Anatomy Of Pleura & Lung & Respiratory System Development Flashcards
The parietal & visceral pleura are continuous at the …… & leave a fold called ……
Pleural cuff, pulmonary ligament
The visceral pleura leaves the lung to become continous with parietal …..
Medially, around the hilum of the lung & for a short distance below it
Mention the divisions of parietal pleura
Cervical, costal, diaphragmatic & mediastinal
The cervical pleura is crossed anteriorly by …., & related posteriorly to …,…&…. .
Subclavian artery
Stellate ganglion, superior intercostal artery & ventral ramus of first thoracic nerve
Mention the attachments of Sibson’s fascia
Attached laterally to the inner border of the 1st rib and medially to the 7th cervical transverse process
…… separates the costal pleura from the thoracic wall.
Endothoracic fascia
Which divison of parietal pleura is continuous with visceral
Mediastinal pleura
The pleural recessses are represented by …….. which are opposed
Two layers of parietal peritoneum
Costomediastinal recess is opposition between ……, on left side overlies the ….. .
Costal pleura & mediastinal pleura
Heart
The costodiaphragmatic recesses are regions between ….&….
The inferior margin of the lungs & inferior margin of the pleural cavities
Describe innervation of parietal pleura
By somatic nerves (sensitive to pain, temp, pressure & touch)
The costal & peripheral diaphragmatic are supplied by intercostal nerves.
The mediastinal & central diaphragmatic are supplied by phrenic nerves.
Describe the nerve supply of visceral pleura.
Autonomic nerves from ant & post pulmonary plexuses, sensitive to stretch
Describe the blood supply/lymph drainage of parietal pleura
Intercostal, internal thoracic & musculophrenic vessels
Intercostal, parasternal, posterior mediastinal & diaphragmatic L.N.
Describe referred pain of pleurae
- thoracic & abdominal wall if costal and peripheral parts of diaphragmatic pleura are inflammed.
- lower neck & shoulder tip if the mediastinal and central part of diaphragmatic are inflammed.
Name the filling of pleural cavity with air, pus, air&pus, blood & fluid.
Pneumothorax, empyema, pyopneumothorax, haemothorax & hydrothorax (pleural effusion)
Describe the relations of the apex of lungs
Anterosuperiorly: suprapleural membrane outside cervical pleura & the subclavian artery.
Posteriorly: stellate ganglion, superior intercostal vessels & ventral ramus of 1st thoracic spinal nerve.
Relations of base of lung
Related to diaphragm separating:
- right lung from right lobe of liver.
- left lung from left lobe of liver, fundus of stomach & spleen
GR: the diaphragm extends higher on the right than on the left.
Due to the presence of the liver
The anterior border of left lung presents a notch at level of ….., extends opposite …..&….
4th costal cartilage
4th & 5th intercostal spaces
The tongue-shaped process of the left lung is the
Lingula
Posterior border of lungs is related to …. & occupies the …..
Heads of the ribs
Paravertebral gutter
The inferior border of lung extends in …. Recess
Costodiaphragmatic recess
The inferior border of lung is rounded …..
Medially
Compare the relations of costal & medial surfaces of the lung
Costal surface: related to costal pleural separating it from ribs, costal cartilage & intercostal spaces.
Medial surface: divided into posterior vertebral & anterior mediastinal parts.
-mediastinal: related to heart
-vertebral: sides of thoracic vertebrae, intervertebral discs, posterior intercostal vessels, splanchnic nerves & sympathetic chain.
Mention the lobes & fissures of right/left lungs
Right: Superior, middle & inferior lobes. Oblique & horizontal fissures.
Left: Superior & inferior lobes. Oblique fissure.
Fissures of the lung may be partially or completely obliterated by ….
Inflammatory adhesions
Mention structures related to right lung in front of the hilum.
- Pericardium enclosing right atrium & part of right ventricle.
- Inferior vena cava
- Superior vena cava & brachiocephalic vein
- Ascending aorta & thymus gland
- Right phrenic nerve
Mention the structures related to right lung above the hilum
Arch of azygos vein
Trachea, right vagus & esophagus
Structures related to left lung in front of the hilum
Pericardium covering the left ventricle, left auricle & infundibulum of right ventricle.
Structures related to the left lung behind the hilum
Descending aorta & esophagus
Structures related to the left lung above the hilum
- The arch of the aorta (left vagus nerve, left superior intercostal vein, left phrenic nerve)
- left common carotid & subclavian
- eosphagus, thoracic duct, left recurrent laryngeal
- pulmonary trunk & remains of thymus
- left phrenic nerve
Enumerate structures in the root of the lung
Principal bronchus, pulmonary artery, pulmonary veins, pulmonary autonomic plexus, bronchial arteries, bronchial veins & bronchopulmonary L.N.
The most posterior & inferior structures of the hilum
P: bronchus
I:inferior pulmonary vein
Branches of the main bronchus
Ep-arterial & hyparterial bronchi
Describe the position of the pulmonary artery in the hilum of right lung
Anterior & in-between branches of main right bronchus
Bronchial vessels lie on the ……… aspect of the bronchus.
Posterior
Describe the arterial supply of the lungs
Two branches of descending aorta to the left lung
A branch to right lung from posterior intercostal artery/3rd right intercostal space or left suo bronchial art.
Describe the venous return of the lungs
2 veins on each side
- drain into azygos on the right
- drain into hemiazygos or left superior intercostal vein on the left
Ant & post pumonary plexuses are formed by…. .
They supply …..
Sym, fibers from 2nd-5th segments of sym chain
Para, from vagus
Bronchial tree, lung substance & visceral pleura
Compare right & left lungs
R: larger, shorter, wider, straight, three lobes, two bronchi.
L: smaller, longer, narrower, two lobes, one bronchus.
Define the bronchopulmonary segment
The anatomic, functional & surgical unit of the lung.
Describe the structures associated with each bronchopulmonary segment.
Segmental bronchus, segmental artery, lymph vessels, autonomic nerves, intersegmental veins.
Lymphatic drainage of the lung
Bronchopulmonry lymph nodes
Functions of sym & para in the lung
Para: motor to smooth muscles, secretory to the mucous glands of the bronchial tree.
Sym: bronchodilator, inhibitory to the mucous gland of the bronchial tree.
The area in which the two pleurae touch
From the sternal angle to the 4th costal cartilage
On the left side, the pleura deviates laterally till the level of ….
6th costal cartilage
Describe the extension of the inferior margin of the pleura
Begins behind 6th costal cartilage desacend to 8th rib (midclavicular), then to 10th rib midaxillary then ascend to cross 12th rib to end 2 cm lateral to 12th thoracic spine.
The posterior margin of pleura extends from ….. to ….
T12 to C7
The elements of thoracic wall which come in contact with pericardium.
Left part of the sternum
5th & 6th costal cartilages
The inferior border of the lung end …… than that of the pleura
2 ribs higher
Describe the extension of inferior border of lung.
Crosses 6th rib midclavicular, 8th rib midaxillary, crosses 10th rib to end 2 cm lateral to 10th thoracic spine.
Compare surface anatomy of oblique & horizontal fissures.
O: begins opposite 3rd thoracic spine (level of medial end of scapular spine) to the inferior border of lung at 6th costochondral junction.
H: begins opposite 4th costal cartilage to join oblique fissure at the midaxillary line.
Mention the week when the olfactory placodes appear and the next steps of their development
5th week
They form the olfactory pit (nasal sac)
Then its margins proliferate forming medial/lateral nasal prominences
Describe the development of parts of the external nose
- Frontal prominence gives dorsum of the nose
- Lateral nasal prominence will give the ala of the nose
- Medial nasal prominence will give the nasal septum
Mention the mechanism of deepening of the nasal pits
Partly by growth of the nasal folds & partly by penetration into the underlying mesenchyme
The primitive nasal cavities communicate with the stomodeum throigh …
Primitive internal naris (choanae)
The chonchae developmas …. while the paranasal sinuses develop as ….
Elevations on the lateral wall of the nasal cavity
Diverticula from the lateral wall of the nose
Describe the development of the paranasal sinuses
- The maxillary & ethmoid sinuses are present at birth, but are small; the development of the former is nit completed until the eruption of all adult teeth; while the latter is developed by about 8 years.
- The frontal & sphenoid sinuses develop postnatally; the former during the 7th year & the latter around the 2nd year.
The devepment of laryngeotracheal tube begins at
Middle if the 4th week
The direction in which the larygeo-tracheal groove fuses
Caudo-cranial direction
The division of laryngeo-tracheal tube results in formation of:
A. Dorsal part will give the pharynx & esophagus
B. Ventral part called larygeo-tracheal tube
Derviatives of the laryngeo-tracheal tube and those of the surrounding splanchnic mesoderm.
- L/T tube gives lining epithelium of larynx, trachea, bronchial tree & alveoli.
- M: gives cartilagenous plates, smooth muscles, connective tissue & blood vessels (bronchial & pulmonary)
The communication between the laryngo-tracheal tube & the pharynx
The laryngeal inlet
The copula (median elevation) gives …
Epiglottis
The period in which the laryngeal inlet becomes obliterated & the structures formed during racanalization.
8th-10 weeks
True & false vical cords
Describe the divisons of the lung bud
Each lung bud forms a main bronchus, divides into secondary (lobar) bronchi, which divide into tertiary (segmental) bronchi each is surrounded by splanchnic mesoderm to form a broncho-pulmonary segment.
Repeated dichotomous division give 17 orders of division giving terminal bronchioles, by 6th month.
Further division occurs up to 8 years with 7 more orders of division. Total of 24 orders
Parietal pleura is dervied from …. while visceral pleura is derived from ….
Somatic mesoderm
Splanchnic mesoderm
Mention anomalies of respiratory system
Esophageal atresia & tracheo-esophageal fistula, surfactant deficiency, agenesis, hypoplasia, variation in lobe number, accessory lung, ectopic lung lobes & congenital lung cyst.
GR: occurrence of tracheo-esophageal fistule & most common variety.
Mention its effect intra-uterine
Incomplete fusion of tracheo-esophageal folds
Atresia of upper portion of esophagus & fistula of its lower portion with trachea.
Polyhydraminos
The major cause of RDS.
Hyaline membrane disease
Hormones which increase surfactant production
Cortisone & thyroxine
The parts contributing to development of diaphragm
Septum transversum, pleuroperitoneal membranes, dorsal mesentery of the esophagus & lateral body walls.
During 4th week of development, the septum transversum lies opposite ……
3rd to 5th cervical somites
The somites migrate into developing diaphragm during the ….
5th week
The most common congenital anomaly of the diaphragm
Congenital diaphragmatic hernia
GR: CDH is more common on the left side.
Due to earlier closure of the right pleuroperitoneal opening
