Pleura & Lungs (Ach) - W1 Flashcards
What supplies blood to the parietal pleura? visceral pleura?
- parietal
- supplied by intercostal and pericardioacophrenic arteries
- Visceral
- supplied by broncial arteries
What nerves innervate:
parietal pleura
visceral pleura
- parietal = sensitve to pain
- intercostal nerves: costal and peripheral
- phrenic: mediastinal and central diphagragmatic
- Visceral pleura
- insensitve to pain - no sensation
What level does the trachea fibrufacte?
T4-T5
What is the difference between the left and right bronchi?
- Left bronchi:
- longer
- smaller diamter
- greater angle - 45 degrees
explain the lymphatic drainage of the lung:
- superficial + lymphatic plexuses –> drain to bronchopulmonary nodes –> drain to superior & inferior tracheobronchial nodes –> terminate at lymphatic duct and thoracic duct
Autonomic POSTGANGLIONIC sympathetic FIBERS of pulmonary plexus
- derived from T1-T5 of spinal cord
- synapse in upper thoracic or cervical sympathetic ganglia
- produce bronchodilation & vasoconstriction
- EPI is neurotransmitter
Autonomic innervation with PREGANGLIONIC PARASYMPATHETIC fibers
- derived from VAGUS NERVE
- synapses in pulmonary plexus or on walls of lung
- mediate BRONCHOCONSTRICTION, VASODILATION & INCREASED GRANDULAR SECRETION
- mediate allergic rxns that cause bronchoconstrictino
pleuritis
inflammation of pleura that can lead to pleura adhesions - rough surfaces rub together and can be heard with stethoscope
Most common source of blood from hemothroax
intercostal arteries
Clinical signs of tension pneumothorax
- distended neck veins
- shifted trachea
- decreased breath sounds
- hypotension
- agitation
How do you relieve pressure from a tension pneumothorax?
wide bore needle into 2nd anterior or 4th lateral intercostal space
Atelectasis
partial or complete collapse of lung at alveoli - may be caused by mucous accumulation (post surgical, asthma, cystic fibrosis), obstruction, decreases in surfactant, tumors, clots
How is a pleural tap performed?
needle inserted into intercostal space close to UPPER BORDER of rib beelow to avoid intercostal neurovascular bundle.
9th interspace in midaxillary line is the safest place for this procedure.
Where is a chest tube inserted?
- fluid or air in pleural cavity can be removed.
- small incision made in 4th-5th (at nipple level) intercostal space in midaxillary line.
- Suction air out SLOWLY.
During development, what is the phrenic nerve trapped between
Pericardial sac and pleura of lungs
