Lungs & Pleura Flashcards
Surface anatomy of lungs: lung borders + pleural reflection lines
MCL = 6th + 8th ribs MAL = 8th + 10th MSL = 10th + 12th
Surface anatomy of lungs: oblique fissure
Post. midline, near spine of T4 Lat. in downward direction Crosses 4th + 5th ICS Reaches 6th rib + follows curve
Surface anatomy of lungs: horizontal fissure
Ant. follows curve of 4th rib Meets oblique in MAL
Surface anatomy of lungs: apex, anterior borders (L+R), inferior border + posterior border
Apex = 2.5 cm above medial 2 thirds of clavicle Ant. (R) = apex, sternoclavicular joint, sternal angle, midline, xiphisternal joint Ant. (L) = same, turns lat. at 4th cartilage to form notch + returns to 6th cartilage Inf. = sternum to MAL Post. = C7-T10, 4cm from midline
Pulmonary/pleural cavities
Either side of mediastinum Separate Btw. visceral + parietal pleura
Visceral + parietal pleura: what it covers
Visceral = lung + contnuous with parietal at hilum Parietal = wall of cavity
Parietal pleura: subdivisions
Costal Cervical Mediastinal Diaphragmatic
Mediastinal pleura
Mediastinum Cont. with visceral
Diaphragmatic pleura
Sup. surface diaphragm
Costal pleura
Cartilages, ICSs + post. surface sternum
Cervical pleura
Apex of lung Continuation of costal + mediastinal Suprapleural membrane - reinforces + attaches to int. border of 1st rib & transverse process of C7
Pleural reflection lines
Sternal/ant. = costal + mediastinal ant. Costal/inf. = costal + diaphragmatic inf. Verterbal/post. = costal + mediastinal post.
Pleural recesses
Lungs do not fill ant./post. inferior regions of cavity 2 layers of parietal = opposed Expansion in forced inspiration + space for fluid Costomediastinal = btw. cardiac notch + ant. line Costodiaphragmatic = btw. lower border of lung + inf. line
Innervation of lungs
Pulmonary plexuses = ant. + post. - root of lung Parasympathetic = vagus - constriction Sympathetic = trunks - dilation
Innervation of parietal pleura
IC nerves = costal + peripheral diaphragmatic Phrenic = diaphragmatic + mediastinal
Blood supply + venous drainage of parietal pleura
IC vessels ITA Musculophrenic a. Accompanying veins
Blood supply + venous drainage of visceral pleura
Bronchial a. Subpleural + intersegmental v. to pulmonary v.
Pulmonary arteries: function
Deoxy. blood to lungs, from RV
Pulmonary veins: function
Oxy. blood from lungs to LA
Which lung is larger and why?
Right
Middle mediastinum (heart) bulges more to left
Base of lung
On diaphragm
Apex of lung
Above rib 1 + into root of neck
Costal surface of lungs
Adj. to ribs + ICSs
Mediastinal surface of lungs
Against mediastinum ant. + vertebral column post.
Contains hilum
Inferior border vs. anterior & posterior borders of lung
Inf. = sharp + separates base from costal
Ant. + post. = smooth + rounded, separate costal from mediastinal
Left lung: structure
Long + narrow
2 lobes, oblique
Inf. portion of med. surface = notched
Lingula = inf. projection of sup. lobe, above bulge
Left lung: impressions
Aortic arch
Descending aorta
Cardiac impression
Right lung: structure
Short + wide
3 lobes
Oblique = inf. from sup. + middle
Horz. = sup. from middle
Right lung: impressions
Azygous arch
SVC
IVC
Impressions on both lungs
Oesophagus
Trachea
1st rib
Brachiocephalic vein
Root of lung: postition
Opposite T5-T7
Root of lung: anterior relations
Phrenic n.
Pericardiophrenic a. + v.
Ant. pulmonary plexus
SVC (R)
RA (R)
Aortic arch (L)
Root of lung: inferior relations
Pulmonary ligament
Root of lung: superior relations
Aortic arch (L)
Branch of azygous (R)
Root of lung: posterior relations
Vagus n.
Post. pulmonary plexus
Oesophagus (R)
Descending aorta (L)
Bronchial tree: structure
Trachea = trunk
T4/T5 = bifurcation - 2 primary bronchi
Main bronchus enters root + passes through hilum
Trachea, primary, secondary/lobar, tertiary/segmental, terminal bronchioles, respiratory bronchioles, alveolar ducts, sacs, alveoli
Right bronchus vs. left bronchus
Right = wider, shorter + more vertical
Bronchopulmonary segment
Area supplied by segmental bronchus + pulmonary a. branch
10 in each lung, sep. connective tissue
Smallest, functionally independent region, can be isolated + removed
Pathology of bronchial tree
Object = more likely to travel down right bronchus
Upright = B10 segment
Supine = B6 segment
Root of right lung
Most ant. + inf = pulmonary v.
Central = pulmonary a.
Post. + most sup. = primary bronchus
Root of left lung
Most ant. + inf. = pulmonary v.
Central + most sup. = pulmonary a.
Post. = primary bronchus
Blood supply of lungs
Systemic:
*3rd post. IC a. + descending aorta, right bronchial a
*descending aorta, 2 left bronchial a.
*bronchi, respiratory bronchioles + visceral pleura
Pulmonary:
*pulmonary trunk, pulmonary a. (L + R)
*rest of lung + alveoli
Venous drainage of lungs
Bronchi, respiratory bronchioles + pleura:
*bronchial v.
*right bronchial v. - azygous
*left - hemi-azygous/sup. IC v.
Lung tissue + alveoli:
*pulmonary capillaries
*unite, pulmonary v.
*oxy blood to LA
