Lungs

Question 1

Parietal Pleura

Answer 1

lies on the internal surface of the thoracic walls

Costal, diaphragmatic, mediastinal, cervical (cupula)

Question 2

Pulmonary ligament

Answer 2

inferior extension of pleura which tethers the lung to the diaphragm

Question 3

Pleurisy

Answer 3

inflammation of the pleura, become rough, no longer slide over each other.

causes referred pain to the shoulder via phrenic n.

Question 4

Innervation of the pleura

Answer 4

Phrenic n.–>
IC nerves–> costal portion
Internal thoracic nerves–>paracadiophrenic n.–> diaphragmatic and mediastinal portions

Question 5

Bare area of the heart

Answer 5

an area of pericardium in direct contact with the anterior thoracic wall
created by the part of the left lung which turns laterally at the 4th costal cartilage to create the cardiac notch

opening for pericardiocentesis

Question 6

Pleural reflections and recesses

Answer 6

(rib) 2: Visceral and parietal pleura and very close
4-Visceral and parietal pleura and very close
6- L lung visceral pleura is pushed laterally for the heart, slightly more divergence b/w layers
8- diverged at MCL
10 and 12: large gap b/w visceral and parietal pleura ( costodiaphragmatic recess)

Question 7

Pneumothorax

Answer 7

when the pleura are punctured causing air to enter thereby creating a “ real space”

lung collapses

-hemothorax=blood, hydrothorax=water, chylothorax=lymph, empymema=pus

Question 8

costomediastinal recess

Answer 8

where mediastinal and costal pleura meet on anterior/medial

small area where lungs do not completely occupy the space during quiet respiration

Question 9

costodiaphragmatic recess

Answer 9

where costal pleura contacts diaphragmatic pleura near the diaphragm

small area where lungs do not completely occupy the space during quiet respiration

may be damaged during procedures in the abdomen (think kidney surgery)

Question 10

level of visceral and parietal pleuras at MCL

Answer 10

6th and 8th rib

Question 11

level of visceral and parietal pleuras at midaxillary

Answer 11

8th and 10th

Question 12

level of visceral and parietal pleuras at scapular line

Answer 12

10th and 12th

Question 13

tension pneumothorax

Answer 13

damage to visceral or parietal pleura–>air into pleural space thru a one way valve –>air can’t leave–>increased intrathoracic pressure–> shift heart and stuff to contralateral side

• –>Beck’s triad:
  1) distended neck veins
  2) muffled heart sounds
  3) hypotension

Question 14

Right lung

Answer 14

2 fissures (oblique and horizontal)
3 lobes (superior, middle, inferior)
wider/more vertical primary bronchi
3 secondary bronchi
10 bronchopulmonary segments

Question 15

Left Lung

Answer 15

1 fissure ( oblique 
2 lobes (superior, inferior) 
cardiac notch and lingula 
2 secondary bronchi 
8 bronchopulmonary segments

Question 16

Location of the lung

Answer 16

apex=first rib
@ MCL the lung projects to rib 6
@ mid-axillary line the lung projects to rib 8
@ scapular line the lung projects to rib 10

Question 17

Bronchopulmonary segments

Answer 17

smallest functional unit of the lung
area supplied by 1 tertiary bronchus and associated artery 
pulmonary veins run inb/w segments 
divided by CT septa 
(intersegmental)

Question 18

Pulmonary arteries

Answer 18

carry deoxygenated blood to the lungs from the heart
-in the lung they run with bronchial airways
1/segment

blocked in a pulmonary embolism

Question 19

pulmonary veins

Answer 19

superior and inferior veins
return O2 blood to LA
originate in alveoli and travel intersegmental

Question 20

bronchial arteries

Answer 20

from the thoracic aorta
2L 1R
supplies trachea and bronchi

Question 21

Sympathetic innervation of lungs

Answer 21

mostly comes from the cardiopulmonary splanchnic nerves (POSTGANGLIONIC)
Efferent: VC, BD, inhibit gland secretion
Afferent: acute pain

Question 22

Parasympathetic innervation of lungs

Answer 22

Vagus nerve

efferent: VD?, BC, gland secretion

Question 23

Pancoast Tumor/syndrome

Answer 23

Malignant neoplasm of superior lobe of the lung that compresses brachial plexus and cervical SNS ganglia

1) Shoulder pain rad toward axill and scapula
2) Pain along ulnar aspect of the muscles of the hand
3) atrophy of hand and arm muscles
4) horner’s (ptosis, miosis, anhidrosis)