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MBBCh 2- ANAT2020A > Pleura and Lungs > Flashcards

Pleura and Lungs Flashcards

1
Q

What are the pleurae? (2)

A

o Each lung is invested by and enclosed in a serous pleural sac of 2 continuous membranes
o Pleural cavity- potential space between the layers of pleura containing serous pleural fluid

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2
Q

What is the visceral pleura? (3)

A
  • Closely covers the lungs and adheres to all its surfaces, including surfaces within fissures
  • Provides lung with smooth and slippery surface, allowing it to move freely on parietal pleura
  • Continuous with the parietal pleura at the hilum of the lung
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3
Q

What is the parietal pleura? (3)

A
  • Lines pulmonary cavities
  • Adheres to the thoracic wall, mediastinum and diaphragm
  • Thicker than visceral pleura
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4
Q

What are 3 parts of the parietal pleura? (3)

A
  • Costal part: covers the internal surfaces of the thoracic wall and is separated from that surface by endothoracic fascia
  • Mediastinal part: covers lateral aspects of the mediastinum and reflects laterally onto the root of the lung to become continuous with the visceral pleura
  • Diaphragmatic part: covers superior surface of diaphragm on each side of the mediastinum. Phrenicopleural fascia connects diaphragmatic pleura to diaphragm
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5
Q

What is the cervical pleura?

A

Cervical pleura: covers the apex of the lung and projects above the 1st rib and clavicle

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6
Q

What are the lines of pleural reflection?

A

Lines along which the parietal pleura changes direction as it passes from one wall of the pleural cavity to another.

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7
Q

3 lines of pleural reflection on each side:

A
  1. Left and right sternal lines
  2. Costal lines
  3. Vertebral lines
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8
Q

What are the characteristics of the Left and right sternal lines? (6)

A
  • Occur where costal pleura is continuous with mediastinal pleura
  • Run inferomedially passing posterior to sternoclavicular joints
  • Left and right lines meet at the anterior median line (midsternal line) at level of the sternal angle.
  • Right line- continues down anterior median line until xiphoid process where it turns laterally
  • Left line- continues down anterior median line until 4th costal cartilage where it turns laterally to form the cardiac notch
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9
Q

What are the characteristics of the Costal lines? (5)

A
  • Occurs where costal pleura becomes continuous with diaphragmatic pleura inferiorly
  • Right line- proceeds laterally from the anterior median line
  • Left line- begins at the midclavicular line due to bare area of pericardium on left side
  • Continue symmetrically when they proceed laterally, posteriorly and then medially, passing obliquely across the 8th rib in the midclavicular line and the 10th rib in the midaxillary line
  • Becomes continuous posteriorly with the vertebral lines at the necks of the 12th
    ribs inferior to them
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10
Q

What are the vertebral lines? (4)

A
  • Rounder, gradual reflection
  • Occurs when costal pleura becomes continuous with the mediastinal pleura posteriorly
  • Parallel to the vertebral column
  • Run from T1 through T12 where they become continuous with costal lines
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11
Q

What are the recesses? (2)

A
  • Costodiaphragmatic recesses
  • Costomediastinal recesses
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12
Q

What is the Costodiaphragmatic recess? (2)

A
  • Surround upward convexity of the diaphragm
  • Inferior borders of lungs descend into these recesses
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13
Q

What is the Costomediastinal recess? (2)

A
  • Between costal and mediastinal pleurae
  • Left recess is larger
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14
Q

What is the pulmonary ligament?

A
  • Hangs inferiorly from the root of long where visceral and parietal pleura meet as a sleeve surrounding the structures passing to and from the lungs
  • Expands to allow movement of lung root and expansion of pulmonary veins
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15
Q

Blood supply of pleurae: Parietal (6)

A

Post. Intercostal aa.
Int. thoracic aa.
Musculophrenic aa.
Thoracic aorta
Sup. Intercostal aa.
Subcostal aa.

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16
Q

Blood supply of pleurae: Visceral

A

Bronchial aa.

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17
Q

Nerve supply of pleurae: Parietal (2)

A
  • Somatic nerves-
    2nd -12th IC nn. (sensory)
  • Phrenic nn.
    (pain sensitive)
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18
Q

Nerve supply of pleurae: Visceral

A

Autonomic fibers- Sympathetic fibers from T2-T5

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19
Q

Lymph drainage of pleurae: Parietal

A

Axillary nodes

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20
Q

Lymph drainage of pleurae: Visceral

A

Lymph nodes on hilum of lungs

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21
Q

Describe the apex of the lung.

A

Blunt superior end ascending above the level of the 1st rib

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22
Q

Describe the base of the lung.

A

Concave inferior surface opposite to the apex, resting on and accommodating the ipsilateral dome of the diaphragm

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23
Q

General features:

Lobes (2 or 3) created by _______ (1 or 2)

A

fissures

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24
Q

What are the 3 surfaces and 3 borders of the lungs?

A

o 3 surfaces (costal, mediastinal and diaphragmatic)
o 3 borders (anterior, inferior and posterior)

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25
Q

Describe the apex of the lung.

A

Blunt superior end ascending above the level of the 1st rib

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26
Q

What are the features of the right lung? (4)

A
  • has oblique and horizontal fissures
  • 3 lobes- superior, middle and inferior
  • Larger and heavier than left lung
  • Shorter and wider than left lung since dome of diaphragm is higher, and the heart bulges more to the left
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27
Q

What are the features of the left lung? (3)

A
  • Single oblique fissure
  • 2 lobes- superior and inferior
  • Anterior border has a cardiac notch due to left
    deviation of the heart
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28
Q

What is the significance of the indentations on the left lung? (2)

A
  • Indents anterior inferior aspect of superior lobe
  • Results in the most inferior anterior part of the superior lobe being thin and tongue-like, called the lingula
29
Q

What is the oblique fissure?

A

Oblique fissure (right and left)- extends posteriorly from level of spinous process of T2 to 6th costal cartilage anteriorly

30
Q

What is the horizontal fissure?

A

Horizontal fissure (right only)- runs from anterior border at level of 4th costal cartilage to meet oblique fissure at midaxillary line

31
Q

What are the characteristics of the costal surface of the lungs? (3)

A
  • Large, smooth and convex
  • Costal pleura separates it from the ribs
  • Posterior part (vertebral part) is related to the bodies of the thoracic vertebrae
32
Q

What are the characteristics of the mediastinal surface of the lungs? (2)

A
  • Concave
  • Includes the hilum
33
Q

What are the features of the mediastinal surface on the right lung? (2)

A
  • Groove for esophagus
  • Cardiac impression
34
Q

What are the features of the mediastinal surface on the left lung? (4)

A
  • (larger) cardiac impression
  • Groove for aortic arch
  • Groove for descending aorta
  • (smaller) area for esophagus
35
Q

What are the features of the diaphragmatic surface? (2)

A
  • Concave- forms base of the lung
  • Concavity is deeper in the right lung due to higher position of right dome
36
Q

What are the lung borders? (3)

A
  • Anterior border
  • Inferior border
  • Posterior border
37
Q

What is the anterior border?

A

Costal and mediastinal surfaces meet anteriorly and overlap the heart.

38
Q

What is the inferior border?

A

Circumscribes the diaphragmatic surface and separates it from costal and mediastinal surfaces

39
Q

What is the posterior border?

A

Broad and round, separating costal and mediastinal surfaces posteriorly at the side of the thoracic vertebral column,

40
Q

Roots of lungs joins lungs to ________.

A

mediastinum

41
Q

What do the root of the lungs consist of?

A
  • Bronchi
  • Pulmonary arteries
  • Superior and inferior pulmonary veins
  • Pulmonary plexuses
  • Lymph vessels
42
Q

_____ to the hilum, the lung root is enclosed within the area of continuity between the
parietal and visceral pleurae by the pleural sleeve (___________).

A

Medial
mesopneumonium

43
Q

What are the differences between the left lung and right lung in terms of length?

A

R: Shorter
L: Longer

44
Q

What are the differences between the left lung and right lung in terms of width?

A

R: Wider
L: Narrower

45
Q

What are the differences between the left lung and right lung in terms of lobes?

A

R: 3 (superior, middle and inferior)
L: 2 (superior and inferior)

46
Q

What are the differences between the left lung and right lung in terms of fissures?

A

R: 2 (oblique and horizontal)
L: 1 (oblique)

47
Q

What are the differences between the left lung and right lung in terms of the cardiac notch?

A

R: Absent
L: Present

48
Q

What are the differences between the left lung and right lung in terms of Lingula?

A

R: Absent
L: Present

49
Q

What are the differences between the left lung and right lung in terms of the base?

A

R: More concave
L: Less concave

50
Q

What are the components of the right lung (veins)? (6)

51
Q

What are the components of the left lung (arteries)? (5)

52
Q

Anterior borders of the lungs lie adjacent to the anterior line of reflection of the _____ pleurae between the ____ and ____ costal cartilages.

A

parietal
2nd and 4th

53
Q

Margin of the left pleural reflection moves laterally at 4th costal cartilage and inferiorly at the _____ ____ to reach ____ costal cartilage.

A

cardiac notch
6th

54
Q

o Margin of the right pleural reflection continues inferiorly from ____ to ____ costal cartilage
o Both pleural reflections and ______ lung borders pass laterally at 6th costal cartilages

A

4th to 6th
anterior

55
Q

Landmark: Midclavicular line

A

Lung margin: 6th rib
Pleural margin: 8th rib

56
Q

Landmark: Midaxillary line

A

Lung margin: 8th rib
Pleural margin: 10th rib

57
Q

Landmark: Mid-scapular line

A

Lung margin: 10th rib
Pleural margin: 12th rib

58
Q

Landmark: Paravertebral line

A

Lung margin: T10
Pleural margin: T12

59
Q

What are the types of arterial supply to the lungs? (2)

A
  • Bronchial circulation
  • Pulmonary circulation
60
Q

What does the bronchial circulation entail? (3)

A
  • Bronchial arteries arise from systemic circulation to support tissues with nutrients
  • 2 left bronchial arteries arise form descending thoracic aorta
  • 1 right brachial artery arises from the 3rd posterior intercostal artery
61
Q

What does the pulmonary circulation entail? (2)

A
  • Arise from the pulmonary trunk at level of sternal angle
  • Divide into lobar and then segmental arteries
62
Q

o Bronchial veins drain lung tissue supplied by bronchial
arteries
- Right bronchial v. drains into _____ vein/
- Left bronchial v. drains into ______
_______ v. or _____ _____ _____l v.

A

azygos
accessory hemiazygos
left superior intercostal

63
Q

Pulmonary veins (2 on each side)
- Carries _____ blood to the _____ atrium of the heart

A

oxygenated
left

64
Q

What is the Lymphatic drainage of the lungs?

65
Q

What is the innervation of the lungs? (3)

A

o Parasympathetic fibres from vagus nn.
o Sympathetic fibres from sympathetic trunks
o Both contributing to pulmonary plexuses

66
Q

What are the parts of the Tracheobronchial tree?

67
Q

What is a bronchopulmonary segment?

A

A bronchopulmonary segment is a portion
of the lung supplied by a specific segmental bronchus and a tertiary branch of pulmonary artery.

68
Q

Arteries branching from the _______ and
bronchial arteries run together through the
_____ of the segment.

A

pulmonary
centre

69
Q

Veins and lymphatic vessels drain along
the ____ of the segments.

MBBCh 2- ANAT2020A (60 decks)

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