10.25.16 Lungs and Posterior Mediastinum Flashcards
The lung ___ is the superior-most aspect and is rounded and somewhat conical.
Apex
The lung apex is covered with ___ and is commonly referred to as the ___ of the lung.
Cervical pleura; cupula
The lung ___ is inferior, and is large and concave due to the dome of the diaphragm.
Base
The medial aspect of each lung is concave to allow for the presence of the ___.
Heart
The anterior, lateral, and posterior surfaces of the lung is ___ and follows the contours of the internal thoracic wall.
Convex
What are the two fissures of the lungs?
- Oblique fissure (major)
2. Horizontal fissure (minor)
The posterior aspect of the oblique fissure is located at the ___ thoracic vertebrae. The anterior aspect is inferior and is located at the ___ junction.
Second; sixth costochondral
In the left lung, the oblique fissure separates the lung into what two lobes?
Superior and inferior
The most anteroinferior portion of the superior lobe forms a tongue-shaped extension called the ___.
Lingula
In the right lung, the oblique fissure posteriorly separates what two lobes? Anteriorly, it separates what two lobes?
Posteriorly - superior from inferior
Anteriorly - middle from inferior
The horizontal fissure is found in the ___ lung only.
Right
The horizontal fissure separates the ___ lobe from the ___ lobe.
Superior; middle
What are the 5 impressions on the medial surface of the right lung?
- Groove for the superior vena cava
- Groove for the inferior vena cava
- Groove for the esophagus
- Groove for the azygos vein
- Cardiac impression
What are the 3 impressions on the medial surface of the left lung?
- Groove for the arch and descending aorta
- Groove for the subclavian artery
- Cardiac impression
What is the point where structures leave and enter the lung?
Hilus
At the inferior aspect of the hilus, the visceral pleura reflects and forms the ___.
Pulmonary ligament
What is formed by all structures of the lung that enter or leave the lung at its hilus?
Root
What carries deoxygenated blood?
Pulmonary arteries
What carries oxygenated blood?
Pulmonary veins
What gives parasympathetic fibers to the lungs?
Vagus nerve (CN X)
What gives sympathetic fibers to the lungs?
Sympathetic trunk (T1 or 2-T6)
The bronchial arteries of the right lung are derived from what three arteries?
Intercostal arteries, aorta, or left highest intercostal artery
The bronchial arteries of the left lung are derived from what artery?
Descending thoracic aorta
The lungs are vascularized by both ___ and ___ vessels.
Pulmonary; bronchial
What do pulmonary arteries do?
Bring deoxygenated blood to the lungs to be oxygenated
What is cardiac contraction?
Systole
During systole, the blood in the right ventricle enters the ___.
Pulmonary trunk
What do pulmonary veins do?
Bring oxygenated blood back to the left atrium
What are the superficial lymphatics of the lungs?
Bronchopulmonary nodes in the root of the lung and tracheobronchial lymph nodes near the tracheal termination and the two main stem bronchi
What are the deep lympathics of the lungs?
Pulmonary nodes
What has no lymphatic drainage?
Alveoli
What is the flexible tube supported by about 20 cartilages?
Trachea
Anteriorly, the tracheal cartilages are ___ shaped rings.
Horseshoe
What allows the diameter of the trachea to be increased?
Trachealis muscle
What is the cartilaginous projection of the last tracheal ring?
Carina
Describe the branches of the trachea.
- Primary bronchi
- Secondary bronchi
- Tertiary bronchi
The ___ bronchi enter and serve each lung. The ___ bronchi enter and serve each lobe of the lung. The ___ bronchi enter and serve the segments of each lobe.
Primary; Secondary; Tertiary
Which primary bronchus is larger, more vertical, and shorter?
Right main bronchus
What is the primary site of aspirated objects?
Primary bronchi
How many secondary bronchi are there?
3 on the right and 2 on the left
___ have no cartilage because of their small diameter. What do these do?
Bronchioles; enter and serve the lobules
The thoracic cavity is lined by pleura, a serious membrane divided into what two parts?
- Visceral pleura
2. Parietal pleura
Which pleura invests the lungs and provides a slippery surface that enables the lungs to move freely against the other pleura?
Visceral pleura
Which pleura lines the pulmonary cavity and is named according to the area of the thoracic cavity that it covers?
Parietal pleura
What are the 4 parts of the parietal pleura?
- Cervical
- Costal
- Diaphragmatic
- Mediastinal
What is the potential space between the visceral and parietal pleural layers and what is found there?
Pleural cavity; serous fluid
Where is the pulmonary ligament found?
Bilaterally, at the root of the lung
What is the pulmonary ligament?
The pleural sleeve found at the inferior aspect of the hilus where the mediastinal pleura meets with the visceral pleura surrounding the lung
What are formed between the parietal and visceral pleura that allow maximum expansion of the lung during forced ventilation?
Pleural recesses
What are the two major pleural recesses?
Costodiaphragmatic recess and costomediastinal recess
What are the boundaries of the posterior medastinum?
Anterior: pericardium
Posterior: thoracic vertebrae
What are the contents of the posterior mediastinum?
- Descending thoracic aorta and its branches
- Esophagus
- Thoracic duct
- Right lymphatic duct
- Azygos and hemiazygos veins
- Sympathetic chain (greater, lesser, and least splanchnic nerves)
- Esophageal plexus (vagus nerve)
Which vein drains the intercostal, right renal, and right ascending lumbar veins?
Azygos vein
Where does the azygos vein empty?
Superor vena cava (only on the right side)
Which vein drains the lower intercostal, left ascending lumbar, and left subcostal veins?
Hemiazygos vein
The hemiazygos vein crosses at the level of the ___ vertebra before emptying into the ___ vein.
T9; azygous
Which vein drains the upper intercostal veins and connects the middle 3-4 intercostal veins?
Accessory hemiazygous vein
What makes up the esophageal plexus of nerves?
- Thoracic sympathetic trunks
- Thoracic splanchnic nerves
- Right and left vagus nerves