lungs Flashcards

1
Q

function of lungs

A

oxygenate the blood by bringing inspired air close to venous blood in pulmonary capillaries

inspired air flows along the following conducting ariways to reach the lungs: nasal cavity, pharynx (nasal and oral parts), larynz, trachea and bronchi

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2
Q

right lung

A

has 3 lobes (upper, middle, and lower); horizontal fissure separates the upper and middle lobes; oblique fissure separates the lower lobe from upper and middle lobes; is larger than the left lung, but shorter and wider because the right dome of the diaphragm is higher and the heart bulges to the left

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3
Q

left lung

A

has 2 lobes (upper and lower); oblique fissure separates the upper and lower lobes; its anterior border has the cardiac notch indenting its upper lobe and the lingula (tongue-like part of the upper lobe) extends below the cardiac notch

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4
Q

location of lower lobes of both lungs

A

located mainly posteriorly

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5
Q

oblique fissure of both lungs

A

from T2 spine posteriorly to 6th rib anteriorly; follows the medial border of the abducted scapula; horizontal fissure of right lung – from the oblique fissure, parallels the 4th rib anteriorly

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6
Q

apex

A

ascends into the root of the neck

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7
Q

3 surfaces of the lung

A

costal
mediastinal
diaphragmatic

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8
Q

costal surfaceof the lung

A

adjacent to sternum, costal cartilage and ribs

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9
Q

mediastinal surface of the lung

A

adjacent to the mediastinum

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10
Q

diaphragmatic surface of the lung

A

adjacent to the diaphragm

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11
Q

anterior border of the lung

A

where costal and mediastinal surfaces meet anteriorly

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12
Q

inferior border of the lung

A

separates diaphragmatic lung surface from costal and mediastinal suraces

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13
Q

posterior border of the lung

A

where costal and mediastinal lung surfaces meet posteriorly

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14
Q

root of the lung

A

is formed by structures connecting the lungs with the heart and trachea

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15
Q

each lung contains

A

pulmonary artery
pulmonary veins
main bronchus
autonomic nerves, sensory nerves, lymphocytes

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16
Q

pulmonary artery

A

located superiorly on the left; upper lobar bronchus

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17
Q

pulmonary veins

A

located anteriorly and inferiorly

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18
Q

main bronchus

A

located posteriorly; has bronchial vessels surrounding it

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19
Q

what encircles root structures

A

pleural sleeve with the pulmonary ligament hanging inferiorly

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20
Q

hilum of the lung

A

region on the lung’s mediastinal surface where parietal pleura of the pleural sleeve and pulmonary ligament is continuous with visceral pleura covering the lung and root structures enter and exit the lung

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21
Q

root structures entering the lung

A

bronchi, arteries, and nerves

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22
Q

root structures leaving the lung

A

veins and lymphatics

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23
Q

anterior of the hilum of the right lung

A

heart (forms cardiac impression) and superior vena cava

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24
Q

superior of the hilum of the right lung

A

arch of azygos vein

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25
posterior of the hilum of the right lung
esophagus and azygos vein
26
anterior of the hilum of the left lung
anterior - heart (forms cardiac impression
27
superior of the hilum of the left lung
aortic arch
28
posterior of the hilum of the left lung
esophagus and thoracic (descending) aorta
29
main bronchi
arise from the bifurcation of the trachea at the level of the sternal angle; walls of trachea and bronchi are supported by cartilage; trachea contains the carina, a ridge that internally marks its bifurcation
30
bronchoscopy
during bronchoscopy, the carina marks the openings to the main bronchi; a deviation in carina position may indicate metastasis (spreading) oflung cancer to lymph nodes near the tracheal bifurcaton
31
aspiration of foreign objects
an aspirated foreign object usually enters the right main bronchus because it is shorter, wider, and more vertical than the left main bronchus; "inhale a bite, goes down to the right"
32
bronchial tree
each main (primary) bronchus branches into lobar bronchi (3 on the right; 2 on the left); right main bronchus gives off its upper lobar bronchus early, before entering the hilum; all other branching occurs within the lungs
33
each lobar (secondary) bronchus
branches into segmental (tertiary) bronchi (10 on the right; 8-10 on the left)
34
main bronchus and pulmonary artery
supply a lung
35
lobar branches
supply a lung lobe
36
segmental branches
supply a bronchopulmonary segment; each bronchopulmonary segment is a wedge-shaped area of lung tissue within a lung lobe; the segmental bronchus and artery run centrally within the bronchopulmonary segment
37
branching pattern for each segmental bronchus
segmental bronchus --> bronchioles --> terminal bronchioles --> respiratory bronchioles --> alveolar ducts --> alveolar sacs --> alveoli
38
where does gas exchange begin
respiratory bronchioles
39
intersegmental veins
drain oxygenated blood from adjacent segments and are tributaries of the pulmonary veins
40
surgical removal of lung segments
bronchopulmonary segments are independent functional and surgical units of the lung; intersegmental veins, lying in connective tissue septa between adjacent segments are surgical landmarks so a bronchopulmonary segment can be removed (segmentectoromy) without disrupting surrounding lung tissue
41
pulmonary arteries and veins
for gas exchange; deal with circulation of blood between the heart and lungs
42
bronchial arteries and veins
for nutrition; are the vascular supply to the lungs
43
pulmonary arteries
arise from the pulmonary trunk, which receives deliver deoxygenated blood to the lungs for oxygenation right pulmonary artery runs under the aortic arch and posterior to the ascending aorta and superior vena cava left pulmonary artery is shorter and arches over the left main bronchus
44
pulmonary veins
transport oxygenated blood from the lungs to the left atrium of the heart
45
bronchial arteries
supply oxygenated blood to lung tissue, lung root, and visceral pleura
46
left bronchia arteries
arise from the thoracic aorta
47
right bronchial artery
variable origin (origin as a common trunk with the 3rd posterior intercostal artery is shown)
48
bronchial veins
only drain blood from the lung root near the hilum; most is drained by pulmonary veins (does not significantly reduce oxygen concentration of blood carried by pulmonary veins)
49
right bronchial veins
drain into azygos vein
50
left bronchial veins
drain into accessory hemiazygos vein
51
lymphatic drainage of the lungs
extensive and occurs via 2 lymphatic plexuses
52
superficialy plexus
lies deep to the visceral pleura and drains toward the hilum
53
deep plexus
follows the bronchial tree toward the hilum and includes pulmonary nodes within the lung
54
drainage routes
lymph from both plexuses drains to bronchipulmonary nodes, tracheobronchial nodes, paratrachealnodes, and then to a bronchomediastinal trunk right and left bronchomediastinal trunks each drain to a venous angle (junctionof internal jugular and subclavian veins), either directly or through the right lymphatic duct and the thoracic duct, respectively all drainage eventually reaches the brachiocephalicveins (tributaries of the superior vena cava)
55
metastasis of lung cancer
lung cancer cells may metastasize through the lymphatics (cancer cells enter lymphatic vessels and seed nearby lymph nodes), veins (cancer cells enter bronchial veins and pass to the azygos system), and arteries (cancer cells enter pulmonary veins and are returned to the left side of the heart)
56
innervation of the lungs
is via the anterior and posterior pulmonary plexuses located anterior and posterior to the roots of the lungs both plexuses receive fibers from the sympathetic trunks (on each side of vertebral column) and vagus nerves (run posterior to roots of the lungs)
57
components of the pulmonary plexuses
sympathetic postganglionic fibers from upper thoracic ganglia of the sympathetic trunks parasympathetic pregangiolinic fibers from the vagus nerves, parasympathetic ganglia, and postganglionic parasympathic fibers visceral sensory fibers
58
sympathetic postganglionic fibers from upper thoracic ganglia of the sympathetic trunks
bronchiodilators, vasocontstrictors, and inhibit mucus secretion
59
parasympathetic preganglionic fibers
bronchoconstrictors, vasodilators, and stimulate mucus secretion
60
visceral sensory fibers
these fibers run in the vagus nerves; carry information involved in reflexes for coughing and for preventing over-inflation of the lungs
61
diaphragm
a dome-shaped skeletal muscle partition between the thoracic and abdominal cavities
62
superior relation of diaphragm
diaphragmatic parietal pleura are fibrous pericardium (attached to the central tendon of the diaphragm)
63
inferior relation of diaphragm
liver, stomach, spleen,suprarenal glands, and kidneys
64
functions of the diaphragm
drops on contraction, increasing the vertical dimension of the thoracic cavity and increasing intra-abdominal pressure forcible contraction with anterior abdominal wall muscles assists in voiding responses such as micturtion (urination), childbirth, and defecation
65
diaphragm attachments
consists of peripheral muscle fibers that converge to insert on a central tendon (has no bony attachments) muscle fibers are arranged in 3 parts by their origins
66
sternal muscle fibers
arises from the xiphoid process
67
costal muscle fibers
arises from the lower 6 ribs and costal cartilages
68
lumbar muscle fibers
arises from arcuate ligaments and crura of the diaphragm
69
acruate ligaments
medial and lateral acruate ligaments are tendinous arches of the psoas major and quadratus lumborum muscles, respsectively
70
crura of the diaphragm
arise from upper lumbar region of vertebral column; right crus is longer than the left; crura are united by the median acruate ligament
71
apetures of the diaphragm
openings that allow structures to pass between the thorax and abdomen
72
caval opening
an opening in the central tendon at T8 vertebral level; transmits the inferiore vena cava (IVC)
73
esophageal hiatus
an opening in the muscle of the right crus at T10 vertebral level; transmits the esophagus and the anterior and posterior vagal trunks
74
aortic hiatus
an opening posterior to the median acruate ligament at T12 vertebral level; transmits the aorta and the thoracic duct
75
thoracic surface arterial supply
supplied mostly by superior phrenic arteries from the thoracic aorta
76
abdominal surface arteral supply
supplied mostly by inferior phrenic arteries from the abdominal aorta
77
venous drainage of the diaphragm
most veins accompany arteries and all drainage eventually reaches the IVC
78
motor innervation of the diaphragm
all motor supply is from the right and left phrenic nerves (ventral rami C3-C5 of cervical plexus) each nerve runs anterior to the root of the lung, between the fibrous pericardium and mediastinal pleura and supplies the hemidiaphragm on its respective side
79
sensory innervation
most sensory nerve supply from the diaphragm runs in the phrenic nerves
80
phrenic nerve lesion
a destructive lesion to a phrenic nerves results in paralysis and paradoxical movement of the affected hemidiaphragm; the paralyzed hemidaphragm fails to drop on inspiration and is forced upward by an increase in intra-abdominal pressure