PRELIMS: THORAX - REGIONAL ANATOMY (PLEURAL CAVITIES) Flashcards
How many pleural cavities are present in the body?
2
Where are the pleural cavities located?
BOTH SIDES OF THE MEDIASTINUM
What surrounds the lungs that is lined by mesothelium and associated layer of supporting connective tissues.
The potential space enclosed between the visceral and parietal pleura that normally contains a very thin layer of serous fluid.
PLEURAL CAVITIES
How does the pleural cavity surrounds the lungs superiorly?
THEY EXTEND ABOVE THE RIB 1 INTO THE ROOT OF THE NECK
How does the pleural cavity surrounds the lungs inferiorly?
THEY EXTEND TO A LEVEL ABOVE THE COSTAL MARGIN
What is the medial wall of pleural cavities?
MEDIASTINUM
What is the single layer of flat cell that lines the pleural cavities?
MESOTHELIUM
What structures forms the pleura?
~MESOTHELIUM
~ASSOCIATED LAYER OF SUPPORTING CONNECTIVE TISSUE
What are the types of pleura based on their location?
~PARIETAL PLEURA
~VISCERAL PLEURA
The pleura associated with the walls of pleural cavity.
PARIETAL PLEURA
The pleura that reflects the medial wall and into the surface of the lung.
It adheres and covers the surface of the lungs, including both opposed surfaces of the fissure that divides the lungs into lobes.
It is continuous with the parietal pleura at the hilum of each lung, where structures enter and leave the organ.
VISCERAL PLEURA
TRUE OR FALSE:
The surface of the lung directly opposes and freely slides over the parietal pleura attached to the wall
TRUE
What are the parts of parietal pleura?
~COSTAL PART
~DIAPHRAGMATIC PART
~MEDIASTINAL PART
~CERVICAL PLEURA (DOME OF PLEURA OR PLEURAL COPULA)
Pleura related to the ribs and intercostal spaces
COSTAL PART
Pleura that covers the diaphragm
DIAPHRAGMATIC PART
Pleura that covers the mediastinum
MEDIASTINAL PART
The dome shaped layer of parietal pleura lining the cervical extensions of the pleural cavity
CERVICAL PLEURA (DOME OF PLEURA OR PLEURAL CUPOLA)
A distinct dome-like layer of fascia and connective tissue membrane that covers the superior surface of the cervical pleura.
It is attached laterally to the medial margin of the first rib and behind to the transverse process of Vertebra C7.
Superiorly, it receives muscle fibers from some of the scalene muscles.
It provides apical support for the pleural cavity in the root of the neck
SUPRAPLEURAL MEMBRANE
It is the deep muscle in the neck that functions to keep the membrane taut
SCALENE MUSCLE
It reflects off the mediastinum as a tubular, sleeve-like covering for structures that passes between the lungs and mediastinum in the region of Vertebrae T5 to T7.
It is continuous with the visceral pleura
MEDIASTINAL PLEURA
The mediastinal pleura and the structures it contains forms what?
ROOT OF THE LUNG
The root joins the medial surface of the lung at an area referred to as?
HILUM OF THE LUNG
What innervates the parietal pleura?
SOMATIC AFFERENT FIBERS
What innervates the costal pleura?
BRANCHES FROM THE INTERCOSTAL NERVES RESULTING TO PAIN FELT IN RELATION TO THE THORACIC WALL
What innervates the diaphragmatic pleura and mediastinal pleura?
PHRENIC NERVES (ORIGINATING AT SPINAL CORD LEVELS C3, C4, AND C5)
Pain from spinal cord level C3, C4, and C5 are called?
C3, C4, AND C5 DERMATOMES
Where does C3, C4, and C5 spinal cord level located?
LATERAL NECK AND SUPRACLAVICULARREGION OF THE SHOULDER
It marks the extent of the pleural cavities
PERIPHERAL REFLECTIONS OF PARIETAL PLEURA
How does the pleural cavities approach superiorly?
THE PLEURAL CAVITIES PROJECT AS MUCH AS 3 TO 4 CM ABOVE THE FIRST COSTAL CARTILAGE BUT IT DOES NOT EXXTEND ABOVE THE NECK OF RIB 1
What causes the limitation of the pleural cavities projection superiorly?
INFERIOR SLOPE OF RIB 1 TO ITS ARTICULATION WITH THE MANUBRIUM
How does the pleural cavities approach anteriorly?
THE PLEURAL CAVITIES APPROACH EACH OTHER POSTERIOR TO THE UPPER PART OF THE STERNUM
How does the pleural cavities approach inferiorly?
THE COSTAL PLEURA REFLECTS ONTO THE DIAPHRAGM ABOVE THE COSTAL MARGIN
It is where the pleural cavity extends inferiorly to approximately rib 8
MIDCLAVICULAR LINE
It is where the pleural cavity extends to rib 10
MIDAXILLARY LINE
TRUE OR FALSE:
The lung does not completely fill the anterior and posterior inferior regions of the pleural cavities
TRUE
The lungs that do not completely fill results to what in which two layer of parietal pleura becomes opposed.
Provides potential spaces in which fluids can collect and from which fluids can be aspirated
RECESSES
When does the expansion of the lungs into pleural recesses occurs
FORCED INSPIRATION
It occurs on each side where costal pleura is opposed to mediastinal pleura anteriorly
COSTOMEDIASTINAL RECESS
Where is the largest costomediastinal recess located
ON THE LEFT SIDE IN THE REGION OVERLYING THE HEART
What are the largest and clinically the most important recesses which occur in each pleural cavity between the costal pleura and diaphragmatic pleura?
It is the regions between the inferior margin of the lungs and inferior margin of the pleural cavities.
They are the deepest after forced expiration and shallowest after forced inspiration
COSTODIAPHRAGMATIC RECESSES
Organs of respiration that lies on either side of the mediastinum surrounded by the right and left pleural cavities.
Half-cone shape, with a base, apex, 2 surfaces and 3 borders
LUNGS
Air enters and leaves the lungs via?
It is branches of the trachea
MAIN BRONCHI
The structure that delivers deoxygenated blood to the lungs from the right ventricle of the heart
PULMONARY ARTERIES
The structure where oxygenated blood returns to the left atrium?
PULMONARY VEINS
Why is the right lung larger than the left lung?
BECAUSE THE MIDDLE MEDIASTINUM THAT CONTAINS THE HEART BULGES MORE TO THE LEFT THAN TO THE RIGHT
Where does the diaphragm sit?
BASE
It projects above rib 1 and into the root of the neck
APEX
What are the 2 surfaces of the lung?
~COSTAL SURFACE
~MEDIASTINAL SURFACE
The surface that lies immediately adjacent to the ribs and intercostal spaces of the thoracic wall
COSTAL SURFACE
The surface that lies against the mediastinum anteriorly and the vertebral column posteriorly and contains the comma-shaped hilum of the lung, through which structures enter and leave
MEDIASTINAL SURFACE
What are the 3 borders of the lungs?
~INFERIOR BORDER
~ANTERIOR BORDER
~POSTERIOR BORDER
The border of the lung that is sharp and separates the base from the costal surface
INFERIOR BORDER
The borders that separate the costal surface from the medial surface
~ANTERIOR BORDERS
~POSTERIOR BORDERS
The border that is also sharp
ANTERIOR BORDERS
The border that is smooth and rounded
POSTERIOR BORDERS
TRUE OR FALSE: The lungs lie directly adjacent to, and are indented by, structures contained in the overlying area
TRUE
Structures that bulges in the mediastinum that indent the medial surfaces of the lung
HEART AND MAJOR VESSELS
Structure that indent the costal surfaces
RIBS
TRUE OR FALSE:
Pathology such as tumors or abnormalities in one structure can affect the related structure
TRUE
A short, tubular collection of structures that together attach the lungs to structures in the mediastinum
ROOT OF EACH LUNG
TRUE OR FALSE: The root of each lung is covered by a sleeve of mediastinal pleura that reflects onto the surface of the lung as visceral pleura
TRUE
The region outlined by the pleural reflection on the medial surface of the lung where structures enter and leave
HILUM
A thin blade-like fold of pleura that projects inferiorly from the root of the lung and extends from the hilum to the mediastinum.
It could possibly stabilize the position of the inferior lobe and accommodate the down-and-up translocation of structures in the root during breathing
PULMONARY LIGAMENT
In the mediastinum, it is a structure that passes immediately posterior to the roots of the lungs
VAGUS NERVES
The structure that passes immediately anterior to the vagus nerves
PHRENIC NERVES
Structures that is within each root and in the hilum
~PULMONARY ARTERY ~PULMONARY VEINS ~MAIN BRONCHUS ~BRONCHIAL VESSELS ~NERVE ~LYMPHATICS
The structure superior at the hilum
PULMONARY ARTERY
The structure inferior at the hilum
PULMONARY VEINS
The structure somewhat posterior in position at the hilum
BRONCHI
An organ of respiration that has 3 lobes and 2 fissures
RIGHT LUNG
TRUE OR FALSE:
Normally, the lobes are freely movable against each other because they are separated, almost to the hilum, by invaginations of the visceral pleura.
TRUE
Fissures formed by the invaginations of the visceral pleura
~OBLIQUE FISSURE
~HORIZONTAL FISSURE
The fissure that separates the inferior lobe from the superior lobe and the middle lobe of the right lung
OBLIQUE FISSURE
The fissure that separates the superior lobe from the middle lobe.
It follows the 4th intercostal space from the sternum until it meets the oblique fissure as it crosses rib 5
HORIZONTAL FISSURE
In quiet respiration, its position can be marked by a curved line on the thoracic wall that begins roughly at the spinous process of vertebra T4 level of the spine, crossing the 5th interspace laterally, and follows the contour of rib 6 anteriorly
POSITION OF OBLIQUE FISSURE
TRUE OR FALSE:
The orientations of the oblique and horizontal fissures determine where clinicians should listen for lung sounds from each lobe
TRUE
The largest surface of the superior lobe OF THE RIGHT LUNG is in contact with what?
THE UPPER PART OF THE ANTEROLATERAL WALL AND THE APEX OF THIS LOBE PROJECTS INTO THE ROOT OF THE NECK
The structure that lies mainly adjacent to the lower anterior and lateral wall
SURFACE OF MIDDLE LOBE
The structure that is in contact with the posterior and inferior wall
COSTAL SURFACE OF THE INFERIOR LOBE
TRUE OR FALSE:
When listening to lung sounds from each of the lobes, it is important to position the stethoscope on those areas of the thoracic wall related to the underlying positions of the lobes.
TRUE
The structure that lies adjacent to a number of important structures in the mediastinum and root of the neck
MEDIAL SURFACE OF THE RIGHT LUNG
Important structures in the mediastinum and the root of the neck
~HEART ~INFERIOR VENA CAVA ~SUPERIOR VENA CAVA ~AZYGOS VEIN ~ESOPHAGUS
The structures that arch over and are related to the superior lobe of the right lung as they pass over the dome of the cervical pleura and into the axilla
RIGHT SUBCLAVIAN ARTERY
An organ smaller than the right lung and has 2 lobes separated by an oblique fissure
LEFTLUNG
TRUE OR FALSE:
The oblique fissure of the left lung is slightly more oblique than the corresponding fissure of the right lung
TRUE
TRUE OR FALSE:
During quiet respiration, the approximate position of the left oblique fissure can be marked by a curved line on the thoracic wall that begins between the spinous process of vertebrae T3 and T4, crosses the fifth interspace laterally, and follows the contour of rib 6 anteriorly
TRUE
The largest superior lobe OF THE LEFT LUNG is in contact with what?
THE UPPER PART OF THE ANTEROLATERAL WALL, AND THE APEX OF THIS LOBE PROJECTS INTO THE ROOT OF THE NECK
The costal surface of the inferior lobes of the left lung is in contact with what?
THE POSTERIOR AND INFERIOR WALLS
A notched structure because of the heart’s projection into the left pleural cavity from the middle mediastinum
INFERIOR PORTION OF THE MEDIAL SURFACE OF THE LEFT LUNG
A tongue like extension that projects over the heart bulge from the anterior border of the lower part of the superior lobe
LINGULA OF THE LEFT LUNG
A structure of the left lung that lies adjacent to a number of important structures in the mediastinum and root of neck
MEDIAL SURFACE OF THE LEFT LUNG
Important structures in the mediastinum and root of neck from the medial surface of the left lung
~HEART
~AORTIC ARCH
~THORACIC AORTA
~ESOPHAGUS
Structures that arch over and are related to the superior lobe of the left lung as they pass over the dome of the cervical pleura and axilla
LEFT SUBCLAVIAN ARTERY
A flexible tube that extends from the vertebral level C6 in the lower neck to vertebral level T4/T5 in the mediastinum where it bifurcates into a right and a left main bronchus
TRACHEA
The trachea is held open by what structure?
THE TRACHEA IS HELD OPEN BY C-SHAPED TRANSVERSE CARTILAGE RINGS EMBEDDED IN ITSWALLS
A hook shaped structure that projects backward in the midline between the origins of the two main bronchi in the lowest tracheal ring
CARINA
The posterior wall of the trachea is composed mainly of what?
SMOOTH MUSCLE
TRUE OR FALSE:
Each main bronchus enters the root of a lung and passes through the hilum into the lung itself
TRUE
The part of bronchus that is wider and takes more vertical course through the root and hilum than the left main bronchus
RIGHT MAIN BRONCHUS
Where does inhaled foreign bodies tend to lodge more frequently
ON THE RIGHT SIDE OF THE MAIN BRONCHUS
The main bronchus divides within the lung into what?
It supplies a lobe
LOBAR (SECONDARY) BRONCHI
TRUE OR FALSE:
On the right side, the lobar bronchus to the superior lobe originates within the root of the lung
TRUE
The lobar bronchi further divides into what?
It supplies bronchopulmonary segments.
It gives rise to multiple generations of divisions and ultimately to bronchioles which further subdivide and supply the respiratory surfaces within each bronchopulmonary segment
SEGMENTAL (TERTIARY) BRONCHI
The walls of the bronchi are held open by what?
DISCONTINUOUS ELONGATED PLATES OF CARTILAGE, BUT THESE ARE NOT PRESENT IN BRONCHIOLES
The area of lung supplied by a segmental bronchus and its accompanying pulmonary artery branch.
It is shaped like an irregular cone, with the apex at the origin of the segmental bronchus and the base projected peripherally onto the surface of the lung.
The smallest functionally independent region of a lung and the smallest area of lung that can be isolated and removed without affecting adjacent regions.
BRONCHOPULMONARY SEGMENT
TRUE OR FALSE:
Tributaries of the pulmonary vein tend to pass intersegmentally between and around the margins of segments
TRUE
How many bronchopulmonary segments are present in each lung?
- SOME OF THEM FUSE IN THE LEFT LUNG
Where does the right and left pulmonary arteries originate from?
PULMONARY TRUNK
Carries deoxygenated blood to the lungs from the right ventricle of the heart
RIGHT AND LEFT PULMONARY ARTERIES
The process that occurs to the left of the midline just inferior to vertebral level T4/T5, and anteroinferiorly to the left of the bifurcation of the trachea
BIFURCATION OF PULMONARY TRUNK
The structure that is longer than the left pulmonary arteries and
passes horizontally across the mediastinum
RIGHT PULMONARY ARTERY
The structure that is longer than the left pulmonary arteries and
passes horizontally across the mediastinum.
It enters the root of the lung and gives off a large branch to the superior lobe of the lung.
RIGHT PULMONARY ARTERY
The right pulmonary artery passes posteriorly where?
TO THE ASCENDING AORTA, SUPERIOR VENA CAVA, AND UPPER RIGHT PULMONARY VEIN
It continues through the hilum of the lung, gives off a second branch to the superior lobe, and then divides to supply the middle and inferior lobes
MAIN VESSEL
Shorter that the right pulmonary artery and it lies anteriorly to the descending aorta and posterior to the superior pulmonary vein.
It passes through the root and hilum and branches within the lung.
LEFT PULMONARY ARTERY
Carries oxygenated blood from the lungs back to the heart.
They begin at the hilum of the lung, passing through the root of the lung, and immediately drain into the left atrium
SUPERIOR PULMONARY VEIN
INFERIOR PULMONARY VEIN
Constitutes the “nutritive” vascular system of the pulmonary tissues.
Interconnects within the lung with branches of the pulmonary arteries and veins
BRONCHIAL ARTERIES AND VEINS
What are the structures of the Vascular system of pulmonary tissues
~BRONCHIAL WALLS AND GLANDS
~WALLS OF LARGE VESSELS
~VISCERAL PLEURA
Where does bronchial arteries originate from?
FROM THORACIC AORTA OR ONE OF ITS BRANCHES
Branches of bronchial arteries
~RIGHT BRONCHIAL ARTERY
~LEFT BRONCHIAL ARTERY
The artery that normally arises from the 3rd posterior intercostal artery
RIGHT BRONCHIAL ARTERY
Where does the right bronchial artery occasionally originates from?
UPPER LEFT BRONCHIAL ARTERY
The artery that arises directly from the anterior surface of the thoracic aorta
LEFT BRONCHIAL ARTERY
The artery that arises at the vertebral level T5, and the inferior one to the left bronchus
SUPERIOR LEFT BRONCHIAL ARTERY
TRUE OR FALSE:
The bronchial arteries run on the posterior surfaces of the bronchi and ramify in the lungs to supply pulmonary tissues.
TRUE
Where does the bronchial veins drain to?
~EITHER THE PULMONARY VEINS OR THE LEFTATRIUM
~INTO THE AZYGOS VEIN ON THE RIGHT OR INTO THE SUPERIOR INTERCOSTAL VEIN OR HEMIAZYGOS VEIN ON THE LEFT
TRUE OR FALSE:
Structures of the lung and the visceral pleura are supplied by visceral afferents and efferents distributed through the anterior pulmonary plexus and posterior pulmonary plexus. These interconnected plexuses lie anteriorly and posteriorly to the tracheal bifurcation and main bronchi.
TRUE
The plexus that is much smaller than the posterior plexus
ANTERIOR PLEXUS
Originates from the sympathetic trunks and vagus nerves, and are distributed along branches of the airway and vessels
BRANCHES OF ANTERIOR PLEXUS
Nerves that constrict the bronchioles
VAGUS NERVES
The system that dilates the bronchioles
SYMPATHETIC SYSTEM
Where does the superficial, subpleural, and deep lymphatics of the lungs drain into these lymph nodes.
Surrounds the root of lobar and main bronchi and along the sides of the trachea
TRACHEOBRONCHIAL NODES
TRUE OR FALSE:
As a group, these lymph nodes (tracheobronchial nodes)extend from within the lung, through the hilum and root, and into the posterior mediastinum
TRUE
TRUE OR FALSE:
Efferent vessels from tracheobronchial nodes superiorly along the trachea to unite with similar vessels from parasternal nodes and brachiocephalic nodes, which are anterior to brachiocephalic veins in the superior mediastinum, to form the right and the left bronchomediastinal trunks.
TRUE
The trunks that drains directly into the deep vessels at the base of the neck, or may drain into the right lymphatic trunk or thoracic duct
RIGHT & LEFT BRONCHOMEDIASTINAL TRUNK
