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Flashcards in Pulmonary Deck (47)
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1
Q

What are the two layers of pleura?

A

Visceral and parietal

2
Q

At what point is each pleural layer continuous?

A

The hilum

3
Q

What is a pleural cavity

A

Normally surface tension holds 2 pleura layers close together so potential space exists between parietal and visceral pleura. Contains small amount of serous fluid

4
Q

Innervation of parietal pleura

A

Phrenic or intercostal nerves depending on region (the diaphragmatic and mediastinal pleura is mainly innervated by the phrenic nerves, while the costal pleura is innervated by the intercostal nerves).

5
Q

What are pleura. What sort of cell does it entail?

A

Serous membranes that line the lungs and thoracic cavity. (simple squamous cells)

6
Q

Which layer of pleura is thicker?

A

Parietal

7
Q

What are functions of pleural serous fluid?

A

1) Lubricates surfaces of pleura, allowing them to slide over each other
2) Produces surface tension, pulls 2 pleura layers closer together

8
Q

What is the costodiaphragmatic recess?

A

The lung does not fill the pleural cavity completely during normal breathing, the parietal pleura forms costodiaphragmatic recesses between thoracic wall (costal pleurae) and diaphragm (diaphragmatic pleurae) into which the lung can expand during deep inspiration.

9
Q

Why is the recess clinically significant?

A

Knowledge of these pleural recesses is important, as they are a site of potential fluid accumulation (pleural effusion). Any procedure crossing the costodiaphragmatic recess risks lung damage and pneumothorax.

10
Q

What is a pneumothorax?

A

Collection of air within pleural cavity surrounding lung, resulting in lung collapsing as surface tension breaks and negative pressure lost.

11
Q

Where does bronchial tree start?

A

Trachea, C6 below cricoid cartilage

12
Q

What marks the bifurcation of the trachea?

A

At carina (T4/sternal angle). Divides in into Left and Right Primary Bronchi.

13
Q

What is the trachea lined with?

A

Respiratory epithelium acting as escalator wafting particulate matter up out of airways.

14
Q

What is benefit of hyaline cartilage rings of trachea being incomplete posteriorly?

A

1) permits expansion of oesophagus

2) provides attachment for trachealis muscle, which narrows ariways during coughing.

15
Q

What is the purpose of fibroelastic tissue between cartilage in trachea?

A

Assists smooth muscle in varying tracheal diameter in forced respiration

16
Q

Describe innervation of trachea?

A

Parasympathetic from vagus (recurrent laryngeal) and sympathetic from chain

17
Q

Which artery supplies the trachea?

A

Inferior thyroid

18
Q

Which nodes drain trachea?

A

Postoinferior deep cervical nodes

19
Q

What’s the difference between bronchi and why is this clinically significant?

A

Right bronchus wider, more vertical and shorter. More vertical therefore more likely to be obstructed by an inhaled object.

20
Q

What level do bronchi enter hilum?

A

T5/6

21
Q

Difference in bronchus lung entry (between left and right)

A

Right gives off superior branch of lobar bronchus before it enters the lung.

22
Q

What happens to the bronchi inside lungs?

A

Each divides into lobar/secondary bronchi

23
Q

What do the secondary bronchi supply?

A

Lobes

24
Q

What happens to the secondary bronchi inside the lungs?

A

Divides into tertiary/segmental bronchi

25
Q

What do tertiary bronchi supply? (how many on left and right)

A

Bronchopulmonary segment, 10 right lung, 8-10 left lung.

26
Q

What happens to tertiary bronchi

A

Divide to form bronchioles

27
Q

What happens to bronchioles?

A

Divide to form 5-6 terminal bronchioles

28
Q

What happens to terminal bronchioles?

A

From 2-5 respiratory bronchioles

29
Q

What do respiratory bronchioles form?

A

2-11 alveolar ducts

30
Q

Describe right lung lobes and fissures?

A

Superior, inf and middle lobe

Middle and inf separated by oblique fissure

Middle and superior separated by horizontal fissure

31
Q

Describe lobes and fissures of left lung

A

Superior and inferior lobes divided by oblique fissure

E: lingular lobe (remnant of middle lobe on left side)

32
Q

What are the 3 borders of lung?

A

Anterior: costla and mediastinal surface

Inferior: diaphragmatic surface

Posterior: costal and mediastinal

33
Q

What is special about anterior border of left lung?

A

Marked by cardiac notch (on medial surface where lateral heart border indents)

34
Q

What is the hilum?

A

Where all pulmonary vessels, lypmh vessels, nerve, bronchial vessels and bronchi enter lung through

35
Q

What are the external markings of the lung?

A

T6 - midclavicular line
T8 - mid axillary
T10 -posterior

36
Q

Describe arrangement of structures in hilum

medial lateral

A

Pulmonary artery
Bronchi
Pulmonary veins

37
Q

Describe para innervation of lung

A

From vagus innervate smooth muscle and secretory glands in/of bronchial tree and pulmonary vessels

Carry sensation from stretch receptors in bronchial muscles, interalveolar connective tissue and baroreceptors in pulmonary artery / chemoreceptors in pulmonary veins.

38
Q

Describe role of sympathetic fibres in innervation of lung

A

From T1-T5 sympathetic ganglia.

Innervate smooth muscle of bronchial tree and pulmonay vessels and secretory glands of bronchial tree

39
Q

What do the bronchial arteries supply?

A

Bronchi, lung roots, visceral pleura etc

40
Q

What do bronchial veins drain into?

A

Right bronchial vein drains into azygous vein

Left vein drains into accessory hemiazygous vein

41
Q

Describe the lymphatic drainage of the lungs

A

Bronchopulmonary lymph nodes at hilum receive lymh from supeperficial and deep lymphatic plexi

42
Q

What do bronchopulmonary nodes drain lymph to?

A

Tracheobronchial lymph nodes surrounding tracheal bifurcation which drain into paratracheal nodes.

43
Q

Where is lymphatic drainage from right lung, lower left lobe received by?

A

Right lymphatic duct

44
Q

Where is lymphatic drainage from superior left lobe drained to?

A

Thoracic duct

45
Q

Where does the trachea begin?

A

Lower border of cricoid cartilage

46
Q

Is cricoid inferior or superior to thyroid cartilage?

A

Inferior

47
Q

Where does the trachea bifurcate?

A

T4 sternal angle