Anat of trachea and lungs Flashcards
What is the extent of the trachea?
From C6 and cricoid cartilage to sternal angle and T4-T5 IV disc
What is related to the trachea anteriorly?
Thyroid isthmus
Inferior thyroid V
Sternohyoid and sternothyroid muscles
Manubrium sterni
Thymus remnant
L brachiocephalic V
Brachiocephalic trunk
Aortic arch
L common carotid
Cardiac plexus
What is laterally related to the trachea in the neck?
Common carotids
thyroid lobes
Recurrent laryngeal nerves in their grooves
Inferior thyroid As
What is laterally related to the trachea in thorax?
Right: pleura, R vagus, brachiocephalic trunk
Left: L recurrent laryngeal N, aortic arch, L common carotid, L subclavian
What is related to the trachea posteriorly?
Esophagus
How many tertiary/segmental bronchi are there?
10 on R
8-10 on L
What arteries supply the trachea?
Inferior thyroid branch of thyrocervical trunk or subclavian
Bronchial branches from thoracic aorta
What veins drain the trachea?
Inferior thyroid veins
Where does lymph from the trachea drain?
Adjacent lymph nodes –> deep cervical, paratracheal, and tracheobronchial
What is the innervation of the trachea?
Vagus
Recurrent laryngeal
SyNS trunks
What is the arterial supply of the bronchial tree?
Bronchial branches of thoracic aorta
What veins drain the bronchial tree?
Bronchial veins drain proximal root of lung and larger bronchi
Pulmonary veins drain distal lung and smaller bronchi
Where does lymph from the bronchial tree drain?
Bronchopulmonary nodes
Tracheobronchial nodes
What is the innervation of the bronchial tree?
Cardiopulmonary plexus
What makes up the cardiopulmonary plexus?
PsNS – vagus
SyNS – T1-T4 sympathetic trunks
Where is a tracheostomy incision made?
Through thyroid isthmus between 2nd and 4th tracheal rings
What is the extent of the oblique fissure of the lungs?
Posterior from spinous process of T2 to 6th costal cartilage anteriorly
What is the extent of the horizontal fissure of the R lung?
From oblique fissure at the mid-axillary line of the 5th rib to the 4th costal cartilage anteriorly
Where would a foreign object aspiration typically land in a person standing upright?
Posterior basal segment of R lower lobe
Where would a foreign object aspiration typically land in a person lying supine?
Upper segment of R lower lobe
Where would a foreign object aspiration typically land in a person lying on their R side?
Posterior segment of R upper lobe
What arteries supply the thoracic wall and parietal pleura?
Anterior and posterior intercostal arteries
What is the lymphatic drainage of the lungs and pleurae?
Intrapulmonary vessels and nodes to hilar/bronchopulmonary nodes to tracheobronchial/carinal nodes to paratracheal nodes to bronchomediastinal lymph trunk to lymph ducts
What is the innervation of the parietal pleura?
Intercostal nerves
Phrenic nerves
Where does pain stimulating the intercostal nerves refer?
Dermatomes on thoracic and abdominal walls
Where does pain stimulating the phrenic N refer?
C3-C5 dermatomes
What is the purpose of visceral afferent fibers from the lungs?
Cough reflexes
Chemoreceptors
Baroreceptors
Pain
What is indicated by increased breath sounds?
Consolidation, fibrosis
What is a sign on an x-ray of pleural effusion?
Loss of sharp shape of the costodiaphragmatic recess
Where is the needle inserted for a thoracocentesis?
In the 8th or 9th intercostal space along the superior border of the rib in the mid-axillary line at an oblique angle
What are complications associated with pancoast tumors?
Compression syndromes
