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Anatomy of the Thorax > 3. Bronchi, Lungs, Pleura and Diaphragm > Flashcards

3. Bronchi, Lungs, Pleura and Diaphragm Flashcards

1
Q

Sternal angle

A

Point at which 2nd costal cartilage attaches

Posteriorly, this is at the vertebral level T4/5

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2
Q

What vertebral level does the trachea start and end at?

A

C6 to T4/T5

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3
Q

What is the name of the hooked cartilage at the bottom of the trachea?

A

Carina

Hooks under bifurcation of trachea into left and right main bronchus

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4
Q

What are the 3 divisions of the bronchi?

A

Primary
Lobar
Segmental

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5
Q

Primary bronchi

A

Formed at T4/5

Right is wider and more vertical than left: solid objects more likely found in right

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6
Q

Lobar (secondary) bronchi

A

Formed within the lungs

Supply the lobes of the lungs (more in right than left, as right has an extra lobe)

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7
Q

Segmental (tertiary bronchi)

A

Supply the bronchopulmonary segments

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8
Q

Lobes in each lung

A

Right: 3
Left: 2

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9
Q

What are the cartilaginous structures found at the top of the airway?

A

Thyroid Cartilage

Cricoid Cartilage

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10
Q

Thyroid cartilage in males and females

A

Larger in males than females

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11
Q

What is the clinical significance of the gap between the cartilaginous structures at the top of the airway?

A

In an emergency situation, a cricothyroidotomy can be performed by piercing a hole in the median cricothyroid ligament.

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12
Q

How many bronchopulmonary segments are there per lung?

A

10

Despite there being different number of lobes in each

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13
Q

What is the arrangement of bronchopulmonary segments? How is this advantageous?

A

Smallest, functionally independent regions that can be removed without affecting anything upstream (not in series)
Because they’re functionally independent they have their own nerve supply, blood supply and airway

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14
Q

How are the lungs arranged?

A

Each lies freely in its pleural cavity (filled with pleural fluid which creates surface tension between layers)
Free apart from its attachment to the heart (via pulmonary vessels) and trachea at the lung root (hilum)

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15
Q

Describe the 2 types of circulation to and from lungs

A

Pulmonary circulation: arteries take deoxygenated blood to lungs and veins return oxygenated blood to heart
Bronchial circulation: arteries takes O2 to lungs and veins remove deoxygenated blood

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16
Q

What do the vessels, nerves and bronchi from the mediastinum have to pass through to get to the lungs?

A

Root of the lung

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17
Q

Describe the shape of the lungs

A

Conical

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18
Q

Where is the apex of the lung?

A

Thoracic inlet oblique

3-4 cm above the level of the 1st costal cartilage

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19
Q

Describe the base of the lung

A

Concave

Rests on convex surface of diaphragm (dome superiorly)

20
Q

What are the 3 edges of the lung?

A

Anterior
Posterior
Inferior

21
Q

What are the 3 surfaces of the lung?

A

Costal (Outer, closest to ribs)
Mediastinal (Closest to heart)
Diaphragmatic (Rests on diaphragm)

22
Q

What does the diaphragm separate the left and right lung from?

A

Right lung: from right lobe of liver

Left lung: from left lobe of the liver, stomach and spleen

23
Q

Describe the posterior part of the mediastinal surface of the lung

A

Thick

In contact with thoracic vertebrae

24
Q

Describe the anterior part of the mediastinal surface of the lung

A

Deeply concave: accommodates the heart

Cardiac impression larger on L than R because of position of heart

25
Q

Describe the part above and behind the cardiac impression of the mediastinal surface of the lung

A

Hilum (pleural reflection) of the lung where vessels, bronchi and nerves enter and leave the mediastinum

26
Q

What are the root and hilum?

A

Hilum: reflection in pleura
Root: is inside the hilum, structures going from lung to heart

27
Q

Describe the left lung from a mediastinal aspect

A

Lingula projects forwards infront of heart (at front, flap, like a tongue)
Groove for aorta
Cardiac impression for heart
2 pulmonary veins from each lung

28
Q

Describe the structure of the left lung

A 
2 lobes:		
Superior (upper)
Inferior (lower)
Separated by oblique fissure 
Superior lobe lies above the fissure, includes:
Apex
Most of anterior part of lung
29
Q

Describe the right lung from a mediastinal aspect

A

Grooves for major vessels

Groove for oesophagus at back

30
Q

Describe the structure of the right lung

A

3 lobes:
Superior
Middle
Inferior
Separated by 2 fissures
Oblique fissure: separates inferior lobe from the other 2 lobes
Horizontal fissure: separates superior from middle lobe
Right lung is slightly larger than the left (as heart is located on left side)

31
Q

What structures enter of leave the hilum of the lung?

A 
Pulmonary artery
2 Pulmonary veins
Primary bronchus
Bronchial arteries
Pulmonary nerve plexus
Lymph vessels and nodes
32
Q

Pulmonary trunk

A

Large artery emerging from right ventricle, which goes superiorly then posteriorly, before dividing into left and right pulmonary artery.
It’s the 1st vertically orientated blood vessel coming from the right ventricle.

33
Q

What is the pulmonary ligament?

A

Inferior fold of pleura (below the hilum)
Thickening of tissue
Expands on inhalation and allows expansion of lung

34
Q

Pleura

A

A thin layer of flattened cells supported by connective tissue that lines each pleural cavity and covers the exterior of the lungs

35
Q

What are the 2 pleural layers?

A

Visceral pleura: covers surface of lungs and lines fissures between the lobes
Parietal pleura: lines inner surface of chest walls

36
Q

Where do the visceral and parietal pleura become continuous?

A

At the hilum of the lungs

37
Q

Describe the pleural cavity in health

A

Pleural cavity is collapsed (visceral and parietal mostly touching each other with small amount of fluid inbetween)
Moist surfaces allow lungs to glide as they expand and collapse

38
Q

Heart location

A

Mainly centrally located, but projects downwards and towards left side

39
Q

Lungs and pleural cavity locations

A

Lungs and pleural cavities are next to each other at top of chest
Pleural cavity at bottom is larger: only in deep inhalation lung will fill pleural cavity

40
Q

What is the gap between the inferior surface of the lung and the inferior surface of the pleura called?

A

Costo-diaphragmatic recess

41
Q

Where does the oblique fissure run?

A

Along 6th rib

42
Q

Where does the horizontal fissure on the right side run?

A

From 4th costal cartilage and 4th rib runs laterally, directly out until it meets the oblique fissure

43
Q

How does the diaphragm function as the main inspiratory muscle?

A

Contraction of the diaphragm increases the vertical dimension of the thoracic cavity.
-presses on the abdominal viscera which initially descend (because of relaxation of the abdominal wall during inspiration)
Further descent is stopped by the abdominal viscera, so more diaphragm contraction raises the costal margin
Increased thoracic capacity produced by diaphragm and rib movements in inspiration, reduces intrapleural pressure, with entry of air through respiratory passages and expansion of the lungs

44
Q

What are the attachments of the diaphragm?

A

Costal margin
Xiphoid process
Ends of ribs 11 and 12
Lumbar vertebrae

45
Q

How do the dimensions of the thoracic cavity change when inspiring?

A

Anteroposterior diameter increases

Transverse diameter increases

46
Q

What causes expiration?

A

Expiration is PASSIVE

Caused by the natural elastic recoil of the lungs

47
Q

What happens in forced expiration?

A

Abdominal muscle contracts pushing the abdominal viscera against the diaphragm and pulling the costal margin down.

Anatomy of the Thorax (8 decks)

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