuses
- Spenoid simuses
- Maxillary sinuses
What type of epithelial cells line the sinuses?
Pseudo stratified ciliated columnar epithelium
What is the function of vascular mucosa lining the paranasal sinuses (and turbinates)?
Warm and moiste air
What is the glottis?
Vocal cords and aperture between cords in larynx (connects pharynx to trachea)
Vocal cords aka vocal folds, vocal ligaments
How is the entrance to the trachea closed off during swallowing?
Laryngeal inlet narrows, epiglottis folds down- like lid
Suprahyoids lift larynx- close of trachea
Vocal cords adduct
Which muscles cause the vocal cords to move and what are they innervated by?
Intrinsic laryngeal muscles
Recurrent laryngeal nerve
Why does intra thoracic disease sometimes cause a hoarse voice?
(eg aortic aneurysm)
Recurrent laryngeal nerve on LEFT has long course- down into thoracic cavity
Nerve= compressed or infiltated
Paralysis of left vocal cord= hoarse voice
If the larynx and vocal cords are dysfunctional, what might there be an increased risk of?
Food and liquid aspiration (inhalation)
Trachea may not be properly closed off
What is the cough reflex and what is its function?
Ability to close vocal cords- build up intrathoracic pressure
Then sudden opening of vocal cords- air expelled quickly
Protective mechanism--> expel inhaled particles
Clearance mechanism for excessive secretions
What components make up the 'bony thorax'?
Which costal cartilage (rib) articulates with the sternum at the level of the sternal angle?
What forms the floor of the thoracic cavity?
How many joints do thoracic vertebrae have?
Fill in the missing labels on the 'typical' rib (3-9)
Name the 3 muscles contained in the intercostal space, superficial to deep.
Describe the external intercostal muscles and the movement they create.
Fibres run downwards and anteriorly
Responsible for 30% of chest expansion during QUIET RESPIRATION
Bucket handle movement
Describe the internal intercostal muscles.
Run downwards and posteriorly
Pull ribs down from postive chest expansion
(Innermost intercostal muscles- similar to internal, act along them)
Which muscle is responsible for >70% of chest expansion in quiet respiration?
The peripheral muscular fibres of the diaphragm arise from the lower margin of the thoracic cavity. What makes up the lower margin of the thoracic cavity?
- Inner aspect of xiphisternum
- Inner aspect of 7-12 costal cartilages
- Arcuate ligaments
- Crura of diaphragm
The diaphragm is innervated by which nerves?
Right and left phrenic nerves (C3,4,5)
If one of the phrenic nerves is damaged, how with the chest x-ray appear?
Elevated hemidiaphragm on affected side
At which spinal level does the diaphragm have openings for:
- Vena cava
- Aortic Hiatus
- Vena cava T8
- Oesophagus T10
- Aortic Hiatus T12
Where do the left and right domes of the diaphragm lie? (vertically)
Right: 5th Rib
Left: 5th Intercostal space
What is the costodiaphragmatic recess?
Peripheral gutter around edge of diaphragm
Space where lungs don't fill thoracic cavity
How do the bronchi divide to eventually form bronchioles?
Where does the trachea begin and where does it end (divides into right and left main bronchi)?
Begins: Lower border of cricoid cartilage (of larynx) (C6)
Ends: Sternal angle (T4/T5)
What is the angle between the right and left bronchi known as?
What is a bronchopulmonary segment?
(important clinically: can be removed without much bleeding, air leakage or interfering other segments)
Area of lung supplied by:
- segmental bronchus
- accompanying branch of pulmonary artery
- drained by segmental pulmonary vein
=pyramid shaped, apex faces towards segmental bronchus
What parts of the respiratory system can be viewed when a bronchoscopy is done?
(used in diagnosis of bronchial carcinoma)