lungs anatomy Flashcards
(38 cards)
What are the parts of the pleurae?
- Parietal pluera:
Cervical,
Mediastinal,
Costal,
Diaphragmatic - Visceral pleura: adherent to lungs
- Continuity btw parietal & visceral gives pulmonary ligament
- Pleural cavity: potential space containing pleural fluid
- Pleural fluid: lubricates pleural layers allowing sliding as lung inflates,
plus surface tension of fluid allows cohesion of lung surface to thoracic wall
=> ensures that lungs follow chest movements during breathing
What are the pleural recesses and what is their significance?
- Costodiaphragmatic recess: where costal & diaphragmatic pleura meet,
at inferior border of lungs - Costomediastinal recess: where costal & mediastinal pleura meet, at anterior border of lungs
Recesses form as lungs do not fully occupy pulmonary cavities during expiration
=> allow for expansion of lungs during inspiration
What is the structure of the bronchial tree?
1. Trachea forms from larynx at (…), supported by (…)
2. At (…), trachea bifurcates into right & left (…)
3. (…) separates the 2 main bronchi,
and is sensitive, triggers cough reflex
4. Primary (main) bronchi divide into (…), each supplying a lobe
5. Secondary (lobar) bronchi divide into (…)
6. Further division into conducting bronchioles, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveoli
- Trachea forms from larynx at C6, supported by C-shaped rings of hyaline cartilage
- At sternal angle (T4), trachea bifurcates into right & left primary (main) bronchi
-
Carina separates the 2 main bronchi,
and is sensitive, triggers cough reflex - Primary (main) bronchi divide into secondary (lobar) bronchi, each supplying a lobe
- Secondary (lobar) bronchi divide into tertiary segmental bronchi
- Further division into conducting bronchioles, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveoli
When foreign objects are aspirated into lungs, where are they more likely to enter?
Right main bronchus
as it is shorter and more vertical
What is a bronchoscopy?
Allows viewing of tracheobronchial tree
What are bronchopulmonary segments?
- 18-20 pyramidal-shaped subdivisions of a lobe, apices facing root of lung, bases at pleural surface
- Each supplied by tertiary segmental bronchi and tertiary branch of pulmonary artery
- Venous drainage not by specific vein
- Surgically resectable when tumours localise in 1 segment
3 surfaces
What are the surfaces of the lungs?
- Costal
- Mediastinal
- Diaphragmatic
defined by the structures they face
What are the borders of the lungs?
- Anterior
- Inferior
- Posterior
serve as transitions between surfaces
Where is the apex and base of the lungs?
- Apex: extends into root of neck
- Base: rests on diaphragm
What are the unique features of the left lung?
-
Deep cardiac notch
to make room for heart
which is more to the left side of the chest - Lingula (tongue-shaped process)
-> compensates for lack of middle lobe
What is the structure of the right lung?
- 3 lobes
(superior, middle, inferior) - Oblique fissure
- Horizontal fissure
What is the structure of the left lung?
- 2 lobes
(superior, inferior) - Oblique fissure
What is the pulmonary blood supply?
-
2 pulmonary arteries which divide to form
→ lobar arteries
→ tertiary segmental arteries - 4 pulmonary veins
What are the pulmonary lymphatics? - Tracheobronchial nodes surround roots of main & lobar bronchi
tracheal sides - Efferent vessels from tracheobronchial
parasternal
brachiocephalic nodes join to form bronchiomediastinal trunks - Bronchiomediastinal trunks drain into thoracic duct (L side) & right lymphatic duct (R side) - Bronchopulmonary (hilar) nodes at hilum of lung
How does a lung carcinoma affect the diaphragm? Lung carcinoma leads to swelling of supraclavicular lymph nodes
may affect phrenic nerve
paralyse diaphragm
What are the bronchial vessels? - Bronchial arteries - Bronchial veins - Drain directly into left atrium
creating a physiological shunt
diluting oxygenated blood of aorta
What is the neurovascular supply of the pleurae? Parietal pleura: supplied by nerves & vessels that supply cutaneous layer - Pain may be local or referred to same spinal dermatome Visceral pleura: supplied by nerves & vessels that supply viscera - Pain may be referred to C3-5 (shoulder & root of neck)
What is the autonomic nervous supply to the lungs?
What are the features labelled in the diagram? L: Lung R: Rib T: Trachea AK: Aortic knob A: Ascending aorta H: Heart (on LHS) P: Pulmonary artery S: Spleen Li: Liver (breast shadows may be vis)
What is the condition present in this X-ray?
Pneumothorax in R lung
- Collapsed lung (atelectatic)
- Air appears black
- No vascular markings
<- sign of collapsed lung
(and indicates NOT fully expanded lung)
as vascular markings are typically visible along lung parenchyma
- Deep sulcus (larger costodiaphragmatic recess)
due to accumulation of air pushing lung away from diaphragm
- Increased haziness on L lung
due to diversion of entire cardiac output
-> increased blood vol and thus vascular distension (i.e. increased diameter)
of blood vessels of L lung
What is a pneumothorax?
Air in pleural cavity
What is a hemothorax?
Blood in pleural cavity
What is a tension pneumothorax? Punctured skin & fascia forms a one-way valve
allowing air in but not out → thoracic pressure increases → compresses mediastinal structures
affects cardiovascular function Clinical symptoms: - Trachea shifted to side - Elevated JVP
What is the condition present in this X-ray?
Pneumonia
- Density in right upper lobe
<- consolidation (fluid, pus or inflammatory cells filling the alveoli)
- Horizontal fissure not shifted
-> indicates lack of large consolidation or lung collapse
bcos in those cases lung tissue shrinks
and pull fissure upward
