Lungs and Pleura

Question 1

Label

Answer 1

Question 2

Miliary tuberculosis

Answer 2

Granulomas from mycobacterium tuberculosis

Question 3

Label

Answer 3

Question 4

Label

Answer 4

Question 5

Label

Answer 5

Question 6

Which primary bronchus is being described below?

Wider, shorter and runs more vertically

Answer 6

Right

Question 7

Which primary bronchus is being described below?

Passes inferior to the arch of the aorta and anterior to esophagus and thoracic aorta

Answer 7

Left

Question 8

The trachea bifurcates at the level of the ___________.

Answer 8

Sternal angle

Question 9

_____________ are several large lymph nodes inferior to the tracheal bifurcation.

Answer 9

Carinal lymph nodes

Question 10

From where do carinal lymph nodes receive afferents and to where do they send efferents?

Answer 10

Afferents: Bronchopulmonary nodes and the heart

Efferents: Superior tracheobronchial and tracheal nodes

Question 11

The deep part of the cardiac plexus is formed by which nerves?

Answer 11

• Cardiac nerves derived from the cervical ganglia of the sympathetic trunk
• Cardiac branches of the vagus and recurrent laryngeal nerves

Question 12

Where is the deep part of the cardiac plexus situated?

Answer 12

In front of the bifurcation of the trachea, above the point of division of the pulmonary artery, and behind the aortic arch

Question 13

Which cardiac nerves do not enter into the foramtion of the deep part of the cardiac plexus?

Answer 13

Superior cardiac nerve of the left sympathetic trunk

Lower of the two superior cervical cardiac branches from the left vagus nerve (which passes to the superficial part of the plexus)

Question 14

The _________ is a cartilaginous ridge in the sagittal plane of the trachea where it splits into the two primary bronchi.

Answer 14

Carina

NOTE: The carina is located on the internal surface at point of the tracheal bifurcation.

Question 15

Label

Answer 15

Question 16

A bronchopulmonary segments consists of :

Answer 16

The tertiary bronchus, the portion of lung it ventilates, and artery, and a vein.

NOTE: Each bronchopulmonary segment is a discrete anatomical and functional unit, and this separation means that a bronchopulmonary segment can be surgically removed without affecting the function of the others.

Question 17

Label

Answer 17

Question 18

The mesothelial lining of each hemithorax is dereived from ________________.

Answer 18

Embryonic coelomic lining

Question 19

Which of the two types of pleura is sensitive to pain?

Answer 19

The parietal pleura

Question 20

What is the function of the pleural cavity?

Answer 20

• Reduces friction
• Surface tension provides cohesion between lung and thoracic wall

Question 21

The pleural cavity is a potential space between ________ and _________ pleura.

Answer 21

Visceral; parietal

Question 22

The pleural cavity contains a capillary layer of serous fluid produced by ___________.

Answer 22

Mesoepithelium

Question 23

___________ is the serous membrane lining the pleural cavity on the superor surface of the diaphragm.

Answer 23

Diaphragmatic parietal pleura

Question 24

The diaphragmatic parietal pleura is continuous superiorly with the _______________ at the costodiaphragmatic reflection.

Answer 24

Costal parietal pleura

Question 25

The diaphragmatic parietal pleura is continuous superiorly with the _______________ at the inferomedial borders of the pleural cavities.

Answer 25

Mediastinal pleura

Question 26

\_\_\_\_\_\_\_\_\_\_\_\_\_ is the serous membrane lining the pleural cavity on the inner surfaces of the ribs, costal cartilges, and intercostal mm.

Answer 26

Costal pariteal pleura

Question 27

Which pleura is the the costal parietal pleura continuous with?

Answer 27

* **Anteriorly** with the **mediastinal parietal pleura** at the costomediastinal reflection * **Posteriorly** with the **mediastinal parietal pleura** at the vertebral bodies * **Inferiorly** with the **diaphragmatic parietal pleura** at the costodiaphragmatic reflection * **Superiorly** with the **cervical parietal pleura** at the level of the 1st rib

Question 29

The _________ is the serous membrane lining the pleural cavity which extends above the level of the 1st rib into the root of the neck.

Answer 29

Cupula

Question 30

The cupular pleura is continuous inferiorly with the ______ and __________ parietal pleura.

Answer 30

Costal; mediastinal

Question 31

The cupula is reinforced by a specialization of scalene fascia called \_\_\_\_\_\_\_\_\_\_\_\_.

Answer 31

Sibson's fascia

Question 32

The pericardium is a double-walled sac containing a _________ layer and a _________ layer.

Answer 32

**Serous (Internal)** * Consists of two layers: visceral and parietal **Fibrous (External)** * Encloses the heart and the roots of the great vessels

Question 33

What are the parasympathetic and sympathetic actions of the lungs?

Answer 33

**Parasympathetic** * Secretion of bronchial glands * Cotnraction of tracheal-bronchial musculature **Sympathetic** * Inhibits secretion of bronchial glands * Releaxes tracheal-brinchial musculature

Question 34

What nerves provide innervation to the pleura?

Answer 34

Costal parietal pleura- **intercostal nerve** Diapragmatic pleura- **phrenic nerve** Visceral pleura- NO INNERVATION

Question 35

What are the 4 recesses and where are they located?

Answer 35

**Costomediastinal recess** * Behind the sternum and costal cartilages **Costodiaphragmatic recess** * Between the diaphragm and chest wall **Phrenicomediastinal recess** * Between the diaphragm and mediastinum **Vertebromediastinal recess** * Between the vertebral bodies and mediastinum

Question 36

The costomediastinal recess is more pronounced on the ____ (left/right).

Answer 36

**Left** becuase this is where the heart is

Question 37

At the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, the parietal pleura is continuous with the visceral pleura.

Answer 37

Root of the lung

Question 38

The costal parietal pleura is separated from the thoracic wall by \_\_\_\_\_\_\_\_\_\_\_\_\_\_.

Answer 38

Endothoracic fascia

Question 39

What is a pneumothroax?

Answer 39

Prescence of free air or gas in the pleural cavity

Question 40

What are the types of pneumothorax?

Answer 40

Open (sucking) pneumothorax Tension pneumothorax Spontaneous pneumothorax

Question 41

What is an open pneumothorax?

Answer 41

An unsealed opening in the chest wall; when the opening is sufficiently large, respiratory mechanics are impaired.

Question 42

What is a tension pneumothorax?

Answer 42

accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart.

Question 43

What is a hemothorax?

Answer 43

Intrathoracic bleeding **NOTE:** There are numerous sources of potential bleends. A large hemothorax can result in in hypovolemic shock and restricted ipsilateral ventilation, contralateral mediastinal shift

Question 44

Malignant mesothelioma

Answer 44

* Neoplasm of pleural serosa * Linked to **asbestos exposure** * May be restricted to parietal pleura but can involve viscera pleura * Can lead to contracture of all structures in affected hemithorax

Question 45

Pleural effusion

Answer 45

* Accumulation of fluid in pleural space * Types: transudative vs. exudative effusion