Chest x-ray

Question 1

Describe the appearance of the apex of the lung

Answer 1

The apex of the lung is rounded and protrudes superior to the thoracic inlet (approximately 2c above the clavicle)

Question 2

Describe the lung bases

Answer 2

Concave and rest on the diaphragm. The lateral margins contain grooves which correspond to the ribs.
Medially, the lungs have curved recesses for the spine and mediastinum, located posterior and anterior respectively. The anterior aspect is deeply concave to accommodate the heart.

Question 3

Name five parts of the lung

Answer 3

Superior (upper) lobe, horizontal fissure, middle lobe, inferior (lower) lobe, oblique fissure,
Also cardiac notch on left lung.

Question 4

What does the oblique fissure do?

Answer 4

Divides the upper and lower lobes

Question 5

What is the difference between the right and left obliques fissures?

Answer 5

Right fissure is less vertical than the one on the left side.

Question 6

Where does the right oblique fissure start from?

Answer 6

Begins posterior at the level of T4

Question 7

Where does the right oblique fissure go to?

Answer 7

Continues anteriorly through the hilum. Reaches the inferior surface - approx. 7cm posterior to the anterior chest wall.

Question 8

What does the horizontal fissure do?

Answer 8

Divides the upper and middle lobes.

Question 9

Where does the horizontal fissure run?

Answer 9

Runs from the oblique fissure at the 4th costo-cartilage anteriorly to the hilum.

Question 10

Where does the left oblique fissure run?

Answer 10

Extends from 6cm inferior to the lung apex posteriorly through the hilum. Terminates at the diaphragm just behind the anterior chest wall.

Question 11

Where would you find the Lingula of the upper lobe?

Answer 11

Right middle lobe is adjacent to the cardiac aspect of the left lung.

Question 12

What does the hila do?

Answer 12

Connects the medial aspect of the lung to the heart and the trachea.

Question 13

What structures form the hila?

Answer 13

Formed by the structures that enter and leave the lungs: main bronchus, pulmonary artery, 2x pulmonary veins, bronchial vessels, lymphatics, bronchopulmonary lymph nodes, connective tissue, pleura

Question 14

Where is the hila located?

Answer 14

Between T5 to T7

Question 15

Which hila is located higher than the other?

Answer 15

The left hila is higher than the right hila

Question 16

Where is the vagal nerve located?

Answer 16

Posterior to the hila

Question 17

Where is the Phrenic nerve located?

Answer 17

Anterior to the hila

Question 18

Where is the right hilum located?

Answer 18

Posterior to the superior vena cava and right atrium and inferior to the azygos vein.

Question 19

What are the conducting airways?

Answer 19

A branching network of tubes (epithelial lined channels). Larger airways contain incomplete cartilaginous rings which are open posteriorly and united by fibrous tissue and smooth muscle.

Question 20

What do the Conducting airways do?

Answer 20

Deliver air to the gas exchange surfaces. There are 16-20 divisions of the airways. Gas exchange components are thin walled sacs that allow for diffusion of O2 and CO2 in/out of the body.

Question 21

Describe the Trachea

Answer 21

Largest structure in the conductive airways. Midline structure connecting the upper airway to the mainstream bronchi.
Contains 16-20 incomplete rings of caritlage.
Begins at the pharynx at the level of C6
Bifurcates at the carina at the level of T5
Anteriorly it is related to the: skin of the neck, thyroid, sternum, thymus, aortic arch

Question 22

Where is the Oesphagus located in relation to the trachea?

Answer 22

Posterior

Question 23

Left laterally the trachea is adjacent to what?

Answer 23

L common carotid artery, L subclavian artery, L recurrent laryngeal nerve, Aortic nerve

Question 24

Right laterally the trachea is adjacent to what?

Answer 24

Brochiocephalic vein, superior vena cava, right vagal nerve

Question 25

What are Acni?

Answer 25

Acni is a collective term for the bronchioles and alveoli.

Gas exchange site where alveoli are bunched surrounding the walls of the bronchioles.

Question 26

What are the two types of cells in alveolar walls?

Answer 26

Type 1 pneumocytes - 90% of aveolar air, gas diffusion between air and blood.
Type 2 pneumocytes - surfactant production that covers the alveolar surface to reduce surface tension and prevent alveolar collapse and increase efficiency of ventilation.