3. Pulmonology

Question 1

How can the right lung and the left lung be differentiated from eachother?

Answer 1

The right lung has 3 lobes while the left only has 2. The left lung will have a lingua (tongue in latin) near the diaphragmatic end. Both lungs have a more linear posterior side and a thin and floppy anterior side

Question 2

What separates the two lobes on the left lung and what separates the THREE lobes on the right lung?

Answer 2

Left: Oblique fissure (separates superior and inferior lobes)
Right: Oblique fissue (separates superior and middle lobes from inferior)
Horizontal fissure (separates superior and middle lobes)

Question 3

What consists of each hilum in the left and right lung and how can you differentiate?

Answer 3

Pulmonary Artery: superior and thicker wall vessel
Pulmonary Vein: anteroinferior and thinnest wall vessel
Main bronchus: posteroinferior- cartilage in wall
Pulmonary L: hanging pleura from root of lung

Question 4

What are the different surfaces of the lungs?

Answer 4

Apex, mediastinal surface, costal surface, and diaphragmatic surface

Question 5

What two grooves are important to remember for the right lung?

Answer 5

Groove for azygous Vein of the right lung (right above hilum in arch formation)
Groove for the esophagus of the right lung (posterior side, along the hilum)

Question 6

What are important features to remember on the left lung?

Answer 6

Cardiac notch of the left lung (right above the lingula)
Lingula of left long (below cardiac notch, above oblique fissure)
Groove for aorta (posterior side of the hilum)

Question 7

Where does the inferior border of the lungs sit on?

Answer 7

The diaphragm (called the diaphragmatic surface)

Question 8

What are the costomediastinal and costodiaphragmatic recesses?

Answer 8

Open spaces in the thorax where blood/fluid/pus can pool, making it hard for the lungs to intake air

Question 9

Lung cancer can derive from actual lung tissue or from the bronchi. It can involved the Phrenic N. Vagus N. and recurrent laryngeal N due to proximity of those nerves to the lungs. What are some ways to treat lung cancer?

Answer 9

Removal of the lung (pneumonectomy), removal of a lobe of the lung (lobectomy), or a specific bronchopulmonary segment (segmentectomy) through a procedure called a lung resection

Question 10

Pleura are serous membranes surrounding the lungs. Parietal pleura is adherent to the thoracic wall, mediastinum, and diaphragm. What are the 4 different names based on location?

Answer 10

1. Costal Pleura (internal surface of thoracic wall)
2. Mediastinal Pleura (lateral mediastinum)
3. Diaphragmatic Pleura (superior diaphragm)
4. Cervical Pleura (over apex)

Question 11

Where is visceral pleura located?

Answer 11

It is adherent to the lungs and extends into the fissures

Question 12

What is pleural cavity and what does it contain?

Answer 12

Pleural cavities are potential space between layers of the pleura that contains serous lubricating fluid that reduces friction and produces cohesion through surface tension

Question 13

What occurs during pulmonary collapse?

Answer 13

A lung collapses due to air entering the pleural cavity, breaking the surface tension between 2 layers of pleura

Question 14

What is pneumothorax?

Answer 14

Entry of air into pleural cavity due to a penetrating wound to the thoracic wall or rupture of pulmonary lesion

Question 15

What is pleuritis and how does it occur?

Answer 15

Is an inflammation of the pleura producing roughness on the lungs making breathing difficult- red & gross

Question 16

What occurs during hydrothorax?

Answer 16

Accumulation of excess fluid in the pleural cavity, usally due to fluid escape into the pleural cavity or pleural effusion

Question 17

What occurs during hemothorax?

Answer 17

Accumulation of blood in the pleural cavity due to a chest wound, laceration of intercostal or internal thoracic vessels

Question 18

What are the different lines of pleural reflection, which are abrupt changes in the direction of parietal pleura?

Answer 18

Sternal line
Costal line
Vertebral line

Question 19

The trachea extends from the larynx and goes down where it splits and becomes?

Answer 19

1. primary/main bronchi
2. secondary/lobar bronchi
3. Tertiary/segmental bronchi

Question 20

What is the difference between bronchi and bronchioles?

Answer 20

Bronchi have cartilage while bronchioles do not

Question 21

What is the difference between the left and right bronchi?

Answer 21

The right bronchi are more vertical, allow more ‘things’ to roll into it, more complications commonly with right bronchus, whereas left bronchus is more horizontal

Question 22

What is the procedure bronchoscopy?

Answer 22

Insertion of a bronchoscope into the trachea to visualize the main bronchi. Will be able to see the carina- the ridge where it splits to form left and right main bronchi

Question 23

What bronchopulmonary segments are in the superior, middle, and inferior lobe for the right lung?

Answer 23

Superior: Apical, anterior, posterior
Middle: lateral , medial
Inferior: Superior, anterio basal, medial basal, lateral basal, posterior basal

Question 24

What bronchopulmonary segments are in the superior and inferior lobe of the left lung, and what are they called together?

Answer 24

superior: Apical + posterior= (apicoposterior), anterior, superior + inferior lobe segments =lingular segment
Inferior: superior, lateral basal, posterior basal, anterior basal + medial basal= anteromedial basal