Lungs

Question 1

Which lung is larger

Answer 1

Right lung because the middle mediastinum (containing the heart) bulges more to the left than to the right

Question 2

Where does the apex sit

Answer 2

Projects above rib I and into the root of the neck

Question 3

Anterior border

Answer 3

Sharp

Question 4

Inferior border

Answer 4

Sharp

Question 5

Posterior border

Answer 5

Smooth and rounded

Question 6

Roots and hila of the lungs

Answer 6

Question 7

What does the pulmonary ligament (thin-like fold of pleura) do

Answer 7

Stabilises the position of the inferior lobe and may also accommodate the down and up translocation of structures in the root during breathing

Question 8

Name the nerves that pass immediately posterior and anterior to the roots of the lungs

Answer 8

• Vagus nerves pass posterior
• Phrenic nerves pass anterior

Question 9

Structures located within each root and located in the hilum

Answer 9

• Pulmonary artery (superior)
• 2 pulmonary veins (most anterior and inferior)
• A main bronchus (posterior)
• Bronchial vessels
• Nerves
• Lymphatics

Question 10

On the right side, where does the lobar bronchus to the superior lobe branch from

Answer 10

The main bronchus in the root

Question 11

On the left side, where does the lobar bronchus to the superior lobe branch from

Answer 11

Branches within the lung itself

Is superior to the pulmonary artery

Question 12

How many lobes does the right lung have

Answer 12

3 lobes => 2 fissures

Question 13

Position of the oblique fissure on a patient

Answer 13

Begins at the SP of T4, crosses the 5th IC laterally and then follows the contour of rib 6 anteriorly

Question 14

Position of the horizontal fissure

Answer 14

Follows the 4th IC space from the sternum until it meets the oblique fissure as it crosses rib 5

Question 15

What is the superior lobe in contact with

Answer 15

Upper part of the anterolateral wall

Question 16

Where does the surface of the middle lobe lie

Answer 16

Mainly adjacent to the lower anterior and lateral wall

Question 17

What is the costal surface of the inferior lobe in contact with

Answer 17

Posterior and inferior walls

Question 18

Structures adjacent to the medial surface of the right lung

Answer 18

• Heart
• IVC
• SVC
• Azygos vein
• Oesophagus
• right subclavian artery and vein arch over and are related to the superior lobe of the right lung (as they pass over the dome of the cervical pleura into the axilla)

Question 19

Structure of left lung

Answer 19

Oblique fissure is more oblique

Question 20

Position of oblique fissure (left lung)

Answer 20

Begins between SP of T3 and T4, crosses the 5th interspace laterally and follows the contour of rib 6 anteriorly

Question 21

LEFT LUNG

Position of superior lobe

Answer 21

It’s in contact with the upper part of the anterolateral wall

Question 22

LEFT LUNG

What is the costal surface of the inferior lobe in contact with

Answer 22

Posterior and inferior walls

Question 23

Extension of the anterior border of the lower part of the superior lobe

Answer 23

Lingula of left lung projects over heart bulge

Question 24

What does the medial surface of the left lung lie adjacent to

Answer 24

• Heart
• Aortic arch
• Thoracic aorta
• Oesophagus
• The left subclavian artery and vein arch over and are related to the superior lobe of the left lung as they pass over the dome of the cervical pleura and into the axilla

Question 25

Bronchial tree 1. Where does it extend from 2. Name of the lowest tracheal ring 3. What is the posterior wall of the trachea composed of

Answer 25

1. C6 - T4/5 2. Carina 3. Smooth muscle

Question 26

Difference between the right and left main bronchi

Answer 26

The right main bronchus is wider and takes a more vertical course through the root and hilum than the left main bronchus. Therefore, inhaled foreign bodies tend to lodge more frequently on the right side than on the left

Question 27

Division of bronchi

Answer 27

Main bronchus Lobar bronchi (supplying a lobe) Segmental bronchi (supplying bronchopulmonary segments)

Question 28

Within each bronchopulmonary segment, what do the segmental bronchi give rise to

Answer 28

Multiple generations of divisions and ultimately to bronchioles (which further subdivide and supply respiratory surfaces)

Question 29

What are the walls of the bronchi held open by

Answer 29

Discontinuous elongated plates of cartilage (not present in bronchioles)

Question 30

Bronchopulmonary segment

Answer 30

Area of lung supplied by a segmental bronchus and its accompanying pulmonary artery branch 10 in each lung Smallest functionally independent region of a lung and the smallest area of lung that can be isolated and removed without affecting adjacent regions

Question 31

What passes intersegmentally between and around the margins of segments

Answer 31

Tributaries of the pulmonary vein

Question 32

Pulmonary arteries

Answer 32

Question 33

Where does the bifurcation of the pulmonary trunk occur

Answer 33

To the left of the midline just inferior to T4/5 Anteroinferiorly to the left of the bifurcation of the trachea

Question 34

Path of the right pulmonary artery

Answer 34

Right pulmonary artery is longer and passes horizontally across the mediastinum * anteriorly and slightly inferiorly to the tracheal bifurcation and anteriorly to the right main bronchus, and * posteriorly to the ascending aorta, superior vena cava, and upper right pulmonary vein * Enters the root of the lung and gives off a large branch to the superior lobe of the lung * Continues through the hilum of the lung * Gives off a 2nd recurrent branch to the superior lobe * Then divides to supply the middle and inferior lobes

Question 35

Path of the left pulmonary artery

Answer 35

Shorter than the right and lies anterior to the descending aorta and posterior to the superior pulmonary vein Passes through the root and hilum and branches within lung

Question 36

Path of superior and inferior pulmonary veins

Answer 36

Begin at the hilum of the lung Pass through the root of the lung Immediately drain into the left atrium

Question 37

What do the bronchial arteries and veins constitute

Answer 37

The "nutritive" vascular system of the pulmonary tissues (bronchial walls and glands, walls of large vessels, visceral pleura) They interconnect within the lung with branches of the pulmonary arteries and veins

Question 38

Where do the bronchial arteries originate from

Answer 38

Thoracic aorta or one of its branches

Question 39

Origin of a single right bronchial artery

Answer 39

Normally arises from the 3rd posterior IC artery (but occasionally, it originates from the upper left bronchial artery)

Question 40

Origin of 2 left bronchial arteries

Answer 40

Directly from the anterior surface of the thoracic aorta - the superior left bronchial artery arises at T5 Inferior one inferior to left bronchus

Question 41

Where do the bronchial arteries run

Answer 41

On the posterior surfaces of the bronchi and ramify in the lungs to supply pulmonary tissues

Question 42

Where do the bronchial arteries drain into

Answer 42

Either the pulmonary veins or left atrium Into the azygos vein on the right or into the superior IC vein or hemiazygos vein on the left

Question 43

What are structures of the lung and visceral pleura supplied by

Answer 43

Visceral afferents and efferents distributed through the anterior pulmonary plexus and posterior pulmonary plexus

Question 44

Which is smaller - the anterior or posterior plexus

Answer 44

Anterior plexus

Question 45

Where do the ant and post plexuses originate from

Answer 45

Sympathetic trunks and vagus nerves

Question 46

Lymphatic drainage of the lungs

Answer 46

* Superficial, or subpleural, and deep lymphatics of the lung drain into lymph nodes called tracheobronchial nodes around the roots of lobar and main bronchi and along the sides of the trachea. As a group, these lymph nodes extend from within the lung, through the hilum and root, and into the posterior mediastinum * Efferent vessels from these nodes pass superiorly along the trachea to unite with similar vessels from parasternal nodes and brachiocephalic nodes, which are anterior to brachiocephalic veins in the superior mediastinum, to form the right and left bronchomediastinal trunks. These trunks drain directly into deep veins at the base of the neck, or may drain into the right lymphatic trunk or thoracic duct