Lungs and Pleura Flashcards
Thin, extrapleural layer of loose connective tissue
Forms a natural cleavage for the surgical operation of the costal pleura from the thoracic wall
Allows the thoracic surgeon to move and place instruments inside the thoracic wall yet remain outside, preventing infection of the pleural cavities
Endothoracic fascia
TRUE or FALSE
The pleura is vulnerable to injury during the first few years after birth
TRUE
The cervical pleura reaches a relatively higher level in infants and young children because of the shortness of their necks
TRUE or FALSE
The pleura is not in danger from an incision in the posterior abdominal wall
FALSE
Small areas of pleura exposed in the COSTOVERTEBRAL ANGLES inferomedial to the 12th ribs are posterior to the superior poles of the kidneys
‘Danger’ regions:
Infrasternal angle, right part
Costovertebral left and right
Presence of air in the pleural cavity
Pneumothorax
(G. pneuma)
What happens when
Sufficient amount of air enters the pleural cavity
Surface tension adhering visceral to parietal pleura (lung to thorax) is broken
Pleural cavity (normally a potential space) becomes a real space
Pulmonary collapse
Lung collapses because of its inherent elasticity (elastic recoil)
Laceration of a lung and its visceral pleura / penetration of the thoracic wall -> hemorrhage and escape of air into the pleural cavity
What happens when
there is a penenatrating wound of the parietal pleura or rupture of a lung from a bullet?
- Pneumothorax - entry of air; fractured ribs tear the parietal pleura
2. Hydrothrorax- accumulation of a significant amount of fluid (which resulted from pleural effusion - escape of fluid in the pleural cavity)
- Hemothorax - blood enters (injury to a major intercostal vessel than from laceration of a lung)
What condition
Lung surfaces become rough
There is inflammation of the pleura
- Pleural rub *(friction) is detected with a stethoscope
- Pleural adhesion -* adherence of inflamed surfaces of pleura (parietal and visceral)
Pleuritis (Pleurisy)
What is felt
In acute pleuritis, sharp, stabbing pain during exertion, when rate and depth of air are increased, even slightly
What is found in the hilum of the lung (medial surface of the lung)?
Hint: Structures which form the root of the lung
Main bronchus
Pulmonary vessels
Bronchial vessels
Lymphatic vessels
How many lobe has the
RIGHT lung has?
LEFT lung?
What divide the lungs into lobes?
3 lobes
2 lobes
Horizontal and oblique fissues
Identify structure
Thin, tongue-like process of the superior lobe of the left lung
Extends below the cardiac notch and slides in and out of the costomediastinal recess during inspiration and expiration
Lingula
(L. dim of lingua, tongue)
Identify structure
Most common “accessory lobe”
Appears in the right in approx. 1% of people
Azygos lobe
Azygos vein arches over the apex of the right lung and not over the right helium
Medial part of the apex isolated
Identify structure
These special cells remove carbon from the gas-exchanging surfaces and deposit it in the “nonactive” connective tissue (which supports the lung)
or
in lymph nodes reseiving lymph from the lungs
Dust cells (phagocytes)
What is auscultation and percussion of the lungs?
How is it done?
Auscultation - listening to sounds with a stethoscope
How? In auscultating the base of the lung, place te stet to the posterior thoracic wall at the level of the 10th thoracic vertebra. This is the inferoposterior part of the inferior lobe, not the diaphragmatic surface or anatomical base.
Percussion - tapping the chest over the lungs with the fingers to detect sounds in the apices of the lungs
TRUE or FALSE
- Diseased lungs filled with fluid, fetal lings and lungs from a stillborn infact float when placed in water
- The lungs of a liveborn infant who dies shortly after birth sinks
- False
- False
* Fresh healthy lungs contain some air*
What condition results in
- Paralysis of the hemidiaphragm
- Hoarseness from paralysis of a vocal fold (cord)
- *Lung cancer involving a phrenic nerve *
* 2. *Due to the intimate relationship of the recurrent laryngeal nerve to the apex of the lung
Which nerve passes anterior to the root of the lung? Posterior to the root of the lung?
Options:
Phrenic nerve
Vagus nerve (CN X)
Anterior: Phrenic
Posterior: Vagus (CN X)
TRUE or FALSE
The main bronchi (primary bronchi) pass superolaterally from the bifurcation of the trachea at the level of the sternal angle to the hila of the lungs
FALSE
Inferolaterally
The bronchi has what type of cartilage?
Hyaline (same as trachea)
The mucous membrane covering the carina is one of the most sensitive areas of the tracheobronchial tree. It is associated with what reflex?
Cough reflexe.g. When children aspirate a peanut, they choke and cough. Once the peanut passes the carina, coughing usually stops.Lung secretions pass to the carina and cause coughing, which helps to expel them.
Which bronchus is wider, shorter and running more vertically than the other one such that foreign bodies more likely enter and lodge in it?
Right bronchusDentists insert a thin rubber dam into the oral cavity–when performing a root canal.
IDENTIFY STRUCTURE
Cartilaginous projection of the last tracheal ring
Distorted, widened posteriorly and immobile when there is bronchogenic carcinoma
Carina
What chemical is released when there is inflammation of the bronchus (caused by substances released from peanut)?
Arachidic bronchitis
Collapse of the lung is called?
Atelectasis
Difficulty in breathing caused by a foreign body is called?
Dyspnea
Surgical resections are done when there are diseased segments of the bronchopulmonary (tumors, abscesses, collections of pus). What do you call the removal of a whole lung? a lobe? a bronchopulmonary segment?
PneumonectomyLobectomySegmentectomy
TRUE or FALSE
In the course of an asthmatic attack, more wheezing noises and breathing difficulties are experienced during air inspiration than expulsion
FALSE
What is pulmonary thromboembolism?
Hint: Thrombus is a blood clot and is a common cause of morbidity and mortality
Obstruction of a pulmonary artery by a thrombus (blood clot)HOW?Trauma from tibial fracture -> Thrombus/fat globule/air bubble in the leg vein -> Blood -> Pulmonary artery -> Right side of the heart -> Lung
Pulmonary Circulation
What is so special about the pulmonary artery?
It carries blood away from the heart to the lungsHeart -> LungsBut, DEOXYGENATED blood
Pulmonary Circulation
What is so special about the pulmonary vein?
It carries the blood back to the heartLung -> HeartBut, OXYGENATED blood
Pulmonary Circulation
What is the pathway of the blood (poorly oxygenated to oxygenated)?
Deoxygenated blood travels to inferior vena cava (from lower part of the body) and superior vena cava (upper part) -> Tricuspid valve -> Right ventricle -> Right and left pulmonary arteries -> Pulmonary capillaries (gas exchange - O2 and CO2) -> Pulmonary veins -> Left atrium of the heart -> Mitral valve -> Left ventricle -> Descending (to lower limbs) and ascending aorta (upper limb)
What happens during pleural adhesion?
Adhesion of parietal and visceral layers -> Drainage of lymphatic vessels in the lung and visceral pleura into the axillary lymph nodes
The left bronchial artery arise from?
Thoracic aorta
TRUE or FALSE
The right pulmonary artery passes under the arch of the aorta
The left pulmonary artery lies completely to the left of the arch
True
True
