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The lower respiratory tract begins with what structure?
trachea
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What is included in the lower respiratory tract?
- trachea
- main stem bronchi
- bronchial tubes
- lungs (alveoli)
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What lines the trachea, bronchi and branchial tubes?
ciliated pseudostratified columnar epithelium contained in a mucous membrane
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What is the functon of the cilia?
move layer of mucous toward laryngopharynx where it can be swallowed or coughed up
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The trachea is continuous with what structure?
larynx
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Where is the trachea?
midline structure from C6 vertebra to sternal angle at the same level as T4
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What is the sternal angle?
junction of manubrium with body of sternum
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Where does the trachea bifurcate?
at sternal angle
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When the trachea bifurcates at the sternal angle, what does it branch to?
R/L main bronchi
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What is the area of bifurcation of the trachea called?
carina
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What is the diameter of the trachea?
3/4"
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How long is the trachea in adults?
3 1/2" to 5" long
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What is the shape of the trachea?
cylinder with cross-sectionalprofile shaped like a horseshoe
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What makes up the trachea?
- cartilage rings
- smooth muscle
- mucous glands
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How many cartilage rings does the trachea have?
20
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What is the shape of the cartilage rings of the trachea?
"U-shaped"
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What are the cartilage rings of the trachea made of?
hyaline cartilages
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What is the function of the hyaline cartilages of the cartilage rings of the the trachea?
hold airway open
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Is the hyaline cartilage of the cartilage rings of the trachea elastic?
no, it is fairly rigid
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Are there cartilage rings on the bronchial tubes?
no, cartilage plates
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Where is the smooth muscle of the trachea found?
in elastic posterior wall of trachea, next to esophagus
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What is the function of the smooth muscle of the trachea?
- contract during coughing (decreasing opening in trachea) to help get air out of lungs
- allows esophagus to enlarge with food/drink (elastic wall bulges forward)
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What is the function of the mucous glands in the trachea?
keep surface of epithelium coated with mucous
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Which arteries supply the trachea?
superior and inferior thyroid aa
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Which veins drain the trachea?
superior, middle, and inferior thyroid vv
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Which lung is bigger?
right lung
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Which main bronchi has a large diameter?
right main bronchus
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Why does the right main bronchus have a larger diameter?
because the right lung is bigger
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Which main bronchi has a smaller diameter?
left main bronchus
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Which main bronchi is more vertical?
right main bronchus
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What main bronchi is less vertical?
left main bronchus
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Which main bronchi is shorter in length?
right main bronchus
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Which main bronchi is longer in length?
left main bronchus
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What is the organization of the bronchi and alveoli?
- primary (main stem) bronchi
- secondary (lobar) bronchi
- tertiary (segmental) bronchi
- terminal bronchioles
- respiratory bronchioles
- alveoli
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Where do the secondary (lobar) bronchi go?
to lobes of lungs
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How many lobes does the right lung have?
3
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How many lobar bronchi does the right lung have?
3
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How many lobes does the left lung have?
2
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How many lobar bronchi does the left lung have?
2
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What is another name for primary bronchi?
main stem bronchi
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What is another name for secondary bronchi?
lobar bronchi
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What is another name for tertiary bronchi?
segmental bronchi
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Where do the tertiary bronchi go?
to bronchopulmonary segments
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What are bronchopulmonary segments?
- independently functional units
- one physiological unit in the lung (has own air supply, blood supply, nerve supply, and lympatic drainage)
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How many segments does the right lung have?
10
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How many segmental bronchi does the right lung have?
10
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How many segmental bronchi does the upper lobe of the right lung have?
3
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How many segmental bronchi does the middle lobe of the right lung have?
3
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How many segmental bronchi does the lower lobe of the right lung have?
5
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How many segments does the left lung have?
8
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How many segmental bronchi does the left lung have?
8
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How many segmental bronchi does the upper lobe of the left lung have?
4
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How many segmental bronchi does the lower lobe of the left lung have?
4
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What are the terminal bronchioles?
branches of segmental bronchi
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Do the terminal bronchioles have cartilage plates?
no
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Do the terminal bronchioles have smooth muscle? If so, why?
yes, to change the diameter of the bronchioles
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What part of the lower respirator tract is microscopic?
- terminal bronchioles
- respiratory bronchioles
- alveoli
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If object is inhaled, where would it most likely get caught?
in right main bronchus
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What are contained in the respiratory bronchioles?
alveoli and smooth muscle
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How thick are alveoli?
single cell in thickness
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How are alveoli organized?
in clusters
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What surrounds the alveoli?
dense capillary network
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What are the two sources of blood supply to the lung?
- pulmonary arteries
- bronchial arteries
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Of the three bronchial arteries, how many are left?
2
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Of the three bronchial arteries, how many are right?
1
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Where do th three bronchial arteries come from?
descending aorta
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What do the 3 bronchial arteries supply?
bronchial tubes, but not alveoli
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Are the bronchial arteries part of the pulmonary circulation?
no
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Where do the bronchial arteries go into?
into the lungs
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What do bronchial arteries carry?
oxygenated blood to bronchial tubes
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Which veins drain the bronchi and alveoli?
bronchial veins
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Where do bronchial veins drain to?
azygous veins
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Azygous veins are tributaries to what?
superior vena cava
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Are impressions on the lungs present in a living person?
no, only in cadaver
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What special type of bronchi does the right lung have?
EP bronchi
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What does the oblique fissue in the left lung divide?
upper and lower lungs
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What does the oblique fissure in the right lung divide?
- middle lobe from lower lobe
- upper lobe from middle lobe
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Which lung has a horizontal fissure?
right lung
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What does the horizontal fissure of the right lung divide?
upper lobe from middle lobe
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Where is the cardiac notch of the lung?
upper lobe of left lung adjacent to the heart
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Where is the lingula of the lung?
upper lobe of left lung; adjacent to cardiac notch
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What is the shape of the lingula of the lung?
shaped like a tongue
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Where is the apex of the lungs?
area of lungs above the first ribs
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What is the apex of the lungs also known as?
cupola
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Where is the base of the lungs?
areaof lungs adjacent torespiratory diaphragm
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What is the hilum of the lung?
contains structures entering and exiting the lungs (bronchi, pulmonary vessels and nerves, lymphatic vessels, and bronhial vessels)
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What is visceral pleura?
serous membrane covering external surface of lungs
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Where is the pulmonary trunk?
emerges from right ventricle
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How many pulmonary arteries are there?
2, right and left
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The pulmonary arteries have a branching pattern similar to which other structure?
bronchi
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What do branches of the pulmonary arteries form?
capillary network around alveoli that connects with pulmonary veins
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Does the capillary network cover the entire surface area of the alveoli?
yes
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What is the alveolar capillary network?
- functional part of pulmonary circulation
- provides exchange of blood gases with air in alveoli
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What is the function of pulmonary veins?
collect blood from alveoli and return it to left atrium
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Why are sensory (GVA) neurons needed in the lower respiratory tract?
- because CNS needs certain information from the tract
- like how much air fills the alveoli (stretch receptors) and to measure the irritation of the bronchial tubes (irritant receptors)
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Where is sensory (GVA neurons) innervation of the lower respiratory tract contained?
in vagus nerve
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Where are stretch receptors of the sensory innervation of the lower respiratory tract?
contained in alveoli
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Where are irritant receptors of the sensory innervation of the lower respiratory tract?
respiratory epithelium
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Where is motor (GVE neurons) innervation of the lower respiratory tract contained?
autonomic fibers contained in pulmonary nerve plexus
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Where are the preganglionic sympathetic neurons?
spinal cord levels T1-L2
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Where do the preganglionic sympathetic neurons synapse with the postganglionic?
in the sympathetic chain ganglion
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Where do sympathetic (post-ganglionic) nerve fibers of the motor part of the lower respiratory tract go?
to smooth muscle and glands
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What is the function of sympathetic (post-ganglionic) nerve fibers of the motor part of the the lower respiratory tract?
- decrease glandular secretion
- vasocontriction of bronchial vessels (decrease blood flow to mucous glands)
- dilate bronchial tubes (increase air to alveoli)
- inhibit contraction of smooth muscle in bronchioles
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Where are the preganglionic parasympathetic neurons located?
in the brain stem (CN X)
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Where does the preganglionic parasympathetic neuron synapse with the postganglionic?
in wall of target organ (smooth mm/gland)
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Where do parasympathetic nerve fibers of the motor part of the lower respiratory tract go?
- to smooth muscle in bronchioles
- bronchial arteries
- mucous glands
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What is the function of parasympathetic nere fibers of the the motor part of the lower respiratory tract?
- increase glandular secretion (increase sefactant [keeps alveoli open so they don't collapse])
- vasodilation of bronchial vessels (increase blood flow to mucous glands)
- constrict bronchial tubes (decrease amount of air to alveoli)
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Pre-ganglionic parasympathetic fibers of the motor part of the lower respiratory tract are contributed to which plexus by the vagal nerves?
pulmonary nerve plexus
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The pre-ganglionic parasympathetic fibers of the motor part of the lower respiratory tract synapse with post-ganglionic fibers where?
on surfaces of bronchial tubes and bronchial vessels
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What ar the lymphatic plexuses of the lower resiratory tract?
superficial and deep
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Where is the superficial lymphatic plexus?
lies deep to visceral pleura
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Where does the superficial lymphatic plexus drain lymph from?
visceral pleura and lung parenchyma
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What is lung parenchyma?
alveoli (functional tissue)
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Where does the superficial lymphatic plexus drain lymph to?
bronchopulmonary lymph nodes in the hilum
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Where are the deep lymphatic plexus of the lower respiratory tract?
in substance of bronchi
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Where does the deep lymphatic plexus drain lymph from?
bronchi
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Where does the deep lymphatic plexus drain lymph to?
pulmonary lymph nodes near the hilum
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Where does lymph from the pulmonary lymph nodes (near the hilum) go?
to brochopulmonary nodes in hilum
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List the lymph nodes in sequence of lymphatic drainage:
- pulmonary nodes
- bronchopulmonary (hilar) nodes
- tracheobronchial nodes
- tracheal nodes
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Where are the pulmonary nodes?
in lungs at bifurcations of larger bronchi
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What is another name for bronchopulmonary nodes?
hilar nodes
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Where are bronchopulmonary nodes?
in the hilum
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Where are tracheobronchial nodes?
at bifurcation of trachea
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What is another name for tracheal nodes?
paratracheal nodes
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Where are tracheal nodes?
lateral surfaces of trachea
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Where do the bronchomediastinal lymph trunks drain lymph from?
thoracic organs
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How many lymph trunks are in the lower respiratory tract?
2, right and left bronchomediastinal lymph trunks
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Where does the right bronchomediastinal lymph trunk drain lymph from?
right side of trachea
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Where does the right bronchomediastinal lymph trunk drain lymph to?
right lymphatic duct
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Where does the left bronchomediastinal lymph trunk drain lymph from?
left side of trachea
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Where does the left bronchomediastinal lymph trunk drain lymph to?
thoracic duct
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What structures pass through the superior thoracic aperture?
- cervical parietal pleura
- trachea
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Describe the spread of bronchogenic cancer:
- spreads to pulmonary nodes
- then bronchopulmonary nodes
- tracheobronchial nodes (secondary tumor forms here)
- trachea shifts (carina shifts R/L)
- spread to tracheal nodes
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