3. Thoracic Pulmonology Flashcards
how many lobes does the right lung have
3
superior, middle & inferior
how many lobes does the left lung have
2
superior & inferior
what seperates the superior lobe from the inferior lobe of the left lung
oblique fissure of the left lung
what does the horizontal fissure of the right lung seperate
superior lobe from the middle lobe of the right lung
what does the oblique fissure of the right lung seperate
superior & middle lobes from the inferior lobe of the right lung
what are the surfaces of the lung
mediastinal surface
costal surface
diaphragmatic surface
what is a hilum
place where things go in and out of the lung - located in the mediastinal surface
contain the:
Pul A
Pul V
Main Bronchus
how do you differentiate between the pul A & V in the hilum of the lung
pul A = thicker - low O2 content (more superior)
pul V = thinner - high O2 content (more anterioinferior)
what are the grooves present on the right lung
cardiac impression & groove for -
- Brachiocephalic V
- 1st Rib
- arch of the Azygos V
- superior & inferior Vena cava
- Esophagus
BRAVE
what grooves are present on the left lung
large cardiac impression & groove for -
- 1st Rib
- arch of Aorta
- Descending aorta
- Subclavian A
RADS
describe the borders of the lung
- anterior: thin & flappy
- posterior: tall & columnar
- inferior: ring around diaphragmatic surface
what direction is the hilum mostly pointing
medial
what are two areas of the left lung that are not present on the right
cardiac notch: indentation of anteroinferior superior lobe; creates the lingula
lingula: thin process of superior lobe
where do the borders project during a really deep breath
costomediastinal recess: ant border
costodiaphragmatic recess: inf border
how can lung cancer occur
can derive from actual lung tissue or bronchi
can metastasize to specifc lymph nodes of the thorax
what Ns may be affected by lung cancer
phrenic N
vagus N
recurrent laryngeal N
how can you treat lung cancer
pneumonectomy: remove lung
lobectomy: remove lobe
segmentectomy: remove specfic bronchopulmonary segment
what is pleura
serous membrane surrounding lungs
= visceral -contact lungs
=parietal -contact thoracic wall, mediastinum & diaphragm
what is the pulmonary cavity
area that holds lungs and pleura
what is pleural cavity
potential space btn 2 layers of pleura
contains serous lubricating fluid that reduce friction and produce cohesion thru surface tension
-prevent lungs from collapsing
what is pleuritis
inflam of pleura
produce roughness –> difficulty breathing (lungs lose ease of gliding & sliding)
what happens when air enters the pleural cavity
pulmonary collapse
- break surface tension btn 2 layers of pleura
- opened up space inside pulmonary and pleural cavity (stab wound)
what is pneumothorax
entry of air into pleural cavity from penetrating wound to thoracic wall or rupture of pulmonary lesion into pleural cavity
result in collapsed lung
what is hydrothorax
accumulation of excess fluid in pleural cavity
-due to fluid escape into pleural cavity or pleural effusion
what is hemothorax
accumulation of blood in pleural cavity
-due to chest wound, laceration of intercostal vessel or internal thoracic vessel rather than laceration of lung
what are lines of pleural reflection
abrupt changes in direction of parietal pleura
- sternal line - costal to mediastinal anteriorly
- costal line - costal to diaphragmatic
- vertebral line - costal to mediastinal posteriorly
what are the sections of parietal pleura
- cervical
- costal
- diaphragmatic
- mediastinal
what is the passage way of air
trachea –> main bronchi –> lobar bronchi –> segmental bronchi –> conducting bronchioles –> terminal bronchioles –> respiratory bronchioles –> alveolar ducts
what are main bronchi
primary bronchi
-wider, shorter
right side runs more vertical than left
what are lobar bronchi
secondary bronchi
associated with lobes
what are segmental bronchi
tertiary bronchi
associated with bronchopulmonary segments
what are conducting bronchioles
no more cartilage
carry air from segmental bronchi to terminal bronchioles
where does gas exchange occur
respiratory bronchiole (some)
alveolar ducts (primary site) = fxnal unit of lungs
what is bronchial asthma
widespread narrowing of airway produced by contraction of smooth M (constrict & inflammed)
edema of mucosa & mucus in lumen of bronchi & bronchioles
what is bronchoscopy
insertion of bronchoscope into trachea to visualize main bronchi
what are broncopulmonary segments?
piece of lung that has single blood supply and airway
