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Lungs, Pleura & Respiratory Development
Terms in this set (61)
The visceral and parietal pleura become continuous at the _______ , which lies at the root of the lung.
In a healthy lung, what can be found between the visceral & parietal pleura? What is it's purpose?
A little bit of serous fluid is found between the pleura layers, which allow the lungs to move & slide in their cavities. It also aids in surface tension between the pleura, thus allowing for the parietal pleura to 'pull' on the visceral pleura during inspiration.
What is the innervation of the parietal pleura?
intercostal & phrenic nerves
The suprapleural membrane is a thickening of the ______________ over the cervical pleura.
What is the defining characteristic of a pleural recess?
A place where the parietal pleura reflects back on itself
Where is the lowest point of the pleural cavity in an upright individual? What is its clinical significance?
costodiaphragmatic recess; any fluid in the pleural cavity will fall to this recess, therefore a thoracocentesis can be more easily drawn from here
Your attending physician mentions that your patient has blood in his pleural cavity. What condition is this and what are you going to immediately do about it?
Hemothorax; you'll do a thoracocentesis into the costodiaphragmatic recess at the 9th intercostal space at the mid axillary line (you'll try to avoid going too deep, thus injuring the diaphragm &/or internal organs)
Which chamber of the heart is the most posterior?
Which chamber of the heart makes up most of the right border of the heart?
A _________ pneumothorax is air in the pleural cavity without being exposed to the outside, while an _______ pneumothorax is air in the pleural cavity after being exposed to the outside.
The right lung has ___ lobes separated by what fissure(s)?
3; horizontal & oblique fissures
The left lung has ___ lobes separated by what fissure(s)?
2; oblique fissure
What unique features are found in the superior lobe of the left lung?
cardiac notch & lingula
Why is it important for us to know the different bronchopulmonary segments?
they'll be on the exam
Why is it clinically important to know the different bronchopulmonary segments?
-aids in interpretation of chest radiographs
-diseases are often localized to segments
-knowledge of branching pattern important for postural drainage
What vessel supplies the terminal bronchioles with gas/nutrients?
A pulmonary artery is (inter)/(intra)segmental and it carries ____________ blood to the alveoli.
intrasegmental; deoxygenated blood
A pulmonary vein is (inter)/(intra)segmental and it carries ____________ blood from the alveoli.
intersegmental; oxygenated blood
The trachea starts at ____ vertebra and divides at _____ vertebra, which is the __________, where the manubrium & sternum meet.
C6; T4; Sternal angle
Which of the bronchi is wider & more vertical? What is the clinical significance of this?
right bronchus; foreign objects will usually go into the right bronchus and if medical personnel trache (sp?) too far, it will most likely go through the right bronchus.
The right lung has a superior lobe, consisting of the __________, ___________, and __________ segments.
apical, posterior & anterior segments
The right lung has a middle lobe, consisting of the __________ and __________ segments.
lateral & medial segments
The right lung has a inferior lobe, consisting of what 5 segments?
The left lung has a superior lobe, consisting of the ___________ and __________ segments, along with a lingular division made of the _________ and ___________ .
apicoposterior & anterior segments
superior lingular & inferior lingular
The left lung has a inferior lobe, consisting of what 5 segments?
(same as the inferior lobe of the right lung)
Which segments of the right and left lung inferior lobe don't touch the diaphragm?
What nerve fibers will be found in the pulmonary plexuses?
postgang symp fibers, pregang parasymp fibers, visceral afferent fibers
(postgang parasymp fibers are found coming from small ganglia along the bronchial tree)
In the fight-or-flight mode the bronchi experience _________ and the bronchial secretions are _________ .
In the rest & digest mode the bronchi experience _________ and the bronchial secretions are _________ .
The afferent innervation of the lungs and visceral pleura comes from afferent _______ fibers and afferent ________ fibers, which travel with the sympathetic and vagal fibers back to the spinal cord & brain.
nociceptive & reflex
What sensations/stimuli do afferent nociceptive fibers detect?
chemical irritants, ischemia, excessive stretch
What sensations/stimuli do afferent reflex fibers detect?
cough reflexes, stretch reflexes, pressure (via baroreceptors), chemicals (via chemoreceptors)
The parietal pleura is innervated by ________ and ________ nerves.
intercostal & phrenic
Which regions of the parietal pleura do the intercostal nerves innervate?
costal, cervical & peripheral diaphragmatic of parietal pleura
Which regions of the parietal pleura do the phrenic nerves innervate?
central diaphragmatic & mediastinal regions of parietal pleura
True or False: The apices of the lungs end beneath the clavicle.
False. They rise above the clavicle.
Which fissure runs along the 4th rib and costal cartilage on right side?
horizontal fissure of the right lung
Which fissure starts at spinous process of T2 or T3 and then runs down and around to follow curvature of 6th rib?
oblique fissure of both the right & left lungs
Where does the cardiac notch lie?
along the 4th-6th costal cartilages left of the sternum
What is the clinical importance of the cardiac notch?
Within the cardiac notch, there are intercostal spaces you can go though where you can get to the pericardial cavity without touching the lungs
If you want to listen to the superior lobe on either lung, where would you place your stethoscope to listen?
on the anterior side of the thorax
If you want to listen to the inferior lobe on either lung, where would you place your stethoscope to listen?
on the posterior side of the thorax
(triangle of auscultation)
The lower respiratory system develops as an outpocketing from the _______ , beginning during the ____ week.
cranial foregut; 4th
What is the name of the bud that initially protrudes from the cranial end of the foregut? What germ layer is it derived from?
laryngotracheal diverticulum; endoderm
The ________ will form the epithelium and glands of the lower respiratory tract, while cartilaginous, muscular and connective tissue components of the of the trachea and lungs are derived from surrounding _____________.
endoderm; splanchnic mesoderm
Laryngeal cartilages, membranes and muscles develop from the mesoderm and endoderm of pharyngeal arches ___ & ___ .
4 & 6
The laryngotracheal diverticulum opens where in respect to the pharyngeal arches?
It opens on the anterior & caudal ends between pharyngeal arches 4 & 6.
The developing respiratory system becomes separated from the pharynx when ________________ form along the longitudinal margins of the diverticulum and fuse medially to produce the ___________________.
tracheoesophageal folds; tracheoesophageal septum
What germ layer are the tracheoesophageal folds derived from?
Through what anatomical feature does the laryngotracheal tube retain its connection with the pharynx?
A _________________ is an abnormality in which the tracheoesophageal folds close incompletely resulting in unusual connections between the developing larynx and foregut.
An ____________ results when the upper part of the esophagus ends as a blind end pouch.
What are the clinical signs in an infant of a tracheoesophageal fistula?
-excessive accumulation of saliva or mucous in nose and throat
-gagging and cyanosis after swallowing a liquid
-abdominal distension after crying (air goes into stomach)
-gastric reflux into lungs, which can cause pneumonitis (can lead to pneumonia)
When too much amniotic fluid builds up in the uterus around a developing fetus, we call it ______________
Tracheo-esophageal atresia can occur alone or it may be associated with one or more additional anomalies. What is this group referred as? What do the anomalies include?
V- Vertebral anomalies
A - Anal atresia
C - Cardiovascular anomalies
T - Tracheoesophageal fistula
E - Esophageal atresia
R - Renal (Kidney) anomalies
L - Limb defects
Further branching of the respiratory tree creates tertiary (segmental) bronchi. The tertiary bronchi are surrounded by an expanding mass of _________. Each segmental bronchus and its mesoderm are known as a ________________.
mesoderm; bronchopulmonary segment
What is the earliest period in gestation in which premature fetuses can survive?
weeks 25-28 - with intensive care
Before birth, what does a fetus do that helps stimulate lung development and condition the respiratory muscles?
Aspiration of amniotic fluid via fetal breathing movements
Why are the lungs of a newborn infant more dense than an adult lung?
Infants have fewer mature alveoli than an adult, because the majority of alveoli are formed up to age 8-10
What anatomical feature is missing or deficient in Respiratory Distress syndrome (RDS)? What could one do to treat RDS?
surfactant - a lipid rich fluid complex which forms a film over the terminal sacs
treatment - administer corticosteroids to the mother (prior to birth) to increase surfactant production or start surfactant replacement therapy in the newborn
In RDS, what is the pathological consequence if the infant has repeated gasping inhalations? What would it look like histologically?
hyaline membrane disease; collapsed membranes of alveoli on top of other alveoli
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