Lecture 13: Lung

Question 0

Thoracic cavity:
What is contained within the mediastinum?
Pulmonary cavity (lateral) ?

Answer 0

Mediastinum (central): contains heart and great vessels
Pulmonary cavities (lateral): contains lungs and pleurae.
Pulmonary cavities completely separate from each other

Question 1

Alveolarisation

Answer 1

Your born with 50 million alveoli, and an adult has >300 million alveoli.
Not until week 20 that they begin to get alveoli ducts

Question 2

Right lung has 3 lobes, left lung has 2.

Label diagram on slide 6

Answer 2

Yep

Question 3

The left lung.
The right lung
Describe its anatomy

Answer 3

Has 2 lobes
-cardiac impression 
-cardiac notch 
-groove for thoracic aorta branching over left lung root 
Slide 8 for image 

The right lung:
3 lobes
Cardiac impression
Groove for azygos vein branching over right lung root

Question 4

Pleura.

Describe it and what is its function?

Answer 4

Visceral = on lung and in fissures
Parietal = lines internal thoracic cavity
Pleural fluid in pleural space between the 2 serous membranes
Function is to lubricate for smooth movement in chest cavity? That was a guess
Costal pleura: lines inner surfaces of ribs, costal cartilage, intercostal spaces, sides of vertebral bodies and posterior sternum.
Diaphragmatic pleura: covers thoracic surface of diaphragm
Mediastinal pleura: covers and forms lateral boundary of mediastinum; forms cuff around hilum of lung (visceral and parietal layers join) = pulmonary ligament
Look at slide 10 to see we’re all the different pleuras sit

Question 5

Innervation of pleura: 
What innervates 
Coastal pleura
Mediastinal pleura 
Diaphragmatic pleura (central) 
Diaphragmatic pleura (periphery)

Answer 5

Coastal pleura: intercostal nerves
Mediastinal pleura: phrenic nerve
Diaphragmatic pleura (central): phrenic nerve
Diaphragmatic pleura (periphery): intercostal nerves (T6-T12)
Look at slide 13 for picture

Question 6

Costodiaphragmatic recess. Explain

Costomediastinal recess. Explain?

Answer 6

Lungs expands into costodiaphragmagic recess during forces inspiration.
Recess contains pleural fluid during expiration
Costomediastinal recess: lungs expand into costomediastinal recess during inspiration

Question 7

Look at the landmarks the pleura crosses with on slide 16- don’t really understand

Answer 7

Pleural and pulmonary boarder reflections (right lateral view) slide 19.
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Question 8

Anterior auscultation of lungs

Posterior auscultation of lungs

Answer 8

Slide 22

Slide 23

Question 9

Tracheal anatomy.
Be able to label the diagram on slide 25
Also be able to label the diagram of the tracheobronchial tree slide 26

Answer 9

Do itt

Question 10

What is something special about the cricoid cartilage?

Answer 10

It is the only complete ring. The rest of the airways are maintained by C-shaped rings if hyaline cartilage

Question 11

What are the differences between the left and right primary bronchi?
Inhaled objected are most likely to get stuck in which primary bronchus?

Answer 11

Right primary bronchus is shorter, wider and more steep.

Left primary bronchus is longer, more narrow and less steep

Question 12

Tell me about the trachealis muscle?

Answer 12

It us smooth muscle on posterior aspect. It is innervated by ?

Question 13

Sympathetic innervation of trachea and bronchi?

Answer 13

Pre-ganglionic fibres from IML in upper thoracic spinal cord segments.
Cell bodies of post ganglionic fibres in paravertebral sympathetic ganglia
Bronchchodilator
Vasoconstrictor
Inhibit alveoli glands
Slide 30

Question 14

Parasympathetic innervation of trachea and bronchus

Answer 14

VAGUS NERVE
Preganglionic cell bodies in medulla oblongata
Post-ganglionic cell bodies in pulmonary plexus

• bronchoconstrictor
• vasodilator
• secretomotor to alveolar glands

Question 15

Cough reflex

Answer 15

• Vagal afferent nerves regulate coughing
• larynx and carina are particularly sensitive to mechanical stimuli
• intra-pulmonary airways more sensitive to mediators and irritants

Question 16

Arnold’s reflex?

Answer 16

You cough when you clean your ear? How?
Afferent nerve carried by the auricular branch of the vagus nerve (sometimes called Arnold nerve) innervates the external acoustic meatus

Question 17

Pulmonary lymphatics

Answer 17

Phagocytes in lymphatic vessels on surface of lung ingest carbon particles from inspired air- that’s what Gives our cadavers the black colour in those fine vessels on their lungs

Question 18

Why is the anterior margin on the Right lung straight but not for left?
Slide 35

Answer 18

Don’t know

Question 19

Know the nerves, veins and arteries on this cadaver slide 38

Answer 19

Need to look at lecture

Question 20

Were do the bronchial arteries run?

Answer 20

Branch from descending aorta and run along the branching bronchi to supply blood to all the lung tissue EXCEPT alveoli (eg root of lung, supporting tissues, visceral pleura)
Slide 41

Question 21

Pulmonary arteries, were do they run, what do they do?

Answer 21

Pulmonary arteries pump de-oxygenated blood from heart to lungs.
Originate from pulmonary trunk emerging from right ventricle of heart
One artery on each side

Question 22

Bronchial veins

Answer 22

Bronchial veins drain lung tissue near roots.
Right bronchial vein -> azygos vein
Left bronchial vein-> accessory hemiazygos or left superior intercostal vein
How is the rest of the blood drained from the lungs? The pulmonary veins

Question 23

Pulmonary veins

Answer 23

Pulmonary veins pump oxygenated blood from lungs back to heart
Enter left atrium of heart
Two pulmonary veins on each side

Question 24

Average respiratory rates by age:

Answer 24

Newborns: 30-40 breaths per minute
Less than 1 year: same
1-3yrs: 23-35 breaths per minute 
3-6 years: 20-30 breaths per minute
6-12 yrs: 18-26 breaths per minute 
12-17 yrs: 12-20
Adults over 18: 12-20 breaths per min

Question 25

Learn the sequence of event on slide 46

Answer 25

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