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Gross Anatomy > Thorax: Pleura and Lungs > Flashcards

Thorax: Pleura and Lungs Flashcards

1
Q

Divisions of the Thoracic Cavity

A
  • Pulmonary cavities

- Mediastinum

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2
Q

Pulmonary Cavities

A
  • Lungs

- Pleurae (pleural cavity)

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3
Q

Mediastinum

A
  • Between pulmonary cavities

- Contains all other thoracic structures

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4
Q

Pleurae

A
  • Double layer cavity that surround the lungs
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5
Q

Mediastinum

A
  • Anything that is not the lungs or pleura
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6
Q

Pleural Sac

A
  • 2 continuous membranes that enclose the lungs
  • Visceral Pleura
  • Parietal Pleura
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7
Q

Visceral Pleura

A
  • Covers the surface of the lung

- Lacks nociceptive innervation

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8
Q

Parietal Pleura

A
  • Lines thoracic wall/mediastinum
  • Somatic innervation, nociceptive innervations
  • Intercostals and phrenic nerves
  • Named based on location
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9
Q

Hila

A
  • Parietal and visceral layers are continuous with each other at the lung at this site
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10
Q

Pleural Cavity

A
  • Space between pleural layers

- Contains serous fluid secreted by the pleurae

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11
Q

Endothoracic Fascia

A
  • Fascial layer
  • Separates parietal pleura from inner thoracic wall and diaphragm
  • Cleavage plane
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12
Q

Costal Pleura

A
  • Parietal pleura that covers inner thoracic wall

- Lining the ribs

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13
Q

Diaphragmatic Pleura

A
  • Parietal Pleura that covers superior diaphragm
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14
Q

Mediastinal Pleura

A
  • Parietal pleura that covers mediastinum

- Lateral reflection covers root of lung and is continuous with visceral pleura

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15
Q

Cervical Pleura (Cupola)

A
  • Parietal pleura that covers apex of the lung

- Extension of mediastinal and costal pleura through thoracic inlet

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16
Q

Suprapleural Membrane (Sibson Fascia)

A
  • Extension of endothoracic fascia from rib 1 to C7 TP
  • Protects lung apex, encloses thoracic cavity
  • Penetrating trauma above the clavicle can damage the parietal pleural, suprapleural membrane, and lung apex
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17
Q

Pleurisy (Pleuritis)

A
  • Inflammation, irritation of pleural membrane
  • Pleural layers rub instead of glide past each other
  • Chest pain with respiration
  • Can also have back, neck and shoulder pain
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18
Q

Root of the Lung

A
  • Mediastinal structures going to the lung
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19
Q

Sternal Lines of Pleural Reflection

A
  • Junction of mediastinal and costal pleurae anteriorly
  • Left and right in contact between ribs 2-4
  • Left deviates laterally at rib 4 vs. 6 on right (clinically important)
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20
Q

Costal Lines of Pleural Reflection

A
  • Costal pleura continuous with diaphragmatic pleura
  • Left line begins more lateral
  • Midclavicular, midaxillary, and posterior
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21
Q

Midclavicular Line

A
  • Rib 8
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22
Q

Midaxillary Line

A
  • Rib 10
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23
Q

Posterior Line

A
  • Rib 12
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24
Q

Costodiaphragmatic Recess (Gutter)

A
  • Potential space in pleural cavity
  • Jxn of costal and diaphragmatic pleurae
  • Lungs do not fill pulmonary cavity (except with deep inspiration)
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25
Costomediastinal Recesses
- Potential space at border of costal and mediastinal pleurae - Left is larger than right
26
Pleural Space Pathology
- Hydrothorax: fluid - Hemothorax: blood - Chylothorax: lymph - Pneumothorax: air
27
Hydrothorax
- Fluid
28
Hemothorax
- Blood
29
Chylothorax
- Lymph
30
Pneumothorax
- Air
31
Thoracocentesis (Pleural Trap)
- Percutaneous procedure where a needle is inserted into the pleural space - Diagnostic or therapeutic - Midaxillary or midposterior line - Posterior approach is preferred (deeper gutter, wider space between ribs) - Needle inserted superior to rib, bottom of intercostal space - Below rib 9 (your textbook) - Too deep, can penetrate diaphragm and underlying viscera
32
Horizontal Fissure
- Separates superior and middle lobes of right lung
33
Oblique Fissure
- Separates superior and inferior lobes of left lung | - Inferior lobe from the middle and superior lobes of right lung
34
Lingula
- Part of superior lobe of left lung
35
Oblique Fissure
- Begins at the level of T4-ish SP posteriorly | - Ends at rib 6 costal cartilage antero-laterally
36
Horizontal Fissure
- Follows anterior aspect of right rib 4
37
Hila of the Lungs
- Mediastinal surface | - Entrance of lung root
38
Root of the Lung
- Structures that attach the lung to the mediastinum - Surrounded by pleural sleeve (continuity between parietal and visceral pleura) - Pulmonary ligament
39
Pulmonary Ligament
- Inferior extension of parietal/visceral pleura
40
Tracheobronchial Tree
- Treachea | - Bronchi
41
Trachea
- Spans C6 to T4/5 (sternal angle) | - Bifurcates into main bronchi at sternal angle supported by C shaped cartilage rings
42
Carina
- Keel-shaped cartilage at the bifurcation | - Sensitive against irritants (cough reflex)
43
Right Main Bronchi
- Shorter, wider, more vertical vs. left | - Foreign objects tend to lodge here
44
Left Main Bronchi
- Inferior to the aortic arch, anterior to descending thoracic aorta
45
Bronchi
- Begin branching after they enter hila | - Except right superior lobar bronchus (eparterial bronchus)
46
Eparterial Bronchus
- Right superior lobar bronchus
47
Right Main Bronchus
- Branches into 3 lobar bronchi
48
Left Main Bronchus
- Branches into 2 lobar bronchi
49
Lobar Bronchi
- Branch into segmental bronchi | - Supply a bronchopulmonary segment (subdivisions of each lobe)
50
Bronchopulmonary Segments
- Largest subdivisions of a lobe - Supplied by segmental bronchi - Anatomically distinct from neighboring segments - Can be individually resected - 10 in the right lung, 8 – 10 in the left
51
Atelectasis
- Collapsed lung
52
Lung collapse (Atelectasis)
- Can be whole lung, lobe, or bronchopulmonary segment (segmental atelectasis)
53
Obstructive Atelectasis
- Airway obstruction (mucous, foreign body)
54
Non-Obstructive Atelectasis
- Loss of contact between parietal and visceral pleura, loss of surfactant - Pneumothorax, Hemothorax, Hydrothorax
55
Tension Pneumothorax
- Air buildup/trapping within pleural space - Tracheal contralateral deviation - Mediastinal contralateral shift - Depression of hemidiaphragm
56
Pulmonary Arteries
- Take blood from right side of heart to lungs for re-oxygenation - Right ventricle > pulmonary trunk > R & L pulmonary arteries > lungs - Branching follows bronchi
57
Pulmonary Veins
- Bring blood from lungs to left side of heart lungs > R and L pulmonary veins > left atrium - Superior and inferior veins on each side
58
Bronchial Arteries
- Supply root of lung, visceral pleura, lung supporting tissue
59
Left Bronchial Arteries
- Usually paired, branch from aorta
60
Right Bronchial Artery
- Usually single vessel, origin varies | - Aorta, posterior intercostal, common trunk with left
61
Bronchial Veins
- Drain small portion of the lungs | - Most of venous blood returns via the pulmonary veins
62
Lymph Drainage: Superficial
- Subpleural lymphatic plexus
63
Superficial Lymph Drainage
- Drains the visceral pleura and lung parenchyma into the bronchopulmonary nodes
64
Lymph Drainage: Deep
- Bronchopulmonary lymphatic plexus
65
Deep Lymph Drainage
- Located in bronchial wall surrounding tissue - Drains structures forming the root of the lung - Pulmonary nodes > bronchopulmonary nodes
66
Sympathetic Innervation of Tracheobronchial Tree, Lungs, and Visceral Pleura
- Presynaptic (preganglionic) - Originate IML of T1-4(5) levels - Synapse in paravertebral ganglia of upper thoracic sympathetic chain - Post-synaptic neurons travel to the anterior and posterior pulmonary plexuses
67
Sympathetic Tracheobronchial Tree, Lungs, and Visceral Pleura Funtcion
- Bronchodilation | - Inhibition of secretion
68
Parasympathetic Innervation of Tracheobronchial Tree, Lungs, and Visceral Pleura
- Preganglionics - Originate brainstem - Travel in Vagus (CN X) nerve
69
Parasympathetic Treacheobronchial Tree, Lungs, and visceral Pleura Function
- Bronchoconstriction - Secretomotor - Vasodilation
70
Visceral Afferents
- Travel in vagus nerve - Stretch receptors - Tactile receptors (cough reflex) - Baroreceptors and chemoreceptors (in the pulmonary vessels)

Gross Anatomy (50 decks)

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