Thoracic Pulmonology Flashcards
Left lung lobes
Superior
Inferior
Lobes separated by oblique fissure
Right lung lobes
Superior, middle, inferior
Oblique fissure separates superior/middle from inferior
Horizontal fissure separates superior and middle lobes
Structures located at the pulmonary hilum
Pulmonary artery- thicker, more superior located vessel
Pulmonary vein- anteroinferior, has thinnest wall
Main bronchi- posteroinferior, has thickest wall which contains cartilage
Pulmonary ligament- hanging pleura from the root of the lung
Right lung grooves
Groove for: Azygous V Esophagus Superior/inferior vena cava 1st rib Brachiocephalic V
Left lung grooves
Groove for: Aortic arch Descending aorta 1st rib Subclavian artery
Anterior border of the lungs
Includes left lung
Cardiac notch- indentation of anteroinferior aspect of superior lobe
Lingula- thin process of superior lobe created by cardiac notch
Inferior border of the lungs
Projects into the costodiaphragmatic and costomediastinal recesses
Lung cancer
Can derive from actual lung tissue, or from the bronchi
Can involve the phrenic n., vagus n. and recurrent laryngeal n. due to their proximity to the lungs
Treatment can include removal of lung, lobe of lung, or a specific bronchopulmonary segment
Parietal pleura
Adherent to thoracic wall, mediastinum and diaphragm
Includes:
Costal pleura- internal surface of thoracic wall
Mediastinal pleura- lateral mediastinum
Diaphragmatic pleura- superior diaphragm
Cervical pleura- over apex of lung
Visceral pleura
Adherent to lungs, extends into the fissures
Pleuritis
Inflammation of the pleura producing a roughness on the lungs, making breathing difficult
Pulmonary collapse
Occurs when enough air enters the pleural cavity to break the surface tension b/w the two layers of pleura. The elasticity of the lungs causes them to collapse
Pneumothorax
Entry of air into the pleural cavity from a penetrating wound to the thoracic wall or a rupture of a pulmonary lesion into the pleural cavity, which results in lung collapse
Hydrothorax
Accumulation of excess fluid in the pleural cavity, usually the result of fluid escape into the pleural cavity or pleural effusion
Hemothorax
Accumulation of blood in the pleural cavity, usually the result of a chest wound, or laceration of an intercostal vessel or internal thoracic vessel rather than laceration of the lung
Sternal line of pleural reflection
Costal pleura becomes mediastinal pleura anteriorly
Costal line of pleural reflection
Costal pleura becomes diaphragmatic pleura
Vertebral line of pleural reflection
Costal pleura becomes mediastinal pleura posteriorly
Trachea branch point
Posterior mediastinum
Right main bronchus
Wider, shorter and runs more vertically than the left main bronchus
Segmental bronchi
Tertiary bronchi, associated corresponding bronchopulmonary segment, branches into conducting bronchioles
Bronchiole pathway
Primary-> Segmental-> Conducting-> Terminal-> Respiratory-> Alveolar duct- functional unit of the lung
Secondary bronchus is the
Right superior, middle and inferior lobar bronchi
Bronchial asthma
Widespread narrowing of the airways produced by contraction of smooth muscle, edema of the mucosa and mucus in the lumen of the bronchi and bronchioles
Bronchopulmonary segments of right superior lobe
Apical, posterior, anterior
BP segments of right middle lobe
Lateral, medial
BP segments of right inferior lobe
Superior, anterior basal, medial basal, lateral basal and posterior basal
BP segments of left superior lobe
Apical, posterior (usually combined as apicoposterior), anterior, superior and inferior (sup/inf are lingular)
BP segments of left inferior lobe
Superior, anterior basal, medial basal (usually combined as anteromedial basal), lateral basal, posterior basal
