Pulmonology

Question 1

what are the 3 surfaces of the lung?

Answer 1

• diaphragmatic surface–part of lung up against diaphragm
• costal surface–part of lung up against rib
• mediastinal surface–part of lung up against mediastinum

Question 2

which lung has 3 lobes and what are those lobes?

Answer 2

right lung–superior, middle, inferior lobes

Question 3

what are the lobes of the left lung called?

Answer 3

superior and inferior lobe

Question 4

what is the oblique fissure in the left lung? in the right lung?

Answer 4

RIGHT: separates superior and middle lobes from the inferior lobe
LEFT: separates superior and inferior lobes

Question 5

what is the horizontal fissure?

Answer 5

• found in the right lung

- found b/w superior and middle lobes

Question 6

apex of lung

Answer 6

-superior aspect of lung–tip of lung at top

Question 7

how to tell what is the posterior and anterior surface of lung?

Answer 7

• posterior: tall and columnar

- anterior: thin and flappy

Question 8

what is the difference between the diaphragmatic surface, the inferior border and the base?

Answer 8

• diaphragmatic surface: whole part on the inferior surface of the lung that sits on diaphragm
• inferior border: ring around diaphragmatic surface
• base: diaphragmatic surface+inferior border

Question 9

what is the hilum?

Answer 9

• where things are going in and out of lung
  
  • blood goes into lung to get oxygenated and blood goes out to rest of body
• holds the pulmonary A, pulmonary V, main bronchi, pulmonary L.

Question 10

pulmonary A in hilum

Answer 10

• typically more superior

- thicker walled vessels b/c blood is at a higher pressure being directly from the heart

Question 11

pulmonary V in hilum

Answer 11

• typically more anteroinferior

- thinnest walled structure in pulmonary hilum

Question 12

main bronchi in hilum

Answer 12

• typically most posteroinferior
• thickest walled structure at the pulmonary hilum
• contains cartilage in the wall

Question 13

pulmonary L. in hilum

Answer 13

-hanging pleura from the root of the lung

Question 14

Review grooves and impressions found in lung by looking at pictures

Answer 14

–

Question 15

which lung has a larger cardiac impression?

Answer 15

left b/c the heart points left

Question 16

on which lung is the groove for the aortic arch?

Answer 16

left lung

Question 17

what is the cardiac notch and on which lung is it on?

Answer 17

• on the left lung
• indentation of the anteroinferior aspect of the superior lobe
• void where the heart is but the lung is not

Question 18

what is the lingula and on which lung is it on?

Answer 18

• on left lung

- thin process of the inferior lobe created by the cardiac notch

Question 19

costomediastinal recess

Answer 19

-space b/w ribs and mediastinum

Question 20

costodiaphragmatic recess

Answer 20

-space b/w ribs and diaphragm lung

Question 21

lung cancer

Answer 21

• can derive from actual lung tissue or from the bronchi
• can involve the phrenic N, vagus N, and recurrent laryngeal N due to proximity of those nerves to the lungs
• treatment: removal of a lung (pneumonectomy), lobe of lung (lobectomy), or a specific bronchopulmonary segment (segmentectomy) through lung resection

Question 22

pleura

Answer 22

• serous membrane surrounding the lungs

- parietal and visceral pleura are parts of the same piece of pleura

Question 23

parietal pleura and the 4 parts

Answer 23

• adherent to thoracic wall, the mediastinum, and diaphragm
• 4 parts:
  1. costal pleura–internal surface of thoracic wall
  2. mediastinal pleura–lateral to mediastinum
  3. diaphragmatic pleura–superior to diaphragm
  4. cervical pleura–dome shaped over the apex of the heart

Question 24

visceral pleura

Answer 24

• adherent to lungs

- extends into fissures

Question 25

pleural cavity

Answer 25

-potential space b/w 2 layers of pleura that contains a serous lubricating fluid (surfactant) that reduces friction and produces cohesion through surface tension

Question 26

pleuritis

Answer 26

- also called pleurisy | - inflammation of pleura producing a roughness of lungs

Question 27

pulmonary collapse

Answer 27

- occurs when enough air enters the pleural cavity break the surface tension b/w the 2 layers of pleura - elasticity of lungs tends to collapse

Question 28

pneumothorax

Answer 28

- entry of air into the pleural cavity from a penetrating wound to the thoracic wall or a rupture of a pulmonary lesion into the pleural cavity - results in a collapse of the lung

Question 29

hydrothorax

Answer 29

- accumulation of excess fluid in the pleural cavity | - usually result of fluid escape into the pleural cavity or pleural effusion

Question 30

hemothorax

Answer 30

- accumulation of blood in the pleural cavity - usually the result of a chest wound, such as a laceration of the intercostal vessel or internal thoracic vessel rather than laceration of the lunglin

Question 31

lines of pleural reflection

Answer 31

abrupt changes in the direction of the parietal pleura

Question 32

sternal line of pleural reflection

Answer 32

-costal pleura becomes mediastinal pleura anteriorly

Question 33

costal line of pleural reflection

Answer 33

-costal pleura becomes diaphragmatic pleura

Question 34

vertebral line of pleural reflection

Answer 34

-costal pleura becomes mediastinal pleura posteriorly

Question 35

trachea and larynx

Answer 35

trachea extends from the larynx to its first branch point at the left and right main bronchi -exists in posterior mediastinum

Question 36

right main bronchus

Answer 36

- primary bronchus - shorter and runs more vertical than left main bronchus - b/c it is more vertical it is easier for foreign matter to get into the lungs

Question 37

what comes off of the primary bronchi or main bronchi?

Answer 37

- we have secondary bronchi called "lobar bronchi" | - we have one for each of the lobes o the lung, so 3 in the right lung and 2 in the left lung

Question 38

what comes off of the secondary bronchi or lobar bronchi?

Answer 38

- we have tertiary bronchi called "segmental bronchi" | - travels with the bronchopulmonary segment

Question 39

what are bronchioles and what are the 3 types of bronchioles?

Answer 39

- smaller than bronchi - this is what segmental bronchi branch into - 3 types: 1. conducting bronchiole 2. terminal bronchiole 3. respiratory bronchiole

Question 40

conducting bronchiole

Answer 40

- branches off of terminal bronchi or segmental bronchi | - no cartilage

Question 41

terminal bronchiole

Answer 41

- branches off of respiratory bronchioles to a specific cluster of alveoli - no cartilage

Question 42

respiratory bronchiole

Answer 42

- branches into the alveolar ducts - capable of gas exchange - no cartilage

Question 43

alveolar duct

Answer 43

- ending at the alveolus - functional unit of lung - primary site of gas exchange

Question 44

bronchial asthma

Answer 44

-widespread narrowing of the airways produced by contraction of SM, edema of mucosa, and mucus in the lumen of the bronchi and bronchioles

Question 45

bronchoscopy

Answer 45

-insertion of the bronchoscope into the trachea to visualize the main bronchi

Question 46

bronchopulmonary segments

Answer 46

- pyramid shaped segment with apex at the hilum and base at the pulmonary surface - separated by CT septa - supplied by and named for a single segmental bronchus - surgically resectable

Question 47

why do we care about bronchopulmonary segments?

Answer 47

-if someone has lung cancer, need to know these segments exist b/c we will have to go in and take out a specific segment that is supplied by a segmental bronchus and corresponding artery