Bony Thorax pt. 3 Flashcards
Lines the lungs, has a frosty appearance. Spongy.
-Think like Pia Mater. Directly applied to the lungs
Visceral Pleura
Lines the chest wall anteriorly around the area of the lungs.
Divided into 4 parts:
-Costal Pleura: largest; lines chest wall all the way around the chest.
-Diaphragmatic Pleura: portion underneath the lungs that lines the diaphragm
-Cervical Pleura: Lies on the apex of the lung
-Mediastinal Pleura: Lines medial aspect of the lungs, looks into the space created between the two lungs on either side.
Parietal Pleura
Covered tightly by parietal pleura (derived from scalene fascia)
-Cervical Pleura
Apex of the Lung
Ends above the end of the pleura, creating a space called the costodiaphragmatic recess. Allows room for the lungs to expand, prevents restrictive breathing.
-With inflammation/infection, fluid collects here due to gravity.
-Pleura ends about 2 rib spaces below the end of the lungs.
Base of lungs
Base of lungs: MCL to the 6th rib; MAL to the 8th rib; PVL to the 10th rib
Parietal Pleura: MCL to the 8th rib; MAL to the 10th rib; PVL to the 12th rib
Ending Locations
Where do you insert the needle for a thoracentesis?
At the 10th ICS or below (no lung present)
-Go over the top of the rib to avoid the IC artery, nerve, etc.
-Slide needle over the 11th rib
Healthy lungs should be about ____ in above the clavicle
1 in
-Radiolucent (Dark)
-Normal vessel cloudiness
-Heart shadow
-Aortic Knuckle/Arch of the aorta
-Clavicles
-Lungs above the clavicles by about 1 in
Healthy Lungs CXR
Where the blood vessels and airway come and go.
Hilum
Found below the hilum. Formed by two layers of parietal pleura coming together
Pulmonary Ligament
In the right lung, the bronchus is ______.
-Airway lies behind and slightly above the artery.
Epiarterial
In the left lung, the bronchus is ______.
-Airway lies below the pulmonary artery.
Hypoarterial
Contains:
-Aortic Impression (Groove for the Aortic Arch): Large impression that curves and runs posteriorly.
-Cardiac impression: hole for the heart
-Cardiac notch: Interruption in the impression (on the side)
-Lingula: residual 3rd lobe, projection off of the upper lobe
Left Lung
Contains:
-Esophageal Impression: Indentation for the esophagus
-Impression Arch - Azygos Vein
Right Lung
A large vein that bypasses some of the load of blood volume to get it back to the heart. Terminates in the SVC. Typically found on the right side.
Azygos Vein
Subdivisions of the lungs separated by fissures.
Lobes
Subdivisions of the lobes, each are separated by a fibrous septum.
Bronchopulmonary Segments
Fissure that separates the upper and middle lobes of the right lung
Horizontal fissure
Fissure that separates the middle and lower lobes of the right lung.
Oblique Fissure
Fissure that separates the upper and lower lobes of the left lung.
Oblique Fissure
The right lung has _____ Bronchopulmonary Segments
10
The left lung has _____ Bronchopulmonary Segments
8
Bronchopulmonary segments of the right upper lobe
Apical, Posterior, and Anterior
Bronchopulmonary segments of the right middle lobe
Lateral and Medial
Bronchopulmonary segments of the right lower lobe
Superior, Anterior Basal, and Lateral Basal
Bronchopulmonary segments of the right lower lobe (medial view)
Medial Basal and Posterior Basal
Bronchopulmonary segments of the left upper lobe
Apico-Posterior, Anterior, Superior, and Inferior (Lingula)
Bronchopulmonary segments of the left lower lobe
Superior, Antero-Medial Basal, and Lateral Basal
Bronchopulmonary segments of the left lower lobe (medial view)
Posterior Basal
Arteries that supply the lung tissue.
-1 on the right (off of the 3rd Post. IC artery)
-2 on the left (Aortic Arch)
-Run and subdivide with the airways out to the bronchial capillaries
-Can have variations of normal
Bronchial Arteries
Variable, but run retrograde with the bronchial arteries.
-Drain into the Accessory Hemiazygos Vein and the Left Superior Intercostal Vein
Left Bronchial Veins
Variable, but run retrograde with the bronchial arteries.
-Drain into the Azygos Vein
Right Bronchial Veins
Some Bronchial Veins may form cross-anastomoses with Pulmonary veins, resulting in _______ _____________.
-Inability for SpO2 to naturally register as 100% due to this physiologic mixing of blood.
Venous Admixture
The Trachea is about ___ in long in total. About ___ in in the neck (Cervical part), and about ____ in in the thorax (thoracic part).
-Has about ____ C-Shaped Rings
4; 2; 2.
20 C-shaped rings
Muscle that gives the esophagus the flexibility to expand and contract. Prevents the esophagus from hitting against hard cartilage. Smooth muscle. Covers the incomplete back of the trachea.
Trachealis Muscle
Provide stability to the tracheal wall while you breathe due to changing pressures. Gives the trachea a “Skeleton” that prevents it from expanding/contracting as you breathe.
-Provides integrity to the trachea and bronchial systems.
C-Shaped Cartilaginous Rings
The Trachea bifurcates at the _____________________.
Sternal Angle of Louis (Manubrio-sternal Joint)
From Right to Left MS Bronchi is ______ degrees
-Right down is _____ degrees
-Left down is ______ degrees
62; 25; 37
Bronchus that is longer, smaller in diameter, and more horizontal
Left Mainstem Bronchus
Bronchus that is shorter, larger in diameter, and more vertical (Steeper angle)
Right Mainstem Bronchus
Mainstem Bronchus divide in the Lobar Bronchi, named for each of the lobes of the lung (3 on the R and 2 on the L). The Lobar Bronchi divide into the Bronchopulmonary Segments. Each Bronchopulmonary Segment has its own Segmental Bronchus. (R: 10 BP segments, so 10 segmental bronchi). Segmental Bronchi form Subsegmental Bronchi, getting smaller and smaller. From there, divide into Bronchioles
Airway Progression
By the time you get down to the ______, you have lost the cartilaginous rings, but you keep the cartilaginous plates that help to protect the airway and keep it from collapsing.
Subsegmental Bronchi
Less than 1 mm in Diameter.
-No cartilage
-Smooth muscle tubes that keep the airways open.
-Muscle & Epithelium
-Terminate in the Alveoli
Bronchioles
Exchange O2 and CO2 with the blood in the alveolar capillaries via a very small membrane
Alveoli
Which is more difficult to diffuse, O2 or CO2?
O2 is more difficult.
-Increased thickness of the alveolar-capillary membrane makes it difficult for gases to absorb.
Has several layers:
-Surfactant: on the alveolar side. Layer of moisture that lines mucus membranes
-Alveolar epithelium
-Alveolar Basement Membrane: connecting tissue that alveoli sits on
-Interstitial Space
-Capillary Basement Membrane
-Capillary Epithelium
-RBC
Alveolar-Capilary Membrane
