The Thorax: Respiratory System, Upper Respiratory Tract

Anam Ijaaz
Flashcards by Anam Ijaaz, updated more than 1 year ago
Anam Ijaaz
Created by Anam Ijaaz about 6 years ago
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Flashcards on The Thorax: Respiratory System, Upper Respiratory Tract, created by Anam Ijaaz on 02/21/2015.

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Question Answer
pharynx
oesophagus
larynx
Describe the structure of the trachea Made of 15-20 C-shaped rings of cartilage. The ends of the rings where there is no cartilage is completed by the trachealis muscle. The only complete ring of cartilage of the trachea is the cricoid cartilage, which separates it from the larynx superiorly.
Why is the space within the upper respiratory tract termed 'dead space'? Because no gas exchange occurs here.
Which parts of the upper respiratory tract contain smooth muscle? Trachea and bronchial tree.
What is a URTI, and what usually causes it? Upper respiratory tract infection; usually viral infection.
What does the upper respiratory tract refer to? The tract above the level of the vocal cords, although there is no generally agreed definition.
Carina
Why can a URTI spread to the ears? Because there is a tube connecting the ear to the pharynx where infection can spread.
Name the three parts of the pharynx Nasopharynx Oropharynx Laryngopharynx
What are the consequences of viral URTIs? - Secondary bacterial infections - Inflammation of nose, ear, throat - Subsequent infection of LRT; bronchitis
Name the epithelium which lines the upper part of the respiratory tract (nasal cavities to bronchi)? Pseudostratified ciliated columnar epithelium
What are goblet cells, and what is the advantage of them being present within the respiratory epithelium of the upper tract? Goblet cells are mucus-secreting cells; this mucus protects the airway by trapping foreign particles.
Apart from goblet cells, what other cells lining the URT aid protection of the airway by trapping foreign particles? Submucosal glands which secret mucus and serum.
What are vibrissae? Hairs lining the openings of the nasal cavities (vestibule) which trap large air-borne particles.
What do serous glands secrete? Antibiotic enzymes
Why are the cilia known as the 'mucocilary escalator'? Because they waft the fluid of the nasal cavities, trachea and bronchi towards the pharynx where it can be swallowed.
If viruses and bacteria manage to bypass the upper respiratory tract protective mechanisms and reach the alveoli, how are they dealth with? - They are phagocytosed and destroyed by macrophages. - Macrophage presents antigens to awaiting B and T cells which then produce more antibodies to activate the macrophage. - Macrophage also releases factors initiating an inflammatory response.
Which immune cells secrete a substance which can cause restriction of the airways? Mast cells release histamine.
What are the paranasal sinuses, and how many are there? Group of 4 air-filled spaces that surround the nasal cavities.
Name the paranasal sinuses.
The paranasal sinuses are present at birth, true or false? False; they develop soon after.
List the 5 functions of the paranasal sinus. 1 - Decrease weight of bones on the face 2 - Increase resonance of voice 3 - Provide buffer against blow to face 4 - Insulate sensitive structures, e.g. dental roots and eyes, from rapid temperature fluctuations in the nasal cavity. 5 - Humidify and heat inhaled air
Describe the position of the frontal sinus Located in the frontal bone of the forehead just above the eyes.
Describe the position of the maxillary sinuses. In the cheekbones on each side of the nose.
Describe the position of the ethmoid sinuses Just above the nasal cavity
Describe the position of the sphenoidal sinuses. Within body of sphenoid bone, behind ethmoid sinuses.
What is sinusitis? Infection of the nose which has spread to the sinuses.
What is the consequence of sinusitis? Inflamed mucous membranes become swollen and close the openings, preventing exit of infected material. Painful build up of pressure = dizziness, runny nose. Maxillary sinus infection can also cause tooth-ache due to their close proximity.
How are sinus disorders treated? Rest, liquid diet, serious infection may require surgical intervention to drain infected material.
From where the the nerve fibres of the lung (pulmonary plexus) arise from? Vagus and sympathetic nerves.
Visceral pain in the thorax is transmitted through sympathetic nerves arising from where on the spinal cord? T1-T4
Give examples of EFFERENT fibres of the pulmonary plexus Phrenic and other somatic nerves, (recurrent laryngeal), vagal efferents
Give examples of AFFERENT fibres of the pulmonary plexus ipsilateral vagus nerve
What is referred to as the 'cough center'? Medulla oblongata, which contains afferent fibres separate from those that control breathing.
What initiates the cough reflex? Stimulation of sensory nerves/receptors in the lining of the upper respiratory tract
What 3 changes occur in the thorax in inspiration during the cough reflex? - The glottis opens - Bronchioles enlarge - Lungs expand
When the lungs are fully stretched and ready to recoil (height of inspiration) during the cough reflex, what happens next? - Glottis closes - Chest contracts with inspiration - Intrathoracic pressure increases - Glottis gives way = rapid air flow during expiration
The causes of coughing have been divided into two categories; name these. Intrinsic and extrinsic irritation
What is extrinsic irritation? Stimulation of the cough reflex arising from outside the lungs.
Give the most common examples of intrinsic irritation - Pharyngitis - Tuberculosis - Tracheobronchitis; whooping cough, influenza - Pneumonia - Asthma - Carcinoma
Give the most common examples of extrinsic irritation - Large heart from congestive heart failure of single chamber enlargement = compression of bronchus/laryngeal nerve = cough - Pericarditis - Aortic aneurysms - Large lymph node (Hodgkin) - Trauma
What acts as the sphincter of the airway, and name the muscle involved? Larynx, aryepiglottic muscle
What happens to the epiglottis during swallowing? It rises to hit the posterior tongue to protect the layngeal inlet.
vestibular fold
vocal fold
epiglottis
What prevents fluid from entering the airways? Piriform fossae, sinuses on either side of the laryngeal orifice.
Why are vocal fords readily identifiable with a laryngoscope? They are avascular, hence appear white.
What is the glottis? The gap formed between the vocal cords and which is covered by the epiglottis on swallowing.
Complete closure of the glottis, shown above, happens when you 1) Speak 2) Cough 3) Breathe 4) Whisper Cough
The partial separation of the vocal cords and arytenoid cartilages, shown above, happens when you 1) Speak 2) Cough 3) Breathe 4) Whisper Speak
Complete separation/abduction of the vocal cords and arytenoid catilages, shown above, happens when you 1) Speak 2) Cough 3) Breathe 4) Whisper Breathing
Movement of the vocal cords towards the midline, and abduction/separation of the arytenoid cartilages, shown above, happens when you 1) Speak 2) Cough 3) Breathe 4) Whisper Whisper
In what circumstance would an emergency laryngotomy be required? Obstruction of the glottis
thyroid cartilage
cricothyroid membrane
trachea
cricoid cartilage
thyrohoid membrane
epiglottis
hyoid bone
thyroid gland
What is a laryngotomy? Surgical procedure to ensure air can get into the airways.
How is a laryngotomy carried out? Penetration of the CRICOTHYROID MEMBRANE with a sharp object. When the blood bubbles, twist the sharp object to create an air opening and secure an empty ball point pen tube in place to maintain patency.
Which arteries supply the larynx? (hint: same as those which supply the thyroid gland) Superior thyroid arteries
Venous drainage of the larynx is into which veins? Jugular veins
The mucosal lining of the larynx ABOVE the vocal cords is innervated by which nerves? Internal laryngeal branch
The mucosal lining of the larynx BELOW the vocal cords is innervated by which nerves? Recurrent laryngeal branch of the vagus nerve
The motor supply to the larynx (except the cricothyroid muscle) is entirely from which nerves? Recurrent laryngeal nerves
The motor supply to the cricothyroid muscle is by which nerves? External laryngeal nerve; branch of vagus.
Describe the course of the recurrent laryngeal nerves. Lie in the groove between oesophagus and trachea. As they approach the larynx, they lie embedded within the posterior wall of the thyroid gland.
The trachea is composed of C-shapes rings of which type of cartilage? Hyaline cartilage
Which muscle can modify the diameter of the trachea? Trachealis muscle
Why is an inhaled objected more likely to enter the right bronchus than the left bronchus? Because the left bronchus is at more of an angle to the trachea than the right.
From where on the vertebrae does the trachea extend from and to? C6-T4
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