Lungs and Pleura Flashcards
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Miliary tuberculosis
Granulomas from mycobacterium tuberculosis
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Which primary bronchus is being described below?
Wider, shorter and runs more vertically
Right
Which primary bronchus is being described below?
Passes inferior to the arch of the aorta and anterior to esophagus and thoracic aorta
Left
The trachea bifurcates at the level of the ___________.
Sternal angle
_____________ are several large lymph nodes inferior to the tracheal bifurcation.
Carinal lymph nodes
From where do carinal lymph nodes receive afferents and to where do they send efferents?
Afferents: Bronchopulmonary nodes and the heart
Efferents: Superior tracheobronchial and tracheal nodes
The deep part of the cardiac plexus is formed by which nerves?
- Cardiac nerves derived from the cervical ganglia of the sympathetic trunk
- Cardiac branches of the vagus and recurrent laryngeal nerves
Where is the deep part of the cardiac plexus situated?
In front of the bifurcation of the trachea, above the point of division of the pulmonary artery, and behind the aortic arch
Which cardiac nerves do not enter into the foramtion of the deep part of the cardiac plexus?
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)
The _________ is a cartilaginous ridge in the sagittal plane of the trachea where it splits into the two primary bronchi.
Carina
NOTE: The carina is located on the internal surface at point of the tracheal bifurcation.
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A bronchopulmonary segments consists of :
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.
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The mesothelial lining of each hemithorax is dereived from ________________.
Embryonic coelomic lining
Which of the two types of pleura is sensitive to pain?
The parietal pleura
What is the function of the pleural cavity?
- Reduces friction
- Surface tension provides cohesion between lung and thoracic wall
The pleural cavity is a potential space between ________ and _________ pleura.
Visceral; parietal
The pleural cavity contains a capillary layer of serous fluid produced by ___________.
Mesoepithelium
___________ is the serous membrane lining the pleural cavity on the superor surface of the diaphragm.
Diaphragmatic parietal pleura
The diaphragmatic parietal pleura is continuous superiorly with the _______________ at the costodiaphragmatic reflection.
Costal parietal pleura
The diaphragmatic parietal pleura is continuous superiorly with the _______________ at the inferomedial borders of the pleural cavities.
Mediastinal pleura
_____________ is the serous membrane lining the pleural cavity on the inner surfaces of the ribs, costal cartilges, and intercostal mm.
Costal pariteal pleura
Which pleura is the the costal parietal pleura continuous with?
- 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
The _________ is the serous membrane lining the pleural cavity which extends above the level of the 1st rib into the root of the neck.
Cupula
The cupular pleura is continuous inferiorly with the ______ and __________ parietal pleura.
Costal; mediastinal
The cupula is reinforced by a specialization of scalene fascia called ____________.
Sibson’s fascia
The pericardium is a double-walled sac containing a _________ layer and a _________ layer.
Serous (Internal)
- Consists of two layers: visceral and parietal
Fibrous (External)
- Encloses the heart and the roots of the great vessels
What are the parasympathetic and sympathetic actions of the lungs?
Parasympathetic
- Secretion of bronchial glands
- Cotnraction of tracheal-bronchial musculature
Sympathetic
- Inhibits secretion of bronchial glands
- Releaxes tracheal-brinchial musculature
What nerves provide innervation to the pleura?
Costal parietal pleura- intercostal nerve
Diapragmatic pleura- phrenic nerve
Visceral pleura- NO INNERVATION
What are the 4 recesses and where are they located?
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
The costomediastinal recess is more pronounced on the ____ (left/right).
Left becuase this is where the heart is
At the _______________, the parietal pleura is continuous with the visceral pleura.
Root of the lung
The costal parietal pleura is separated from the thoracic wall by ______________.
Endothoracic fascia
What is a pneumothroax?
Prescence of free air or gas in the pleural cavity
What are the types of pneumothorax?
Open (sucking) pneumothorax
Tension pneumothorax
Spontaneous pneumothorax
What is an open pneumothorax?
An unsealed opening in the chest wall; when the opening is sufficiently large, respiratory mechanics are impaired.
What is a tension pneumothorax?
accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart.
What is a hemothorax?
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
Malignant mesothelioma
- 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
Pleural effusion
- Accumulation of fluid in pleural space
- Types: transudative vs. exudative effusion
