62 - Anatomy of Lungs and Pleura

Question 1

Parts of pleura 1) 2)

Answer 1

1) Visceral pleura line the lung surfaces.
2) Parietal pleura arise when the visceral pleura reflect away from the lungs at the lung hila. The parietal pleura then line the interior of the thoracic cavity

Question 2

Pleura

Answer 2

Single layer of serous membrane lining the lungs and interior thoracic wall

Question 3

Pleural cavity

Answer 3

Potential space between visceral and parietal pleura

Question 4

*Subdivisions of parietal pleura

Answer 4

Question 5

Name for condition where air fills pleural cavity

Answer 5

Pneumothorax

Question 6

Name for condition where blood fills pleural cavity

Answer 6

Haemothorax

Question 7

When can visceral and parietal pleura meet?

Answer 7

Full inspiration

Question 8

Pulmonary ligament

Answer 8

A sleeve of pleura descending from hilum (double fold). Allows pleura some slack for lungs to expand.

Question 9

Serous structures sharing the same visceral nerve supply

Answer 9

Pericardium, pleura

Question 10

Pain of injured pleura

Answer 10

Dull, diffuse when not breathing. Sharp, loacalised, very painful on inspiration

Question 11

Where does the trachaea begin?

Answer 11

C6

Question 12

Path of the trachaea 1) 2) 3)

Answer 12

1) Begins at C6
2) Descends through thoracic inlet into superior mediastinum
3) At T4/T5, divides into left and right main bronchi

Question 13

Structure of the trachaea

Answer 13

Series of U-shaped cartilage rings closed posteriorly by trachealis muscle

Question 14

Divisions of bronchi 1) 2) 3)

Answer 14

1) Main bronchus
2) Lobar bronchi
3) Segmental bronchi

Question 15

Air supply of a bronchopulmonary segment

Answer 15

Supplied by a single segmental (tertiary) bronchus

Question 16

Bronchopulmonary segments 1) 2) 3) 4)

Answer 16

1) Segments of lungs supplied each by a single segmental bronchus
2) Zones of functionally-distinct lung tissue.
3) Pyramid-shaped. Apex directed towards hilum, base on surface of lung
4) 10 in right lung, 8 in left.

Question 17

Examples of clinical use of knowing about bronchopulmonary segments 1) 2)

Answer 17

1) When someone has pneumonia, can use gravity-assisted drainage to remove debris from lungs. Ascertain which lobe is affected, position the patient in a position which allows this lobe to drain
2) If someone is unconscious, aspirates vomit, the vomit will enter apical segment of lower lobe. This is drained in a prone position

Question 18

Number of lobes on right lung

Answer 18

Three

Question 19

Number of lobes on left lung

Answer 19

Two

Question 20

How are lobes of right lung divided?

Answer 20

Horizontal fissure divides upper and middle lobes. Oblique fissure divides lower lobe

Question 21

*Left and right lung lobes

Answer 21

Question 22

Surface landmarks of the left lung 1) 2) 3) 4)

Answer 22

1) Cardiac notch (where heart is)
2) Lingula (below cardiac notch)
3) LV imprint
4) Aorta imprint

Question 23

Relative position of pulmonary arteries, veins and bronchi 1) 2) 3)

Answer 23

1) Pulmonary arteries most-anterior
2) Pulmonary veins between pulmonary arteries and bronchi
3) Bronchi posterior to pulmonary vessels

Question 24

Structure of right lung hilum (superior to inferior) 1) 2) 3) 4)

Answer 24

1) Most anterior structures are right upper lobe branch of pulmonary artery and right upper lobe bronchus
2) Pulmonary artery, anterior pulmonary vein and bronchus intermedius
3) Lymph nodes
4) Inferior pulmonary vein

Question 25

*Surface features of right lung

Answer 25

Question 26

*Surface features of left lung

Answer 26

Question 27

*Mediastinunm left lateral view

Answer 27

Question 28

*Mediastinum right lateral view

Answer 28

Question 29

*Main bronchi with pulmonary arteries and veins in situ

Answer 29

Question 30

Lymphatic drainage of lungs

Answer 30

Superficial lymphatics just below visceral pleura. Drain to tracheobronchial lymph nodes (hilar), then to thoracic trunk (if left lung) or right trunk (if right lung, and if right trunk is present).

Question 31

Blood supply of lungs 1) 2) 3)

Answer 31

1) There are 3-5 bronchial arteries that arise from anterior surface of thoracic aorta.
2) They enter lungs at hila.
3) Bronchial veins drain to azygous system.

Question 32

Nerve supplying parasympathetic innervation of lung

Answer 32

Vagus nerve.

Question 33

How does the vagus nerve innervate lung?

Answer 33

Branches from vagus to form pulmonary plexus just before the oesophageal plexus is formed.