Lecture 2: Lungs & Tracheobronchial Tree Flashcards
What parts make up the thoracic cavity?
- superior thoracic aperture
- right and left lung
- right and left pulmonary space
- superior mediastinum
- diaphragm (closes inferior thoracic aperture)
What are the bony boundaries of the thoracic cavity?
vertebrae, ribs, and sternum
What are the muscular boundaries that make up the walls of the thoracic cavity?
intercostal muscles (external, internal, innermost), transversus thoracic, subcostal muscles
What is the muscular boundary that makes up the flood of the thoracic cavity?
the diaphragm
What are the levels of the thoracic cavity?
8, 10, 12
What is pleura?
serous membrane sac
Which pleura covers the organs?
the visceral pleura
Which pleura covers the body cavity walls?
the parietal pleura
What is the fascia that lines the parietal pleura?
the endo-thoracic fascia
What are the 4 parts of the parietal pleura?
- cervical part
- costal part
- diaphragmatic part
- mediastinal part
Where does the suprapleural membrane attach?
1st rib + TP of C7
What is the suprapleural membrane?
a fibrous extension of endothoracic fascia
Which pleura is the thickest?
the parietal pleura
Which pleura can separate from adjacent structures during dissection?
the parietal pleura
What are pleural reflections?
when the parietal pleura lines along which it changes directions
Where is the parietal pleura continuous with the visceral pleura?
at the hilum of the lung
What is the opening for the root of the lung called?
the hilum
What are pleural recesses?
bilateral potential spaces filled during inspiration
What are the 2 kinds of recesses?
costmediastinal and costodiaphragmatic
What are costomediastinal recesses?
spaces posterior to the sternum; left recess larger due to cardiac notch
What are costodiaphragmatic recesses?
“gutter” along thoracic wall surrounding the domes of the diaphragm
What is dyspnea?
difficulty breathing
What is pneumothorax?
air in the pleural cavity
What happens when the pneumothorax is open?
air enters from outside the body
What happens when the pneumothorax is closed?
air enters from within respiratory system
How can we intervene when somebody has pneumothorax?
with needle decompression
What two fissures are found on the right lung?
the oblique fissure and horizontal fissure
Which fissure is found on the left lung?
the oblique fissure
How is the right lung divided?
superior, middle and inferior
How is the left lung divided?
superior and inferior
What are the 2 parts of the left lung that aren’t found on the right lung?
the cardiac notch and the lingula
What are the 3 surfaces of the lungs?
diaphragmatic (base), costal & mediastinal
What are the 3 borders of the lungs?
inferior, anterior, & posterior
Which organ is found under the diaphragm on the right lung?
the liver
Which organ is found under the diaphragm on the left lung?
the stomach
What are the 4 impressions found on the right lung?
superior vena cava, brachiocephalic trunk, esophagus, azygous vein
What are the 4 impressions found on the left lung?
brachiocephalic vein, subclavian artery, esophagus, aorta
What is the root of the lung comprised of?
B: bronchus
A: pulmonary artery
V: pulmonary vein
What is the tracheobronchial tree?
sequential branching of respiratory tract
What does the trachea bifurcate into?
right and left primary bronchi
What do primary bronchi divide into?
secondary and lobular bronchi
How many secondary bronchi does the right primary bronchus have?
3
How many secondary bronchi does the left primary bronchus have?
2
What do secondary bronchi divide into?
2-5 tertiary/segmental bronchi
What is found on the trachea?
C-shaped hyaline cartilage rings
What are C-shaped hyaline cartilage rings connected by?
annular ligaments
What level does the tracheal bifurcation happen?
T4/T5
What are the parts of the tracheobronchial tree from a superior view?
- esophagus
- trachealis muscle
- mucosa
- cartilage
What is the function of the trachealis muscle?
it helps the esophagus push food down
What is the right primary bronchus divided into?
superior (3), middle (2) and inferior (5)
What is the left primary bronchus divided into?
superior (5) and inferior (5)
Where is aspiration of a foreign body most likely to lodge?
in the right primary bronchus
Why do foreign bodies get lodged in the right primary bronchus?
because of the straighter trajectory and larger width
Where do very small foreign bodies may become lodged?
in secondary bronchi (especially inferior due to gravity)
What is a pneumectomy?
removal of an entire lung
What is a lobectomy?
removal of an entire lobe
What is a segmentectomy?
removal of one (or more) segments
How is the respiratory tract divided?
conducting and respiratory components
What comprises the conducting zone?
from nose to terminal bronchioles
What comprises the respiratory zone?
respiratory bronchioles, alveolar sacs, alveolar ducts, alveoli
What is the difference between bronchi and bronchioles?
bronchioles have no cartilage
What is found on the respiratory bronchioles and alveolar sacs?
branch of a pulmonary artery and tributary of a pulmonary vein
What kind of blood is found in the 2 pulmonary arteries?
deoxygenated blood
What kind of blood is found in the 4 pulmonary veins?
oxygenated blood
Where do bronchial arteries branch off?
aorta and/or posterior intercostal arteries
Where do bronchial veins drain?
into the heart via veins in the posterior mediastinum
What is the blood supply for the visceral pleura?
pulmonary and bronchial vessels
What is the blood supply for the parietal pleura?
thoracic wall vessels (intercostal) + diaphragmatic and pericardial vessels
What are the 2 ducts that make up the lymphatic drainage?
right lymphatic duct
thoracic duct
What are venous angles?
where subclavian and internal jugular veins meet to form brachiocephalic veins
What innervates the sympathetic system?
T2-T5 (sympathetic trunk/chain)
What innervates the parasympathetic system?
vagus nerve CN X (from the brainstem)
What innervates both the sympathetic and parasympathetic system?
the pulmonary plexuses
What innervates the visceral pleura?
the pulmonary plexus
What system is the visceral pleura part of?
the autonomic nervous system
What innervates the parietal pleura?
the phrenic nerve and intercostal nerves
What parts of the parietal pleura does the phrenic nerve innervate?
the mediastinal and medial diaphragmatic parts
What parts of the parietal pleura does the intercostal nerves innervate?
the costal, cervical & peripheral diaphragmatic parts
What are the spinal levels of the referred pain patterns seen by the phrenic nerve?
C3-C5 dermatomes
What are the spinal levels of the referred pain patterns seen by the intercostal nerves?
in dermatomes along thoracic wall corresponding to affecting intercostal nerves
