Lungs And Pleura

Question 1

Pulmonary ligament

Answer 1

Anterior to the esophagus
It’s double layered
Inferior to the root

Question 2

Mediastinal pleura

Answer 2

Covers the lateral side of the mediastinum

Continues with the cervical pleural, costal pleural(anterior) , diaphragmatic ( inferior)

Question 3

Cervical pleura

Answer 3

Covers the apex of the lung
Extends into the root of the neck ( 3-4cm above the level of the costal cartilage, up to the level of the 1st rib)
Summit( 2-3 cm above the medial third of clavicle)

Question 4

Supra pleural membrane is also known as

Answer 4

Sibson fascia

Question 5

Supra pleural fascia

Answer 5

Fibrous thickening, c7 transverse process to internal border of first rib

Question 6

Diaphragmatic pleura

Answer 6

Covers the superior surface of the diaphragm

Question 7

Phrenicopleural fascia

Answer 7

Continuous with endothoracic and connects with the diaphragm with the diaphragmatic pleurae.

Question 8

Pleural lines

Answer 8

Sternoclavicular joint to behind the sternal. Right and left descend in contact with each other to the 4 th costal cartilage

Question 9

Right side of the pleural lines

Answer 9

Passes down to the xiphisternal joint

Question 10

Left side pleura line

Answer 10

Line diverges laterally from the lateral margin of the sternum to 6th costal cartilage.

Question 11

Pleural reflection

Answer 11

These are the relatively abrupt lines along whic the parietal pleura folds back or changes direction from one wall of the pleural cavity or another

Question 12

Sternal line of reflection

Answer 12

This is where the costal pleural is continuous with the mediastinal pleura, posterior to the sternum .

Question 13

Costal line of reflection

Answer 13

Continues obliquely to the 8th rib in the midclavicular line, 10th rib in midaxillary.

It crosses the 12th rib to the level of t12 vertebral spines. The para vertebral plane.

Question 14

The pleural recess

Answer 14

During the inspiration, the lungs fill the pleural cavity, but during respiration, the lungs do not fill these part so the cavity.

Question 15

Costomediastinal recess

Answer 15

Behind the sternum and costal cartilages, anterior margin of the lung fails to reach the anterior margin of the pleura.

Question 16

Costodiaphragmatic

Answer 16

Between the costal and diaphragmatic pleurae. They are slit like intervals btw the costal and diaphragmatic pleurae on each side.

Question 17

Why is the left recess larger

Answer 17

Because of the presence of a semicircular deficiency, the cardiac notch, in the left lung anterior to the pericardium

Question 18

Arterial supply and venous drainage of parietal

Answer 18

Internal thoracic, intercostal, musculophenric

Question 19

Cervical pleura is supplied by ?

Answer 19

Branches of subclavian

Question 20

Arterial supply of visceral pleural

Answer 20

Bronchial artery

Question 21

Venous drainage of visceral pleurae

Answer 21

Pulmonary vein

Question 22

Development of parietal pleurae

Answer 22

Somatopleural layer

Question 23

Development of visceral pleurae

Answer 23

Splanchopleural

Question 24

Nerve supply of parietal

Answer 24

Intercostal (costal and peripheral diaphragmatic )

Phrenic ( mediastinal and central diaphragmatic

Question 25

Visceral nerve supply

Answer 25

Autonomic and para sympathetic ( t2-t5 and vagus)

Question 26

Lymphatic drainage of parietal

Answer 26

Intercostal, parasternal, mediastetnal

Question 27

Lymphatic of visceral

Answer 27

Bronchopulmonary

Question 28

Clinical importance of apex of lung and cervical pleurae

Answer 28

Injuries to the root of the neck may cause pneumothorax

Question 29

Why are infants and young children more vulnerable to pneumothorax?

Answer 29

Because of the shortness ness of the neck

Question 30

Inferior border of costodiaphragmatic recess is related to

Answer 30

The kidney close to lateral border of erector spinae at the level of 12th rib

Question 31

What is pneumothorax ?

Answer 31

Accumulation of air in the pleural cavity that may be due to trauma.

Question 32

Chylothroax

Answer 32

Accusation of lymph

Question 33

Hydrothroax

Answer 33

Accumulation of fluid

Question 34

Hemothorax

Answer 34

Blood

Question 35

Pleural effusion

Answer 35

Causes obliteration of the costophenic angle

Question 36

Auscultation

Answer 36

Faint breath sounds over the compressed lung and absent breath sounds over the fluid in the cavity.

Question 37

Right side pleural effusion

Answer 37

Mediastinum displaced tot he left and right lung compressed

Question 38

Thoracentesis

Answer 38

Insertion if a needle into the pleural cavity to obtain a sample of fluid

Question 39

Where is the thoracentesis taken?

Answer 39

9th ICS in the midaxillary line during expiration

Question 40

Pleuritis is also known as

Answer 40

Pleurisy

Question 41

In pleuritis the surface of the pleurae becomes

Answer 41

Rough and a pleural rub is detected

Question 42

Which layer of pleurae is sensitive to pain

Answer 42

Parietal

Question 43

Explain pulmonary collapse

Answer 43

Penetrating wound through the thorax lung, air is sucked into the pleural cavity leading to collapse of the lung. The pleural cavity explains

Question 44

When is a chest tube needed?

Answer 44

During tension pneumothorax , air enters the pleural cavity during inspiration but cannot escape during expiration, large pleural effusion requires insertion of chest tube

Question 45

Where is the chest tube inserted?

Answer 45

5th and 6th ICS in the midaxillary line

Question 46

How is the needle point for the withdrawal of fluid in the lungs

Answer 46

Downwards

Question 47

What colour is the lungs at birth and adult?

Answer 47

Pink and grey

Question 48

Which border of the lungs is darker?

Answer 48

Posterior border

Question 49

Fetuses and still born infants lungs?

Answer 49

Lungs are firm, non Crepitant and do not float in water

Question 50

Pats of the lung

Answer 50

Apex 3 border: anterior , posterior, inferior 3 surfaces ; costal, diaphragmatic, mediastinal

Question 51

Apex of lungs

Answer 51

Extends into the root of the neck covered by cervical pleura

Question 52

Costal surfaces of the lungs

Answer 52

Related to thoracic wall, preserved specimens show impressions for ribs, costal cartilages and intercostal muscles.

Question 53

Diaphragmatic surface ( base)

Answer 53

Concave, related to diaphragm, the deeper on the right

Question 54

Mediastinal

Answer 54

Shows hilum,pulmonary liagment

Question 55

What is anterior to the hilum?

Answer 55

Cardiac impression

Question 56

What is in the caradiac impression?

Answer 56

Right auricle , atrium and ventricle

Question 57

The cardiac impression ascends with

Answer 57

Groove for Superior vena cava and right brachio cephalic vein

Question 58

What is joined posteriorly with the superior vena cava?

Answer 58

Azygos veinw

Question 59

Relations of mediastinal surface

Answer 59

Esophagus- behind the hilium and pulmonary liagment Anteroinferior to cardiac impression for IVC Above the groove for azygos the trachea and right vagus related

Question 60

Relations of mediastinal surface left side

Answer 60

Cardiac impression - left ventricle, auricle and right ventricle. Arch and descending aorta- arches over the hilium and pulmonary liagment From the summit above: groove for left subclavian artery Behind the groove for subclavian- esophagus.

Question 61

Oblique fissure

Answer 61

Starts posterosuprior to the hilum, ascends to cross the posterior border about 5cm below the apex. Passes obliquely to reach the inferior border at 6th costochrondal junction 7.5 cm from the midline.

Question 62

Horizontal fissure

Answer 62

4th rib midaxillary line to anterior border of the right lung.

Question 63

How many lobes are on the left lung ?

Answer 63

2

Question 64

How many lobes are on the right lung?

Answer 64

3 lobes

Question 65

Where is the pulmonary hilum located

Answer 65

Mediastinal surfaces

Question 66

What is the level of root?

Answer 66

T5, 6,7

Question 67

Structures passing in the pulmonary hilum?

Answer 67

``` Bronchi Pulmonary artery 2 pulmonary veins Bronchial vessels Pulmonary autonomic plexus Lymph vessels Bronchopulmonary lymph nodes ```

Question 68

What shape is the bronchopulmonary segment?

Answer 68

Pyramidal

Question 69

What supplies the bronchopulmonary segment?

Answer 69

Segmented bronchus and a tertiary branch of the pulmonary artery