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130 Cards in this Set
- Front
- Back
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What is the location of the bronchi?
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between the trachea and the bronchioles?
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What is located between the trachea and the bronchioles?
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the bronchi
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How many generations of bronchi are there?
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3
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What are the types of bronchi?
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primary, secondary and tertiary
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What are the first generation of bronchi called?
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primary bronchi
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Which generation is the primary bronchi?
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first
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What are the primary bronchi also known as?
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mainstem bronchi
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If the ETT is advanced too far it will go past the carina into where?
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mainstem bronchi, most likely the right side
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Which side of the mainstem bronchi can be intubated easier and why?
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right: larger and more in line with the trachea
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Because the right mainstem bronchi is larger and more in line with the trachea, what error is easier on that side?
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Mainstem bronchi intubation
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What kind of cartilages are found in the mainstem bronchi?
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C-shaped
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The orientation of the cartilages in the mainstem bronchi is the same as where?
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the trachea
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C-shaped cartilages can be found in the trachea and where else?
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mainstem bronchi
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What is the last of the extrapulmonary airways?
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mainstem bronchi
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What is the first intrapulmonary airway?
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secondary (lobar) bronchi
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What is the angle of the mainstem bronchi in the infant/small child?
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55 degrees from the trachea
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What is the angle of the mainstem bronchi in the adult?
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45 degrees on left and 25 degrees on right from the trachea
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Which side of the mainstem bronchi is wider and shorter?
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right side
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Which side of the mainstem bronchi is longer and more narrow?
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left side
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What is different about the cartilage in the intrapulmonary airways compared to extrapulmonary?
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intra: completely surround airway, they are irregular. extra: regularly c-shaped
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How many secondary bronchi are there?
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5, one for each lobe
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What is significant about the number of secondary bronchi?
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one for each lobe
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What is the third generation of bronchi called (and synonym)?
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tertiary (segmental) bronchi
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How does cartilage change as we move down the bronchi?
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goes from C-shaped to irregularly shaped completely surrounding the airway
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The bronchi are the last places to find ______ and ______ in the tracheobronchial tree.
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mucous glands and cartilage
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The bronchi contain what kind of muscle?
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smooth M
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The bronchi contain what kinds of connective tissue?
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cartilage, elastic and collagen fibers
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What is the epithelial lining of the bronchi?
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respiratory epithelium
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What are present in the submucosa of the bronchi?
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mucus glands
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What is the arterial and venous blood supply to the bronchi?
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bronchial arteries and bronchial veins
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Bronchial arteries are branches from where?
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aorta or intercostal arteries
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For bronchi, where does lymph drain to?
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tracheobronchial LyNds, bronchopulmonary (hilar) LyNds, and pulmonary (intrapulmonary) LyNds
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The tracheobronchial lymph nodes drain what?
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primary bronchi, trachea
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The bronchopulmonary (hilar) lymph nodes drain what?
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primary bronchi, visceral pleura (by the superficial lymphatic plexus), and pulmonary lymph nodes
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The pulmonary (intrapulmonary) lymph nodes drain what?
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secondary and tertiary bronchi and bronchioles
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What lymph nodes drain the primary bronchi and the trachea?
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tracheobronchial LyNds
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What lymph nodes drain the primary bronchi, visceral pleura, and the pulmonary lymph nodes?
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bronchopulmonary (hilar) lymph nodes
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What lymph nodes drain the secondary and tertiary bronchi?
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pulmonary (intrapulmonary) LyNds
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What is the sensory and motor innervation of the bronchi?
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vagus and vagus
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In unit 1, the vagus innervates what (sensory, motor, both)?
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Lungs(B), visceral pleura(S), laryngopharynx(S), mucus glands of laryngopharynx(M), pharyngeal M's (not stylopharyngeus,M), Larynx(B), trachea (b), bronchi (b), bronchioles(b)
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What is between the bronchi and respiratoratory bronchioles?
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conducting bronchioles
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What is before and after the conducting bronchioles?
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bronchi and respiratory bronchioles
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What is the definition of bronchioles?
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diameter of 1 mm and do NOT have cartilage in their walls
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What is the difference between the walls of the bronchi and the walls of the bronchioles?
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mucus glands and cartilage are NOT in bronchioles
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How many generations of bronchioles are there?
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13
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What is the term that relates to branching into two?
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dichotomous branching
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When does the first generation of the bronchioles begin?
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when the bronchi branch for the third time
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What is the support tissue of the bronchioles?
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collagen and elastin
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How is the epithelial lining of the bronchioles different from the conducting airways before it?
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cells cuboidal, less goblet cells, more bronchiolar (clara) cells
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When do we first see cuboidal cells in the tracheobronchial tree?
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bronchioles
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Bronchioles have a large amount of smooth muscles in relation to what?
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lumen size
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Lumen size is not a good predictor of what in the bronchioles?
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smooth M amount
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Contraction and relaxation of the SmM in the bronchioles causes what?
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contraction and dilation of the airway
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What is the arterial and venous blood supply to the bronchioles?
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bronchial arteries and pulmonary veins
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What is the significance of the venous drainage of the bronchioles?
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puts poorly oxygenated blood into oxygen rich blood (causes a 1-3% shunt)
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The lymph vessels in the lungs originate where?
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the terminal bronchioles
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From the beginning of the lymph capillaries in the lungs, what is the next lymph node?
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pulmonary (intrapulmonary) LyNds
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What is the sensory innervation of the conducting bronchioles?
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PSNF's to Vagus
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Motor impulses from the vagus to the bronchioles cause what?
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bronchoconstriction
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Motor impulses from T2-T6 do what to the bronchioles?
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very, very slight bronchodilation
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What produces bronchodilation in the bronchioles?
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circulating catecholamines from the adrenal medulla
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What is the mechanism of bronchiolar constiction?
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Ach> M3R> Gs Protein> α subunit> PLC+PIP2> IP3+DAG> IP3+SR> increased Ca++> Ca-calmodulin> MLCK activated> phosphorylated myosin X-bridge> M+A> powerstroke> ATP site available> ATP binds> myosin dissociates> ATP split> myosin recharged> etc.
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What is the mechanism of bronchiolar dilation?
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Epi> B2R> Gs> adenylate cyclase> ATP to cAMP> inactive to active protein kinase> bronchodilation
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What breaks down cAMP to 5' AMP?
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phosphodiesterase
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Narrowing of the airway in COPD is in part related to what?
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increased parasympathetic tone
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What is the best way to achieve bronchodilation in COPDers?
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block PSNS tone through atropine or atrovent
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What are the functions of the conducting airways?
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transport of O2 and CO2, warming inhaled air, humidify inhaled air, filtration of inhaled air
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How do the conducting airways humidify incoming air?
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H2O vapor from mucous membrane
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How is incoming air filtered by the conducting airways?
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mucous, turbulent air flow, and mucociliary escalator
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What is the mucocilliary escalator?
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Mucous traps the particles and cilia make it flow up and over the laryngeal inlet into the esophagus and/or expectorated
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What is the relative cross-sectional area of the bronchioles?
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relatively large
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What is the ramification of the cross-sectional area of the bronchioles?
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larger area = less resistance to airflow = slower flow
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What is the canal of Lambert?
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potential airway that connects a preterminal bronchiole to the gaseous exchange airways
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What is the ramification of the canal of Lambert?
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provides collateral air circulation in case of an obstruction
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What are the terminal bronchioles?
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the last bronchioles before the respiratory bronchioles
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What are the gaseous exchange airways?
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airways that contain alveoli in their walls?
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What are airways that contain alveoli in their walls called?
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gaseous exchange airways
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What are the structural components of the gaseous exchange airways?
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respiratory bronchioles, alveolar ducts, alveolar sacs
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What is the first portion of the airway in which gas exchange occurs?
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respiratory bronchioles
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How many generations of respiratory bronchioles are there?
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3
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What are in the walls of the respiratory bronchioles that were not in the conducting bronchioles?
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alveoli
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______ zone is the collective term for the three generations of respiratory bronchioles.
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transitional
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What is the transitional zone?
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collective term for the three generations of respiratory bronchioles
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As we move from the first to the last generation of respiratory bronchioles, how do they change?
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less SmM, less elastic tissue in walls, more alveoli
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What is the morphology of the respiratory bronchioles?
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less SmM, less elastic tissue in walls, ciliated cuboidal cells, Clara cells, NO goblet cells mucus glands or cartilage
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What is between the respiratory bronchioles and the alveolar sacs?
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alveolar ducts
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How many generations are there of the alveolar ducts?
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3
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What is the structure of the alveolar ducts?
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straight tubelike structures completely lined with alveoli
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What is found in the walls of the alveolar ducts?
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small and decreasing amount of smooth muscle and elastic fibers. Same types of cells as in alveoli
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Each 3rd generation of alveolar ducts ends in what?
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an alveolar sac
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How many generations of alveolar sacs are there?
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one
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What is found in the walls of the alveolar sacs?
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alveoli, small amount of smooth muscle and elastic fibers
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What is the last segment of the gaseous exchange airways?
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alveolar sacs
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What is the respiratory zone?
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completely lined with alveoli. Includes alveolar ducts and alveolar sacs.
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What is the pulmonary acinus (terminal respiratory unit)?
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that portion of the lung that is distal to a single terminal bronchiole
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What is the portion of the lung that is distal to a single terminal bronchiole?
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pulmonary acinus (terminal respiratory unit)
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What is a pulmonary (primary) lobule?
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terminal bronchiole + pulmonary acinus
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What consists of a terminal bronchiole and a pulmonary acinus?
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pulmonary (primary) lobule
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How many alveoli are in the adult lung?
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300 gajillion (aka million)
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What is the shape and reason for the shape of the alveoli?
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polygonal, more surface area than a sphere
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What is the total surface area available for gas exchange in a human?
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50-100 sq m
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What is the normal BSA of a human?
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1.7 sq meters
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Alveoli are surrounded by a ______ ______ ______ ______.
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very dense capillary network
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What are the types of cells in the alveoli?
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Type I (agranular pneumocyte), type II (granular pneumocyte), and alveolar macrophages
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What is the function of type I alveoli cells?
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involved with gas exchange
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what is 90-95% of the alveolar wall composed of?
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type 1 pneumocytes
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what is the function of the type II pneumocyte?
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secretes surfactant and the fluid that lines the inside of the alveoli. Is the progenitor of type 1 cells
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what is the relative ratio of type 1 to type 2 pneumocytes?
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1 to 1
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What happens in pulmonary fibrosis or preterm infants that decreases gas exchange?
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too many type 2 pneumocytes
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where do alveolar macrophages originate?
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from monocytes
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what is the most phagocytic WBC?
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monocytes (number mono!)
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what removes debris that hasn't been removed by the mucociliary escalator?
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alveolar macrophages
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What is the sterility of the gaseous exchange airways?
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pretty much (quoted)
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What are alveolar pores (pores of Kohn)?
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opening between adjacent alveolar sacs or septums
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What are openings between adjacent alveolar sacs or septums?
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alveolar pores (pore of Kohn)
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what are the advantages and disadvantages of alveolar pores (pores of Kohn)?
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adv: collateral ventilation. Dis: spreads infection, during emphysema see larger pores therefore less surface area
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What is the inherent stability of the alveoli?
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very unstable
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what are factors that prevent alveoli from spontaneously collapsing?
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canals of lambert, alveolar pores, pulmonary surfactant, and interdependence
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what is meant by interdependence of alveoli?
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as alveoli attempt to close down, the surrounding alveoli oppose the inward force by their own inward forces
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What is the arterial and venous blood supply to the gaseous exchange airways?
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pulmonary arteries and pulmonary veins
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how many pulmonary veins arise from each lung?
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3 to 5
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How do we get 5 pulmonary veins?
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one vein from each lobe of the lung
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How do we get 4 pulmonary veins?
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RU+RM lobes fuse, RL lobe, LU lobe, LL lobe
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How do we get 3 pulmonary veins?
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RU+RM lobes fuse, RL lobe, LU+LL lobes fuse
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What is the lymph drainage from the gaseous exchange airways?
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there is none, extra fluid and other things eventually migrate up to terminal bronchioles
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What is the innervation of the gaseous exchange airways?
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none
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How do gaseous exchange airways develop from birth?
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birth 30 million, 8 yrs have 300 million and lung development is completed
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What is the ramification of completed lung development at age 8?
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early childhood pulmonary diseases can cause disabilities in adult life
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What is the function of the gaseous exchange airways?
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O2 from alveoli into pulmonary capillary blood. CO2 from pulmonary capillary blood into alveoli
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How many generations of branching are there in the tracheobronchial tree?
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23
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