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The Pleura and Lungs Flashcards

1
Q

Abbreviation for layers of thorax and label the diagram below.

A

SSDMEPPV

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2
Q

Pleura definition

A

serous membrane that lines the pulmonary cavity and invests the lungs; parietal pleura and visceral pleura

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3
Q

pleural cavity definition

A

potential space between the layers of pleura

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4
Q

Parietal pleura lines the

A

pulmonary cavities

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5
Q

Visceral pleura lines the

A

invests/envelops the parenchyma each lung

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6
Q

What are the 4 parts of the parietal pleura?

A
  • costal part - thoracic wall
  • mediastinal part - mediastinum
  • diaphragmatic part - superior surface of the diagram
  • cervical pleura - lung apex
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7
Q

Costal part of parietal pleura is associated with the —— part of the thoracic wall.

A

anteriolateral

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8
Q

The cervical pleura sits at the

A

root of the neck and extends above the first rib (cervical vertebrae at the base of the neck

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9
Q

Pleural reflections

A

change in direction of pleura from one wall of pleural cavity to another:

  • sternal reflection = anteriorly, costal parietal pleura becomes mediastinal part
  • costal reflection = costal part becomes diaphragmatic part, an inferior reflection
  • vertebral reflection = posteriorly, costal parietal pleura becomes mediastinal part

all parts are present on both left and right lungs

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10
Q

Pleural Recesses

A

slightly expanded pleural reflection

larger pleural spaces, allow for lung expansion in forced inspiration:

  • costodiaphragmatic recess:
  • costomediastinal recess
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11
Q

Costomediastinal recess

A

at costal and sternal reflection, on left hand side, greater change in direction as we have to go around the mediastinum

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12
Q

Costodiaphragmatic/ costophrenic recess

A

most inferior recess of costal reflection, costal part becomes diaphragmatic part, lungs expand when we inhale, so fill the space inferiorly.

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13
Q

Clinically importance of costodiaphragmatic recess

A

normally a sharp angle
if blunting of angle occurs, generally excess fluid in pleural recess, indicative of a pathology

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14
Q

How many secondary/lobar bronchi on the left?

A

2

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15
Q

How many secondary/lobar bronchi on the right?

A

3

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16
Q

Right main bronchus is short, wide and travels more vertically.

True or False?

A

True

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17
Q

Left main bronchus is long, narrow, inferolateral.

True or False?

A

True

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18
Q

Any inhaled foreign body is more likely to pass through the right main bronchus because

A

Wider and more vertical, hence a clearer continuation of the trachea

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19
Q

How many lobar bronchi are there?

A

5
One bronchi going to each lobe of the lung
2 left
3 right

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20
Q

Terminal bronchioles further divide into

A

respiratory bronchioles

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21
Q

Respiratory bronchioles further divide into

A

alveolar ducts and sac, which further divide into alveoli

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22
Q

How many alveolar ducts per respiratory bronchioles?

A

2-11

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23
Q

How many alveolar sacs per alveolar duct?

A

5-6 sacs

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24
Q

How many alveoli in the lungs?

A

300 million alveoli per lung

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25
Location of the lungs
within respective pulmonary cavity, surrounded by visceral pleura
26
List the features of lungs (6):
* apex * base * lobes * fissures * surfaces * borders
27
Apex of the lung:
covered by cervical pleura, extends into the root of the neck apex of the lung is the superior peak; not always the case like the heart
28
Base of the lung:
Lays on each hemi-diaphragm Opposite the apex
29
Lobes of the lung:
superior, middle (right only), inferior
30
Fissures of the lung:
oblique (both), horizontal (right only)
31
Surfaces of the lung:
Costal, diaphragmatic, mediastinal
32
Borders of the lung:
anterior, posterior and inferior Change in direction in surface of the lung
33
Left lung features:
Lingula = little tongue like projection (posterior) Cardiac notch = covers the heart/ middle mediastinum Lobes = superior and inferior Fissures = oblique fissure, higher posteriorly than anteriorly, separates superior and inferior lobe Surfaces = costal, diaphragmatic, mediastinal Borders= anterior, inferior, posterior
34
Diagram of left lung:
35
Right Lung features
Lobes = superior, middle, inferior Fissures = oblique fissure in same orientation as left lung, horizontal fissure divides superior and middle lobes Surfaces = mediastinal, costal, diaphragmatic Borders = anterior, posterior, inferior
36
Bronchopulmonary segments:
- pyramidal shaped segments - apices faces root (medially), base faces pleural surface (externally/superficially) - 10 in right lung - 8-10 in the left lung - named after segmental/tertiary bronchus
37
Bronchopulmonary segments diagram
insert
38
serous membrane develops from what embryological structure?
lateral plate mesoderm
39
The cervical pleura is inferior to the clavicle. True or False?
False Cervical pleura is 2/3 cm superior to 1/3 of the medial clavicle or 3-4cm above the first costal cartilage
40
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Root (lungs):
all structures collectively entering and exiting the hilum of the lung
43
Hilum
wedge shaped depression where those structures enter and exit
44
Root of the left lung:
- pulmonary artery - superior pulmonary vein - inferior pulmonary vein - Bronchial artery x2 - Bronchial Vein - Main bronchus - Pulmonary plexus - Lymphatic vessels
45
Root of the right lung:
- pulmonary artery - superior pulmonary vein - inferior pulmonary vein - bronchia artery x3 - bronchial vein - pulmonary plexus - lymphatic vessels
46
General organisation of the root of lung diagram:
47
Hilum of the left lung diagram:
- pulmonary artery sits higher than the main bronchus
48
Hilum of the right lung diagram and deviation from general organisation:
-
49
Hilum features ( & root of lung):
Pleural Sleeve: reflection from parietal to visceral pleura, surrounding the root of the lung Pulmonary ligament: inferior continuation of the pleural sleeve
50
What is the green and red label?
bit that hangs down is pulmonary ligament
51
Pulmonary circulation
supplies the lung parenchyma, involved in gas exchange oxygenated and deoxygenated switched around out Low pressure system
52
Bronchial circulation
supplies the tracheobronchial tree till respiratory bronchioles, root of lung, supporting lung tissue, visceral pleura systemic system, follows normal oxygenated and deoxygenated, higher pressure
53
Pulmonary arteries are (2)
right and left
54
pulmonary veins are (4) and drain into
right superior right inferior left superior left inferior - bronchopulmonary segment veins merge and eventually form pulmonary veins which drain into the left atrium of the heart
55
Pulmonary circulatory system diagram
56
Bronchial arteries arise from
2 on the left 1 on the right arise directly from the thoracic aorta on left arise as a single trunk with the left superior bronchial artery or can branch off the right third posterior intercostal artery
57
Bronchial veins drain
Right and Left Right vein drains into azygous vein Left bronchial vein drains into accessory hemiazygous vein all drains into azygous, which drains into the superior vena cava at bifurcation of trachea sternal angle
58
Bronchial circulation diagram:
59
Bronchial circulation diagram:
60
Innervatiion of parietal pleura is ----- and therefore
somatic Sensory supply to parietal pleura: left and right phrenic nerves, C3-C5, intercostal nerves
61
Innervation of visceral pleura, which --------, hence ----- and therefore ------
- visceral - sensory supply to visceral pleura: sympathetic trunk T2-T6
62
Innervation of lungs are ------- afferents and -------
visceral afferents and autonomic
63
Mixed signals of sympathetic and parasympathetic travel to and fro from lungs via a
plexus
64
Pulmonary Plexus (mixed) innervation LUNGS
Sensory supply: Vagus nerve (parasympathetic pathway) C10 Somatic nervous system: Sympathetic Trunk T2-T6 Parasympathetic Nervous System: Vagus nerve C10
65
what dermatomes for referred parietal pleura pain
C3-C5; cervical and shoulder
66
Innervation of any serous membrane lining viscera will have same innervation
as viscera it is lining
67
Innervation diagram:
68
Last card about dermatome confusion pain
complete
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Right lung:
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HLB (49 decks)

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