Lungs & Pleura

Question 1

Endothoracic fascia

Answer 1

Thickens at rib 1
Allows for separation during surgery

Question 2

Sibson’s fascia

Answer 2

Thickening of endothoracic fascia above rib 1

Question 3

Right lung

Answer 3

3 lobes - upper, middle, lower
2 fissures - oblique and horizontal

Question 4

Left lung

Answer 4

2 lobes - upper and lower
1 fissure - oblique

Question 5

Oblique fissure

Answer 5

Divides upper and lower lobes

Question 6

Horizontal fissure

Answer 6

Divides upper and middle lobes

Question 7

Right lung impressions

Answer 7

Trachea
SVC
IVC
Cardiac
Esophagus

Question 8

Left lung impressions

Answer 8

Subclavian
Aorta
Cardiac impression

Question 9

Pleural reflections

Answer 9

Access pleural cavity without damaging lung
Lung: 6 (midclavicular) - 8 (midaxillary) - 10 (posterior vertebral)
Pleura: 8-10-12

Question 10

Segmentectomy

Answer 10

Veins at risk because runs in middle of bronchopulmonary segment

Question 11

Right main bronchus

Answer 11

More likely to obstruct as it is wider and more vertical

Question 12

Fluids entering pleural cavity

Answer 12

Pneumothorax - open or tension
Hydrothorax
Hemothorax
Hemopneumothorax
Pyothorax
Chylothorax

Question 13

Auscultation of lungs

Answer 13

Apex - superior middle third of clavicle
Superior lobe - 2nd ICS
Middle lobe - 4th ICS
Inferior lobe - 6th or 7th ICS

Question 14

Trachea bifurcation

Answer 14

Separated by carina

Question 15

Air conduction

Answer 15

Trachea - 1ary bronchi - 2ary bronchi - 3ary bronchi - bronchioles

Question 16

1ary bronchi

Answer 16

Main to lobes

Question 17

2ary bronchi

Answer 17

Lobar
Right upper lobar, bronchus intermedius (middle and lower)
Left upper lobar, left lower lobar

Question 18

Hilum

Answer 18

1 pulmonary artery, 2 pulmonary veins
Eparterial bronchus (right only)
Hypoarterial bronchus

Question 19

Embolism

Answer 19

Common site is pulmonary artery

Question 20

Lung innervation

Answer 20

Pulmonary plexus

Question 21

Lung lymphatic drainage

Answer 21

Superficial and deep lumbar plexus

Question 22

Lung blood supply

Answer 22

R & L bronchial arteries
R & L bronchial veins

Question 23

Right bronchial vein

Answer 23

Drains into azygos

Question 24

Left bronchial vein

Answer 24

Drains into accessory hemiazygos v

Question 25

Lingula

Answer 25

Extension of superior left lobe

Question 26

Parietal pleura

Answer 26

Cervical - apex of lungs Costal - internal surface of thoracic Mediastinal - medially, lateral sides of mediastinum Diaphragmatic

Question 27

Pulmonary ligament

Answer 27

Junction between parietal and visceral pleura

Question 28

Innervation of parietal pleural

Answer 28

IC n and phrenic nerve

Question 29

Vulnerable pleural sites

Answer 29

Cervical pleura, r. infrasternal angle, costovertebral angles

Question 30

Open pneumothorax

Answer 30

Air can escape, collapse of lung

Question 31

Tension pneumothorax

Answer 31

Air builds up, shifts mediastinum, collapse of lung

Question 32

Bronchopulmonary segement

Answer 32

Discrete unit 2 veins, 1 artery in centee

Question 33

Right bronchial artery

Answer 33

Comes off thoracic aorta

Question 34

Left bronchial artery

Answer 34

Comes off thoracic aorta

Question 35

Right bronchial vein

Answer 35

Drains into azygos vein

Question 36

Left bronchial vein

Answer 36

Drains into accessory hemiazygos vein

Question 37

Right horizontal fissure

Answer 37

4th rib

Question 38

Right oblique fissure

Answer 38

4th rib posteriorly, 6th rib anteriorly

Question 39

Left oblique fissure

Answer 39

4th rib posteriorly, 6th rib anteriorly

Question 40

Order of lymph drainage

Answer 40

Paratracheal nodes - trachea Superior tracheobronchial nodes - junction of bronchi and trachea Bronchopulmonary (hilar) nodes - primary bronchi Pulmonary nodes - secondary bronchi