Anatomy of the lung Flashcards
what is the thorax
just the rib cage
between neck and abdomen
what is the chest
rib cage and pectoral girdle ( clavicle, upper humerus and scapula)
what is the superior thoracic aperture/ anatomical thoracic inlet/ thoracic outlet
opening at the top of the thoracic cavity allowing connections of structures between the thorax and the neck
inferior thoracic aperture- anatomical thoracic outlet
formed by 12 the thoracic veterbra - bottom hole
what passes through the superior thoracic aperture
right and left subclavian arteries and veins
function of mediastinum
conduit for structures transversing the thorax on their way to the abdomen
what are the compartments of the mediastinum
Superior mediastinum
Inferior mediastinum - anterior , middle and posterior mediastinum
divisions of thoracic cavity counting heart thymus gland and portions of the oesophagus and trachea
where does the superior mediastinum run between
line of sternal angle and terminates at the superior thoracic aperture ( T1-T4
at what vertebral level can you find your your sternal angle
T4-T5
what is the manubrium
superior portion of the sternum
what is the jugular notch
the suprasternal notch is a dip in the neck between the clavicles
borders of the superior mediastinum
superior - thoracic inlet
infer - continues with the infer mediastinum at level of the sternal angle
posterior - vertebral bodies of T1-T4
lateral - pleura of the lungs
What things can be found in the superior mediastinum
arch of the aorta superior vena cava vagus nerve phrenic nerve thymus oesaphagus thoracic duct
the middle mediastinum as anterior and posterior borders to the pericardium, lateral to mediastinal pleura of the lungs and superiorly to sternal angle line and inferior to the diaphragm
true or false
true
Which major lymph nodes are found in the medial mediastinum and are associated with the trachea and bronchi of the respiratory system
tracheobronchial lymph nodes
which mediastinum contains no major structures and accommodates loose connective tissue and in infants the thymus extends inferably into it
anterior mediastinum
what is contained in the posterior mediastinum
thoracic duct
oesophagus
thoracic aorta
sympathetic trunk
at what vertebral level does the mediastinum end
T12
xiphoid process level
T10(T9)
at what level does counting of the ribs start?
2nd as first should normally be covered by clavicle
what is the infrasternal angle
cartilages of 10-7 ribs
Thoracic levels refer to someone lying in a supine position
Gravity takes its toll on viscera when you stand
Four type be clear thoracic vertebral levels thoracic rib levels thoracic costal cartilages levels thoracic dermatome levels e.g. thoracic vertebral level - T10 thoracic rib levels 0 none thoracic costal cartilages levels is T7 throaci dermatome level is T5
In patients with COPD why are there clavicles visible
barrel chest - lungs are chronically overinflated with air so the rib cage stays partially expanded all the time
pleurisy
what are the symptoms
when the thin lining between your lungs and ribs becomes inflamed
sharp chest upon upon breathing in deeply
pleural effusion - chest gets pushed onto normal side
build up excess fluid between the layers of the pleura outside the lungs - i.e. in the intrapleural cavity
what does a pleural effusion look like on an x-ray and how is it treated
looks very white at lung base
chest drains
pleural rub
and when does pain stop
inflamed and roughened pleural surfaces against one another during movement of the chest wall
normally pleurisy
pain stop when you hold your breath
pneumothorax
collapsed lung - air leaks into the space between lungs and chest wall
haemothorax
blood collects between chest wall and lungs - pools in the pleural cavity
what is the costodiaphragmatic recess - clinical importance
as most fluid collections pool here
when finding pain visceral pleura gives an autonomic dull idefined pain whereas partial pleura give a somatic sharp localised pain true or false
true
good example
Abscess in lung - and when it goes through visceral it will be really painful and localised - could be coughing with no pain and then hold spot
which membrane of the lung gives sharp localised pain
parietal pleura
where does parietal and visceral pleura attach and meet
root of the hilum
parietal pleura covers superior diaphragm to aid in what
respiration
when locating the inferior borders of the lungs using the mid clavicular line, mid axillary line and mid scapula line - what are these values respectively
how do they values change when you find inferior borders of the pleural cavity
6th rib
8th rib
10th rib
2 up
8,10,12
how many lobes does the right lung have ?
3
how many lobes does left lung have
2
what is the horizontal fissure
separates the middle lobe from the upper lobe at the level of the 4th costal cartilage
what is the oblique fissure
separates the lower lobe from both the middle and upper lines at the base level of 6th costal cartilage and starts at the level of T3 vertebrae
why is there a lingual and smaller superior lobe in the left lung
due to the heart
emphysema
alveoli are damaged so the surface area reducing SA fro gas exchange and causes lungs to loose elasticbiltiy
asthma
inflammation of mucosa airways - WBC thicken airway creating wheezing sound
cystic fibrosis - CFTR channel problem
what ions affected
chord ions blocked through channels so sodium does not follow chloride ion then water does not follow sodium ion so dehydration of mucus sets in
bronchiectasis
break down of cilia and increase mucosa so you swallow or cough it up - smells and is green
long term cough
( airway wide)
bronchitis
infection of bronchi causing them to become irritated and inflamed - dry cough and yellow grey mucus/none
sore throat and wheezing
pneumonia
inflammation of the lungs due to infection - high temp and chest pain with cough
Covid 19 symptoms
fever and dry cough first signs
signs after a week
SOB and breathing difficulties
pulmonary consolidation
lung tissue that has filled with liquid - swelling or hardening of normally soft tissue - normally aerated lung
left costolphrenic angle clinical importance
blunting or edge filled signifies pleural effusion
3 places that the pleural fluid comes from
parietal pleura circualtion ( main source )
visceral pleura ( from lungs)
peritoneal cavity via small holes in the diaphragm
functions of pleura
allows for change in lung shape during respiration
pleura revente lungs from collapsing by maintaining positive transpulmonary pressure
in the parietal space what can you find
systemic capillaries and parietal lymph vessels
pleuritis
inflammation of parietal pleura - mainly due to viral infection or autoimmune disease
SOB - pleurais chest pain -pain breathing
pleural rub - during respiration - grating sound
pleural effusion
accumulation of fluid in pleural space result of inflammation
standing up pushed fluid down - breath sounds decrease , dull percusion and decrease lung expansion
How do you diagnose a pleural effusion
pleural tap( aspirate excess and can be analysed) of thoracocentesis - technique used to remove fluid or air from the pleural space used as both diagnostic tool and therapeutic intervention
pneumothorax
accumulation of air in pleural space
2 main mechanisms
- spontaneous ( result of ruptured bullae - air leaks in normally with people with COPD, causing partial collapse)
-open - external trauma - air leaks in from outside - collapse
hyper resonant percus, ascultate will eb reduced breath sounds
tension pneumothorax- normally results from a valve defect ( air can’t leave)
over accumualtionof air - external trauma - opening results as a vlave - air in inspiration increasing pleural pressure e, however air can’t leave pleural space
large increase in pressure will cause tracheal deviation
and cause hypotension as pressure on the heart
which pleura is sensitive to pain , pressure and temperature and produces a well localised pain
and what nerves is it innervated by
Blood supply is by the intercostal arteries
parietal pleura
phrenic and intercostal nerves
The visceral pleura is not sensitive to pain temperature or touch. Its sensory fibres only detects stretch. It receives autonomic innervation from the pulmonary plexus (nerves from sympathetic trunk and vagus nerve)
what gives it the arterial supply
bronchial arteries - branch of descending aorta - also supplies parenchyma of the lungs
