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71 Cards in this Set

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Name the pleura involved w/ the lung and what each covers?
visceral-covers each lung
parietal-lines the pleural cavity of the lung
What is the pleural cavity filled with? What is it produced by? How much fluid is present normally?
serous fluid produced by the mesothelium
What is the purpose of serous fluid?
it keeps the two membranes close together, but allows movement of the thoracic cage, diaphragm and lungs w/ little friction
Describe the pressure of the fluid of the pleural cavity. What is its significance?
it has a slight negative pressure (2-6mm Hg)
it helps keep the lungs filling the pleural cavity
What is the visceral pleura continuous with?
the parietal pleura at the hilum of the lung
What is pleurisy?
inflamation of the pleural membrane
What is the hilum?
where the bronchus and pulmonary vessels enter and leave the lung
Describe the pulmonary ligament. Where is it located?
it is an extra reflection of the pleural membranes onto each other
it is inferior to each hilar region
Describe the 4 subdivisions of the parietal pleura.
costal-contacts rib cage
mediastinal-mediastinal structures
diaphragmatic-upper surface of diaphragm
cervical-extends superior to 1st rib
The pleural cavity extends more inferiorly than the lungs. What does this form?
inferior recesses form when the parietal pleura has no intervening lung tissue
Name the two recesses formed by the parietal pleura. Where is each located?
costomediastinal-left pleural space where costal and mediastinal pleura meet anterior to the heart-it is adjacent to the caudal portion of the superior lobe (lingula)
costodiaphragmatic-posterior inferior most part of the pleura
Which recess is most likely to collect excess fluid in the pleural space?
costodiaphragmatic recess
Does each lung have its own pleural cavity?
Describe pneumothorax.
caused by traumatic injury to the wall of the lung
allows air to be pulled into the pleural space and the lung collapses
Describe hemothorax. What usually causes it?
accumulation of blood in the pleural space
caused by injury to an intercostal vessel rather than laceration of the lung
Describe hydrothorax. What causes it?
excessive accumulation of fluid, other than blood, in the pleural space
caused by infection
Describe the trachea and alveoli.
air divides 23 times as it moves down the trachea
area of alveoli is 2000 times > tracheal x.s.
new alveoli cont to dev until 8 yrs of age
end up w/ about 300 million
how many times does air divide in the trachea?
surface area of alveoli?
how long the develop?
how many a person has?
How much air can a person take in during heavy breathing? normal?
What is the significance of flotation of the lungs at autopsy?
lungs which have never taken a breath will sink when placed in water
=still born baby or inhalation of water
What is located at the root or hilum of each lung?
main bronchus, pulmonary artery, two pulmonary veins
Describe the lobes and fissures of the lungs.
3 lobes-upper, middle, lower
2 fissures-horizontal fissure sbdivides superior and middle lobe-oblique fissure divides superior and inferior
2 lobes-superior and inferior
1 fissure-oblique fissure
Describe the position of the superior and inferior lobes of the right and left lungs.
the superior lobe is always anterior, the inferior lobe is always posterior
they are the same
What do bronchopulmonary segments include and how many are in each lung?
include bronchi and pulmonary arteries, with pulmonary veins draining a segment nearby
there are 10 segments in each lung
Discuss pulmonary arteries and veins. (de/oxygenated)
arteries carry deoxygenated blood from the R ventricle to the lungs
veins carry oxygenated blood to the L atrium
What is the left pulmonary artery attached to? What attaches it?
arch of aorta by ligamentum arteriosum, a remnant of the ductus arteriosus
Where does the right pulmonary artery cross?
under the arch of the aorta to reach right lung
Discuss bronchial arteries and veins. Where do they branch from?
bronchi have small arteries that supply oxygenated blood to the bronchial tree
2 on the left come off the descending aorta
1 on the R comes off the 3rd posterior intercostal artery
Where do the small bronchial veins drain?
the azygos vein of the R
hemiazygos vein on L
What are the 3 surfaces of the lung? What does each contact?
costal-contacts ribs, costal cartilage and sternum
mediastinal-mediastinal structures including side of vertebral bodies
diaphragmatic surface-convex dome to diaphragm
Describe the mediastinal impressions of the right lung? (3)
groove for superior vena cava, arch of azygos vein, esophagus
Describe the mediastinal impressions of the left lung? (3)
cardiac impression, groove for arch of the aorta and subclavian artery
What is located in the right hilum and describe their anatomical positions?
bronchus-superior and posterior
pulmonary arteries-middle
pulmonary veins-anterior and inferior
What is located in the left hilum and describe their anatomical positions?
pulmonary artery-superior
pulmonary veins-anterior and linferior
Describe the shape of the left and right bronchi. What does this mean for inhaled bodies?
Left-narrow and more horizontal
Right-wider, shorter, more vertical
aspirated bodies usu in R
What subdivides the trachea into right and left bronchi?
What are the 2 lymphatic drainages of the lungs?
subpleural lymphatic plexus (superficial and small)
deep lymphatic plexus
What are the nodes of the deep lymphatic plexus called?
peribronchial nodes
Describe the drainage of the deep lymphatic plexus.
peribronchial nodes to bronchopulmonary (hilar) nodes, these drain along w/ subpleural nodes into superior and inferior trancheobronchial nodes, which drain into bronchomediastinal lymph trunks which drain to right lymphatic duct (on R) or thoracic duct (on L)
What does the pulmonary plexus receive sympathetic and parasympathetic innervation from?
What does parasympathetic innervation of the lungs produce?
bronchial constriction, mucous secretion, and inhibits pulmonary arterial vosoconstriction
What does sympathetc innervation of the lungs produce?
relaxation of bronchial muscle, inhibits mucous secretion and induces pulmonary arterial vasoconstriction
What are responsible for pain and cough reflex? What do they travel w/?
afferent nerves, they travel w/ sympathetic nerves
Which pleura of the lungs is innervated with pain fibers? Where may the pain be referred? Why is the pain referred here?
the parietal pleura has nerve pain fibers, the visceral does not (insensitive to pain)
pain may be referred to the neck and shoulder region b/c the diaphragm is innervated by C3,4,5
Describe what happens during heavy breathing.
diaphragm moves inferiorly
ribs raised to increase lateral dimension as well as anterior/posterior dimension
contracting of scalene muscles/sternocleidomastoid
What is involved in quiet inspration?
diaphragm, external intercostals, and interchondral portion of internal intercostals
What is involved in quiet expiration?
passive elastic recoil of lungs and abdominal muscles, as well as some thoracic cage muscles
What is added during forced inspiration?
scalene muscles
levator costarum
serratus posterior superior
What is added during forced expiration?
active contraction of rectus abdominis
external & interal oblique muscles
internal intercostal muscles
serratus posterior inferior
What is emphysema? What does it lead to?
destruction of the respiratory and terminal bronchioles by fibrosis
leads to the need to increase the amount of air drawn into the lungs in order for adequate gas exchange
causes barrel chest-increase in anteroposterior dimension of the chest, ribs more horizontal and diaphragm flattened-similar to heavy inspiration
What does the diaphragm develop from?
pleuroperitoneal membrane
septum transversum

paraxial mesoderm of the body wall
esophageal mesoderm
Describe the initial development of the lungs.
the lung develops as a bud develop off the ventral surface of the forgut (endodermal and mesodermal tissues)
What happens in week 4 in development of the lungs?
respiratory (laryngotracheal) diverticulum (=lung bud) dev off the ventral wall of the pharynx (foregut) (endoderm)
the lung bud branches into R&L bronchial buds
Describe the branching of the lungs.
branching into R&L occurs at the end of week 4
3R & 2L bronchial buds, further branching occurs later
What does the tracheoesophageal ridge form and separate?
tracheoesophageal septum which separates foregut from developing trachea and lung buds
What remains connected w/ the pharynx at the laryngeal orifice?
respiratory primordium
What is tracheoesophageal fistula (TEF)? What usually occurs
defects in development of the esophagus and trachea
blind esophagus and developed trachea, TEF attaches just below the bifurcation to the distal portion of the esophagus
What is esophageal atresia?
an interruption
What other defects are seen in infants w/ TEF?
vertebral anomalies
anal atresia (absence
cardiac defects
renal anomalies
limb defects
What is polyhydramniois?
common complication of TEF-normally the fetus swallows significant vol of amniotic fluid-if excess amniotic fluid when water breaks part of the dif diagnosis should include esophageal atresia
Growing lungs expand laterally into what canal?
What does the parietal pleura of the lungs form from? visceral pleura?
parietal-somatic mesoderm epithelium
visceral-mesoderm on top of eveloping lung
What are the 4 stages of lung development and when do they occur?
pseudoglandular period-5-16 weeks, lung divides many times
canalicular-weeks 16-25, functional respiratroy alveoli develop
terminal sac-25-36 weeks-surfactant is produced by type II alveolar cells
alveolar-8 mo to birth, lungs func normally
Why are infants that are born more than one month prematurely at an increased risk for respiratory distress syndrome?
sufficient pulmonary type II cells have not formed or don't produce enough pulmonary surfactant, the alveoli can collapse w/ expiration
insufficient surfactant can damage alveoli and protein and fluid leak from capillaries leading to hyaline membrane disease
What are hiccups?
involuntary, spasmodic contractions of the diaphragm
they are interrupted by spasmodic closure of the glottis
What can cause hiccups?
diaphragmatic irritation, consuption of various foods
What is pumonary emboli? What are the symptoms?
venous clot in lungs
dyspnea, lightheadedness, tachycardia
What are common tumors that metastasize to the lung?
salivary gland
What occurs in the pseudoglandular period? When does it occur?
lung divides many times
week 5-16
When do functional respiratory alveoli develop?
weeks 16-25
canalicular period
What happens in weeks 25-36?
terminal sac period
surfactant is produced by type II alveolar cells
When are lungs able to function normally? What is this period called?
at 8 months
alveolar period