62 - Anatomy of Lungs and Pleura Flashcards
Parts of pleura 1) 2)
1) Visceral pleura line the lung surfaces.
2) Parietal pleura arise when the visceral pleura reflect away from the lungs at the lung hila. The parietal pleura then line the interior of the thoracic cavity
Pleura
Single layer of serous membrane lining the lungs and interior thoracic wall
Pleural cavity
Potential space between visceral and parietal pleura
*Subdivisions of parietal pleura
Name for condition where air fills pleural cavity
Pneumothorax
Name for condition where blood fills pleural cavity
Haemothorax
When can visceral and parietal pleura meet?
Full inspiration
Pulmonary ligament
A sleeve of pleura descending from hilum (double fold). Allows pleura some slack for lungs to expand.
Serous structures sharing the same visceral nerve supply
Pericardium, pleura
Pain of injured pleura
Dull, diffuse when not breathing. Sharp, loacalised, very painful on inspiration
Where does the trachaea begin?
C6
Path of the trachaea 1) 2) 3)
1) Begins at C6
2) Descends through thoracic inlet into superior mediastinum
3) At T4/T5, divides into left and right main bronchi
Structure of the trachaea
Series of U-shaped cartilage rings closed posteriorly by trachealis muscle
Divisions of bronchi 1) 2) 3)
1) Main bronchus
2) Lobar bronchi
3) Segmental bronchi
Air supply of a bronchopulmonary segment
Supplied by a single segmental (tertiary) bronchus
Bronchopulmonary segments 1) 2) 3) 4)
1) Segments of lungs supplied each by a single segmental bronchus
2) Zones of functionally-distinct lung tissue.
3) Pyramid-shaped. Apex directed towards hilum, base on surface of lung
4) 10 in right lung, 8 in left.
Examples of clinical use of knowing about bronchopulmonary segments 1) 2)
1) When someone has pneumonia, can use gravity-assisted drainage to remove debris from lungs. Ascertain which lobe is affected, position the patient in a position which allows this lobe to drain
2) If someone is unconscious, aspirates vomit, the vomit will enter apical segment of lower lobe. This is drained in a prone position
Number of lobes on right lung
Three
Number of lobes on left lung
Two
How are lobes of right lung divided?
Horizontal fissure divides upper and middle lobes. Oblique fissure divides lower lobe
*Left and right lung lobes
Surface landmarks of the left lung 1) 2) 3) 4)
1) Cardiac notch (where heart is)
2) Lingula (below cardiac notch)
3) LV imprint
4) Aorta imprint
Relative position of pulmonary arteries, veins and bronchi 1) 2) 3)
1) Pulmonary arteries most-anterior
2) Pulmonary veins between pulmonary arteries and bronchi
3) Bronchi posterior to pulmonary vessels
Structure of right lung hilum (superior to inferior) 1) 2) 3) 4)
1) Most anterior structures are right upper lobe branch of pulmonary artery and right upper lobe bronchus
2) Pulmonary artery, anterior pulmonary vein and bronchus intermedius
3) Lymph nodes
4) Inferior pulmonary vein
*Surface features of right lung
*Surface features of left lung
*Mediastinunm left lateral view
*Mediastinum right lateral view
*Main bronchi with pulmonary arteries and veins in situ
Lymphatic drainage of lungs
Superficial lymphatics just below visceral pleura. Drain to tracheobronchial lymph nodes (hilar), then to thoracic trunk (if left lung) or right trunk (if right lung, and if right trunk is present).
Blood supply of lungs 1) 2) 3)
1) There are 3-5 bronchial arteries that arise from anterior surface of thoracic aorta.
2) They enter lungs at hila.
3) Bronchial veins drain to azygous system.
Nerve supplying parasympathetic innervation of lung
Vagus nerve.
How does the vagus nerve innervate lung?
Branches from vagus to form pulmonary plexus just before the oesophageal plexus is formed.
