Respiratory System 4: Lungs and Pleurae Flashcards
1
Q
What do the right and left pulmonary cavities contain?
A
The lungs.
2
Q
What lines the pulmonary cavities?
A
A pleural membrane (parietal pleura).
3
Q
What does the parietal pleura reflect onto and cover?
A
The external surface of the lungs, forming the visceral pleura.
4
Q
What is the difference between the parietal pleura and the visceral pleura?
A
The parietal pleura lines the pulmonary cavity, while the visceral pleura covers the external surface of the lungs.
5
Q
A
6
Q
What is the main function of the lungs?
A
To oxygenate the blood by bringing inhaled air into close relation with the venous blood in the pulmonary capillaries.
7
Q
What is the texture and size of the lungs in living people?
A
They are light, soft, spongy, and fully occupy the pulmonary cavities.
8
Q
How do the lungs change when the thoracic cavity is opened?
A
They recoil to approximately one-third of their size.
9
Q
Where do the apices of the lungs extend?
A
(apices = 2 apex’s = the top of lungs)
Above the level of the first rib into the root of the neck.
10
Q
A
11
Q
Name the lobes of the right lung.
A
Superior lobe, middle lobe, and inferior lobe.
12
Q
Name the lobes of the left lung.
A
Superior lobe and inferior lobe.
13
Q
What separates the lobes of the right lung?
A
The horizontal fissure and the oblique fissure.
14
Q
What separates the lobes of the left lung?
A
The oblique fissure.
15
Q
What unique feature does the left lung have at its inferior aspect?
A
The lingula.
16
Q
What part of the lung contains many impressions from neighboring structures?
A
The mediastinal surface of the lung.
17
Q
What does the mediastinal surface include?
A
The hilum.
18
Q
What is the function of the impressions on the mediastinal surface?
A
They are grooves created by neighboring structures resting on the lung’s surface.
19
Q
What is the cardiac notch?
A
An indentation on the left lung caused by the apex of the heart.
20
Q
What does the cardiac notch shape?
A
It shapes the most inferior and anterior part of the superior lobe into a tongue-like lingula.
21
Q
What is the lingula
A
A tongue-like projection of the superior lobe of the left lung
22
Q
A
23
Q
A
24
Q
What is the hilum of the lung?
A
The doorway through which the root of the lung passes.
25
What structures make up the roots of the lungs?
Main bronchi and associated bronchial vessels
Pulmonary arteries
Superior and inferior pairs of pulmonary veins
Pulmonary plexuses of nerves
Lymph nodes (not all visible on specimens)
26
What is the pulmonary ligament?
A structure formed by the continuity between the parietal and visceral pleurae inferior to the root of the lung.
27
28
What is the general arrangement of the main bronchus at the hilum of the right lung?
Posterior
29
What is the general arrangement of the pulmonary veins at the hilum of the right lung?
Anteriormost and inferiormost
30
What is the general arrangement of the pulmonary artery at the hilum of the right lung?
Positioned between the main bronchus and superior pulmonary vein
31
What is the general arrangement of the main bronchus at the hilum of the left lung?
Posterior
32
What is the general arrangement of the pulmonary veins at the hilum of the left lung?
Anteriormost and inferiormost
33
What is the general arrangement of the pulmonary artery at the hilum of the left lung?
Superiormost
34
What is the pleural cavity?
The potential space between the two layers of pleura containing serous pleural fluid, which lubricates the pleural surfaces and allows smooth sliding during respiration.
35
What role does surface tension of pleural fluid play?
It provides the cohesion that keeps the lung surface in contact with the thoracic wall, allowing the lung to expand and fill with air when the thorax expands.
36
What does the visceral pleura cover?
It covers and adheres to the surfaces of the lungs, including those within the horizontal and oblique fissures.
37
whats the order of the lining of the cavities and lungs, from outside to inside
38
What is the relationship between the parietal pleura and visceral pleura?
The visceral pleura is continuous with the parietal pleura at the hilum of the lung, where structures such as the bronchi and pulmonary vessels enter and leave the lungs.
39
What 3 places does the parietal pleura line?
The parietal pleura lines the thoracic wall, mediastinum, and diaphragm.
40
What is the endothoracic fascia?
A thin layer of loose connective tissue that separates the pleura from the thoracic wall. It is not well seen in embalmed donors.
41
What does the costal part of the parietal pleura cover?
It covers the internal surfaces of the thoracic wall facing the ribs.
42
What does the mediastinal part of the parietal pleura cover?
It faces the lateral aspect of the mediastinum.
43
What does the diaphragmatic part of the parietal pleura cover?
It covers the superior surface of the diaphragm.
44
What does the cervical part of the parietal pleura cover?
It covers the apex of the lung.
45
46
What is the costodiaphragmatic recess?
It is a narrow gap between the periphery of the diaphragm and the lower chest wall, forming an extension of the pleural cavity where the lungs do not occupy.
47
What is another name for the costodiaphragmatic recess?
The phrenic angle.
48
Which pleural layers are involved in forming the costodiaphragmatic recess?
The visceral pleura and parietal pleura.
49
Why is the costodiaphragmatic recess clinically significant?
It is a potential site for fluid accumulation in conditions such as pleural effusion, often visible in chest X-rays.
50
What is thoracocentesis?
A medical procedure where a needle is inserted through an intercostal space into the pleural cavity to obtain a sample of fluid.
51
Where is the needle inserted during thoracocentesis?
Through the 9th intercostal space, between the 9th and 10th ribs, in the midaxillary line to enter the costodiaphragmatic recess.
52
Why is the costodiaphragmatic recess used for thoracocentesis?
It is a space where fluid tends to accumulate, making it an ideal site for fluid sampling.
53
How can the risk of lung injury be minimized during thoracocentesis?
By asking the patient to exhale, avoiding the inferior border of the lungs.
54
Where do the cervical pleurae and apices of the lungs pass through?
Through the superior thoracic aperture deep to the supraclavicular fossae.
55
How do the anterior borders of the lungs run?
They run parallel to the reflections of the parietal pleura between the 2nd and 4th costal cartilages.
56
What happens to the left pleural margin?
It moves laterally and then inferiorly to reach the 6th costal cartilage.
57
What is distinct about the left anterior lung border?
It is more deeply indented by the cardiac notch, creating a gap with the pleural margin.
58
Where do the right anterior lung border and pleural margin stay parallel?
Until the 6th costal cartilage.
59
Where do the pleural margins reach at different lines?
Midclavicular line (MCL): At the 8th costal cartilage.
Midaxillary line (MAL): At the 10th rib.
Scapular line (SL): At the 12th rib.
60
Where do the inferior lung margins reach?
MCL: At the 6th rib.
MAL: At the 8th rib.
SL: At the 10th rib.
61
What is auscultation in lung examination?
Listening to the sounds of the lungs with a stethoscope.
62
What is percussion in lung examination?
Tapping on fingers pressed firmly on the thoracic wall over the lungs to detect underlying tissues (air-filled, fluid-filled, or solid).
63
What can auscultation and percussion assess?
They assess airflow into the lobes of the lungs and whether tissues are air-filled, fluid-filled, or solid.
64
How does the sound differ during percussion over the lung tissue versus the costodiaphragmatic recess?
The sounds will vary depending on whether the area is air-filled (lungs) or a space that may be filled with fluid (costodiaphragmatic recess).
65
What creates the bare area of the pericardium?
The deviation of the left anterior lung border and pleural margin from the median plane.
66
Why is the bare area of the pericardium clinically significant?
It allows access to the pericardial sac for needle puncture (pericardiocentesis) with less risk of puncturing the lungs or pleural cavity.
67
What procedure is performed at the bare area of the pericardium?
Pericardiocentesis, which removes excessive fluid in the pericardial cavity to relieve cardiac tamponade.
68
69
What causes lungs to remain distended despite their elasticity?
Surface tension provided by pleural fluid allows the visceral pleura to adhere to the parietal pleura.
70
What happens when the pleural cavity is punctured?
The surface tension is broken, air is sucked into the pleural cavity due to negative pressure, and the lung collapses.
71
What does the pleural cavity become when the lung collapses?
It becomes an actual space instead of a potential space.
72
What is pneumothorax?
The entry of air into the pleural cavity, causing lung collapse.
73
What is hemothorax?
The entry of blood into the pleural cavity, causing lung collapse.
74
How does a penetrating wound cause lung collapse?
By allowing air to enter the pleural cavity, disrupting the negative pressure and surface tension.
75
Which fibers innervate the parietal pleura?
Somatic afferent fibers.
76
What does the phrenic nerve supply in the parietal pleura?
The mediastinal and large portions of the diaphragmatic parts.
77
What does the intercostal nerve supply in the parietal pleura?
The small portions of the diaphragmatic, costal, and cervical parts.
78
How is the visceral pleura innervated?
By the pulmonary plexuses (parasympathetic, sympathetic, and visceral afferent fibers).
79
From which plexus are the nerves of the lungs derived?
Pulmonary plexus.
80
Where is the pulmonary plexus typically located?
Anterior and mainly posterior to the roots of the lungs.
81
What types of fibers does the pulmonary plexus contain?
Parasympathetic, sympathetic, and visceral afferent fibers
82
Which nerve provides parasympathetic fibers to the pulmonary plexus?
The vagus nerve.
83
What type of fibers are the parasympathetic fibers in the pulmonary plexus?
Preganglionic fibers.
84
What type of fibers are the sympathetic fibers in the pulmonary plexus?
Postganglionic fibers.
85
From where does the pulmonary plexus receive sympathetic fibers?
The cardiac nerves.
86
What supplies blood to each lung?
A pulmonary artery.
87
How is blood drained from each lung?
By two pulmonary veins.
88
Into what do pulmonary arteries divide?
Secondary lobar arteries.
89
What do secondary lobar arteries further divide into?
Segmental arteries.
90
What is the function of the superior and inferior pulmonary veins?
They carry oxygenated blood to the left atrium of the heart.
91
Do pulmonary veins follow the bronchial tree branching pattern?
No, they course between bronchopulmonary segments.
92
From where do pulmonary veins collect blood?
From within and among adjacent segments.
93
What supplies blood to the bronchi and visceral pleura?
The bronchial arteries.
94
How many bronchial arteries arise on the left side, and from where do they arise?
Two left bronchial arteries, arising directly from the thoracic aorta.
95
How does the single right bronchial artery commonly arise?
From the third posterior intercostal artery.
96
Into which vein do the right bronchial veins drain?
The azygos vein.
97
Into which veins do the left bronchial veins drain?
The accessory hemiazygos vein or the left superior intercostal vein (if the accessory hemiazygos vein is absent).
98
What does the superficial lymphatic plexus drain?
Lung tissues and visceral pleura.
99
What does the deep lymphatic plexus drain?
Structures of the root of the lung.
100
Where do the lymphatics of the lungs initially drain?
Bronchopulmonary (hilar) nodes.
101
After the hilar nodes, where does lymph drain?
To tracheobronchial nodes.
102
Where does lymph go after tracheobronchial nodes?
To paratracheal nodes.
103
Where do the paratracheal nodes drain lymph?
Into the bronchomediastinal trunks.
104
Where do the bronchomediastinal trunks ultimately drain?
Into the venous angles.
105
106
What is the first site of metastasis for primary lung tumors?
Bronchopulmonary lymph nodes.
107
What distant lymph nodes may enlarge due to lung tumor metastases?
Supraclavicular (scalene) nodes.
108
What does "Nx" represent in the TNM staging system?
Regional lymph nodes cannot be assessed.
109
What does "N0" represent in the TNM staging system?
No regional lymph node metastasis.
110
What does "N1" represent in the TNM staging system?
Metastasis in ipsilateral peribronchial, hilar lymph nodes, and/or intrapulmonary nodes.
111
What does "N2" represent in the TNM staging system?
Metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes.
112
What does "N3" represent in the TNM staging system?
Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph nodes.
