Lung and Diaphragm

Question 1

What lines the lungs and what type of innervation does it have?

Answer 1

Visceral Pleura. It even extends into the lung fissures.

Visceral sensory innervation

Question 2

What lines the thoracic wall and what type of innervation does it have?

Answer 2

Parietal Pleura.

Somatic sensory innervation via intercostal nn. and Phrenic nn.

Question 3

What is it called when your lungs fill up with fluid/blood? How can one fix that issue?

Answer 3

Hydro/Hemothorax.

One would have to undergo a nerve block and a Thoracentesis in the Costodiaphragmatic Recesses (7-9 intercostal space)

Question 4

What are differences between right and left lung?

Answer 4

• R lung: Superior lobe (separated by horizontal fissure) Middle lobe (separated by oblique fissure) Inferior lobe
• L Lung: Cardiac notch in Superior lobe (separated by oblique fissure) Inferior lobe

Question 5

Trace the pathway of the trachea and bronchi.

Answer 5

Trachea –> Right (shorter, fatter, and vertical) and Left main bronchi (Bifurcates at the Carina, T4/T5) –> Lobar bronchi (Intrapulmonary; R has 3, L has 2) –> Segmental bronchi –> splits up into corresponding bronchopulmonary segments (there are 10 bronchopulmonary segments per lung, and they are each separated by connective tissue called the Septa)

Question 6

Describe the pulmonary vessels.

Answer 6

1) Pulmonary trunk: Exits right ventricle and splits into the R and L pulmonary arteries
2) Pulmonary arteries: O2 poor blood goes through lobar aa. and segmental aa. (Both run parallel to bronchi)
3) Pulmonary veins: O2 rich blood to the left atrium (There are two sets of them on each side, they lie in the septa, and do not run parallel with aa. or bronchi)

Question 7

Describe the bronchial vessels.

Answer 7

Bronchial aa.: O2 rich blood. They branch off Thoracic aorta –> lungs
Bronchial vv.: O2 poor blood. Return blood from lungs –> azygos system or intercostal vv.

Question 8

Describe the diaphragm’s attachments.

Answer 8

• Attached to: Xiphoid process, Costal margins, Ribs 11 + 12, L1 + L2 via Right and Left Crura (Right is a little longer)
• Central Tendon (attaches to the heart)

Question 9

What passes through the diaphragm?

Answer 9

• Caval (IVC) opens @ T8 (Goes through Central Tendon)
• Esophageal hiatus (Esophagus and Vagus) @ T10
• Aortic hiatus (Aorta, thoracic duct, and Azygos vv.) @ T12

Question 10

What muscles are used during forced inspiration?

Answer 10

• Pectoral muscles

- External intercostals

Question 11

What muscles are used during forced expiration?

Answer 11

• External obliques
• Internal obliques
• Rectus abdominis