Respiratory system 2 - Intro to Lung and Pleura Flashcards
What do we need to know about organs in anatomy?
Location & Relations, Shape & Function
Covering/s, Surfaces, Borders/Margins
Arterial supply, Venous + Lymphatic drainage, Innervation
Cross-sectional anatomy & Surface Anatomy
Histology & Embryology
Imaging (X-ray, CT, MRI, US)
Describe the main anatomical features of the respiratory tract?
Upper respiratory tract: nose, pharynx and larynx.
Lower respiratory tract : trachea, bronchi (primary, secondary and tertiary) and bronchioles (including terminal and respiratory) to alveoli.
Describe trachea (lower respiratory system)?
Trachea starts at the lower part of the larynx and bifurcate at the level of sternal angle (lower border of T4 vertebrae) to give rise to 2 main bronchi.
Describe the tracheobronchial tree?
Trachealis muscle lies posterior to the trachea and anterior to the oesophagus.
In left lobe- two secondary bronchus (superior and inferior)
In right- three secondary bronchus
(superior, middle and inferior) because right has three lobes
Meaning of primary, secondary and tertiary bronchi?
Primary- each lung
Secondary- each lobe
Tertiary- going to the segments
How many segments does each lung have?
8-10 segments
Describe the divisions of the bronchi?
CONDUCTING PORTION
main bronchus
lobar bronchus (secondary)
segmental bronchus (tertiary)
LOSES CARTILAGE
conducting bronchiole
terminal bronchiole
RESPIRATORY PORTION
respiratory bronchiole
alveolar duct
alveolar sac
alveolus
What is texture of the lung?
spongy
How many lobes and fissures do the left and right lung have?
left lung- two lobes and one fissure
right lung - three lobes and two fissures
What does the oblique fissure separate in the left and right lung?
left lung- superior from inferior
right lung- middle lobe from inferior lobe
How many borders do both of the lungs have and what are they?
three
anterior border- sharp and thin
inferior border- circular or oval
posterior border- more rounded
What are the three surfaces of the lungs?
Costal - convex
Mediastinal (Medial)- concave
Diaphragmatic (Inferior)- concave
What is the difference between roots and hila of the lungs?
Lung hilum is an area located on medial/mediastinal surface of lung.
Lung root is the group of structures (bronchus, artery, veins, lymphatics, nerves) that the enter or leave the lung hilum.
What are the structures in left and right hilum?
Left lung:
-artery higher
-bronchus lower
-pulmonary veins are same
What are the main structures related to the left lung (mediastinal surface)?
heart impression
esophagus
arch of the aorta
continues down as descending thoracic aorta
What are the major structures related to the right lung?
cardiac impression
inferior vena cava below hilum
azygous vein - drains into superior vena cava
esophageal groove at back of the hilum
superior vena cava
How many bronchopulmonary segments?
8-10 bronchopulmonary segments
What are the bronchopulmonary segments of the right lung?
Superior lobe
-apical
-posterior
-anterior
Middle lobe
-lateral
-medial
Inferior Lobe
-superior
-anterior basal
-medial basal
-lateral basal
-posterior basal
What are the bronchopulmonary segments of the left lung?
Superior lobe
-Apical and posterior typically combine into apicoposterior segment
-anterior
-superior
-lingular
-inferior
lingular
Inferior lobe
-superior
-anterior basal and medial basal often combined into anteromedial basal segment
-lateral basal
-posterior basal
Describe bronchopulmonary segment and what it’s clinical significance is?
A bronchopulmonary segment is a part of the lung that gets air from a specific bronchus (a small airway branch). Each lung has ten of these segments—five in the right lung and five in the left.
These segments are like separate “chunks” of the lung, each with its own airway and blood supply. However, while arteries (which carry oxygen-rich blood) follow the bronchial airways, veins (which carry oxygen-poor blood) drain blood from nearby segments. This means the segments aren’t completely independent in terms of blood flow, but they still mostly work on their own.
If there’s a problem like an infection or tumor in one segment, it usually stays in that area, making it easier for doctors to find and treat it. This is why it’s useful to think of the lung as being divided into these smaller, distinct sections.
Describe the blood supply of the lungs?
there are two bronchial arteries (core nutritional supply) on the left side coming from descending thoracic aorta
and one posterior intercostal artery on right side gives one bronchial artery
going to the hylum
What will the bronchial veins be draining?
the azygous and accessory hemizygous veins
Describe the lymphatic drainage of the lungs?
2 lymphatic plexuses: superficial and deep
superficial- draining lung hylum and also visceral pleura. Drains to Pulmonary LN, Bronchopulmonary LN, tracheobronchial LN, broncho-mediastinal LN, broncho-mediastinal lymph trunk.
Describe autonomic innervation?
pulmonary plexus supplies the lung- which is around hilum
Parasympathetic: Vagus nerve (motor to bronchial muscle, secretomotor to mucous glands, vasodilator) -
Sympathetic :T2-T5 or T1-4 (inhibitory to bronchial smooth muscles-bronchodilator, motor to blood vessel smooth muscle)
Describe the stuctural relationship with the heart?
- Pulmonary Arteries:
The pulmonary arteries carry deoxygenated blood (blood that is low in oxygen and high in carbon dioxide) from the right side of the heart (specifically the right ventricle) to the lungs.
This blood travels through the pulmonary arteries to the lungs, where it enters the capillaries surrounding the alveoli (tiny air sacs in the lungs).
In the lungs, oxygen from the air diffuses into the blood, while carbon dioxide is removed from the blood and exhaled from the body. - Pulmonary Veins:
Once the blood has been oxygenated in the lungs, it returns to the heart through the pulmonary veins.
The pulmonary veins carry oxygen-rich blood from the lungs back to the left side of the heart (specifically the left atrium).
From the left atrium, the blood is then pumped into the left ventricle, which in turn pumps it through the aorta to the rest of the body, providing tissues with the oxygen they need to function.
What is endothoracic fascia?
outside parietal pleura
What are the parts of the parietal pleura?
cervical (apex)
costal (ribs)
diaphragmatic
mediastinal (medial)
What nerve innervates the costal and cervical region of the parietal pleura?
intercostal nerve
What is the diaphragmatic portion of the lung supplied by?
phrenic nerve
What is visceral pleura innervated by?
phrenic and intercostal nerves
What is it called when there is air in the pleural cavity ?
pneumothorax
What is it called when there is blood in the pleural cavity ?
haemothorax
What is it called when pus is in the pleural cavity?
empyema
Describe the nerve supply of the parietal pleura?
Parietal pleura: Somatic nerve (Intercostal nerves, phrenic nerves). pain sensitive.
Visceral pleura: Autonomic nerves, not sensitive
What is a pleural reflection?
a place at which parietal pleura changes it direction of travel. Happens when pleura moves from one surface to another
What are pleural recesses?
Pleural recesses are areas of the pleural cavity where the parietal pleura does not come into contact with the visceral pleura (the pleura covering the lungs). These recesses are potential spaces that can accommodate lung expansion during deep breathing or when the lung volume increases.
What are the common pleural reflections?
Costomediastinal
Costodiaphragmatic
Where does the inferior margin cross?
Midclavicular line – Rib 6
Midaxillary line – Rib 8
Paravertebral line – Rib 10
What is the inferior margin of the parietal pleura?
Rib 8
Rib 10
Rib 12
Where is the horizontal fissure of right lung?
follows line of 4th rib anteriorly
Where is oblique fissure of both lungs?
Begins at spine of T3 /T2 (6th edition, Moore) and follows the line of the 6th rib anteriorly.
Describe asthma?
Immune disorder , inflammation of the airways, constriction of bronchial smooth muscles, increased mucous secretion, increased airway resistance, difficulty in breathing etc.
What is nerve blocking?
injection of medication close to a targeted nerve or group of nerves to provide temporary pain relief.
What is thoracocentesis
procedure to remove fluid with a needle from costaldiaphraghmatic recess
