L1.3 Lungs, pleura, bronchial tree Flashcards Preview

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Flashcards in L1.3 Lungs, pleura, bronchial tree Deck (22):
1

Branches of airway:

1) Trachea

  • starts lower border of cricoid cartilage → to T4/5 where it bifucates (at the plane of Louis)
  • 'U' shape cartilaginous ridge (deficient POS)
  • POS deficiency bridged by muscles
    • Deficiency allows expansion of airway → prevents collapse

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2

2) 2 main bronchi

  • R → shorter & wider
  • Hilum = where bronchi enters lungs
    • L enters  before divide
    • R divides before entering (SUP & INT (divides into middle & lower))

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3

3) Lobar bronchi

  • Each goes to single lobe of lung
  • 3R, 2L lobes

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4

4) segmental bronchi

  • 9/10 segments of lungs

5

5) Bronchioles

  • Cartilaginous support ↓ further distally → changes from bronchi → bronchiole (when cart lost)
  • Bronchiole → respiratory bronchiole → alveoli

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6

Asthma

  • involves spasm of S.M ~ lower airways
  • No cartilaginous support → collapses → difficult breathing
  • Cold air makes asthma worsen → triggers S.M spasm

7

What is the position of weakness in the thoracic area

  • SUP apertures → expose lungs → position of weakness

8

BS to lungs

  • Pulmonary blood supply for gas exchange, follows similar branching pattern as airways
  • A (carry DeO2) → branches of pul. Trunk ( blood to lungs)
    • Hilum position: SUP & POS
  • V (carry O2) → blood towards heart
    • Hilum position: INF & ANT
  • Pressure difference b/w A & V  are very small (Thickness difference not as great as other A & V)

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9

Bronchial supply to lungs

  • Supplies parenchyma (non-respiratory parts - i.e not alveoli)
  • Derived from bronchial A which is a branch of descending aorta → branches down to smaller levels

10

Venous drainage

  • Bronchial veins → azygous vein 

11

Bronchopulmonary segments

  • Pyramid shaped with 'apex' towards hilum and base on surface
  • Supplied by segmental bronchus, A & V
  • Functionally distinct
  • Surgically resected without disrupting other lung units

12

Structures on the R medial surface

  • A - SUP & POS
  • V - INF & ANT
  • 2 lobar bronchi

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13

Impressions on the R lung

  • SVC, R Brachiocephalic V, Azygous, Cardiac impression

14

Structures on the L medial surfcae

  • Single LMB
  • A - SUP
  • V - INF & ANT

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15

Impressions on the L lung

  • Arch of aorta, Descending aorta, cardiac impression

16

N supply to the lungs

  • Parasym: From vagus N (10th cranial N)
    • Over arch of aorta → behind LMB → branch to bronchiole  tree
  • Sym: T1-4
    • Synapse at sym ganglia → branches towards bifurcation
    • Inhibits S.M around bronchi

17

Lymphatics of the lungs

  • Vessels → nodes → trunks → Duct (R lymphatic & thoracic)  → Vein (Subclavin)
  • Deep pul lymphatic vessels
  • SUP lymphatic vessels
    • Both drain via hilum lymph nodes → tracheal nodes → bronchomediastinal trunk
  • Macrophages aggregate in lymph nodes → macrophage presents carbon (may be black in colour as a result)

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18

Pleura

  • Closed, double layer membrane surrounding each lung
  • Vis & Parietal
    • May have costodiaphragmatic recess in parietal (results in diaphragm moving down)

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19

What is the pulmonary ligament

  • Pulmonary ligament → parietal pleura extended down from hilum
  • At the point of reflection → allows structures into lungs

20

Development of the pleura

  • Coelom → viscera moves in & enlarges → double layer membrane surrounds it

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21

N supply to the pleura

  • Visceral → same sensory N which innervates visceral
    • Visceral afferent - T1-4 from sym
  • Parietal → from somatic N located adjacent to membrane
    • Phrenic, intercostal

22

Importance of surface tension from pleura

  • important for breathing
  • Broken/punctured → lung collapses