Anatomy Flashcards
Where does the trachea start and end?
- Starts: C6, cricoid carilage
- End: T4, sternal angle
What is the structure of the trachea?
- Fibrocartilaginous tube
- anterior + lateral walls have 15-20 C-shaped cartilage rings
- these rings keep trachea open
- rings are connected by anular ligaments
trachealis muscle located posterier so oesophagus can move
What structures are anterior to the trachea?
- Left brachiocephalic vein
- Arch of aorta
- Brachiocephalic trunk
- Left common carotid artery
What structures are posterior to the trachea?
- Esophagus
- Left recurrent laryngeal nerve
What structures are to the right of the trachea?
- Arch of azygos vein
- Right vagus nerve
- right lung
What structures are seen on the left side of the trachea?
- Arch of aorta
- Left common carotid artery
- Left subclavian artery
- left lung
What is the carina?
- Cartilaginous ridge
- Where trachea splits into two primary bronchi
What are the features of the right main bronchus?
- Wider, shorter, more vertical
- 3 lobar branches
What are the features of the left main bronchus?
- Narrower, longer, more horizontal
- 2 lobar branches
Which bronchus do foreign bodies tend to enter?
- Right main bronchus; wider
What is the clinical relevance of the carina?
- Landmark in bronchoscopy
may be wider in cases of carcinoma
Give all the parts of the tracheobronchial tree:
- Trachea
- Primary (main) bronchi
- Secondary (lobar) bronchi
- Tertiary (segmental) bronchi
- Terminal bronchioles
- Respiratory bronchioles
- Alveolar ducts
- Alveolar saccule + alveoli
What are the bronchopulmonary segments?
see slides for segment names*
- part of lungs supplied by segmental bronchi, pulmonary artery and bronchial arteries
- drained by pulmonary veins
- apex of segments point to hilum
- 10 segments
- Right: 3,2,5
- Left; 5,5
What are the two components of the respiratory tract?
- Conducting portion; trachea ⇒ terminal bronchiole
- Respiratory portion; respiratory bronchiole ⇒ alveoli
What are the subdivisions of the parietal pleura?
- Costal pleura
- Diaphragmatic pleura
- Mediastinal pleura (lateral)
- Cervical pleura
What is pleural recess?
- slit like pleural spaces which are occupied by lungs during inspiration
- costodiaphragmatic
- costomediastinal
What are each parts of the parietal pleura innervated by?
- Costal - intercostal nerves
- Mediastinal - phrenic nerve
- Diaphragmatic - intercostal + phrenic nerves
Visceral only sensitive to stretch only, supplied by pulmonary plexus
What leads to pneumothorax?
clinical
- injury to cervical pleura + apex of lung
- open pneumothorax
- tension (closed) pneumothorax
What techniques are used to drain fluid/air from the pleura?
- Thoracocentesis
- Chest tube insertion
Where is a chest drain preformed?
- Lateral side of pectoralis major
- Anterior to latissimus dorsi
- Nipple or 5th intercostal space
Avoid:
- hitting intercostal VAN
What is the structure of a lung?
- top: apex
- bottom: base
- costal surface
- mediastinal surface; contains hilum
- ## anterior, posterior, inferior borders
Where is the cardiac notch located?
- Anterior border of left lung
How many fissures does the right lung have?
- two: horizontal + oblique
seperates lobes
How many fissures does the left lung have?
- one: oblique
Where do the oblique fissures start and end?
- From T4 to CC6
Where do horizontal fissures start and end?
- From midaxillary line of oblique fissure to CC4
What is seen on the mediastinal surface of the LEFT lung?
Grooves:
- descending aorta
- arch of aorta
- oesophagus
- left brachiocephalic vein
- left subclavian artery
Hilum:
- pulmonary artery
- bronchus
- pulmonary veins
What is seen on the mediastinal surface of the RIGHT lung?
Grooves:
- arch of azygos vein
- trachea
- right subclavian artery
- SVC + IVC
- right brachiocephalic vein
Hilum:
- eparterial bronchus
- pulmonary artery
- hyparterial bronchus
- pulmonary veins
What is the difference between bronchi and bronchioles?
- Bronchi have cartilage in walls, bronchioles do not
What is the clinical importance of bronchopulmonary segments?
- if a tumour/abscess forms, it csn be surgically removed without disrupting surrounding lung tissue
Where do the bronchial arteries arise from?
- Left: thoracic aorta
- Right: third posterior intercostal artery
What is the vascular supply to the lungs?
- Bronchial arteries + veins
- Pulmonary arteries + veins
Where do the bronchial veins drain into?
Right: azygos vein
Left: accessory hemiazygos/ left superior intercostal vein
What is the pulmonary plexus?
- Efferent and afferent autonomic nerve fibres
- Sympathetic; T2, 3, 4
- Parasympathetic: Vagus nerve
What are the lymphatics of lungs?
- Superficial lymph plexus: bronchopulmonary
- Deep lymph plexus: pulmonary
What is the pulmonary ligament?
- Double fold extending from the hilum to diaphragm
