Lecture 3: Lungs, Pleura & Bronchial Tree

Question 1

How many lobar bronchi in the right lung?

Answer 1

3

Question 2

How many lobar bronchi in the left lung?

Answer 2

2

Question 3

Where is the hilum of the right lung?

Answer 3

Across the 2 lobar bronchi (after the right main bronchus)

Question 4

Where is the hilum of the left lung?

Answer 4

Across the left main bronchus

Question 5

At what level does the trachea branch into the left and right main bronchus?

Answer 5

T4/5

Question 6

What is the difference in position of the left and right bronchus?

Answer 6

Left: longer, thinner, more horizonal
Right: shorter, wider, more vertical

Question 7

Which bronchus is food more likely to go down the wrong way and why?

Answer 7

The right because it is more vertical/wider

Question 8

How many orders of branching are there from the trachea to the alveoli?

Answer 8

25

Question 9

At what order is cartilage lost from the lower airways?

Answer 9

At the bronchioles

Question 10

What is asthma?

Answer 10

Spasms of smooth muscle around the lower airways (bronchioles)

Question 11

How many lobes & fissures are there typically in the right lung?

Answer 11

3 and 2 (horizontal and oblique)

Question 12

How many lobes & fissures are there typically in the left lung?

Answer 12

2 and 1 (oblique)

Question 13

Which lung has a cardiac notch and lingula?

Answer 13

Left

Question 14

How do you distinguish between pulmonary arteries and veins?

Answer 14

Both follow similar branching patterns to airways
Pulmonary arteries: superior & posterior
Pulmonary veins: inferior & anterior

Question 15

How many bronchopulmonary segments are there?

Answer 15

9-10 for each lung

Question 16

What is typically seen at the hilum of the right lung?

Answer 16

Pulmonary artery (S & P)
Pulmonary veins (I & A)
2 x Lobar bronchi
Lymph nodes
Bronchial arteries

Question 17

What impressions are seen on the medial surface of the right lung?

Answer 17

Right brachiocephalic vein
SVC
Shallow cardiac impression
Azygous vein
Diaphragm

Question 18

What is typically seen at the hilum of the left lung?

Answer 18

Pulmonary artery (S & P)
Pulmonary veins (I & A)
1 x Lobar bronchi
Lymph nodes
Bronchial arteries

Question 19

The vagus nerve runs ___ to the root of the lung while the phrenic nerve runs ___ to the root of the lung.

Answer 19

The vagus nerve runs posterior to the root of the lung while the phrenic nerves runs anterior to the root of the lung.

Question 20

What impressions are seen on the medial surface of the left lung?

Answer 20

Diaphragm
Descending aorta
Arch of aorta
Deep cardiac impression

Question 21

What is the sympathetic nerve supply to the lungs?
Where does it originate?
What is it’s action?

Answer 21

Spinal cord and sympathetic chain (T1-4)
Branches run A and P to bifurcation of the trachea then follow airways into lungs
Inhibit smooth muscles around bronchi (bronchodilation)

Question 22

What is the parasympathetic nerve supply to the lungs?
Where does it originate?
What is it’s action?

Answer 22

Almost entirely vagus nerve

Motor to smooth muscles of bronchial tree (bronchoconstrictor)

Question 23

Where do visceral sensory afferents run?

Answer 23

Along sympathetics T1-4 (nociceptive) and parasympathetic (reflexes from bronchiole mucosa)

Question 24

What are the divisions of the lymphatics of the lungs?

Answer 24

Deep pulmonary vessels
Lymph vessels in visceral pleura
Hilar (bronchopulmonary) nodes
Tracheal nodes
Bronchomediastinal trunks (to systemic circulation)

Question 25

What are the two recesses in the pleura?

Answer 25

Costomediastinal and costodiaphragmatic

Question 26

What are the two layers of pleura?

Answer 26

Visceral and parietal (continuous)

Question 27

What is the pulmonary ligament?

Answer 27

Where the visceral pleura reflects around the hilum