Term
| What do the bronchial buds become in the developing fetus? |
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Definition
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Term
| What are the two pleura in the thorax called? What do they surround? |
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Definition
| parietal pleura surrounds each half of the thorax; visceral pleura surround each half of the lungs |
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Term
| What are the superior surfaces of the parietetal pleurae called? The lateral surfaces? The medial surfaces? The inferior surfaces? |
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Definition
superior=cervical pleurae
inferior=diaphragmatic pleurae
lateral=costal pleurae
medial=mediastinal pleurae |
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Term
| What is the most inferior corner of the pleural cavity called? |
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Definition
| costodiaphragmatic recess |
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Term
| What layers compose the pleural sac? |
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Definition
| parietal + visceral pleurae |
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Term
| Why is it important to be careful when performing invasive procedures in the area just above the clavicle? |
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Definition
| The apex of the lung, the top of the pleural cavity and the subclavian artery are all located there. |
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Term
| Where is the lowest level of the pleural cavity when viewed from the mid-clavicular line? The lowest level of the lungs? |
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Definition
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Term
| What bones is the diaphragm attached to? |
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Definition
| Anteriorly to the xiphoid process, laterally to ribs 7-12, posteriorly to the upper level of the lumbar vertebrae |
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Term
| Posteriorly, at which rib do the lungs extend to? The pleural cavity? |
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Definition
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Term
| What is happening in the process of a pneuomthorax? |
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Definition
Air can enter in either through a rupture in the lung or the pleural cavity wall; collapsing the lung. Air fills cavity, compressing collapsed lung and shifting mediastinum into the other lung, compressing that one.
During expiration, openings close like valves and pressure rises, increasing with each breath. Mediastinal and tracheal shifts augmented, diaphragm is depressed, and venous return is impaired |
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Term
| Where does the parietal pleura receive most of its sensory innervation? What type of nerve fibers are innervated by this? |
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Definition
| branches of intercostal nerves; somatic sensory fibers |
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Term
| What is pleural adhesion? |
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Definition
| when visceral and parietal pleura adhere to one another; causes localized stabbing pain upon exertion |
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Term
| What is pleurisy or pleuritis? |
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Definition
| inflammation of the pleura |
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Term
| Why would damage to the parietal pleura be reported as localized pain instead of referred pain like most other organs? |
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Definition
| parietal pleura is innervated by somatic sensory, not visceral afferent fibers which usually cause referred pain |
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Term
| What important nerve innervates the diaphragmatic pleura? |
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Definition
| phrenic nerve (made from C3-C5 branches of ventral rami) |
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Term
| What is the phrenic nerve? What are some of its properties? |
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Definition
| made from C3-C5 branches of ventral rami, contains somatic motor fibers (for innervating diaphragm), somatic sensory (diaphragmatic pleura), and postganglionic sympathetic fibers that supply the vasculature |
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Term
| If a patient has an inflamed or irritated diaphragmatic pleura, what type of pain would be expected? |
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Definition
| pain may be felt radiating over the shoulder, due to the relationship of these cervical dermatomes to the phrenic nerve |
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Term
| What are the tops of the lungs called? |
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Definition
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Term
| What is the diagonal groove in the lungs called? |
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Definition
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Term
| What is the horizontal groove in the lungs called? On which side of the lung is this found? |
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Definition
| horizontal fissure; right lung |
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Term
| Which side of the lung has 3 lobes? Which side has 2 lobes? |
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Definition
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Term
| Which side of the lung has the cardiac notch? Which area of the ribs correspond to this area? Why is this area clinically relevant? |
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Definition
| left lung; 4th-6th costal cartilage; Site where fluid can be withdrawn from the pericardial sac (no overlying lung tissue) |
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Term
| What is the outcropping on the inferior portion of the left lung called? |
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Definition
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Term
| What are the 3 lobes of the right lung called? |
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Definition
| Upper(superior), middle, and lower (inferior) lobes |
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Term
| What is the hilum of the lung? At approximately what vertebral level is the hilum? |
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Definition
| the site where the structures that comprise the root of the lung, the pulmonary and bronchial vessels, nerves, lymph nodes, lymphatics and bronchi enter its substance; located at T5-T7 level |
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Term
| What makes up the conducting portion of the lungs? The respiratory portion? |
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Definition
Conducting = directs air to lungs, trachea which bifurcates into primary bronchi, which divide into secondary and then tertiary bronchi
Respiratory portion=contains alveoli and where gas exchange occurs |
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Term
| How many secondary bronchi are there per side of the lungs? |
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Definition
| 3 on right (1 per lobe) and 2 on left |
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Term
| Where is a foreign object likely to be lodged if inhaled? Why? |
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Definition
| the right principal bronchus is shorter, wider and more vertical than the left. For this reason, if a patient has aspirated a foreign object, it is more apt to be found in the right bronchial tree. |
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Term
| What functionally independent defined units are supplied by tertiary bronchi? |
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Definition
| bronchopulmonary segments |
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Term
| What is the trachea made of? |
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Definition
| horseshoe- shaped pieces of hyaline cartilage |
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Term
| What is the functional unit of respiratory exchange? |
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Definition
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Term
| What level are alveoli first seen? |
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Definition
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Term
| What are the small openings between adjacent alveoli in which they can communicate? What is the benefit of these openings? |
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Definition
| pores of Kohn; allow collateral air flow |
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Term
| How many alveoli are in the adult lung? |
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Definition
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Term
| What part of the pulmonary vasculature carries deoxygenated blood to the lungs? Return oxygenated blood to the left atrium? |
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Definition
| pulmonary arteries;pulmonary veins |
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Term
| What part of the pulmonary vasculature run independently, following courses between bronchopulmonary segments? Why are they important to surgeons? |
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Definition
| pulmonary veins; used as landmarks for borders of the bronchopulmonary segments |
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Term
| What part of the pulmonary vasculature follows the bronchial branching pattern and breaking into capillaries around each alveolus? |
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Definition
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Term
| What arteries and veins supply the tissues making up the walls of the airways? |
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Definition
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Term
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Definition
Common sources of clots: deep veins in legs (external iliac v, femoral v, deep femoral v, popliteal v, posterior tibial v, soleal plexus v)
caused by venous stasis (bed rest), coagulation disorders, or trauma (causes known as Virchow's triad); postop/postpartum immobility, hormone medications cause blood clots.
signs: dyspnea, tachycardia
60-80% of PEs are silent due to small size, but complete occlusion of right pulm artery (saddle embolus) can cause right side heart failure and circulatory collapse
Lungs can stop small clots due to fibrinolytic (clot buster mechanism) |
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Term
| What is the primary role of the lymphatic system? |
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Definition
| The primary role of the lymphatic system in the lungs is to remove interstitial fluid in order to maintain an environment that is maximally suited for efficient gaseous exchange |
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Term
| Where do most of the lymphatic vessels and nodes of the lungs drain to? |
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Definition
| bronchomediastinal lymph trunk and then into the brachiocephalic vein |
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Term
| Which lung drains lymph into the other? |
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Definition
| Lymph from the inferior left lobe drains to the right lung |
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Term
| How can otherwise clinically silent diseases of the lungs be detected? |
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Definition
| Enlarged lymph nodes associated with disease processes often partially or totally occlude a portion of the bronchial tree. This may cause shortness of breath, a symptom than can be pivotal in the diagnosis of an otherwise clinically silent condition such as lung cancer |
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Term
| How can a hoarse or weak voice lead to a diagnosis of lung disease? |
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Definition
| An increase in size of bronchopulmonary nodes (or any nodes adjacent to the trachea) can cause a deviation of the carina from the midline. Enlargement of the bronchoplumonary or tracheobronchial nodes localized on the left side may compress the left recurrent laryngeal nerve, causing hoarseness or a “weak” voice |
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Term
| What nerve branches to become the recurrent laryngeal nerves? What vessel does it wrap around before returning up to the larynx? |
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Definition
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Term
| What do the parasympathetic fibers of the pulmonary plexus do? |
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Definition
1.Control the smooth musculature of the airway (bronchoconstrictor)
2.Initiate glandular secretory activity |
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Term
| What do the sympathetic fibers of the pulmonary plexus do? |
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Definition
1.Monitor parasympathetic control of airways (bronchodilator)
2.Control blood flow through the pulmonary vessels (vasoconstrictor) |
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Term
| What nerve provides the parasympathetic fibers and visceral afferent fibers to the pulmonary system? |
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Definition
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Term
| What do the afferent fibers of the pulmonary plexus do? |
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Definition
1.Mucosa of the bronchi – initiate cough reflex
2.Muscles of the bronchi – respond to stretch
3.Interalveolar septae - limit inspiration
4.Pulmonary arteries – pressoreceptors
5.Pulmonary veins – chemoreceptors |
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Term
| Where are the arterial chemoreceptors of the mediastinal area located? What do they do? |
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Definition
| located in the aortic and carotid bodies work in concert with vagal afferent fibers to monitor changes in arterial blood gas tensions and the pH of the blood |
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Term
| How does pain in the lungs work? |
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Definition
| Most of the “pain” associated with the lungs is transmitted by somatic sensory fibers contained within the intercostal and phrenic nerves that supply the parietal pleura. However, there are a limited number of visceral afferent fibers from the bronchi that accompany the sympathetics. Pain is referred over the anterior chest wall (dermatomes T1 – T5) |
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Term
| What dermatome is activated by referred pain from the bronchi? |
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Definition
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Term
| What type of nerve fibers make up the pulmonary plexus? |
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Definition
Postganglionic sympathetic fibers
Preganglionic parasympathetic fibers Visceral afferent fibers |
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Term
| What happens when a large lung tumor invades towards the mediastinum? The superior end of the pleural cavity? |
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Definition
the tumor can impinge on the sympathetic trunk and causes horner's syndrome (neural problems in the face), and if really invasive, can compress vena cava and causes facial edema, distended veins, and dyspnea
When a tumor invades up, it can compress the brachial plexus and cause extremity pain |
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Term
| What is the brachial plexus? |
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Definition
| A large, intricate group of ventral rami controlling movements of the upper extremity |
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