3- Thoracic Pulmonology Flashcards
How many lobes does the Left Lung have?
2
How many lobes does the Right Lung have?
3
The Left Lung has a ________ Lobe and ________ Lobe, separated by the ________ ________.
Superior
Inferior
Oblique Fissure
What are the lobes of the Right Lung?
Superior Lobe
Middle Lobe
Inferior Lobe
What fissure separates the Superior and Middle Lobes from the Inferior Lobe of the Right Lung?
Oblique Fissure
What fissure separates the Superior and Middle Lobes of the Right Lung?
Horizontal Fissure
What is the superior most aspect of the Lungs called?
Apex
What are the 3 surfaces on each Lung?
Costal Surface (opposes the rib cage) Mediastinal Surface (opposes the Mediastinum) Diaphragmatic Surface (opposes the Diaphragm)
This is the portion of the Lung where things are moving in and out of it.
Hilum
***Remember, to help orient yourself on which lung you’re looking at the Hilum ALWAYS points medially!
What are the components of the Hilum?
Pulmonary A.
Pulmonary V.
Main Bronchi
Pulmonary L.
This component of the Hilum is typically more superior and has thicker walls.
Pulmonary A.
This component of the Hilum is typically more anteroinferior and has thinner walls.
Pulmonary V.
This component of the Hilum is typically more posteroinferior and is the thickest-walled structure. It also contains cartilage in the its walls.
Main Bronchi
This component of the Hilum consists of hangin pleura from the root of the lung.
Pulmonary L.
What grooves lie on the Mediastinal Surface of the Right Lung?
Cardiac Impression Groove for Azygous V. Groove for Esophagus Groove for Superior Vena Cava Groove for Inferior Vena Cava Groove for 1st Rib Groove for Brachiocephalic V.
What grooves lie on the Mediastinal Surface of the Left Lung?
Cardiac Impression (larger than Right Lung) Groove for Aortic Arch Groove for Descending Aorta Groove for 1st Rib Groove for Subclavian A.
What are the borders of the lungs?
Anterior Border
Posterior Border
Inferior Border
What is on the anterior border of the Left Lung?
Cardiac Notch – indentation on anteroinferior portion of Superior Lobe
Lingula – thin process of the Superior Lobe (lies inferior)
What recesses does the inferior border of the lungs project into?
Costodiaphragmatic Recess
Costomediastinal Recess
***These are spaces where fluids can fill
Lung cancer can derive from actual lung tissue, or from the _______.
Bronchi
***Called Bronchogenic Carcinoma
What nerves can lung cancer involve?
Phrenic N.
Vagus N.
Recurrent Laryngeal N.
***Because they are in close proximity to the lungs
Treatments for lung cancer include Lung Resection via the removal of a lung, called ________, the removal of a lobe of a lung, called ________, or the removal of a specific Bronchopulmonary Segment, called _________.
Pneumonectomy
Lobectomy
Segmentectomy
This is the paired serous membranes surrounding the lungs and keeps them from rubbing and creating friction.
Pleura
This pleura is adherent to the Thoracic Wall, Mediastinum, and the Diaphragm.
Parietal Pleura
***Around the outside of the balloon!
The Parietal Pleura has 4 types that are named for what they lie next to. What are these types?
Cervical Parietal Pleura
Costal Parietal Pleura
Diaphragmatic Parietal Pleura
Mediastinal Parietal Pleura
When the Parietal Pleura changes from one type to the next (i.e., from Cervical Pleura to Costal Pleura) this is called…
Lines of Pleural Reflection
This pleura is adherent to the lungs and extends into the fissures.
Visceral Pleura
***Outside of fist (going into balloon)!
This is the term for an inflammation of the Pleura, producing a roughness on the lungs making breathing difficult.
Pleuritis (Pleurisy)
This is a potential space between the two layers of Pleura that contains a serous lubricating fluid that reduces friction and produces cohesion through surface tension.
Pleural Cavity
This is what occurs when enough air enters the Pleural Cavity to break the surface tension between the two layers of Pleura. The elasticity of the lungs causes this to happen.
Pulmonary Collapse
This is the term for the 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, which results in a collapse of a lung.
Pneumothorax
This is the term for the accumulation of excess fluid in the Pleural Cavity, usually the result of fluid escape into the Pleural Cavity or Pleural Effusion.
Hydrothorax
This is the term for the accumulation of blood in the Pleural Cavity, usually the result of a chest wound or a laceration of an Intercostal vessel or Internal Thoracic vessel rather than laceration of the lung.
Hemothorax
This Line of Pleural Reflection is where the Costal Pleura becomes Mediastinal Pleura anteriorly.
Sternal Line of Pleural Reflection
This Line of Pleural Reflection is where the Costal Pleura becomes the Diaphragmatic Pleura.
Costal Line of Pleural Reflection
This Line of Pleural Reflection is where the Costal Pleura becomes the Mediastinal Pleura posteriorly.
Vertebral Line of Pleural Reflection
This extends from the Larynx and exists in the posterior Mediastinum. Its first branch point is the Left and Right Bronchi.
Trachea
Put the following bronchi in the correct order:
Lobar Bronchi
Main Bronchi
Segmental Bronchi
Main Bronchi — Lobar Bronchi — Segmental Bronchi
***These can also be called Primary Bronchi, Secondary Bronchi, and Tertiary Bronchi
The Right Main Bronchus divides into what Lobar Bronchi?
Right Superior Lobar Bronchus
Right Middle Lobar Bronchus
Right Inferior Lobar Bronchus
***To help remember, think of the Right Lung having 3 Lobes as well as 3 Lobar Bronchi. The Left Lung has 2 Lobes as well as 2 Lobar Bronchi.
T/F. The Left Main Bronchus is wider, shorter and runs more vertically than the Right Main Bronchus.
False. The Right Main Bronchus is wider, shorter and runs more vertically than the Left Main Bronchus.
***More likely to aspirate in right lung because of its more vertical orientation.
List the general pathway after the Lobar Bronchi.
Lobar Bronchi – Segmental Bronchi – Conducting Bronchiole – Terminal Bronchiole – Respiratory Bronchiole – Alveolar Duct
This is also called the Tertiary Bronchi, and is associated with a corresponding Bronchopulmonary Segment.
Segmental Bronchi
All the bronchioles are devoid of what?
Cartilage
This bronchiole is capable of gas exchange.
Respiratory Bronchiole
This ends at the Alveolus, the functional unit of the lung and the primary site of gas exchange.
Alveolar Duct
Bronchial Asthma is a widespread narrowing of the airways caused by…
Contraction of smooth muscle
Edema of the mucosa
Mucus in the lumen of the Bronchi and Bronchioles
What are the Lobar Bronchi that branch off the Left Main Bronchus?
Left Superior Lobar Bronchus
Left Inferior Lobar Bronchus
This is the term for the insertion of a Bronchoscope into the trachea to visualize the Main Bronchi.
Bronchoscopy
These are pyramid-shaped segments with the apex at the Hilum and the base at the Pulmonary Surface. They are separated by CT septa and are surgically resectable.
Bronchopulmonary Segments
Why are Bronchopulmonary Segments able to be removed with no issues?
Because they contain their own individual vasculature
