Lungs and Pleura

Question 1

Pleural cupula

Answer 1

The covering of the apex of the lung, which sticks out above the superior thoracic aperture

Question 2

What reinforces the plural cupula?

Answer 2

Sibsons fascia (suprapleural membrane)

Question 3

Bare area of pericardium

Answer 3

left portion of the sternocostal aspect of the pericardium, which is not overlapped by parietal pleura (left pleural sac) or lung due to their cardiac notches

Question 4

What are the two pleural recesses and where are they?

Answer 4

Costodiaphragmatic recess (between peripheral diaphragmatic pleura and lowest parts of costal pleura), and costomediastinal recess (between mediastinal pleura and costal pleura)

Question 5

Name the fissures and lobes of the right lung

Answer 5

Right oblique fissure (divides lower from middle lobe) and horizontal fissure (divides lower from upper and middle from upper lobes), lower, middle and upper lobes

Question 6

What is the fissure of the left lung?

Answer 6

Oblique fissure

Question 7

For the visceral pleura and parietal pleura respectively, what are they innervated by and are they sensitive to pain?

Answer 7

Visceral - autonomic nervous system, no. Parietal - somatic nervous system, yes

Question 8

The costal pleura and peripheral parts of diaphragmatic pleura are innervated by what nerves?

Answer 8

Intercostal nerves

Question 9

Central sections of the diphragmatic pleura and mediastinal pleura are innervated by what?

Answer 9

Phrenic nerves

Question 10

Where does the trachea bifurcate?

Answer 10

At the transverse thoracic plane (Carina)

Question 11

Give the levels of bronchial segmentation and what each level supplies

Answer 11

Main (primary) bronchi supply a lung, Secondary (lobar) bronchi supply a lobe, Tertiary (Segmental) Bronchi supply a bronchopulmonary segment

Question 12

What are the two primary things that are supplied to a given bronchopulmonary segment?

Answer 12

A segmental (tertiary) bronchus and a segmental branch of pulmonary artery

Question 13

What drains a given bronchopulmonary segment?

Answer 13

An intersegmental pulmonary vein in the septum between bronchopulmonary segments

Question 14

How many bronchopulmonary segments does each lung have?

Answer 14

Right - 10, Left - 8-10

Question 15

What are the two vascular systems of the lungs?

Answer 15

Pulmonary system (supply deoxygenated blood to be oxygenated) and Bronchial system (systemic circulation to large conducting structures such as bronchi)

Question 16

Where are the visceral and parietal pleura continuous?

Answer 16

At the hilum of the lung

Question 17

Pneumothorax, hydrothorax, and hemothorax

Answer 17

Air, fluid, and blood respectively in the pleural cavity

Question 18

Parts of the parietal pleura

Answer 18

Costal, mediastinal, diaphragmatic, cervical

Question 19

Where do the right and left bronchial veins drain respectively?

Answer 19

Right - Azygos vein, Left - Accessory hemiazygos vein or Left Superior Intercostal vein

Question 20

What are the two systems for lymphatic drainage of the lung and what parts of the lung does each drain?

Answer 20

Superficial lymphatic plexus drains lymph from lung tissue and visceral pleura, Deep lymphatic plexus drains lymph from root of lung

Question 21

Trace the route of lymphatic drainage from structures in the root of the lung

Answer 21

Deep lymphatic plexus –> Pulmonary lymph nodes (along lobar bronchi) –> Bronchopulmonary (hilar) nodes –> Superior tracheobronchial nodes –> Bronchomediastinal lymph trunks –> Venous angle

Question 22

Trace the route of lymphatic drainage from a structure in the lung or visceral pleura

Answer 22

Superficial lymphatic plexus –> Bronchopulmonary (hilar) nodes –> Superior tracheobronchial nodes –> Bronchomediastinal lymph trunks –> Venous angle

Question 23

Describe generally where lymphatic drainage of the left and right lung ends up

Answer 23

Right lung moves superiorly to right venous angle, lower lobe of left lung crosses Carina and follows right lung, upper lobe of left lung moves superiorly to left venous angle

Question 24

Give the division of the airway starting with a main bronchus and ending with the capillary wall

Answer 24

Main Bronchus (primary), Lobar bronchus (secondary), Segmental bronchus (tertiary), Bronchiole, Terminal Bronchiole, Respiratory Bronchiole, Alveolar duct, Alveolus, Alveolar-Capillary barrier

Question 25

Give the number of bronchopulmonary segments in each lobe of each lung and the acronyms for the names of segments in each lung

Answer 25

Right Superior 3 (Apical, Posterior, Anterior), Right Middle 2 (Lateral, Medial), Right Lower 5 (Superior, Medial-Basal, Anterior-Basal, Lateral-Basal, Posterior-Basal) [A PALM Seed Makes Another Little Palm]. Left Superior 2 (Apico-Posterior, Anterior), Left Lingula 2 (Inferior Lingular, Superior Lingular), Left Inferior 4 (Superior, Anteromedial Basal, Posterior Basal, Lateral Basal) [ASIA ALPS] (not in order)