Station 5

Question 1

Which lung lobe has the lingula and cardiac notch?

Answer 1

Left upper lobe

Question 2

What is the surface anatomy of the lung fissures of the R lung?

Answer 2

Horizontal: anteriorly 4th rib, 5th rib in midaxillary line.

Oblique: anteriorly 6th rib, 5th rib in midaxillary line, T4 posteriorly

Question 3

Surface anatomy of lung fissures of L lung

Answer 3

Oblique: 6th ib anteriorly, 5th rib in mid-axillary line, T4 posteriorly

Question 4

Structures and relative position of hilum

Answer 4

Arteries: superior, posterior

Veins: Inferior, more anterior

Bronchi: Somewhere in between identifiable by their cartilage

Hilar lymph nodes

Pulmonary ligament descending inferiorly

Question 5

On plain film, what structures are seen in the hilar regions?

Answer 5

pulmonary arteries and veins filled with blood

Question 6

Describe the bronchial blood supply

Answer 6

Bronchial arteries, arising from the posterior intercostals or the thoracic aorta

Bronchial veins empty into azygos system or into pulmonary veins (venous admixture)

Question 7

Describe the lymphatic drainage of the lungs. Relevance?

Answer 7

Intrapulmonary nodes, hilar nodes, inferior tracheobronchial nodes, superior tracheobronchial nodes, paratracheal nodes, then drain into bronchomediastinal lymph trunks which drain into either the Right Lymphatic Duct, or the Thoracic duct.

*Note, sometimes lymph from lungs may drain into deep inferior cervical nodes *

Imprtant for cancer cell spread through lymph nodes