Lungs & Pleura Flashcards
Endothoracic fascia
Thickens at rib 1
Allows for separation during surgery
Sibson’s fascia
Thickening of endothoracic fascia above rib 1
Right lung
3 lobes - upper, middle, lower
2 fissures - oblique and horizontal
Left lung
2 lobes - upper and lower
1 fissure - oblique
Oblique fissure
Divides upper and lower lobes
Horizontal fissure
Divides upper and middle lobes
Right lung impressions
Trachea
SVC
IVC
Cardiac
Esophagus
Left lung impressions
Subclavian
Aorta
Cardiac impression
Pleural reflections
Access pleural cavity without damaging lung
Lung: 6 (midclavicular) - 8 (midaxillary) - 10 (posterior vertebral)
Pleura: 8-10-12
Segmentectomy
Veins at risk because runs in middle of bronchopulmonary segment
Right main bronchus
More likely to obstruct as it is wider and more vertical
Fluids entering pleural cavity
Pneumothorax - open or tension
Hydrothorax
Hemothorax
Hemopneumothorax
Pyothorax
Chylothorax
Auscultation of lungs
Apex - superior middle third of clavicle
Superior lobe - 2nd ICS
Middle lobe - 4th ICS
Inferior lobe - 6th or 7th ICS
Trachea bifurcation
Separated by carina
Air conduction
Trachea - 1ary bronchi - 2ary bronchi - 3ary bronchi - bronchioles
1ary bronchi
Main to lobes
2ary bronchi
Lobar
Right upper lobar, bronchus intermedius (middle and lower)
Left upper lobar, left lower lobar
Hilum
1 pulmonary artery, 2 pulmonary veins
Eparterial bronchus (right only)
Hypoarterial bronchus
Embolism
Common site is pulmonary artery
Lung innervation
Pulmonary plexus
Lung lymphatic drainage
Superficial and deep lumbar plexus
Lung blood supply
R & L bronchial arteries
R & L bronchial veins
Right bronchial vein
Drains into azygos
Left bronchial vein
Drains into accessory hemiazygos v
Lingula
Extension of superior left lobe
Parietal pleura
Cervical - apex of lungs
Costal - internal surface of thoracic
Mediastinal - medially, lateral sides of mediastinum
Diaphragmatic
Pulmonary ligament
Junction between parietal and visceral pleura
Innervation of parietal pleural
IC n and phrenic nerve
Vulnerable pleural sites
Cervical pleura, r. infrasternal angle, costovertebral angles
Open pneumothorax
Air can escape, collapse of lung
Tension pneumothorax
Air builds up, shifts mediastinum, collapse of lung
Bronchopulmonary segement
Discrete unit
2 veins, 1 artery in centee
Right bronchial artery
Comes off thoracic aorta
Left bronchial artery
Comes off thoracic aorta
Right bronchial vein
Drains into azygos vein
Left bronchial vein
Drains into accessory hemiazygos vein
Right horizontal fissure
4th rib
Right oblique fissure
4th rib posteriorly, 6th rib anteriorly
Left oblique fissure
4th rib posteriorly, 6th rib anteriorly
Order of lymph drainage
Paratracheal nodes - trachea
Superior tracheobronchial nodes - junction of bronchi and trachea
Bronchopulmonary (hilar) nodes - primary bronchi
Pulmonary nodes - secondary bronchi
