Important Vertebral Landmarks Level C3,4 and 5 T4/5 Structure Origin of phrenic nerve 1. Sternal angle 2.

Bifurcation of trachea 3. Aortic arch Heart 1. Inferior vena cava (through tendinous part) 2. Terminal branches of right phrenic nerve 1. Oesophageal hiatus 2. Vagal trunks 1. Aortic hiatus 2. Azygous vein 3. Thoracic duct

T5-T8 T8 T10 T12

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Respiratory Histology Important Points: Respiratory epithelium

Pseudostratified ciliated columnar epithelium

Everywhere EXCEPT: Vocal Cords and Oropharynx Stratified squamous epithelium Note: nasopharynx also has some stratified squamous epithelium Alveoli Simple squamous epithelium As you move down the bronchiole tree, there is a decreasing number of goblet cells (mucous producing) and an increasing number of Clara cells (secrete protective glycosaminoglycans).

Trachea Cartilage Cells Incomplete Goblet cells

Bronchi Complete Goblet cells Clara cells None

Bronchioles

Goblet cells Clara cells Ill-defined (not very rounded) due to lack of cartilage Small

Lumen

Wide Defined

Well defined but smaller

Alveoli Two cell types: Type 1 Pneumocyte Squamous Gas exchange Type 2 Pneumocyte Cuboidal Responsible for producing and secreting surfactant Very few compared to Type 1 Pulmonary lobule: a few bronchioles + alveolar ducts and sacs + alveoli Acinus: terminal bronchiole + respiratory bronchiole + alveolar duct and sacs Pores of Kohn: perforations in alveolar epithelium, provide collateral ventilation but also means of spreading infection

Pulmonary Lobule

Acinus

Layers of the Tracheal Wall Respiratory epithelium closest to lumen Submucosa Incomplete ring of hyaline cartilage (posterior is trachealis muscle) Adventitia