Lower Respiratory tract Flashcards
Trachea
Location: superior mediastinum; C6⇒ Th4
Bifurfation: right⇒ 35 degrees, left⇒ 40degrees
- 9-15 cm long
- 16-20 cartilage rings
Right Bronchus
- 2cm long
- shorter, wider, more vertical
- divides into 3 lobar bronchi
Left bronchus
- 5cm long
- inferolaterally
- divides into 2 bronchi
Parietal pleura
- Costal part
- Mediastinal part
- Diaphragmatic part
Lines of Pleural reflections
- sternal line (between costal + mediastinal)
- costal line (between diaphragmatic + costal)
- vertebral line (between costal + mediastinal)
Borders of pleura
- 2-3 cm above midclavicular line (cupula)
- 2nd intercostal space⇒ parallel down
- 6th rib: sternal line
- 7th rib: midclavicular line
- 8th rib: anterior axillary line
- 9th rib: mid maxillary line
- 10th rib: posterior axillary line
- 11th rib: scapular line
- 12th rib: spinous process of Th11
Recesses of pleura
Costrodiaphragmatic recess: between diaphragm + costal layer
Phrenicomediastinal recess
Costomediastinal recess
Blood supply of Pleura
PARIETAL PLEURA:
- internal thoracic, intercostals, musculophrenic artery
VISCERAL PLEURA:
- bronchial arteries
- bronchial veins ⇒pulmonary veins
Root of the lungs
- bronchi
- pulmonary arteries
- pulmonary veins
- pulmonary plexus + nerves
- bronchial arteries and veins
- lymphatics
Surfaces of lungs
Costal
Mediastinal
Diaphragmatic
Right lung
- 3 lobes⇒ upper, middle, lower
- oblique fissure: separates middle + lower, 4th⇒6th rib
- horizontal fissure: separates upper + middle, 4th rib
- 3 lobar bronchi⇒ 10 segmental bronchi
- right hilum:
- sup+inf ant: 2 pulmonary veins
- sup post: pulmonary arteries
- post: pulmonary bronchi
Impressions of Right lung
- azygos vein
- SVC
- esophagus
- cardiac impression
- costal impression
Left lung
- 2 lobes ⇒ upper, lower
- oblique fissure: 6th rib
- lingula + cardiac notch: 4th⇒6th rib
- 2 lobar bronchi ⇒ 8 segmental bronchi
- left hilum:
- ant inf: 2 pulmonary veins
- sup post: 1 pulmonary artery
- post inf: bronchus
Impressions of left lung
- cardiac impression
- left subclavian artery groove
- aortic impression
Borders of lungs
- apex: 2 cm above clavicle, midclavicular line
- 6th rib: sternal line
- 6th rib: midclavicular line
- 7th rib: anterior axillary line
- 8th rib: midaxillary line
- 9th rib: posterior axillary line
- 10th rib: scapular line
- 11th rib: paravertebral line
Segments of Right lung
- apical segment
- posterior segment
- anterior segment
- lateral segment
- medial segment
- superior segment
- medial basal segment
- anterior basal segment
- lateral basal segment
- posterior basal segment
Segments of Left lung
1+2. apico-posterior segment
- anterior segment
- superior lingular segment
- inferior lingual segment
- superior segment
- –
- anterior basal segment
- lateral basal segment
- posterior basal segment
Bronchopericardial membrane
central CT membrane that firmly attach to root of lung and tracheal bifurcation to posterior wall of pericardium, into tendinous center of diaphragm
forms partition between middle and posterior mediastinum
Bronchial tree
Main bronchus ⇒ lobar bronchus ⇒ segmental bronchus ⇒ terminal bronchi ⇒ bronchiolus ⇒ respiratory bronchioli ⇒ alveolar duct ⇒ alveolar sac ⇒ pulmonary alveolus
Blood supply of Lungs
ARTERY:
- pulmonary arteries
- bronchial arteries
VEINS:
- bronchial veins
- pulmonary veins
LYMPH:
- superficial lymph plexus ⇒ bronchopulmonary nodes
- deep lymph plexus ⇒ pulmonary lymph nodes
⇒⇒ tracheobroncial lymphnodes ⇒ bronchomediastinal lymph nodes
Innervation of lungs
Pulmonary plexus: vagus
phrenic nerve: mediastinal pleura
intercostals nerves: costal + diaphragmatic pleura
