Anatomy

Question 1

what is significant about the right main bronchus compared to the left

Answer 1

the RMB is shorter, wider and more vertical than the left

Question 1

order of bronchial divisions

Answer 1

Main bronchus - lobar bronchi - segmental bronchi - bronchioles - terminal bronchioles - respiratory bronchiols - alveolar ducts - alveoli

Question 1

lobe delineations in the left lung

Answer 1

1 fissure oblique fissure - separates upper lobe from lower lobe

Question 2

what are the imprints on the left lung?

Answer 2

imprints of arterial structures - Aorta and LV

Question 2

where do the lymphatics of the lungs all end up? and where does it then go?

Answer 2

at the hilar lymph nodes –> then series of lymph nodes at the bifurcation of the trachea –> ascending lymphatic channels along the trachea and up into the thoracic lymphatics

Question 4

where are pulmonary veins always situated in the hilum

Answer 4

they are always the most anterior and inferior structures in the hilum

Question 4

What are the two branches of the right main bronchus called before going into the hilum of the lung and where are they situated relative to each other?

Answer 4

Right upper lobe bronchus - sits superior to… Bronchus intermedius

Question 5

where does the trachea begin

Answer 5

in the neck, at the level of C6

Question 6

lobe delineations in the right lung

Answer 6

2 fissures horizontal fissure - separates upper lobe from middle lobe oblique fissure - separates lower lobe behind, from upper and middle lobe infront

Question 7

where is the pulmonary artery in the hilum in the left and right lungs

Answer 7

left - superior to the bronchus right - anterior to the bronchus

Question 8

what are the imprints on the right lung?

Answer 8

imprints of venous structures - RA, SVC, arch of azygous vein

Question 9

where are the pulmonary veins situated in the hilum?

Answer 9

one anterior, one inferior

Question 10

where does the visceral pleura become the parietal pleura?

Answer 10

when it reflects over the hilar structures

Question 11

how does the trachea descend

Answer 11

inferiorly, through the thoracic inlet, into the superior mediastinum At T4-5 - divides into R and L main bronchus

Question 12

what is each bronchopulmonary segment supplied by?

Answer 12

segmental bronchus, segmental artery, segmental vein

Question 13

4 sections of the parietal pleura?

Answer 13

cervical pleura mediastinal pleura costal plerua diaphragmatic pleura

Question 15

what is the clinical significance of the apical segment of the lower lobe?

Answer 15

this is where any fluid would first develop (as the pathway is the easiest) - this is where we auscultate for fluid

Question 17

where is the lingular

Answer 17

on the left lung starts at the cardiac notch tongue like projection that hangs down inferiorly from the upper lobe

Question 18

what is the difference between RMB and LMB in the hilums of the R and L lung

Answer 18

The RMB gives off the right upper lobe bronchus before entering the lung (this means that the pulmonary artery also splits) The LMB does not do this - only 1 bronchial, and 1 arterial structure in the hilum

Question 19

what surfaces do the visceral and parietal pleura cover?

Answer 19

visceral - thin, serous membrane covering both lungs parietal - thin, serous membrane lines the walls of the inside of the thoracic cavity

Question 20

what is the shape of a bronchopulmonary segment?

Answer 20

pyramid shape - apex directed to hilum and base on the surface

Question 21

where are pulmonary arteries placed in the hilum

Answer 21

always anterior or superior to the bronchial tree

Question 22

what is the purpose of the pulmonary ligament

Answer 22

it is a potential space for the pulmonary veins to expand into if needed

Question 23

where is the trachealis muscle

Answer 23

on the posterior of the trachea - closes off the cartilage rings

Question 24

where is the pulmonary plexus?

Answer 24

associated with the bifurcation of the trachea

Question 25

tell me about the surfaces of the lungs?

Answer 25

• concave inferior surface (sits over the convexity of the domes of the diaphragm) - has a pointed apex - has a rounded costal/lateral surface that sits against the ribs - inner surface bears the hilar structures and bears the imprint of the structures

Question 27

what is in the hilum?

Answer 27

1) branches of the tracheobronchial tree 2) vascular supply (pulmonary artery, bronchial arteries, pulmonary veins, bronchial veins) 3) neural 4) lymphatics

Question 28

nerve supply to the lungs

Answer 28

autonomic supply (both SNS and PNS) - regulates both mucus production and the diameters of the bronchioles