Anatomy of the respiratory system - Lecture 8

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1

Outline the upper respiratory system

Nose

  • Cartilaginous exterior
  • Nasal, ethmoid, lacrimal, maxilla and frontal bone
  • 2 cavities separated septum
  • 3 conchae on internal laterally wall of each nostril
    • Superior (small)
    • Middle
    • Inferior
      • Nasolacrimal duct drains tears from medial corner of eye to under inferior
    • Choanae is the posterior opening into the nasopharynx

Hard and soft palate separate from the mouth

Air passes from nasopharynx to the oropharynx or laryngopharynx

Auditory tubes open into the lateral walls of nasopharynx

Lower pharynx = laryngopharynx à Oesophagus at C6

  • Epiglottis closes during swallowing and opens to allow air passage
  • Vocal chords
  • Laryngeal muscles controlled by L.recurrent vagus

Gut Associated Lymphatic tissues

  • Pharyngeal tonsil in posterior wall of nasopharynx
  • Lingual tonsil in posterior tongue

Palatine (paired) tonsil in the oral cavity

2

Outline the respiratory system in detail and connections to paranasal sinuses, middle ear, mastoid process and tonsils

...

3

Describe the structure and relationships of the trachea

card image

10cm long, 2cm diameter

Located C6-T5

  • Deep inspiration down to T6

16-20 anteriorly placed C shaped cartilage rings

  • Tachealis muscle runs posteriorly to join to oesophagus
  • Cricoid cartilage - only full ring located immediately inferior to thyroid cartilage
  • Enables the trachea to stay open
  • Annular lig. join the cartilage together

Carina is the "underpants" shaped cartilage at the bifurcation into the primary bronchi

Relations

  • Anterior
    • Fascia and muscle of the neck
    • Manubrium
    • Brachiocephalic and common carotid arteries
  • Posterior
    • Oesophagus
  • Lateral
    • Lungs
4

Describe the structure and relations of the bronchi and the difference between the R. and L. principal bronchi

card image

Trachea branches to form principal bronchus at T5

  • Branch again to form the lobar bronchi

C shaped cartilage rings until 1mm diameter where they disappear

Bronchioles open into alveolar ducts, which open into alveoli

  • Alveoli consists of
    • Type 1 cells – blood-air barrier
    • Type 2 cells – produce surfactant and wandering macrophages

R.principal

2.5 cm long à shorter, wider and more vertical than the left

- Foreign bodies are more likely to pass into

Gives rise to 3 lobar bronchi as the R.lung has 3 lobes (superior, inferior and middle)

  • Superior arises before principle enters lung
    • Azygous vein arches over
    • Enters hilum of lung posterior to pulmonary artery at T5
  • Principle
    • Posteroinferior to artery & just below superior lobar bronchi

L.principal

5cm long more horizontal

Enters hilum at T6 unbranched

Forms superior and inferior lobar bronchi as L.lung has 2 lobes

Enters hilum inferior to artery

5

Describe the pleura including the visceral and parietal in relation to the cupola, mediastinal, costal and diaphragmatic

card image

Visceral pleura covers the outside of the lung including the fissures

  • Insensitive to pain

Parietal pleura lines the cavities and the root of the lung

  • Subdivides into costal, diaphragmatic, cervical, mediastinal
  • Adjacent to medial surface of either lungs forms pulmonary lig. Down from the hilus
  • Pain sensitive via branches of intercostal and phrenic nerves

Root of the lung = the only point of attachment of the lung, structures enter and leave the lung

  • Blood and lymph vessels
  • Nerves
  • Bronchi

Pleura recesses = areas where regions of parietal pleura are in contact

  • Costodiaphragmatic recess à angle between thoracic cage and diaphragm
  • Costomediastinal recess à medially between ribcage and mediastinum
  • Lung tissue only moves into the space during deep inspiration
6

Outline the differences and similarities between the L. and the R. lungs

card image

Root

  • Bundle of structures entering lung in between mediastinum and hilus
  • Including
    • Pulmonary arteries and veins
    • Bronchial arteries and veins
    • Lymphatic vessels
    • Bronchi
    • Nerves

Costal surface is towards the ribs

Medial surface

  • Includes Hilum
    • Root of lung is attached and structures enter and exit the lung
    • Parietal is reflected to cover the lung as visceral pleura
    • Large hilar lymph nodes can occur

Anterior border

  • Shaped by Costodiaphragmatic recess (angle between diaphragm and ribs) and is sharply angled

Posterior border

  • Shaped by the vertebral column is rounded

Wandering macrophages in lung

  • Appear as grey/black moulting on the surface of the lung as macrophages take up inhaled material

R.lung

  • 3 lobes as no heart indentation
    • Superior
    • Middle
    • Inferior
  • 2 fissures
    • Oblique
    • Horizontal
  • Impressions/relations medial surface
    • Azygous
    • subclavian artery
    • SVC
    • atrium

L.lung

  • 2 lobes
    • Superior
    • Inferior
  • 1 fissure
    • Oblique
  • Lower anterior border
    • Cardiac notch above the lingual (tongue of the superior lobe tissue)
  • Impressions/relation medial surface
    • Aorta
    • subclavian
    • common carotid
    • L. and R.ventricles
7

Describe the lymph, blood vessels and nerve supply of the lung

...