Pulmonology

Question 1

Describe the left lung

Answer 1

Two lobes (superior and inferior) separated by the oblique fissure

Question 2

Describe the right lung

Answer 2

Three lobes (superior, inferior, middle) separated by oblique (separates superior and middle from inferior lobe) and horizontal fissures (separates superior and middle lobes)

Question 3

What are the three surfaces of the lungs?

Answer 3

Costal surface (opposes the rib cage) 
Mediastinal surface (opposes the mediastinum) 
Diaphragmatic surface (opposes the diaphragm)

Question 4

What is the hilum?

Answer 4

Located within the mediastinal surface

Contains the pulmonary A (superior and thicker walled) and V (anteroinferior), main bronchi and pulmonary L

Question 5

What features are present on the mediastinal surface of the right lung?

Answer 5

Cardiac impression, groove for the azygos V, esophagus, superior vena cava, inferior vena cava, 1st rib and brachiocephalic V

Question 6

What features are present on the mediastinal surface of the left lung?

Answer 6

Cardiac impression (more pronounced), groove for the aortic arch, descending aorta, 1st rib, and subclavian A

Question 7

What are the three borders of the lungs?

Answer 7

Anterior border (contains the cardiac notch and lingual on the left lung), inferior and posterior border

Question 8

Describe lung cancer

Answer 8

Can derive from actual tissue or from the bronchi (bronchogenic carcinoma)
Can involve the phrenic N, vagus N and recurrent laryngeal N due to the proximity of those nerves to the lungs

Question 9

What are some treatments for lung cancer?

Answer 9

Removal of a lung (pneumonectomy), a lobe of a lung (lobectomy) or a specific bronchopulmonary segment (segmentectomy) through a procedure called lung resection

Question 10

Describe the parietal pleura

Answer 10

Adherent to the thoracic wall, mediastinum and diaphragm 
Costal pleura (internal surface of the thoracic wall) 
Mediastinal pleura (lateral mediastinum) 
Diaphragmatic pleura (superior diaphragm) 
Cervical pleura (dome shaped over the apex of the lung)

Question 11

What is visceral pleura?

Answer 11

Adherent to the lungs and extends into the fissures

Question 12

What is pleuritis (pleurisy)?

Answer 12

An inflammation of the pleura producing a roughness on the lungs making breathing difficult

Question 13

What is the pleural cavity?

Answer 13

Potential space between the two layers of pleura that contains a serous lubricating fluid that reduces friction and produces cohesion through surface tension

Question 14

Pulmonary collapse occurs when enough air enters the what?

Answer 14

Pleural cavity to break the surface tension between the two layers of pleura
The elasticity of the lungs causes them to collapse

Question 15

What is a pneumothorax?

Answer 15

Entry of air into the pleural cavity from a penetrating wound to the thoracic wall or a rupture of a pulmonary lesion into the pleural cavity which results in a collapse of the lung

Question 16

What is a hydrothorax?

Answer 16

Accumulation of excess fluid in the pleural cavity usually the result of fluid escape into the pleural cavity or pleural effusion

Question 17

What is a hemothorax?

Answer 17

Accumulation of blood in the pleural cavity usually the result of a chest wound or the result of laceration of an intercostal vessel or internal thoracic vessel rather than laceration of the lung

Question 18

What are lines of pleural reflection?

Answer 18

Abrupt changes in the direction of parietal pleura

Includes the sternal, costal and vertebral line

Question 19

What is the sternal line of pleural reflection?

Answer 19

Costal pleura becomes mediastinal pleura anteriorly

Question 20

What is the costal line of pleural reflection?

Answer 20

Costal pleura becomes diaphragmatic pleura

Question 21

What is the vertebral line of pleural reflection?

Answer 21

Costal pleura becomes mediastinal pleura posteriorly

Question 22

Describe the right main bronchus

Answer 22

Also known as primary bronchus

Wider, shorter and runs more vertically than the left main bronchus

Question 23

What is the difference between bronchus/bronchi and bronchioles?

Answer 23

Bronchus and bronchi have cartilage

Bronchioles do not

Question 24

Each lobar (secondary) bronchus contains what?

Answer 24

Segmental bronchi, conducting bronchioles, terminal bronchioles, respiratory bronchioles and alveolar ducts

Question 25

What is a segmental bronchi?

Answer 25

Tertiary bronchi
Associated with corresponding bronchopulmonary segment
Branches into conducting bronchioles

Question 26

What are conducting bronchioles?

Answer 26

Devoid of cartilage

Branches into terminal bronchioles

Question 27

What are terminal bronchioles?

Answer 27

Devoid of cartilage

Branches into respiratory bronchioles

Question 28

What are respiratory bronchioles?

Answer 28

Devoid of cartilage
Capable of gas exchange
Branches into alveolar ducts

Question 29

What are alveolar ducts?

Answer 29

Ending at alveolus

The functional unit of the lung and the primary site for gas exchange

Question 30

What is bronchial asthma?

Answer 30

A widespread narrowing of the airways produced by contraction of smooth muscle, edema of the mucosa and mucus in the lumen of the bronchi and bronchioles

Question 31

Describe the left main bronchus

Answer 31

Primary bronchus

Travels inferolaterally

Question 32

What is a bronchoscopy?

Answer 32

Insertion of a bronchoscope into the trachea to visualize the main bronchi
Down the nose and into trachea to see split of the trachea into the R and L main bronchus
At split we have a ridge called the carina

Question 33

What are bronchopulmonary segments?

Answer 33

Pyramid shaped segment with apex at the hilum and base at the pulmonary surface
Separated by CT septa
Supplied by and named for a single segmental bronchus
Surgically resectable
Segmental bronchi go to these segments
Clinically relevant if you want to take out a piece of someone’s lung