Thoracic Cavity

Question 1

List the cavities in the thoracic cavity and identify in which cavities the pleural cavities are found

Answer 1

• 2 pulmonary cavities
  
  • 2 pleural cavities
  • consists of lung and surounding pleural cavity
• mediastinum
  
  • heart, lymphnodes, large vessels to heart

Question 2

Which cavity contains the pleural fluid and what is the function of the pleural fluid?

Answer 2

pleural cavity

function

• pleural fluid allows pleura to slide over eachother during inspiration (keeps from sticking)

Question 3

On a diagram, identify and label the fissures, lobes, and cardiac notch.

Answer 3

Question 4

Why is the diaphragm higher on the right side then the left?

Answer 4

the liver sites on the right side

Question 5

True or false: The left lung is larger and shorter than the right lung because the diaphragm is on the left side.

Answer 5

false: right is larger and shorter than the left lung because the diaphragm is on the right side

Question 6

What lobes are found in the left and right lung?

Answer 6

Left

• superior
• inferior

Right

• superior
• middle
• inferior

Question 7

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.

Answer 7

cardiac notch

Question 8

Label the lingula, parietal pleura, recesses and cardiac notch.

Answer 8

Question 9

On a diagram, distinguish between the visceral and parietal pleural and identify the roots of the lungs.

Answer 9

root of lung: where bronchi enter the lungs at the hilum

Question 10

List the parts of the parietal pleura and indicate where they are located.

Answer 10

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

Question 11

List the lines of pleural reflection and describe their locations.

Answer 11

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

Question 13

Describe the recesses in terms of their locations and features. Indicate the relationship of the lingula with the costomediastinal recess during inspiration and expiration.

Answer 13

• 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

Question 14

Indicate how many lobes are found in each lung and the fissures found in each lung. Indicate on which lobe the lingula is found.

Answer 14

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

Question 15

Describe the pulmonary ligament and pleural sleeves and identify them on a diagram.

Answer 15

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

Question 16

Describe the lung apex.

Answer 16

• most superior part of the lung that extends into the root of the lung

Question 17

What are the three lung surfaces and the three lung borders? Identify on a diagram.

Answer 17

3 surfaces

• diaphragmatic surface
• mediastinal surface
• costal surface

3 borders

• inferior
• posterior
• anterior

Question 18

What are the three lung surfaces and the three lung borders? Identify on a diagram.

Answer 18

Question 19

What are the three lung surfaces and the three lung borders? Identify on a diagram.

Answer 19

Question 20

Which way does the pulmonary ligament curve?

Answer 20

anteriorly

Question 21

The _____ is where the structures enter the lung.

Answer 21

hilum

Question 22

Where is the main bronchus?

Answer 22

middle of posterior boundary

Question 23

What is the most anterior structure in the hilum of the left lung?

Answer 23

superior pulmonary vein

Question 24

What is the most inferior structure on the hilum of the left lung?

Answer 24

inferior pulmonary vein

Question 25

At the hilum of the left lung, which is most superior?

Answer 25

left pulmonary artery

Question 26

At the hilum of the right lung, which is most superior?

Answer 26

right lobar bronchus

Question 27

At the hilum of the right lung, which is the most inferior structure?

Answer 27

inferior pulmonary vein

Question 28

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

Question 29

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

Answer 29

Question 30

Describe and reproduce a flow chart of the bronchial tree.

Answer 30

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

Question 31

Describe, identify and label the structures of the bronchial tree.

Answer 31

Question 32

Name the bronchopulmonary segments and indicate which lobes they belong to

Answer 32

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

Question 33

Which bronchopulmonary segments in the left lobe are equivalent to the lateral and medial right middle lobe?

Answer 33

* superior lingular * inferior lingular

Question 34

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

Answer 34

Question 35

What is the hilum?

Answer 35

the place where structures enter the lung

Question 36

Identify on a diagram the following arteries: left and right bronchial, right superior posterior intercostal artery, right 34d intercostal artery, left superior intercostal artery

Answer 36

Question 37

Which structures are supplied by the broncial arteries?

Answer 37

supply the roots of the lung and the visceral pleura

Question 38

Where does the left bronchial artery branch from?

Answer 38

direct branch from the thoracic artery

Question 39

Where does the right bronchial artery branch from?

Answer 39

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

Question 40

Indicate what the bronchial veins drain and what the pulmonary veins drain.

Answer 40

bronchial veins * drain blood to bronchial arterys pulmonary veins * drain blood from the lungs

Question 41

Indicate which structure the right bronchial vein drains into

Answer 41

azygous vein

Question 42

Indicate which structure the left bronchial vein drains into

Answer 42

* accessory hemi-azygous vein * left superior intercostal vein

Question 43

Indicate where the parietal pleura veins drain

Answer 43

* systemic veins fo the thoracic wall like the azygous vein

Question 44

Indicate where the visceral pleura veins drain.

Answer 44

* pulmonary veins

Question 45

Describe the superficial lymphatic drainage.

Answer 45

* 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

Question 46

Describe the deep lymphatic drainage.

Answer 46

* 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

Question 47

Describe the parasympathetic supply of the lungs including where the ganglion cells are located as well as the motor and visceral afferent effects.

Answer 47

* 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 * visceral afferent effects * bronchial mucosa * cough reflex * bronchial muscles * stretch * intralveolar connective tisue * pulmonary arteries * BP receptors * pulmonary veins * chemoreceptors for blood gases

Question 48

Describe the sympathetic supply of the lungs including where the ganglia are located as well as the effects.

Answer 48

* ganglia are paravertebral * sympathetic ganglia * bronchodilator * inhibitory to bronchial muscle * vasoconstrictor * motor to pulmonary vessels * inhibitory to alveolar glands of the bronchial tree * needs to divert blood away from the lungs because the blood must be at the skeletal muscle

Question 49

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

Answer 49

Question 50

Distinguish the pulmonary plexuses from the cardiac plexuses.

Answer 50

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

Question 51

Which line of pleural reflection does the costal pleura become continuous with the diaphragmatic pleura inferiorly?

Answer 51

costal line of pleural reflection

Question 52

Which structure moves in and out of the costomediastinal recess during inspiration and expiration?

Answer 52

lingula

Question 53

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?

Answer 53

pulmonary ligament

Question 54

Which vein do veins from the parietal pleura drain into?

Answer 54

systemic veins of the thoracic wall (ex. azygous vein)

Question 55

Which veins do the visceral pleura drain into?

Answer 55

* pulmonary veins

Question 56

What is the starting point for deep lymphatic drainage that drains the bronchi and surrounding tissue?

Answer 56

pulmonary lymph nodes

Question 57

What is the first step for the superficial lymphatic drainage?

Answer 57

bronchopulmonary nodes