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anatomyyyy y2s1 > pleura and lung > Flashcards

pleura and lung Flashcards

1
Q

what does the intraembryonic mesoderm divides to?

A

paraxial

intermediate

lateral plate mesoderm

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2
Q

what is the embryological origin of pleura?

A

lateral part of the INTERMEDIATE MESODERM

it will give raise to peritoneal and pleura

the pleuroperitoneal cavity will divide the peritoneal and pleura from each others

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3
Q

how is the pleura formed?

A

it is a sac that is invaginated by the lung similar to the pericardium

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4
Q

what cells forms the pleura?

A

methothelial like pericardium

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5
Q

what is the inner layer of the pleura and what is it attached to?

A

visceral pleura –> attached to the lungs directly

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6
Q

what is the outer layer of the pleura and what is it attached to?

A

parietal pleura –> attached the inside of the chest wall

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7
Q

what is the hilum of the lung?

A

part of the lung where the vessels enter and leave

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8
Q

what is the root of the lung?

A

the continuation near the mediastinum where the structures are found

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9
Q

whats the extension of the pleura?

A

it is continuous around the lung and then at the root of the lung it ends

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10
Q

what does the pleura form below the root of the lung?

A

pulmonary ligament

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11
Q

what is the function of the pulmonary ligament?

A

provide dead space into which the :

Lung root descends with the descent of the diaphragm

Pulmonary veins and arteries can expand during exercise so this provides space for the enlargement

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12
Q

whats the name of the closed cavity found in between the layers of the pleura?

A

pleural cavity

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13
Q

describe the pleural cavity?

A

it is potential space ( its empty cuz lymphatics keeps draining the excessive fluid )

has thin film fluid –> pleural fluid and encloses the lung

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14
Q

what is pleural rub?

A

friction rub between the 2 layers due to inflammation and it produces a sound heard via stethoscope

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15
Q

where is the visceral pleura absent in?

A

hilum of the lung

between the two layers of the pulmonary ligament ( pulmonary ligament is the extension of pleura below the root of the lung )

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16
Q

describe the parietal pleura?

A

layer of pleura that lines chest wall and covers the mediastinum

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17
Q

what does the parietal pleura divide into to?

A

costal

Cervical

mediastinal

diaphragmatic

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18
Q

what is the costal parietal pleura?

A

parietal pleura lining:

sternum

ribs

costal cartilage

intercostal space

sides of verterbral column

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19
Q

what is the diaphragmatic pleura?

A

parietal pleura covering the diaphragm

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20
Q

what is cervical pleura ?

A

parietal pleura which covers the apex of the lung

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21
Q

what attaches above the cervical pleura?

A

suprapleural membrane

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22
Q

what is mediastinal pleura?

A

part of parietal pleura which covers the sides of the mediastinum

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23
Q

what is the relation between the mediastinal pleura and the mediastinum?

A

in the mediastinum the mediastinal pleura will represent the lungs

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24
Q

what are the narrow extension of the pleural cavity?

A

pleural recesses

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25
Q

whats the function of pleural recessed?

A

allow the lungs to expand during deep inspirations

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26
Q

where are the pleural recesses found?

A

costodiaphragmatic recess :

between costal and diaphragmatic pleura

INFERIOR margin of the pleura –> inferior because diaphragm is inferior

Costomediastinal recess :

between costal and mediastinal pleura

ANTERIOR margin of the pleura ( anterior because mediastinum is anterior )

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27
Q

whats the other name of costodipahragmatic recess?

A

costophrenic angle

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28
Q

what happens to the costophrenic angle during pleural effusions?

A

during pleural effusion

hydrothorax –> fluid in the pleural cavity –> the angle gets obliterated because gravity pulls the fluid down to the costophrenic angle

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29
Q

what is the level of insertion of the needle in thoracocentesis?

A

9th intercostal spaces

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30
Q

describe the thoracocentesis procedure?

A

it is inserted in the 9th intercostal spaces in the MID AXILLARY LINE to avoid inferior border of the lung

because after 9th theres no lung

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31
Q

whats the ending level of the lung in the mid CLAVICULAR line? (anteriorly)

A

6th intercostal spaces

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32
Q

whats the ending level of the lung in the mid Axillary line ( laterally )

A

8th intercostal space

because its 8th when we do thoracocentesis in the mid axillary line we go below 8th to the 9th to avoid the lung

33
Q

whats the ending level of the lung in the back ( posteriorly )

A

10th intercostal spaces

34
Q

whats the ending level of the pleura in the mid CLAVICULAR line? (anteriorly)

A

the pleura is little bit lower

8th intercostal spaces

35
Q

whats the ending level of the pleura in the mid AXILLARY line? (laterally )

A

10th intercostal spaces

here we dont avoid the pleura in thoracocentesis because we are trying to inject the needle in it to drain the fluid so the 9th intercostal space is still within the pleura because it ends at 10th costal cartilage

36
Q

whats the ending level of the pleura in the back ( posteriorly )

A

12th intercostal space

37
Q

describe the costo mediastinal recess

A

lies along the anterior border of the left lung ( remember mediastinum = anterior )

overlies the heart

during full inspiration it becomes occupied by the LINGULA of the left lung

38
Q

where does the costo mediastinum recess lie at?

A

anterior ends of the left 4th and 5th intercostal spaces

39
Q

whats the normal pressure inside the pleural cavity?

A

less than atmospheric

40
Q

whats the normal pressure inside the lungs?

A

same as atmospheric

41
Q

what happens when the air enters pleural cavity?

A

pressure in the pleural cavity becomes similar to the atmospheric –> lung collapse

42
Q

what could cause lung collapse or pneumothorax?

A

stab wound

puncture of the visceral layer –> ruputre of bullae in emphysema for example

43
Q

whats tension pneumothorax?

A

air enters and cannot leave so it accumulates inside

44
Q

what does the tension pneumothorax do the mediastinum?

A

pushes the mediastinum to the other side compressing the opposite lung ( the normal lung ) –> the obstructed lung will inflate and press the other normal lung

45
Q

whats chest tube procedure?

A

procedure of removing air or excess fluid from pleural cavity

46
Q

where is the incision made?

A

5th or 6th intercostal spaces in the mid AXILLARY LINE ( MEDIALLY)

47
Q

whats the risk of chest tube?

A

long thoracic nerve maybe injured resulting in winged scapula

48
Q

whats the site of the lung?

A

pleural cavity and it is separated by mediastinum from the lung on the opposite side

49
Q

describe the shape of the lung?

A

conical shaped

has apex , base

2 surfaces ( costal and medial –> thick and round )

3 borders : anterior ( SHARP) , posterior ( THICK) m inferior

50
Q

describe the costal surface of the lung?

A

it is on the side of the sternum and costal cartilages , ribs ,intercostal muscles and sternocostalis

51
Q

what does the medial surface divide into to?

A

vertebral part : lies behind the hilum and related to the sides of vertebrale bodies and intervertebral disks, sympathetic trunk, splanchnic nerves

mediastinal part : anterior part and it differs between the right and left lungs

52
Q

what are the impressions on the right lung?

A

Pericardium –> right atrium ( because right atrium forms the right border of the heart )

Inferior vena cava

Superior vena cava ( upper part of the hilum ) : continuous with the groove of right brachiocephalic which is coming from above

Groove of arch of azygous vein

Azygous vein impression

Trachea and right vagus nerve

esophagus impression (its anterior to the azygous vein impression)

53
Q

what are the impressions on the left lung?

A

Pericardium impression –> left ventricle and left auricle

Pulmonary trunk and thymus gland

groove for AORTIC ARCH –> Above hilum which is also related to left vagus and left phrenic and left superior intercostal vein

Descending aorta groove

left subclavian artery

left common carotid

Area of relation to ESOPHAGUS ( infront of the descending aorta ) and THORACIC DUCT and LEFT recurrent laryngeal nerve

Esophagus –> in front of descending aorta

54
Q

what is lingula?

A

tongue like projection of the upper lobe at cardiac notch

corresponds to the right middle lobe

55
Q

where is the cardiac notch found?

A

upper lobe of the left lung and its due to the heart

56
Q

how many fissures found on each lung?

A

left lung –> 1 fissure , oblique fissure dividing it into upper and lower

right lung –> 2 fissures , olbique and horizental dividing it into upper and middle and lower

57
Q

where does the oblique fissure begins?

A

posterior border

2.5 inches below the apex

1 inch from median plane

follows the medial border of the scapula when the arm is abducted

58
Q

where does the oblique fissure opposite in relation to the spine?

A

T3

59
Q

whats the extension of oblique fissure?

A

downward and forward

60
Q

where does the obliqure fissure cut in relation to ribs?

A

6th costochondral junction

61
Q

where does the horizontal fissure begin?

A

anterior border
end at oblique fissure in midaxillary lnine

62
Q

at what costal level does it extend and end?

A

4th costal cartilage and extend to the 4th rib

63
Q

what is the hilum?

A

site where structures enter or leave the lung

64
Q

what is the root?

A

structures passing through the hilum connecting mediastinum to the lung

65
Q

what is the most superior structure in the hilum?

A

pulmonary artery

66
Q

whats the most posterior structure ?

A

bronchi

67
Q

what is the most anterior and inferior structure?

A

pulmonary veins

68
Q

how many bronchi are found in the right hilum?

A

2 bronchi because the right bronchi divides before entering hilum

69
Q

what constitutes the vascular nutritive system of the pulmonary tissue ?

A

bronchial arteries and veins

70
Q

what do the bronchial arteries and veins interconnect with?

A

Pulmonary arteries and veins

71
Q

from where does the bronchial arteries originate?

A

thoracic aorta or one of its branches

72
Q

what bronchial artery normally arises from intercostal artery and which intercostal artery does it arive from?

A

Single right bronchial artery normally arise from the THIRD intercostal artery

though sometimes it originate from the upper left bronchial artery

73
Q

from where does other bronchial arteries arise from?

A

two left bronchial arteries arise form the ANTERIOR SURFACE OF THE AORTA DIRECTLY

74
Q

describe the bronchopulmonary segments?

A

-functionally independent unit of lung tissue

largest subdivision of a lobe

pyramid shaped with the apex at the lung root

receives its own segmental bronchus ( tertiary )

has separate arterial supply from the other segments

Surrounded by connective tissue containing intersegmental vein which drain the SEGMENTS

can be removed surgically without affecting the function of other segments.

74
Q

wheres the apical segment of the lower lobe found?

A

scapular spine —> where it also can be heard

75
Q

what is the most dependent part of the lung when lying supine?

A

lower lobe
specifically the apical segment

76
Q

whats segmentectomy?

A

Affected segment may be removed surgically without disrupting the surrounding lung

77
Q

whats bronchography?

A

technique used to visualize the outline of the trachea and bronchi

performed after introducing a contrast medium into respiratory tract

anatomyyyy y2s1 (12 decks)

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