Respiratory System and Posterior Mediastinum

Question 1

Where does the trachea divide?

Answer 1

At the sternal angle anteriorly and T4-T5 posteriorly

Question 2

Describe the unique features of the right bronchi.

Answer 2

It is shorter, larger and more vertical than the left bronchi.

Question 3

Describe the unique features of the left bronchi.

Answer 3

It is longer, smaller and more horizontal than the right bronchi.

Question 4

What are some branches of the right bronchi?

Answer 4

Eparterial Bronchus

Hyparterial Bronchus

Question 5

What is the hilum of the lung?

Answer 5

The hilum is used interchangeably with the root of the lung and it is where the lung is attached to the trachea and the heart.

Question 6

Describe the left lung and its differences compared to the right lung.

Answer 6

The left lung has two lobes: inferior and superior, separated by the oblique fissure.

It also has the lingula, which is not present in the right lung.

Question 7

Describe the right lung and its differences compared to the left lung.

Answer 7

The right lung has three lobes: inferior, middle and superior, separated by the oblique and horizontal fissures.

Question 8

Describe the hilum of the left lung.

Answer 8

The pulmonary arteries lie superior to the bronchus and the pulmonary veins.

Question 9

Describe the hilum of the right lung.

Answer 9

The eparterial bronchus and the pulmonary arteries lie at approximately the same level.

Question 10

Where does the apex of the lung extend?

Answer 10

It extends into the apex of the neck, which is why neck injuries can affect the lung.

Question 11

Where does the cardiac notch lie?

Answer 11

It lies around the junction of the 4th rib cartilage.

Question 12

Where do the oblique fissures lie?

Answer 12

Around the 6th rib

Question 13

Where does the horizontal fissure lie?

Answer 13

Around the 4th rib

Question 14

What is the function of the bronchial arteries?

Answer 14

They supply the lung with oxygenated blood

Question 15

Describe the innervation of the lungs.

Answer 15

Vagus nerve provides both sympathetic and parasympathetic innervation.

Question 16

Describe respiration in adults.

Answer 16

The diaphragm moves down and the upper thoracic wall moves anteriorly while the lower thoracic wall moves laterally.

Question 17

What is the pulmonary ligament?

Answer 17

It is located at the root of the lung and is a double layer of parietal membrane that serves to hold the lower part of the lungs in position

Question 18

Which pleura covers the surface of the lung?

Answer 18

Visceral Pleura

Question 19

Which pleura lines the surface of the thoracic wall?

Answer 19

Parietal Pleura

Question 20

What are the sections of the parietal pleura?

Answer 20

Cupola
Costal
Mediastinal
Diaphragmatic

Question 21

What is the cupola?

Answer 21

It is part of the parietal pleura that covers the apex of the lungs.

Question 22

What is the costodiaphragmatic recess?

Answer 22

It extends from the 8th to the 10th rib on the mid-axillary line and is a space in the pleural cavity, at the posteriormost tips of the cavity, located at the junction of the costal pleura and diaphragmatic pleura.

Question 23

What is the costomediastinal recess?

Answer 23

It is a a potential space at the border of the mediastinal pleura and the costal pleura and it helps the lungs expand during deep inspiration.

Question 24

What are the three structures that go through the diaphragm and where do they pass?

Answer 24

Inferior Vena Cava at T8
Esophagus at T10
Aorta at 12

Question 25

What suspends the cupola?

Answer 25

Sibson's Fascia

Question 26

What are the surface projections of the visceral pleura?

Answer 26

``` Rib 2 - reaches midline Rib 4 - cardiac notch (left) Rib 6 - mid-clavicular line Rib 8 - mid-axillary line Rib 10 - posteriorly ```

Question 27

What are the surface projections of the parietal pleura?

Answer 27

``` Rib 2 - reaches midline Rib 4 - bare area Rib 6 - reflects along costal arch Rib 8 - mid-clavicular line Rib 10 - mid-axillary line Rib 12 - posteriorly ```

Question 28

Where does the trachea begin?

Answer 28

Cricoid Cartilage (C6)

Question 29

What is located at the bifurcation of the trachea?

Answer 29

Carina - cartilaginous ridge

Question 30

What is the lymphatic drainage of the lungs?

Answer 30

It is from pulmonary nodes to tracheobronchial nodes to bronchomediastinal trunks

Question 31

What are the contents of the posterior mediastinum?

Answer 31

``` Descending Aorta Azygos and Hemiazygos Veins Esophagus Vagus Nerve Thoracic Duct Thoracic Splanchnic Nerves ```

Question 32

Where does the azygos vein drain to?

Answer 32

Superior Vena Cava

Question 33

Where does the hemiazygos vein drain to?

Answer 33

Azygos Vein -> Superior Vena Cava