3. Thoracic Pulmonology

Question 1

how many lobes does the right lung have

Answer 1

3

superior, middle & inferior

Question 2

how many lobes does the left lung have

Answer 2

2

superior & inferior

Question 3

what seperates the superior lobe from the inferior lobe of the left lung

Answer 3

oblique fissure of the left lung

Question 4

what does the horizontal fissure of the right lung seperate

Answer 4

superior lobe from the middle lobe of the right lung

Question 5

what does the oblique fissure of the right lung seperate

Answer 5

superior & middle lobes from the inferior lobe of the right lung

Question 6

what are the surfaces of the lung

Answer 6

mediastinal surface

costal surface

diaphragmatic surface

Question 7

what is a hilum

Answer 7

place where things go in and out of the lung - located in the mediastinal surface

contain the:

Pul A

Pul V

Main Bronchus

Question 8

how do you differentiate between the pul A & V in the hilum of the lung

Answer 8

pul A = thicker - low O2 content (more superior)

pul V = thinner - high O2 content (more anterioinferior)

Question 9

what are the grooves present on the right lung

Answer 9

cardiac impression & groove for -

1. Brachiocephalic V
2. 1st Rib
3. arch of the Azygos V
4. superior & inferior Vena cava
5. Esophagus

BRAVE

Question 10

what grooves are present on the left lung

Answer 10

large cardiac impression & groove for -

1. 1st Rib
2. arch of Aorta
3. Descending aorta
4. Subclavian A

RADS

Question 11

describe the borders of the lung

Answer 11

1. anterior: thin & flappy
2. posterior: tall & columnar
3. inferior: ring around diaphragmatic surface

Question 12

what direction is the hilum mostly pointing

Answer 12

medial

Question 13

what are two areas of the left lung that are not present on the right

Answer 13

cardiac notch: indentation of anteroinferior superior lobe; creates the lingula

lingula: thin process of superior lobe

Question 14

where do the borders project during a really deep breath

Answer 14

costomediastinal recess: ant border

costodiaphragmatic recess: inf border

Question 15

how can lung cancer occur

Answer 15

can derive from actual lung tissue or bronchi

can metastasize to specifc lymph nodes of the thorax

Question 16

what Ns may be affected by lung cancer

Answer 16

phrenic N

vagus N

recurrent laryngeal N

Question 17

how can you treat lung cancer

Answer 17

pneumonectomy: remove lung
lobectomy: remove lobe
segmentectomy: remove specfic bronchopulmonary segment

Question 18

what is pleura

Answer 18

serous membrane surrounding lungs

= visceral -contact lungs

=parietal -contact thoracic wall, mediastinum & diaphragm

Question 19

what is the pulmonary cavity

Answer 19

area that holds lungs and pleura

Question 20

what is pleural cavity

Answer 20

potential space btn 2 layers of pleura

contains serous lubricating fluid that reduce friction and produce cohesion thru surface tension

-prevent lungs from collapsing

Question 21

what is pleuritis

Answer 21

inflam of pleura

produce roughness –> difficulty breathing (lungs lose ease of gliding & sliding)

Question 22

what happens when air enters the pleural cavity

Answer 22

pulmonary collapse

• break surface tension btn 2 layers of pleura
• opened up space inside pulmonary and pleural cavity (stab wound)

Question 23

what is pneumothorax

Answer 23

entry of air into pleural cavity from penetrating wound to thoracic wall or rupture of pulmonary lesion into pleural cavity

result in collapsed lung

Question 24

what is hydrothorax

Answer 24

accumulation of excess fluid in pleural cavity

-due to fluid escape into pleural cavity or pleural effusion

Question 25

what is hemothorax

Answer 25

accumulation of _blood in pleural cavity_ -due to chest wound, laceration of intercostal vessel or internal thoracic vessel rather than laceration of lung

Question 26

what are lines of pleural reflection

Answer 26

abrupt changes in direction of parietal pleura 1. sternal line - costal to mediastinal anteriorly 2. costal line - costal to diaphragmatic 3. vertebral line - costal to mediastinal posteriorly

Question 27

what are the sections of parietal pleura

Answer 27

1. cervical 2. costal 3. diaphragmatic 4. mediastinal

Question 28

what is the passage way of air

Answer 28

trachea --\> main bronchi --\> lobar bronchi --\> segmental bronchi --\> conducting bronchioles --\> terminal bronchioles --\> respiratory bronchioles --\> alveolar ducts

Question 29

what are main bronchi

Answer 29

primary bronchi -wider, shorter right side runs more vertical than left

Question 30

what are lobar bronchi

Answer 30

secondary bronchi associated with lobes

Question 31

what are segmental bronchi

Answer 31

tertiary bronchi associated with bronchopulmonary segments

Question 32

what are conducting bronchioles

Answer 32

no more cartilage carry air from segmental bronchi to terminal bronchioles

Question 33

where does gas exchange occur

Answer 33

respiratory bronchiole (some) alveolar ducts (primary site) = fxnal unit of lungs

Question 34

what is bronchial asthma

Answer 34

widespread _narrowing of airway_ produced by contraction of _smooth M (constrict & inflammed)_ edema of mucosa & mucus in lumen of bronchi & bronchioles

Question 35

what is bronchoscopy

Answer 35

insertion of bronchoscope into trachea to visualize main bronchi

Question 36

what are broncopulmonary segments?

Answer 36

piece of lung that has single blood supply and airway