Lecture 2: Lower Resipiratory Tract

Question 1

How many lobes does the L and R lung have?

Answer 1

L lung has 2 lobes (Superior lobe and inferior lobe)

R lung has 3 lobes (Superior lobe, middle lobe and inferior lobe)

Question 2

How can you distinguish the lungs from one another?

Answer 2

Posterior part is tall and columnar. Anterior side is thin and flappy.

Question 3

What separates the superior lobe and inferior lobes of the left lung?

Answer 3

Oblique fissure

Question 4

What are the fissues that are located on the RIGHT lung?

Answer 4

1. Olique fissure separates the [superior and middle lobes] from the inferior lobe.
2. Horizontal fissure separates the superior lobe from the middle lobe.

Question 5

Is the cardiac impression bigger on the L lung or R lung?

Answer 5

LEFT

Question 6

What lung will the

groove for the superior vena cava &

groove for the inferior vena cava

be on?

Answer 6

RIGHT

Question 7

How we do we identify the

left/right main bronchus,

pulmonary artery

and pulmonary vein

on the mediastinal surface?

Answer 7

Left/right main bronchus--> has cartilage

Pulmonary artery–> thickest wall without cartilage

Pulmonary vein--> thin wall without cartilage

Question 8

What is the costodiaphragmatic recess?

Answer 8

Recesses can fill with [fluid or air] and pool.

When we inhale, the inferior border of the lungs will go into the costodiaphragmatic recess, which is in between the ribs and thoracic diapragm.

Question 9

What is the costomediastinal recess?

Answer 9

Recesses can fill with fluid or air and pool.

It is located on the anterior and medial border of the lungs.

Fluid can pool when laying down

Question 10

Pneumonectomy

Answer 10

Take out the entire lung

Question 11

Lobectomy

Answer 11

Take out a lobe of the lung

Question 12

Segmentectomy

Answer 12

Take out a segment of the lung

Question 13

Pleura of the lungs

Answer 13

1. Visceral pleura- aderes to the lungs and goes into the fissues.
2. Parietal pleura (4 parts)- adhered to the thoracic wall, mediastimun and the diapragm

Question 14

What are the 4 parts of the parietal pleura of the lungs?

Answer 14

1. Cervical parietal pleura
2. Costal parietal pleura
3. Diaphragmatic parietal pleura
4. Mediatinal parietal pleura

Question 15

CN: Pleuritis (pleurisy)

Answer 15

Inflammed pleura, producing a roughness on the lungs and making it hard to breathe.

Question 16

Pneumothorax

Answer 16

Thoracic wall and the parietal pleura is punctured, letting air in breaking the surface tension between the 2 layers of pleura.

The elasticity of the lungs causes them to collapse.

Question 17

Hydrothorax

Answer 17

Excess fluid, not blood, in the space in between the two pleura. Often caused by pleural effusion

Question 18

Hemothorax

How is it caused?

Answer 18

Blood in the pleural cavity, usually due to a chest wound.

In these cases, the intercostal vessel or the internal thoracic vessel are often damaged, as opposed to a laceration to the lung.

Question 19

What is the pleural cavity?

Answer 19

The area in between the visceral and parietal pleura of the lungs

It contains lubricating fluid that reduces friction and creates cohesion of the 2 pleura.

Question 20

What is the primary bronchi, secondary bronchi and tertiary bronchi?

Answer 20

Primary bronchi- Main bronchi

Secondary bronchi- Lobar bronchi (left has 2 and right has 3)

Tertiary bronchi- Segmental bronchi (segmental bronchi are splits from the lobar bronchi)

Question 21

Objects that are inhaled are more likely to be caught in what bronchus? Why?

Answer 21

The right bronchus.

Because it is more vertical.

Question 22

Segmental bronchi will divide into what?

Answer 22

Bronchioles.

Question 23

Bronchiole dividsion

Answer 23

Segmental bronchus–> divide into conducting bronchile–> divides into terminal bronchiole–> divides into respiratory bronchiole –> alveolus

Question 24

Where does gas exhange occur?

Answer 24

Alveolus–> primary site for gas exhange.

Some gas exhange does occur at the respiratory bronchiole

Question 25

CN: Lung cancer

Answer 25

Lung cancer can occur in the actual lung tissue or from the bronchi (brochogenic carncinoma).

It can involve the phrenic nerve, vagus nerve and the recurrent laryngeal nerve because of how close they are to the lungs.

To treat: pneuonectomy, lobectomy, segmentectomy (remove a specific bronchopulmonary segment) through a procedure called lung resection.

Question 26

CN: pulmonary collapse

Answer 26

Pulmonary collapse occurs when air enters the pleural cavity and disrupts the surface tension between the 2 layers of pleual.

The elasticity of the lungs causes them to collapse.

Question 27

What is the alveolar duct?

Answer 27

The end of the alveolus.

It is a functional unit of the lung and the primary site for gas exchange.

Question 28

CN; What is bronchiole asthma?

Answer 28

Widespread narrowing of the airways due to

• contaction of smooth muscle
• edema of the mucosa
• mucus in the lumen of the bronchi and bronchioles

Question 29

CN: Bronchoscopy

Answer 29

Insert a bronchoscope into the trachea so that you can see the main bronchi

Question 30

What is the ridge that separates the L and R primary bronchi?

Answer 30

Carina

Question 31

Bronchopulmonary segments of the right lung

Answer 31

1. Superior lobe: apical, posterior and anterior
2. Middle lobe: lateral and medial
3. Inferior lobe: superior, anterior basal, medial basal, lateral basal and posterior basal.

Question 32

Bronchopulmonary segments of the left lung

Answer 32

1. Superior lobe- apical, posterior, anterior, superior and inferior

(apical and posterior are usually combined into apicoposterior)

(Superior and inferior are usually combined into lingular)

2. Inferior lobe- superior, anterior basal, medial basal, lateral basal, posterior basal

(Anterior basal and medial basal are often combined into anteromedial basal).

Question 33

What are bronchopulmonary segments, exactly?

Answer 33

They are pryramid shaped segments that are separated by CT septa.

They are supplied by and named for a single segmental bronchus and can be surgically removed.

Question 34

What is the hilum?

Answer 34

The hilum is on the mediastinal surface and contains our pulmonary artery, pulmonary vein, main bronchi and pulmonary ligament.

Question 35

The ____ border of the lung projects into the costodiaphragmatic and costomediastinal recesses

Answer 35

Inferior