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Questions and Answers
What structures are included in the upper respiratory tract?
What structures are included in the upper respiratory tract?
Which zone of the respiratory tract includes structures where no gas exchange occurs?
Which zone of the respiratory tract includes structures where no gas exchange occurs?
What is the primary function of the conducting zone besides conducting air?
What is the primary function of the conducting zone besides conducting air?
What are the terminal structures of the conducting zone called?
What are the terminal structures of the conducting zone called?
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Which of the following structures are part of the respiratory zone?
Which of the following structures are part of the respiratory zone?
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Where does gas exchange primarily occur within the lungs?
Where does gas exchange primarily occur within the lungs?
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Which statement best defines anatomic dead space?
Which statement best defines anatomic dead space?
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What does the trachea primarily do in the respiratory system?
What does the trachea primarily do in the respiratory system?
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What is the primary function of Type 2 pneumocytes in the alveoli?
What is the primary function of Type 2 pneumocytes in the alveoli?
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What condition is associated with the collapse of lung tissue due to small alveoli without sufficient surfactant?
What condition is associated with the collapse of lung tissue due to small alveoli without sufficient surfactant?
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Which component is primarily responsible for reducing surface tension in the alveoli?
Which component is primarily responsible for reducing surface tension in the alveoli?
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How does surfactant affect lung compliance?
How does surfactant affect lung compliance?
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What happens to the lecithin to sphingomyelin ratio in a fetus around 35 weeks of gestation?
What happens to the lecithin to sphingomyelin ratio in a fetus around 35 weeks of gestation?
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What best defines the Law of Laplace as it relates to alveolar collapse?
What best defines the Law of Laplace as it relates to alveolar collapse?
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Which cell type is most abundant in the alveoli and mainly facilitates gas exchange?
Which cell type is most abundant in the alveoli and mainly facilitates gas exchange?
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What role do macrophages play in the alveoli?
What role do macrophages play in the alveoli?
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What is the risk associated with premature infants regarding lung function?
What is the risk associated with premature infants regarding lung function?
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Why is having small alveoli beneficial despite the high collapsing pressure?
Why is having small alveoli beneficial despite the high collapsing pressure?
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What indicates the lungs are mature enough for a baby to breathe independently?
What indicates the lungs are mature enough for a baby to breathe independently?
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What effect does surfactant have on the collapsing pressure of alveoli?
What effect does surfactant have on the collapsing pressure of alveoli?
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Which of the following statements is true regarding aveolar gas exchange?
Which of the following statements is true regarding aveolar gas exchange?
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What is the primary role of the mucus secreted by goblet cells in the respiratory tract?
What is the primary role of the mucus secreted by goblet cells in the respiratory tract?
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What type of epithelial cells are mainly found in the bronchioles?
What type of epithelial cells are mainly found in the bronchioles?
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Which statement about bronchi and bronchioles is accurate?
Which statement about bronchi and bronchioles is accurate?
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What is the function of club cells found in the terminal bronchioles?
What is the function of club cells found in the terminal bronchioles?
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Why is resistance to airflow highest in the medium bronchi?
Why is resistance to airflow highest in the medium bronchi?
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What initiates bronchodilation in the bronchioles?
What initiates bronchodilation in the bronchioles?
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Which type of flow is associated with terminal bronchioles?
Which type of flow is associated with terminal bronchioles?
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What happens to the type of epithelial cells as one moves from the trachea to the bronchioles?
What happens to the type of epithelial cells as one moves from the trachea to the bronchioles?
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Which of the following structures plays a role in gas exchange?
Which of the following structures plays a role in gas exchange?
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What is the main purpose of the branching structure of bronchioles and alveoli?
What is the main purpose of the branching structure of bronchioles and alveoli?
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Which cells help transport mucus towards the epiglottis in the respiratory tract?
Which cells help transport mucus towards the epiglottis in the respiratory tract?
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Where is the highest total resistance to airflow found in the respiratory system?
Where is the highest total resistance to airflow found in the respiratory system?
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What characteristic differentiates respiratory bronchioles from terminal bronchioles?
What characteristic differentiates respiratory bronchioles from terminal bronchioles?
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Which receptor is linked to bronchoconstriction in the respiratory system?
Which receptor is linked to bronchoconstriction in the respiratory system?
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What is the most likely lung area for an aspirated foreign body to end up?
What is the most likely lung area for an aspirated foreign body to end up?
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What is the reason the right main bronchus is more likely to receive aspirated objects?
What is the reason the right main bronchus is more likely to receive aspirated objects?
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What anatomical feature is used to remember the relationship between the pulmonary artery and the bronchi?
What anatomical feature is used to remember the relationship between the pulmonary artery and the bronchi?
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Which structure is found in the anterior mediastinum?
Which structure is found in the anterior mediastinum?
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What are the commonly associated masses referred to in the anterior mediastinum as the 'Terrible Ts'?
What are the commonly associated masses referred to in the anterior mediastinum as the 'Terrible Ts'?
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In the middle mediastinum, which major structures are typically found?
In the middle mediastinum, which major structures are typically found?
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Which of the following describes the posterior mediastinum?
Which of the following describes the posterior mediastinum?
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What type of tumors are commonly found in the posterior mediastinum?
What type of tumors are commonly found in the posterior mediastinum?
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What condition is often associated with a thymoma?
What condition is often associated with a thymoma?
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Which mass is the most common extra-nodal germ cell tumor location?
Which mass is the most common extra-nodal germ cell tumor location?
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What does the term 'mediastinum' refer to?
What does the term 'mediastinum' refer to?
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Which compartment of the mediastinum typically involves large lymph nodes due to lymphoma or metastasis?
Which compartment of the mediastinum typically involves large lymph nodes due to lymphoma or metastasis?
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What passes anteriorly to the right main bronchus?
What passes anteriorly to the right main bronchus?
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What is the primary function of the diaphragm during quiet respiration?
What is the primary function of the diaphragm during quiet respiration?
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At which thoracic spine level does the inferior vena cava pass through the diaphragm?
At which thoracic spine level does the inferior vena cava pass through the diaphragm?
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Which nerve is responsible for the innervation of the diaphragm?
Which nerve is responsible for the innervation of the diaphragm?
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What happens to the diaphragm if the phrenic nerve is cut?
What happens to the diaphragm if the phrenic nerve is cut?
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What is referred pain in the context of diaphragm irritation?
What is referred pain in the context of diaphragm irritation?
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Which of the following structures passes through the esophageal hiatus?
Which of the following structures passes through the esophageal hiatus?
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Which thoracic spine level is associated with the aortic hiatus?
Which thoracic spine level is associated with the aortic hiatus?
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What type of respiration is characterized by the use of accessory muscles?
What type of respiration is characterized by the use of accessory muscles?
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Which muscle group is NOT typically involved in quiet respiration?
Which muscle group is NOT typically involved in quiet respiration?
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What is the cause of paradoxical movement of the diaphragm?
What is the cause of paradoxical movement of the diaphragm?
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During exercise, which of the following muscles is recruited for forceful exhalation?
During exercise, which of the following muscles is recruited for forceful exhalation?
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Which condition is commonly associated with referred shoulder pain due to diaphragm irritation?
Which condition is commonly associated with referred shoulder pain due to diaphragm irritation?
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How does the diaphragm appear during the sniff test if the phrenic nerve is damaged?
How does the diaphragm appear during the sniff test if the phrenic nerve is damaged?
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What is the mnemonic to remember the nerve roots that keep the diaphragm alive?
What is the mnemonic to remember the nerve roots that keep the diaphragm alive?
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What causes alveolar collapse in neonatal respiratory distress syndrome (RDS)?
What causes alveolar collapse in neonatal respiratory distress syndrome (RDS)?
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Why is oxygen supplementation often ineffective in improving hypoxemia in neonatal RDS?
Why is oxygen supplementation often ineffective in improving hypoxemia in neonatal RDS?
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What major risk factor is associated with neonatal RDS?
What major risk factor is associated with neonatal RDS?
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How does Cesarean delivery increase the risk of neonatal RDS?
How does Cesarean delivery increase the risk of neonatal RDS?
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What is a potential complication of neonatal RDS related to lung development?
What is a potential complication of neonatal RDS related to lung development?
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What condition can occur due to persistent shunting in babies with neonatal RDS?
What condition can occur due to persistent shunting in babies with neonatal RDS?
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What eye condition is associated with neonatal RDS due to high levels of oxygen?
What eye condition is associated with neonatal RDS due to high levels of oxygen?
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What medication can be administered to mothers to stimulate surfactant production in preterm infants?
What medication can be administered to mothers to stimulate surfactant production in preterm infants?
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How many lobes does the left lung have?
How many lobes does the left lung have?
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What is the triangular shape observed in the lateral chest X-ray indicative of?
What is the triangular shape observed in the lateral chest X-ray indicative of?
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Which fissure divides the right lung into its upper and lower lobes?
Which fissure divides the right lung into its upper and lower lobes?
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What is a characteristic finding of right lower lobe pneumonia on an X-ray?
What is a characteristic finding of right lower lobe pneumonia on an X-ray?
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Which structure is a lobe-like part of the left lung that is not considered an official lobe?
Which structure is a lobe-like part of the left lung that is not considered an official lobe?
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Study Notes
Pulmonary Anatomy and Physiology
-
Respiratory Tract Divisions:
- Clinical division: Upper (nasal cavity, pharynx, larynx) and Lower (trachea, bronchi, lungs)
- Physiological division: Conducting zone (no gas exchange, conducts air) and Respiratory zone (gas exchange in alveoli)
Conducting Zone
- Function: Conducts air, filters, warms, and humidifies.
- Components: Large airways, nose, pharynx, trachea, bronchi (all the way to terminal bronchioles)
- Anatomic dead space: Portion of respiratory tract filling with air but not participating in gas exchange. Largely located in the conducting zone.
- Structure Differences (bronchi vs. bronchioles): Bronchi have cartilage, bronchioles do not.
Respiratory Zone
- Function: Gas exchange
- Components: Respiratory bronchioles, alveolar ducts, alveoli
Airways Structure Details
- Bronchial branching: Trachea → primary bronchi → secondary bronchi → tertiary bronchi → bronchioles → terminal bronchioles → respiratory bronchioles → alveolar ducts → alveoli
- Surface area increase: Branching creates a large surface area for efficient gas exchange.
-
Epithelial cell types:
- Goblet cells: Secrete mucus to trap particulates.
- Ciliated epithelial cells: Move mucus towards the throat for removal.
- Club cells: Secrete protective proteins and metabolize toxins.
- Changing Epithelium: Trachea/bronchi: pseudostratified columnar (goblet cells); Bronchioles: simple cuboidal (no goblet cells, club cells present).
- Smooth muscle: Present in bronchioles for bronchodilation (sympathetic) and bronchoconstriction (parasympathetic).
Alveoli
- Structure: Small sacs, thin walls (septa), single layer of epithelial cells, lined by pneumocytes (mainly Type 1).
- Gas exchange: Surrounding capillaries facilitate oxygen absorption and carbon dioxide release.
- Type 1 pneumocytes: Thin cells for efficient gas exchange (97%).
- Type 2 pneumocytes: Secrete surfactant, crucial for lung function and regeneration (3%).
- Macrophages: In alveoli, phagocytose foreign particles.
Surfactant
- Function: Reduces surface tension in alveoli, preventing collapse (atelectasis).
- Composition: Lipid-like substances (lecithins), most importantly dipalmitoylphosphatidylcholine.
- Law of Laplace: Collapsing pressure is inversely proportional to the radius of alveoli. Small alveoli have a higher collapsing pressure.
- Clinical implications: Important for fetal lung maturity (around 35 weeks gestation); L/S ratio (lecithin/sphingomyelin) in amniotic fluid assesses lung maturity.
Neonatal Respiratory Distress Syndrome (NRDS)
- Cause: Surfactant deficiency in premature infants.
- Symptoms: High surface tension, high collapsing pressure, collapsed alveoli (atelectasis), poor lung compliance, hypoxemia, elevated pCO2, intrapulmonary shunting.
- Treatment: Surfactant replacement therapy, glucocorticoids for the mother for fetal lung maturation.
Complications of NRDS
- Bronchopulmonary dysplasia: Lung damage from oxygen treatment.
- Patent ductus arteriosus: Shunt between arteries of the heart stays open due to hypoxia.
- Retinopathy of prematurity: Damage to the retina from high oxygen levels.
Lung Lobes
- Right lung: 3 lobes (upper, middle, lower).
- Left lung: 2 lobes (upper, lower). Lingula is a portion of the upper lobe.
- Fissures: Separate lobes.
- Aspirated foreign body: Predisposition to right lung (wider, less angled main bronchus). (Right side > Left)
Pulmonary Artery and Bronchial Tree Relationship
- Right: Anterior to the bronchus
- Left: Superior to the bronchus (RALS mnemonic)
Mediastinum
-
Structure: Space between lungs in the thoracic cavity;
- Divisions: Anterior, middle, and posterior.
- Anterior: Thymus, internal mammary arteries, lymph nodes; (Terrible Ts)
- Middle: Heart, pericardium, great vessels, airway, esophagus.
- Posterior: Spine, spinal cord, nerves.
Diaphragm
-
Structure/Function: Dome-shaped muscle separating thorax and abdomen
- Hiatus: Openings for inferior vena cava (T8), esophagus (T10), and aorta (T12).
- Innervation: Phrenic nerve (C3, C4, C5)
- Referred pain: Pain from diaphragm irritation often felt in the shoulder.
- Paradoxical movement: One side of diaphragm moves down and the other moves up (seen in diaphragmatic nerve damage).
- Quiet Respiration: Diaphragm is the primary muscle.
- Exercise Respiration: Accessory muscles (neck, abdomen) help in forceful breathing
Further respiratory distress notes:
- Signs of severe distress: using accessory muscles.
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Description
Test your knowledge on the structure and function of the pulmonary system. This quiz covers the divisions of the respiratory tract, the conducting and respiratory zones, and the specific functions of airways. Dive into the details of bronchial branching and gas exchange processes.
