EXAM3_G21_Lungs_Pleura

Question 1

Pleura that adheres to thoracic wall, mediastinum & Diaphragm and four named regions

Answer 1

Parietal Pleura

• Cervical (cupula)
• Costal parietal pleura
• Diaphragmatic pleura
• Mediastinal pleura

Question 2

Pleura that adheres to lungs

Answer 2

Visceral pleura

Question 3

Injuries to the base of the neck can affect lungs and pleura, why?

Answer 3

Cervical pleura extends 2-3 cm above the superior thoracic aperture

Question 4

What is the edge between costal and mediastinal pleural regions called?

Answer 4

L&R STERNAL lines of pleural reflection

Question 5

What is the edge between costal and diaphragmatic pleural regions called?

Answer 5

L&R COSTAL lines of pleural reflection

point that changes direction as it changes from parietal pleura to visceral pleura

Question 6

what is the area of continuity between parietal and visceral pleura called?

Answer 6

Pleural Sleeve

Question 7

Left sternal line of reflection deviates laterally spanning what ribs? what access does this provide?

Answer 7

ribs 4-6 and exposes an anterior access to the mediastinum

Question 8

In a radiograph where does the costal and diaphragmatic pleura intersect at the midclavicular line? Midaxillary line? paravertebral line?

Answer 8

rib 8- midclavicular line
rib 10-midaxillary line
rib 12 paravertebral line

Question 9

Lungs and serous pleural sac are found in the ?

Answer 9

pulmonary cavities

Question 10

The lungs are engulfed in a balloon called the pleural sac and suspend the lungs within the chest. The space created by the pleural sac is called? and filled with ?

Answer 10

Pleural cavity filled with serous fluid for lubrication (

Question 11

inflammation of the parietal and visceral pleura is called?

Answer 11

Pleuritis- sounds like walking on snow

Question 12

The lungs do not entirely fill the pulmonary cavities which leaves two named spaces which can fill with fluid which are called what?

Answer 12

Costomediastinal recess (sternal pleural reflection and cardiac notch)

Costodiaphragmatic recess- (Costal pleural reflection)

Question 13

2 rib rule of the costodiaphragmatic recess helps you remember the inferior extent of the lungs & Parietal pleura. What rib level does the lung end what level does the pleura end at the midclavicular, midaxillary, and paravertebral lines?

Answer 13

Midclavicular line (Lungs-rib 6, CLPR-rib 8)
Midaxillary line (lungs- rib 8, CLPR rib- 10)
Paravertebral line (lungs- rib 10, CLPR rib 12)

Question 14

How do you estimate where the lungs end and where the parietal pleura ends in order to safely insert a needle into the pleural cavity to perform a thoracentesis?

Answer 14

2 Rib rule of costodiaphragmatic recess
- Use:
Midclavicular line intersects (rib 6 lungs, 8 pleura)
Midaxillary line intersects (rib 8 lung, 10 pleura)
Paravertebral line intersects (rib 10 lung, rib 12 pleura)

Question 15

Dypsnea (difficulty breathing) is seen in a patient who has excess fluid accumulated in the recess of the pleural cavity. This space is called?

Answer 15

Costodiaphragmatic recess-

its’ a potential space

Question 16

At the midaxillary line where would you insert the needle to perform a thoracentesis?

Answer 16

Between ribs 9 and 10 (9th Intercostal Space) because at the midaxillary line the lungs end at rib 8 and the pleura ends at rib 10

Question 17

Each lung is surrounded by its own independent pleural sac and cavity. The pleural cavity is under negative pressure which keeps the lungs inflated during inspiration. A breach of pleura releases the suction causing elastic recoil of the lung to collapse. This is clinically called?

Answer 17

Secondary Atelectasis

Question 18

Entry of air into the pleural cavity is called ?

Answer 18

Pneumothorax (a type of pleural effusion)

Question 19

Pleural effusion of serous, blood, lymph called respectively? What sign do you look for on the radiograph?

Answer 19

Meniscus sign on radiograph:
Serous - Hydrothorax
Blood- Hemothorax
Lymph- Chylothorax

Question 20

What are the lungs attached to ?

Answer 20

Mediastinal structures (heart & trachea) via the root of the lungs

Question 21

Structure forming the root of the lung enter and exit the lung through the “spot” called the?

Answer 21

Hilum

Question 22

What structure surrounds each root of the lung? what structure forms by the slack inferior to the root of the lungs?

Answer 22

Pleural Sleeve

Pulmonary ligament (anchors the lung)

Question 23

What three major components of the root of the lung?

Answer 23

Main Bronchus
Pulmonary Artery
Pulmonary Veins

Question 24

What are the first structure to identify in the root of the lung? why?

Answer 24

left and right main bronchi

(posterior part of the lung) very cartilaginous and easy to identify

Question 25

just superior to the clavicle the superior border of the lungs extends into the base of the neck. This border of the lungs is called?

Answer 25

APEX and is associated with the cervical pleura (cupula)

Question 26

What are the identifying borders of the lungs? (how do you determine what your looking at?) anterior posterior inferior

Answer 26

Anterior border is wedge-like Posterior border is rounded Inferior border is concave downward

Question 27

What feature is just inferior to the cardiac notch on the left lung? what lobe is it on?

Answer 27

Lingula- superior lobe of left lung inferior to cardiac notch

Question 28

Inferior the larynx beginning at C6 and palpable at the jugular notch is what?

Answer 28

Trachea

Question 29

Where does the trachea begin and end? | What is the surface landmark for where the trachea ends?

Answer 29

begins C6 and ends at T4/T5 IVD | Sternal angle "transverse thoracic plane"

Question 30

What causes the bumpy anterolateral sides of the trachea? | What is the posterior side of the trachea called?

Answer 30

C shaped hyaline cartilage rings | Trachealis smooth muscle

Question 31

The keel of a boat . thin ridge of cartilage marking the branching of teh trachea into two main bronchi is called ?

Answer 31

Carina

Question 32

Describe the difference between the openings of the left and right main bronchi

Answer 32

Right main bronchi is LARGER and more vertical and has higher chance of foreign objects getting in there

Question 33

The right main bronchus splits into what? | The left?

Answer 33

Right= Three Lobar (secondary Bronchi) Left= Two Lobar Bronchi

Question 34

Each lobar bronchus branches into ? | How many left and right?

Answer 34

Segmental (tertiary bronchi) 10 Right 10 (or 8) on left

Question 35

Each segmental bronchus supplies a wedge-shaped region called a

Answer 35

Bronchopulmonary segment

Question 36

Describe Bronchopulmonary segments

Answer 36

Each segment has independent vasculature and is separated by connective tissue

Question 37

Because bronchopulmonary segments have independent vasculature and separated by CT, each segment can be resegmented without interrupting the neighboring segments. This is called? removing an entire lobe? Entire lung?

Answer 37

Segmentectomy lobectomy numectomy

Question 38

Segmental bronchus branches into smaller airways. Describe from large to small.

Answer 38

1. Segmental Bronchus-> 2. conducting bronchiole> 3. Respiratory bronchiole> 4. Alveolar ducts and sacs> 5. gas exchange in alveolus

Question 39

What supplies low Oxygenated blood from the heart to the lungs for oxygenation?

Answer 39

Pulmonary arteries

Question 40

The pulmonary arteries connect to ______ surrounding alveoli where respiration occurs

Answer 40

capillary beds

Question 41

What supplies blood to the lung parenchyma?

Answer 41

Pulmonary arteries

Question 42

What supplies nutrients and high oxygen blood to root of lungs, stroma of lungs, and visceral pleura?

Answer 42

Bronchial arteries

Question 43

The left bronchial artery is derived from ?

Answer 43

Thoracic aorta

Question 44

Right bronchial artery is derived from ?

Answer 44

Variable origin-- - posterior intercostal artery or, - thoracic aorta or, - left bronchial artery

Question 45

What structures are supplied by the bronchial arteries?

Answer 45

Oxygenated blood to root of lung, stroma of lung, and visceral pleura

Question 46

What structures are supplied by the pulmonary arteries?

Answer 46

lung parenchyma

Question 47

Arteries of thoracic wall supply what?

Answer 47

parietal pleura

Question 48

What mainly drains blood from airway walls & stroma near the root of the lung?

Answer 48

Bronchial Veins

Question 49

Parietal pleura drains into what veins?

Answer 49

veins of the thoracic wall

Question 50

The parietal pleura is supplied by what artery?

Answer 50

Arteries of the thoracic wall

Question 51

right bronchial vein drains where?

Answer 51

Azygous vein then into SVC

Question 52

The left bronchial vein drains where?

Answer 52

Accessory hemiazygous vein then the SVC

Question 53

The remainder of blood in the lungs and visceral pleura drains into the?

Answer 53

pulmonary veins

Question 54

What brings oxygenated blood from capillaries to the heart?

Answer 54

Pulmonary veins

Question 55

What drains deoxygenated blood from the visceral pleura?

Answer 55

Pulmonary veins

Question 56

What drains the superficial lymph from the lung parenchyma & visceral pleura ? what does that drain into?

Answer 56

Superficial plexus then drains into the Hilar (bronchopulmonary) nodes

Question 57

What lymphatic vessels originate in walls of airway and surrounding stroma and drains lymph from structures that form the root of the lung?

Answer 57

Deep plexus

Question 58

Superficial and deep plexus drain into? then describe how they get all the way to the thoracic duct

Answer 58

Hilar(bronchopulmonary) nodes> "corina" Tracheobronchial nodes> paratracheal nodes> R lymphatic or thoracic duct

Question 59

What is the general pattern of lymph flow in the lungs? right lung, left inferior lobe Left superior lobe

Answer 59

Lymph in right lung> right venous angle Lymph in left inferior lobe> right venous angle Lymph in superior lobe > left venous angle

Question 60

Cancer that forms anywhere in the lungs is called?

Answer 60

Bronchogenic carcinoma