Thoracic Cavity Flashcards
List the cavities in the thoracic cavity and identify in which cavities the pleural cavities are found
- 2 pulmonary cavities
- 2 pleural cavities
- consists of lung and surounding pleural cavity
- mediastinum
- heart, lymphnodes, large vessels to heart
Which cavity contains the pleural fluid and what is the function of the pleural fluid?
pleural cavity
function
- pleural fluid allows pleura to slide over eachother during inspiration (keeps from sticking)
On a diagram, identify and label the fissures, lobes, and cardiac notch.
Why is the diaphragm higher on the right side then the left?
the liver sites on the right side
True or false: The left lung is larger and shorter than the right lung because the diaphragm is on the left side.
false: right is larger and shorter than the left lung because the diaphragm is on the right side
What lobes are found in the left and right lung?
Left
- superior
- inferior
Right
- superior
- middle
- inferior
Since the heart sits slightly to the left, on the left lung there is a _____ where it looks like a piece of the lung has been removed to fit the heart.
cardiac notch
Label the lingula, parietal pleura, recesses and cardiac notch.
On a diagram, distinguish between the visceral and parietal pleural and identify the roots of the lungs.
root of lung: where bronchi enter the lungs at the hilum
List the parts of the parietal pleura and indicate where they are located.
Costal
- covers sternum, ribs, costal cartilage, intercostal muscles, sides of thoracic spine vertebrae
Cervical
- extends into the foot of the neck 3 cm superior to the medial end of the clavicle
Mediastinal
- faces mediastinum
Diaphragmatic
- faces superior surface of the diaphragm
List the lines of pleural reflection and describe their locations.
sternal line of pleural reflection
- anterior
- costal pleura becomes continuous with mediastinal pleura
vertebral line of pleural reflecion
- posterior
- where the costal pleura becomes continuous with the mediastinal pleura posteriorly
costal line of pleural reflection
- inferior
- costal pleura becomes continuous with diaphragmatic pleura
Describe the recesses in terms of their locations and features. Indicate the relationship of the lingula with the costomediastinal recess during inspiration and expiration.
- costamedialstinal recess is larger on the left than it is on the right because of the cardiac notch
- costodiaphragmatic recess is inferior and lateral to the costomediastinal recess
- lingula moves in and out of costomediastinal recess
Indicate how many lobes are found in each lung and the fissures found in each lung. Indicate on which lobe the lingula is found.
Right lung (3 lobes)
- superior
- middle
- inferior
- horizontal fissure separates
- superior
- middle
- oblique fissure separates
- middle
- inferior
Left lung (2 lobes)
- superior
- contains lingula
- inferior
- oblique fissure separates
- superior
- inferior
Describe the pulmonary ligament and pleural sleeves and identify them on a diagram.
pulmonary ligament
- a continuation of the visceral and parietal pleura below the root
pleural sleeve
- at the root of the lung
- visceral and parietal pleura are continuous with eachother
Describe the lung apex.
- most superior part of the lung that extends into the root of the lung
What are the three lung surfaces and the three lung borders? Identify on a diagram.
3 surfaces
- diaphragmatic surface
- mediastinal surface
- costal surface
3 borders
- inferior
- posterior
- anterior
What are the three lung surfaces and the three lung borders? Identify on a diagram.
What are the three lung surfaces and the three lung borders? Identify on a diagram.
Which way does the pulmonary ligament curve?
anteriorly
The _____ is where the structures enter the lung.
hilum
Where is the main bronchus?
middle of posterior boundary
What is the most anterior structure in the hilum of the left lung?
superior pulmonary vein
What is the most inferior structure on the hilum of the left lung?
inferior pulmonary vein
At the hilum of the left lung, which is most superior?
left pulmonary artery
At the hilum of the right lung, which is most superior?
right lobar bronchus
At the hilum of the right lung, which is the most inferior structure?
inferior pulmonary vein
Label: hilum, cardiac notch, cardiac area, lingula, thoracic duct, vagus nerve, phrenic nerve, oblique fissure, pulmonary artery, left main bronchus, superior and inferior pulmonary vein, pleural sleeve
Label: pleural sleeve, oblique fissure, horizontal fissure, vagus nerve, phrenic nerve, pulmonary ligament, superior lobar bronchus, superior and inferior pulmonary artery, groove for azygous vein
Describe and reproduce a flow chart of the bronchial tree.
Main bronchus (primary bronchi)
- Secondary bronchi (lobar bronchi)
- 2 on left
- 3 on right
- Tertiary bronchi (segmental bronchi)
- Terminal bronchioles
- Respiratory bronchioles
- Alveolar ducts
- Alveolar sacs
Describe, identify and label the structures of the bronchial tree.
Name the bronchopulmonary segments and indicate which lobes they belong to
Right Superior Lobe
- apical
- posterior
- anterior
Right Middle Lobe
- lateral
- medial
Right Inferior Lobe
- Superior
- Anterior basal
- Medial basal
- Lateral basal
- Posterior basal
_______________________
Left Superior Lobe
- Apical
- Posterior
- Anterior
- Superior lingular
- inferior lingular
Left Inferior Lobe
- superior
- anterior basal
- medial basal
- lateral basal
- posterior basal
Which bronchopulmonary segments in the left lobe are equivalent to the lateral and medial right middle lobe?
- superior lingular
- inferior lingular
Identify the following on diagrams of he mediastini and hilar aspects: lobar bronchi, pulmonary veins, pulmonary ligaments, pulmonary arteries, plueral sleeves, cardiac areas, oblique fissures, cardiac notch, lingula, apex, superior lobar bronchi, middle and inferior lobar bronchi, pulmonary ligament, fissures
What is the hilum?
the place where structures enter the lung
Identify on a diagram the following arteries: left and right bronchial, right superior posterior intercostal artery, right 34d intercostal artery, left superior intercostal artery
Which structures are supplied by the broncial arteries?
supply the roots of the lung and the visceral pleura
Where does the left bronchial artery branch from?
direct branch from the thoracic artery
Where does the right bronchial artery branch from?
ANY of 3 variations (can only be 1 variation, but never 2 or 3)
- right superior posterior intercostal artery
- right 3rd intercostal artery
- left superior intercostal artery
Indicate what the bronchial veins drain and what the pulmonary veins drain.
bronchial veins
- drain blood to bronchial arterys
pulmonary veins
- drain blood from the lungs
Indicate which structure the right bronchial vein drains into
azygous vein
Indicate which structure the left bronchial vein drains into
- accessory hemi-azygous vein
- left superior intercostal vein
Indicate where the parietal pleura veins drain
- systemic veins fo the thoracic wall like the azygous vein
Indicate where the visceral pleura veins drain.
- pulmonary veins
Describe the superficial lymphatic drainage.
- drains the lungs and pleura
- drains first into the bronchopulmonary nodes –> superior and inferior trachial bronchial nodes –> right and left bronchomediastinal trunks –> right trunk: right lymphatic duct, left trunk: thoracic duct
Describe the deep lymphatic drainage.
- bronchi and surrounding tissues
- drainage starts at the pulmonary or interpulmonary nodes –> bronchopulmonary nodes –> superior and inferior trachial bronchial nodes –> right and left bronchomediastinal trunks –> right trunk: right lymphatic duct, left trunk: thoracic duct
Describe the parasympathetic supply of the lungs including where the ganglion cells are located as well as the motor and visceral afferent effects.
- nerves of the parasympathtic lung pleura direct more blood towards the visceral organs (i.e. lungs)
- CNX (Vagus)
- ganglion cells are in the right and left pulmonary plexuses and along the branches of the bronchial tree
- motor effects
- bronchoconstrictor (smooth muscle cells of bronchus)
- oxygenation not a concern when relaxed
- vasodilator (inhibitory to pulmonary vessels)
- have to inhibit the muscle in the arterioles for vasodilation to occur
- secretomotor (glands of bronchial tree)
- produce mucus
- bronchoconstrictor (smooth muscle cells of bronchus)
- visceral afferent effects
- bronchial mucosa
- cough reflex
- bronchial muscles
- stretch
- intralveolar connective tisue
- pulmonary arteries
- BP receptors
- pulmonary veins
- chemoreceptors for blood gases
- bronchial mucosa
Describe the sympathetic supply of the lungs including where the ganglia are located as well as the effects.
- ganglia are paravertebral
- sympathetic ganglia
- bronchodilator
- inhibitory to bronchial muscle
- vasoconstrictor
- motor to pulmonary vessels
- inhibitory to alveolar glands of the bronchial tree
- bronchodilator
- needs to divert blood away from the lungs because the blood must be at the skeletal muscle
Identify on a diagra the following structures: middle cervical ganglion, cervicothoracic ganglion, right vagus nerve, left vagus nerve, sympathetic trunk, right pulmonary plexus and left pulmonary plexus
Distinguish the pulmonary plexuses from the cardiac plexuses.
pulmonary plexus
- autonomic plexus formed from pulmonary branches of the vagus nerve and sympathetic trunk
- innervates bronchial tree and visceral pleura
cardiac plexus
- sitting at the base of the heart
- cardiac branches derived from parasympathetic and sympathetic nervous system
- innervates the heart
Which line of pleural reflection does the costal pleura become continuous with the diaphragmatic pleura inferiorly?
costal line of pleural reflection
Which structure moves in and out of the costomediastinal recess during inspiration and expiration?
lingula
What is the name of the structure seen on the medial view of the lung that is the downward or inferior continuation of the visceral and parietal pleura?
pulmonary ligament
Which vein do veins from the parietal pleura drain into?
systemic veins of the thoracic wall (ex. azygous vein)
Which veins do the visceral pleura drain into?
- pulmonary veins
What is the starting point for deep lymphatic drainage that drains the bronchi and surrounding tissue?
pulmonary lymph nodes
What is the first step for the superficial lymphatic drainage?
bronchopulmonary nodes
