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Anatomy of thorax > Lungs and pleura > Flashcards

Lungs and pleura Flashcards

1
Q

How many lobes does the right lung have

A

3

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2
Q

How many lobes does the left lung have

A

2

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3
Q

Where does the horizontal fissure (right lung) run

A

From T3 vertebra posteriorly to rib 6 anteriorly

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4
Q

Where does the oblique fissure run

A

From rib 4 to horizontal fissure

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5
Q

What are the surfaces of the lungs

A

Cervical surface (top)
Mediastinal surface
Diaphragmatic surface
Costal surface (side)

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6
Q

What are pleural reflections

A

The lines along which the parietal pleura changes direction from one wall of pleural cavity to another

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7
Q

What are the names of the pleural reflections

A

Sternaline line of pleural reflection
Vertebral line of pleural reflection
Costal line of pleural reflection

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8
Q

What is the sternaline line of pleural reflection

A

When the costal pleura changes into mediastinal pleura ANTERIORLY

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9
Q

What is the vertebral line of pleural reflection

A

When the costal pleura changes into mediastinal pleura POSTERIORLY

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10
Q

What is the costal line of pleural reflection

A

When costal pleura changes into diaphragmatic pleura

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11
Q

How does the right lung compare to the left lung and why

A

Right lung is larger and heavier than the L but shorter and wider because right dome of diaphragm is higher and heart and pericardium bulge to the left

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12
Q

Which dome of the diaphragm is higher

A

Right

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13
Q

What is the surface anatomy of the visceral pleura

A

2-4-6-8-10

Reflections closest at plane of sternal angle (rib 2)
Parallel down to rib 4
L indented by cardiac notch but right continues down to cc6
Cross rib 8 at midaxillary line
Cross rib 10 at lateral border of erector spinae

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14
Q

What is the surface anatomy of the parietal pleura

A

2-4-6-8-10-12

Asymmetry and close behind sternal angle (rib 2)
Parallel down to rib 4
L indented but R continues down to cc6
Rib 8 at midclavicular line
Rib 10 at midaxillary line
Rib 12 at lateral border of erector spinae mm

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15
Q

Which bronchus is more vertical and wider and so therefore where are foreign objects more likely to enter

A

R

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16
Q

What do secondary bronchi supply

A

Lobes

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17
Q

What do tertiary bronchi supply

A

Segments

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18
Q

How many segments does the right lung have

A

10

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19
Q

How many segments does the left lung have

A

8

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20
Q

Where does fluid typically accumulate in the lung if the patient is lying on their back for extended periods of time

A

Apical and posterior segments of the inferior lobe (both lungs)

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21
Q

What are the borders of the lung

A

Anterior
Posterior
Inferior

22
Q

What is the anterior border of the lung

A

Where costal and mediastinal surfaces meet anteriorly

23
Q

What is the posterior border of the lung

A

Where costal and mediastinal surfaces meet posteriorly

24
Q

What is the inferior border of the lung

A

Separates diaphragmatic surface from costal and mediastinal surfaces

25
Q

How is blood supplied to the lung

A

Pulmonary trunk –> Lobar artery –> segmental artery to each bronchopulmonary segment

26
Q

What do bronchial arteries supply

A

Blood to structures comprising the;
Roots of the lungs
Supporting tissues of lungs
Visceral pleura

27
Q

What drains the visceral pleura

A

pulmonary veins

28
Q

What supplies the parietal pleura

A

Intercostal arteries

29
Q

How are lungs drained

A

Pulmonary veins

30
Q

How are adjacent bronchopulmonary segments drained

A

Intersegmental veins which then turn into superior pulmonary veins or inferior pulmonary veins

31
Q

Where do the pulmonary veins drain

A

Right atrium

32
Q

What is the role of the bronchial veins

A

drain part of the blood supplied to the lungs by the bronchial arteries

33
Q

What do the bronchial arteries supply

A

Visceral pleura of lungs, connective tissue of lungs, bronchi and oesophagus

34
Q

Difference between pulmonary arteries and bronchial arteries

A

Pulmonary arteries supply deoxygenated blood pumped from the right ventricle

Bronchial arteries supply oxygenated blood pumped from the left ventricle

35
Q

Where does the right bronchial vein drain into

A

Azygos vein

36
Q

Where does the left bronchial vein drain into

A

Accessory hemi-azygos vein

Left superior intercostal vein (which then goes to left brachiocephalic vein)

37
Q

Where does lymphatic fluid from the lung tissue and visceral pleura drain into (sequence of events)

A

1- Superficial lymph plexus
2- bronchopulmonary (hilar) lymph nodes
3- inferior and superior tracheobronchial lymph nodes
4ai) Right bronchomediastinal lymph trunks
aii- right lymph trunk (along with other lymph trunks)
aiii- Terminate at venous angle
4bi)Left bronchomediastinal lymph trunks
bii- terminates at thoracic duct
biii- Terminates at venous angle

38
Q

Where does lymph from structures that form the root of the lung drain into

A

1) Deep lymph plexus
2) Pulmonary lymph nodes
3) these drain into bronchopulmonary (hilar) lymph nodes
4) Then follow same course as lymph fluid from lung tissue and visceral pleura

39
Q

Where does lymph from parietal pleura drain into

A

Lymph nodes of thoracic wall (intercostal, parasternal, mediastinal, and phrenic)

40
Q

Where does lymph from cervical pleura drain into

A

Axillary lymph nodes

41
Q

What is pleuritis and how is it presented

A

Inflammation of pleura so lung surfaces rub. Can be heard with stethoscope.

Presented with sharp, stabbing pain when there is increased exertion (ie climbing stairs)

42
Q

When does pulmonary collapse occur

A

When there is too much air in the pleural cavity

43
Q

Which structures are affected in pulmonary collapse and how

A
  • Lung
  • Diaphragm is elevated in elevated side
  • Mediastinum shifts away (can tell because trachea is displaced)
  • ICS narrowing
  • Pleural sacs are separate so they don’t affect one another
44
Q

Which pleura is insensitive to pain and why

A

Visceral pleura because its innervation is autonomous (vagus nerve and sympathetic fibres)

45
Q

What is the visceral pleura innervated by

A

Vagus nerve and sympathetic fibres

46
Q

What pleura is sensitive to pain and why

A

Parietal pleura

47
Q

What is the parietal pleura innervated by

A

Intercostal nerves and phrenic nerve

48
Q

Which part of the parietal pleura is particularly sensitive to pain

A

Costal pleura

49
Q

If there is irritation of the costal and peripheral parts of diaphragmatic pleura, where would there be pain

A

Local pain and referred pain along intercostal nerves to thoracic and abdominal walls

50
Q

If there is irritation of mediastinal and central diaphragmatic areas of parietal pleura, where would there be pain

A

Pain in root of neck and over the shoulder

51
Q

What are the common pneumonia sites in the lung of patients that are confined to bed

A

Apical and posterior segments of the inferior lobe

Anatomy of thorax (7 decks)

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