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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
Q

Costomediastinal Recesses

A
  • Potential space at border of costal and mediastinal pleurae
  • Left is larger than right
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26
Q

Pleural Space Pathology

A
  • Hydrothorax: fluid
  • Hemothorax: blood
  • Chylothorax: lymph
  • Pneumothorax: air
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27
Q

Hydrothorax

A
  • Fluid
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28
Q

Hemothorax

A
  • Blood
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29
Q

Chylothorax

30
Q

Pneumothorax

31
Q

Thoracocentesis (Pleural Trap)

A
  • 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
Q

Horizontal Fissure

A
  • Separates superior and middle lobes of right lung
33
Q

Oblique Fissure

A
  • Separates superior and inferior lobes of left lung

- Inferior lobe from the middle and superior lobes of right lung

34
Q

Lingula

A
  • Part of superior lobe of left lung
35
Q

Oblique Fissure

A
  • Begins at the level of T4-ish SP posteriorly

- Ends at rib 6 costal cartilage antero-laterally

36
Q

Horizontal Fissure

A
  • Follows anterior aspect of right rib 4
37
Q

Hila of the Lungs

A
  • Mediastinal surface

- Entrance of lung root

38
Q

Root of the Lung

A
  • Structures that attach the lung to the mediastinum
  • Surrounded by pleural sleeve (continuity between parietal and visceral pleura)
  • Pulmonary ligament
39
Q

Pulmonary Ligament

A
  • Inferior extension of parietal/visceral pleura
40
Q

Tracheobronchial Tree

A
  • Treachea

- Bronchi

41
Q

Trachea

A
  • Spans C6 to T4/5 (sternal angle)

- Bifurcates into main bronchi at sternal angle supported by C shaped cartilage rings

42
Q

Carina

A
  • Keel-shaped cartilage at the bifurcation

- Sensitive against irritants (cough reflex)

43
Q

Right Main Bronchi

A
  • Shorter, wider, more vertical vs. left

- Foreign objects tend to lodge here

44
Q

Left Main Bronchi

A
  • Inferior to the aortic arch, anterior to descending thoracic aorta
45
Q

Bronchi

A
  • Begin branching after they enter hila

- Except right superior lobar bronchus (eparterial bronchus)

46
Q

Eparterial Bronchus

A
  • Right superior lobar bronchus
47
Q

Right Main Bronchus

A
  • Branches into 3 lobar bronchi
48
Q

Left Main Bronchus

A
  • Branches into 2 lobar bronchi
49
Q

Lobar Bronchi

A
  • Branch into segmental bronchi

- Supply a bronchopulmonary segment (subdivisions of each lobe)

50
Q

Bronchopulmonary Segments

A
  • 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
Q

Atelectasis

A
  • Collapsed lung
52
Q

Lung collapse (Atelectasis)

A
  • Can be whole lung, lobe, or bronchopulmonary segment (segmental atelectasis)
53
Q

Obstructive Atelectasis

A
  • Airway obstruction (mucous, foreign body)
54
Q

Non-Obstructive Atelectasis

A
  • Loss of contact between parietal and visceral pleura, loss of surfactant
  • Pneumothorax, Hemothorax, Hydrothorax
55
Q

Tension Pneumothorax

A
  • Air buildup/trapping within pleural space
  • Tracheal contralateral deviation
  • Mediastinal contralateral shift
  • Depression of hemidiaphragm
56
Q

Pulmonary Arteries

A
  • 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
Q

Pulmonary Veins

A
  • 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
Q

Bronchial Arteries

A
  • Supply root of lung, visceral pleura, lung supporting tissue
59
Q

Left Bronchial Arteries

A
  • Usually paired, branch from aorta
60
Q

Right Bronchial Artery

A
  • Usually single vessel, origin varies

- Aorta, posterior intercostal, common trunk with left

61
Q

Bronchial Veins

A
  • Drain small portion of the lungs

- Most of venous blood returns via the pulmonary veins

62
Q

Lymph Drainage: Superficial

A
  • Subpleural lymphatic plexus
63
Q

Superficial Lymph Drainage

A
  • Drains the visceral pleura and lung parenchyma into the bronchopulmonary nodes
64
Q

Lymph Drainage: Deep

A
  • Bronchopulmonary lymphatic plexus
65
Q

Deep Lymph Drainage

A
  • Located in bronchial wall surrounding tissue
  • Drains structures forming the root of the lung
  • Pulmonary nodes > bronchopulmonary nodes
66
Q

Sympathetic Innervation of Tracheobronchial Tree, Lungs, and Visceral Pleura

A
  • 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
Q

Sympathetic Tracheobronchial Tree, Lungs, and Visceral Pleura Funtcion

A
  • Bronchodilation

- Inhibition of secretion

68
Q

Parasympathetic Innervation of Tracheobronchial Tree, Lungs, and Visceral Pleura

A
  • Preganglionics
  • Originate brainstem
  • Travel in Vagus (CN X) nerve
69
Q

Parasympathetic Treacheobronchial Tree, Lungs, and visceral Pleura Function

A
  • Bronchoconstriction
  • Secretomotor
  • Vasodilation
70
Q

Visceral Afferents

A
  • 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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