Bronchi, pleura, lungs and diaphragm Flashcards
what are the 4 components of the bronchial tree
trachea
primary bronchi - R and L
Lobar (secondary) bronchi
segmental (tertiary) bronchi
describe the trachea
central
from C6 to T4/5 manubriosternal joint
C shaped rings of cartilage (so oesophagus can expand)
lowest ring has hook called carina - hooks under bifurcation of the trachea
what does the sternal notch relate to anatomically
2nd costal cartilage
T4/5 posteriorally
what can change the appearance of the subcarinal angle
flow to the subcarinal lymph nodes
describe the primary bronchi
formed at T4/5
right is wider and more vertical than left
significance of R primary bronchi being thicker
solid objects are more likely to move down the right when swallowed
describe the lobar bronchi
formed in the lung s
supply the lobes of the lungs
describe the arrangement of lobes in the lung
3 in R (more lobar bronchi)
2 in L
what do the segmental bronchi do
supply individual bronchopulmonary segments - self contained independent units of lung tissue
what is the thyroid cartilage seen as
Adam’s apple
what is a cricothyroidotomy
make an incision in cricothyroid membrane to open airways in trauma
what joins the cricoid cartilage and thyroid cartilage
median cricothyroid ligament
at what point is a tracheostomy done
in hospital
number of bronchiopulmonary segments in each lung
10
what is the term for the branches coming off another branch
airway tree - supply a specific segment of the lungs
are the bronchopulmonary segments related
no - functionally different
can remove 1 without moving any of the others - have own nerve and blood supply and own airways
what are the lungs
essential organs for respiration
where are the lungs
thorax
separated from each other by mediastinum
lie in pleural cavity freely - except from attachment to heart (via pul vessels and trachea at the lung root/hilum . therefore has mobility in pleural cavity
which way does blood flow on the pulmonary circulation
from heart to the lung
which way does deoxygenated blood flow in bronchial circulation
away from the lungs (oxygen used by the lungs to function)
describe the structure of the lungs
conical
apex - thoracic inlet oblique, rises 3- 4cm above 1st costal cartilage
base is concave because diaphragm rises up and it rests on the convex wall
the 3 edges - anterior, posterior, interior
3 surfaces - costal, medial, inferior
what does the diaphragm separate
R lung from R lobe of liver
L lung from l lobe of liver, stomach and spleen
where is the liver
under the rib cage because the diaphragm is curved superiorly
what is the function of the pleural cavity
has fluid
provides surface tension - allow sliding of tissue
if surface tension breaks inner layer doesn’t move with outer layer
3 features of the mediastinal surface of the lung
posterior
anterior
above and behind the cardiac impression - hilum of the lung
describe the posterior part of lung
contact with the vertebrae
thick
describe the anterior part of the lung
deeply concave - where heart is, bigger on L
describe the hilum of the lung
where vessels, bronchi and nerves leave and enter the mediastinum
what is the pleural reflection
change from parietal pleura to visceral pleura
this is the lung hilum
(the root is the structures in this)
describe the medial/mediastinal aspect of the heart
indentation for major muscles
tubes point towards the middle
small vein that brings blood back to other veins
left lung has lingula - ‘hand’ in front of the heart
describe the L lung
2 lobes - superior and inferior
separated by oblique fissure - similar direction to ribs
superior lobe lies above the fissure - has the apex and most anterior part of the heart
mediastinal aspect of R lung
grooves for the arteries
and superior vena cava
and oesophagus
features of the R lobe
superior, middle, inferior lobes
oblique fissure - separates inferior lobe from others
horizontal fissure - separate superior from the middle lobe
R larger than L
what does the lung hilum do
connect mediastinal surface to the heart and trachea
what structures are in the hilum
principle bronchus
pul artery - deoxygenated blood from RV
2 pul veins - ox blood to LA
bronchial arteries (ox blood from descending aorta) and veins
pulmonary plexus of nerves - autonomic - change calibre of airways
lymph vessels and nodes - pathology
this is all in the pleura
what is in the hilum of the L lung
pul artery pul vein (upper lobe) primary bronchus bronchial artery lymph node pul ligament - inferior fold of pleura (thickening of tissue) - expands when you take in breath
why cant you see the LA on x ray
it is at the back of the heart
where is the most oxygenated blood
coronary arteries
what is the pleura
thin layer flattened cells
supported by connective tissue
lines each pleural cavity
covers the exterior of the lung
visceral pleura
covers surface lungs and lines fissures
parietal pleura
lines inner surface of the chest walls
how are visceral and parietal pleura related
continuous with each other around the root of the lung
this is the hilum
what is the pleura like in health
pleural cavity is collapsed
moist surfaces allow lungs to glide as they expand and collapse = mobility
describe the pleural origin
pleural cavities in chest wall
lined by parietal pleura
lung buds grow into them
within the covering of visceral pleura
where is the heart
central but projects to the left
what is the area under the lungs in the pleural cavity
costodiaphragmatic recess
blood and pus can accumulate here
ung is here in maximal inspiration
oblique fissure runs along…
the 6th rib
horizontal fissure runs
from 4th costal cartilage and rib
laterally until 6th rib where it meets the oblique fissure
how does breathing occur
controlled by nervous system and produced by skeletal muscle - automatic
inhalation and exhalation of air out of the lungs to ventilate alveolar sacs
how can you increase the capacity of the thoracic cavity
movements of the diaphragm and ribs
describe the mechanism of breathing
pleural cavity expanded by muscle in walls
elastic lungs expand with the pleural cavity
air bought down trachea and bronchi into lungs
what happens when the diaphragm contract
increase vertical dimension of thoracic cavity
presses on abdominal viscera which descend because of relaxation of the abdominal wall
diaphragm stopped by abdominal viscera so costal margin raised
combined with rib movement - reduced intrapleural pressure - entry of air anmd expansion of respiratory passages
describe the thoracic surface of the diaphragm
skeletal muscle from the costal margin
sheet like central tendon
pericardial sac
a lot of the diaphragm is tendon because it is a muscle - bit from costal margin to tendon that contracts
what is the costal margin
lower border of the rib cage
what is the margin of the diaphragm attached to
costal margin
xiphoid process
ends of ribs 11 and 12
lumber vertebrae in back
where does the dome of the diaphragm go
bulges high into the rib cage
liver are covered by diaphragm pleura and lungs
describe the ribs in breathing
ribs elevated - anterior forward and up
increase anterio-posterior dimension of thoracic cavity
also everted increase transverse diameter of thoracic cavity
intercostal muscle pull rib up and out because they stiffen the rib cage to increase efficiency of diaphragm
effect of rising the costal margin
widens the pleural cavity by raising drooping lateral parts of the ribs
this tilts the sternum upwards = increase in antero-posterior diameter of pleural cavities (pump handle action)
describe breathing out
quiet expiration is a passive activity not requiring muscles - recoil - diaphragm moves up and ribs down
recoil is from the elastic tissue in lungs and rib cage
deep expiration - assisted by muscles of abdominal walls that squeeze the abdominal organs against the diaphragm and pull lower ribs downward
where do you listen to the aorta
top right
where do you listen to the atrioventricular valves
bottom left
why do ribs point posteriorly before anteriorly
allow some of the stuff in the chest posterior to vertebral column
a lot of the lungs are in the paravertebral gutter
what is the pul trunk
vessel from RV then divide into R and L pul artery
1st vertical orientated bv from RV
goes posteriorly and then bifurcates
where is aorta in relation to pul trunk
posterior
where does superior vena cava bifurcate
right of sternoclavicular joint b
path of aorta
over L primary bronchus
through diaphragm
into abdomen
