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[PBR] Pulmo Imaging > Normal Lung Anatomy > Flashcards

Normal Lung Anatomy Flashcards

1
Q

Tracheal rings are completed posteriorly by a flat band of muscle and connective tissue called

A

Posterior tracheal membrane

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2
Q

Left lateral wall of the distal trachea is indented by

A

Transverse portion of aortic arch

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3
Q

Length of trachea im adults

A

12 cm

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4
Q

Normal coronal diameter of trachea in men

A

25 mm

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5
Q

Normal coronal diameter of trachea in women

A

21 mm

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6
Q

Normal coronal to sagittal diameter ratio of trachea

A

0.6:1.0

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7
Q

Narrowing of the coronal diameter of trachea is termed _____ seen in patients with chronic obstructive pulmonary disease

A

Saber sheath trachea

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8
Q

Superior limit of trachea

A

Cricoid cartilage

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9
Q

Inferior border of trachea

A

Main bronchi

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10
Q

Interface of the rigt upper lobe with the right lateral tracheal wall is called

A

Right paratracheal stripe

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11
Q

The right paratracheal stripe should not exceed ____ in thickness

A

4mm

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12
Q

Tracheoesophageal stripe should not exceed ____mm

A

5mm

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13
Q

Thickening of tracheoesophageal stripe is commonly seen with

A

Esophageal carcinoma

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14
Q

Bronchus with more obtuse angle with the long axis of trachea

A

Right

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15
Q

Longer bronchus with length of 5cm

A

Left

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16
Q

Short bronchus with length of 2.2 cm

A

Right

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17
Q

1-3 mm airways are called

A

Bronchioles

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18
Q

Bronchioles bearing alveoli on their walls are termed

A

Respiratory bronchioles

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19
Q

The airway just before the first respiratory bronchiole is the

A

Terminal bronchiole

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20
Q

Smallest bronchiole without respiratory exchange structures

A

Terminal bronchiole

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21
Q

In average, total of ____ to _____ generations are found between the trachea and alveoli

A

21-25

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22
Q

Invaginations of the visceral pleura. Divides the lungs

A

Interlobar fissure

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23
Q

Upper lobe bronchus and its artery arise from _____, branch into 3 segmental branches: anterior, apical and posterior

A

Truncus anterior

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24
Q

Middle lobe bronchus arises from the

A

Intermediate bronchus

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25
Q

Blood supply of the middle lobe is from

A

Branch of right interlobar pulmonary artery

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26
Q

Right lower lobe is supplied by the RLL bronchus and _____

A

pulmonary artery

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27
Q

Gas exchanging units of the lung

A

Alveolar ducts and alveolar sacs

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28
Q

Minor fissure projects at what rib level

A

Right 4th rib

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29
Q

Most common accessory fissure that is found in approx 10-20 % of individuals

A

Inferior accessory fissure

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30
Q

Invagination of the right apical pleura by the azygos vein

A

Azygos fissure

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31
Q

Separates the superior segment from the basal segments of the lower lobe

A

Superior accessory fissure

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32
Q

Sheet of connective tissue that extends from the hilum superiorly to a level at or just above the hemidiaphragm. Contains inferior pulmonary vein superiorly and a variable number of lymph nodes

A

Inferior pulmonary ligament

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33
Q

Pulmonary arteries arises from the

A

Right ventricle

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34
Q

Direct continuation of the main pulmonary artery

A

Left pulmonary artery

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35
Q

Hypoarterial

A

Left hilar bronchus

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36
Q

Eparterial

A

Right main bronchus

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37
Q

Primary nutrient vessels of the lung

A

Bronchial arteries

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38
Q

Supplies bronchial walls to the level of terminal bronchioles, tracheal wall, middle third of the esophagus, visceral pleura, mediastinal lymph nodes, vagus nerve, pericardium and thymus

A

Bronchial arteries

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39
Q

Bronchial arteries usually arise from the

A

Proximal descending thoracic aorta at the level of carina

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40
Q

Arises from the posterolateral wall of aorta in common with an intercostal artery as an intercostobronchial trunk

A

Right bronchial artery

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41
Q

Arise individually from the anterolateral aorta or rarely from an intercostal artery

A

Left bronchial arteries

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42
Q

Approximately 2/3 of the blood from bronchial arterial system returns to the pulmonary venous system via

A

Bronchial veins

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43
Q

Arise within the interlobular septa from the alveolar and visceral pleural capillaries

A

Pulmonary veins

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44
Q

2 major lymphatic pathways in the lung and pleura

A

Visceral pleural lymphatics

Parenchymal lymphatics

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45
Q

The perivenous lymphatics and their surrounding connective tissue when distended by fluid account for the radiographic appearance ofs

A

Kerley A lines

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46
Q

Scaffolding of the lung and as such provides support for the airways and pulmonary vessels

A

Pulmonary interstitium

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47
Q

Interstitial compartment that extends from the mediastinum and envelopes the bronchovascular bundles is termed the

A

Axial interstitium

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48
Q

The axial fiber system continues distally as the _____ along with the arterioles, capillaries and bronchioles to provide support for the air-exchanging portions of the lung

A

Centrilobular interstitium

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49
Q

Parts of the peripheral interstitium which divides secondary pulmonary

A

Subpleural interstitium and interlobulat septa

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50
Q

Edema involving the axial interstitium is recognized radiographically as

A

Peribronchial cuffing

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51
Q

Radiographically, edema of the peripheral and subpleural interstitum accounts for _____ lines or interlobular lines on HRCT and thickened fissures on chest radiograph

A

Kerley B lines

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52
Q

The upper ribs have smooth superior and inferior cortical margins while the middle and lower ribs have flanged inferior cortices where the ______ run

A

Intercostal neurovascular bundles

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53
Q

Cervical ribs are identified in 2% of individuals and may be associated with symptoms of

A

Thoracic outlet syndrome

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54
Q

Reflects contact of the anterosuperior aspect of the upper lobes

A

Retrosternal airspace

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55
Q

On frontal radiographs, the _______ line is seen as a thin vertical line that overlies the thoracic spine. It is the inferior extension of upper lobe reflections off the innominate veins

A

Anterior junction line

56
Q

Radiolucent region representing contact of the posterosuperior portions of the upper lobes

A

Retrotracheal triangle

57
Q

Vertically oriented in the midline that extends from upper thoracic spine to level of azygos and aortic arches

A

Posterior junction line

58
Q

Convexity of the superior third of the azygoesophageal recess interface should suggest

A

Subcarinal lymph node enlargement or mass

59
Q

The azygoesophageal recess, while normally straight or concave, the middle 3rd may have slight rightward convexity at the level of

A

Right inferior pulmonary veins

Or as a result of the confluence of right pulmonary veins or right border of left atrium

60
Q

Left atrial dilatation will enlarge and laterally displace this interface, producing a double-density interface composed of right lateral borders of both right and left atria

A

Azygoesophageal recess

61
Q

Convexity of the inferior third of the ______ recess is most commonly due to a sliding hiatal hernia

A

Azygoesophageal recess

62
Q

Straight, vertical interface extending the length of the right hemithorax and represents contact of the right lung with a small amount of tissue lateral to the thoracic spine

A

Paraspinal interface

63
Q

Individuals with pectus excavatum have leftward cardiac displacement and may not demonstrate the _____ interface

A

Paraspinal

64
Q

In the uppermost portion of the left mediastinum, one or more interfaces may be recognized cephalad to the aortic arch. The interface most often visualized is the

A

Subclavian artery

65
Q

Aortic nipple represents the _____ vein as it arches anteriorly from its paraspinal position around the aortic arch to drain into posterior aspect of left innominate vein

A

Superior intercostal vein

66
Q

Aortic nipple normally measures

A

<5mm

67
Q

This interface enlarges with elevation of right atrial pressure or with congenital or acquired obstruction of venous return to the right heart

A

Aortic arch

68
Q

Immediately inferior to the aortic arch, the left upper lobe contacts the mediastinum to produce the ______ interface

A

Aortopulmonary window

69
Q

Immediately inferior to the aortopulmonary window is the left lateral border of the _____ artery

A

Main pulmonary artery

70
Q

Enlargement of this interface/structure is seen in idiopathic condition in young women, as a result of post stenotic dilatation in valvular pulmonic stenosis, left to right intracardiac shunts

A

Main pulmonary artery

71
Q

Reflection of left lower lobe with the esophagus anterior to the descending aorta, extending vertically from the undersurface of the aortic knob

A

Preaortic recess interface

72
Q

Represents the reflection of the left lung off the paraspinal soft tissues, which largely consist of fat but also contain the sympathetic chain, proximal intercostal vessels, intercostal lymph nodes and hemiazygos and accessory hemiazygos veins

A

Left paraspinal interface

73
Q

Etched in black (negative Mach effect)

A

Preaortic recess

74
Q

Etched in white (postitive Mach effect)

A

Left paraspinal interface

75
Q

Neurogenic tumors, hematoma, paraspinal abscess, lipomatosis and medial pleural effusion can cause lateral displacement of this interface

A

Left paraspinal interface

76
Q

Forms a concave interface immediately below the MPA. Straigtening or convexity of this interface used to be seen commonly in rheumatic mitral valve disease but may be seen in patients with left atrial enlargement of any cause

A

Left atrial appendage

77
Q

Comprises most of the left heart border

A

Left ventricle

78
Q

_______ fat pad is usually unilateral or more prominent on the left and is most often seen in obese patients and those on corticosteroids

A

Epipericardial fat pad

79
Q

Apex of the right hemidiaphragm typically lies at the level of ____ rib

A

6th anterior rib

80
Q

Bordered by the posterior border of trachea/esophagus, anterior border of spine and top of aortic arch

A

Retrotracheal (or Raider) triangle

81
Q

Inferiorly the left lung may be excluded from contracting the anteromedial chest wall by a round or triangular opacity which represents the cardiac apex and adjacent extrapleural fat. This impression on the anterior surface of the lingular has been termed

A

Cardiac incisura

82
Q

Represent pericardial layers between the epicardial and pericardial fat. Nodularity or thickness >2.0 mm suggests disease or effusion

A

Anterior pericardium

83
Q

More vertically oriented lung fissure

A

Left major fissure

84
Q

Narrow, vertically oriented structure that resides between the medial parieral pleural layers of the lungs. Contains central cardiovascular, tracheobronchual structures and esophagus enveloped in fat with intermixed lymph nodes

A

Mediastinum

85
Q

Contents of thoracic inlet

A 
Thymus
Confluence of right and left IJV and subclavian veins
Right and left carotid arteries
Right and left subclavian arteries
Trachea
Esophagus
Prevertebral fascia
Phrenic, vagus, recurrent laryngeal nerves
Muscles
86
Q

Contents of the anterior mediastinum

A

Internal mammary vessels
Internal mammary and prevascular lymph nodes
Thymus

87
Q

Contents of middle mediastinum

A

Heart and pericardium
Ascending and transverse aorta
Main and proximal right and left pulmonary arteries
Confluence of pulmonary veins
Superior and inferior vena cava
Trachea and main bronchi
Lymph nodes and fat within mediastinal spaces

88
Q

Contents of posterior mediastinum

A 
Descending aorta
Esophagus
Azygos and hemiazygos veins
Thoracic duct
Sympathetic ganglia and intercostal nerves
Lymph nodes
89
Q

Triangular or bilobed structure that is maximal in size at puberty and then undergoes gradual fatty involution

A

Thymus

90
Q

Thymus is predominantly fatty with little or no intermixed glandular (soft tissue) component at what age

A

35 years

91
Q

Anatomic route for routine transcervical mediastinoscopy

A

Pretracheal space

92
Q

This space containes fat, lymph nodes, ligamentum arteriosum and left recurrent laryngeal nerve

A

Aortopulmonary window

93
Q

Azygos vein is seen on what side

A

Right

94
Q

Hemiazygos vein is seen on what side

A

Left

95
Q

Represents the junction of the lung with the mediastinum and is composed of upper lobe pulmonary veins and branches of the pulmonary artery and corresponding bronchi

A

Hilum

96
Q

The shape of the right hilum on frontal radiographs has been likened to a sideways V, with the opening pointing rightward. The upper portion of V is composed primarily of

A

Truncus anterior and posterior division of right superior pulmonary vein

97
Q

Forms the lower half of V of the right hilum

A

Right interlobar artery

98
Q

Upper portion of the right hilum is composed of the

A

Right superior pulmonary vein, truncus anterior division of RPA and right upper lobe bronchus

99
Q

It courses vertically, anterolateral to the truncus anterior

A

RUL pulmonary vein

100
Q

The lower portion of the right hilum is composed of _______ laterally, and _______ medially

A 
Right descending (interlobar) pulmonary artery laterally, 
Bronchus intermedius and proximal RLL bronchus medially
101
Q

Upper left hilar shadow is composed centrally of the

A

Distal left main pulmonary artery

102
Q

Forms the lower portion of the left hilar shadow as it descends behind the left heart

A

Descending aorta

103
Q

The left superior pulmonary vein courses _______ to the left pulmonary artery

A

Anteriorly

104
Q

On fronral radiographs, ______ comprise the predominant portion of the hilar opacity

A

Right and left pulmonary arteries

105
Q

90% of normal individuals have higher right/left hilar shadow

A

Left

106
Q

The avascular aspect of the composite hilar shadow, inferior to the shadow of the right pulmonary artery and veins and anterior to the descending left pulmonary artery and left superior vein is called

A

Inferior hilar window

107
Q

This region is roughly triangular in shape, with its apex at the junction of the LUL and LLL bronchi and its base directed anteriorly and inferiorly

A

Inferior hilar window

108
Q

A serosal membrane that envelops the lung and lines the costal surface, diaphragm and mediastinum

A

Pleura

109
Q

Blood supply to the parietal pleura

A

Systemic circulation

110
Q

Blood supply to visceral pleura

A

Pulmonary circulation

111
Q

Composed of striated musclr and a large central tendon separating the thoracic and abdominal cavities

A

Diaphragm

112
Q

The diaphragmatic muscle arises anteriorly from the

A

Posterior aspect of xiphoid process

113
Q

Diaphragmatic muscle arises anterolaterally, laterally and posterolaterally from the

A

6th to the 12th costal cartilages and ribs

114
Q

Originate from the upper lumbar vertebrae and course to the posteroor aspect of the central tendon

A

Diaphragmatic crura

115
Q

Diaphragm has how many potential openings and how many gaps

A

3 normal openings and 2 potential gaps

116
Q

Lies in the midline, immediately behind the diaphragmatic crura and anterior to the 12th thoracic vertebral body

A

Aortic hiatus

117
Q

Aorta, thoracic duct and azygos and hemiazygos veins traverse this opening

A

Aortic hiatus

118
Q

Usually lies slightly to the left midline, cephalad to the aortic hiatus and transmits the esoohagus and vagus nerves

A

Esophageal hiatus

119
Q

The IVC pierces the central tendon of the diaphragm at the level of

A

8th thoracic intervertebral disc space

120
Q

Triangular gaps in the muscles of anteromedial diaphragm

A

Foramina of Morgagni

121
Q

This cleft is normally occupies by fat and internal mammary vessels; it is a site of potential intrathoracic herniation of abdominal contents

A

Foramina of Morgagni

122
Q

defects in the closure of posterolateral diaphragm at the junction of the pleuroperitoneal membrane with the transverse septum

A

Foramina of Bochdalek

123
Q

Curvilinear opacities that arise from the upper 2 or 3 lumbar vertebrae

A

Crura

124
Q

The central interstitial compartment extending from the mediastinum peripherally and enveloping the bronchovascular bundles is termed

A

Bronchovascular interstitium

125
Q

The axial interstitium is contiguous with the interstitium surrounding the small centrilobular arteriole and bronchiole within the secondary pulmonary lobule where it is called the

A

Centrilobular interstitium

126
Q

Most peripheral component of the interstitium in which lies between the visceral pleura and lung surface

A

Subpleural or peripheral interstitium

127
Q

Invaginations of the subpleural interstitium into the lung parenchyma form the borders of the secondary pulmonary lobules and represent the

A

Interlobular septa

128
Q

Extending between the centrilobular interstitium within the lobular core and interlobular septal/subpleural interstitium in the lobular periphery is a fine network of connective tissye fibers that support the alveolar spaces called the

A

Intralobular, parenchymal or alveolar interstitium

129
Q

Subsegment of lung supplied by 3-5 terminal bronchioles and separated from adjacent secondary lobules by intervening connective tissue

A

Interlobular septa

130
Q

Unit of lung subtended from a single terminal bronchiole is called

A

Pulmonary acinus

131
Q

Located at the center of the secondary lobule

A

Centrilobular artery and preterminal bronchiole

132
Q

Run at the margins of lobules within the interlobular septa with lymphatics and connective tissue found within the contiguous subpleural interstitium

A

Pulmonary veins and lymphatics

133
Q

Interlobular septa are normally ____ mm thick and can be seen in the lung periphery, particularly along the superior and inferior pleural surfaces

A

1 mm

134
Q

Normal airways are visible only to within ___cm of the pleura

A

3cm

135
Q

When visible, indicates the locations of interlobular septa

A

Pulmonary veins

136
Q

Not normally visible on thin section ct

A

Peribronchovascular, centrilobular, and intralobular interstitial compartments

[PBR] Pulmo Imaging (9 decks)

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