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LUNGS ANATOMY

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lungs anatomy and pleural cavity

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LUNGS ANATOMY

  1. 1. Group b
  2. 2. LUNGS The lungs lie either side of the mediastinum, within the thoracic cavity. Each lung is surrounded by a pleural cavity, which is formed by the visceral and parietal pleura
  3. 3. Lungs gross anatomy • Lungs are pair of respiratory organs situated in thoraic cavity • Right and left lung are separated by the mediastinum  Weight Left 550 Right 600  Texture Spongy  Colour yellow brown Adults mottled black due to deposition of carbon particles
  4. 4. Lung gross Structure
  5. 5. Apex – The blunt superior end of the lung. It projects upwards, above the level of the 1st rib and into the floor of the neck. Base – The inferior surface of the lung, which sits on the diaphragm. Lobes (two or three) – These are separated by fissures within the lung. Surfaces (three) – These correspond to the area of the thorax that they face. They are named costal, mediastinal and diaphragmatic. Borders (three) – The edges of the lungs, named the anterior, inferior and posterior borders.
  6. 6. Lobes • The right and left lungs do not have an identical lobular structure. • The right lung has three lobes; superior, middle and inferior. The lobes are divided from each other by two fissures:  Oblique fissure Runs from the inferior border of the lung in a superoposterior direction, until it meets the posterior lung border. start from 5tv and end at 6th costochondral junction  Horizontal fissure Runs horizontally from the sternum, at the level of the 4th rib, to meet the oblique fissure.4th costal cartilage to meet oblique fissure The left lung contains superior and inferior lobes, which are separated by a similar oblique fissure.
  7. 7. Surfaces of lungs • are three lung surfaces, each corresponding to an area of the thorax  mediastinal surface The mediastinal surface of the lung faces the lateral aspect of the middle mediastinum. The lung hilum (where structures enter and leave the lung) is located on this surface  diaphragmatic surface The base of the lung is formed by the diaphragmatic surface. It rests on the dome of the diaphragm, and has a concave shape. This concavity is deeper in the right lung, due to the higher position of the right dome overlying the liver.  costal surface The costal surface is smooth and convex. It faces the internal surface of the chest wall. It is related to the costal pleura, which separates it from the ribs and innermost intercostal muscles.
  8. 8. Borders anterior border The anterior border of the lung is formed by the convergence of the mediastinal and costal surfaces. On the left lung, the anterior border is marked by a deep notch, created by the apex of the heart. It is known as the cardiac notch. inferior border The inferior border separates the base of the lung from the costal and mediastinal surfaces.  posterior border The posterior border is smooth and rounded (in contrast to the anterior and inferior borders, which are sharp). It is formed by the costal and mediastinal surfaces meeting posteriorly.
  9. 9. The lower border of every lung is 2 – rib spaces higher than the lower border of the pleura. Therefore, it is located along the line, which cuts. A. 6th rib in the midclavicular line,. B. 8th rib in the midaxillary line, and. C. 10th rib at the lateral border of erector spinae and ends 2 cm lateral to the spine of T10 vertebra Lower Border
  10. 10. Anterior Border • The anterior border of the left lung has a distinctive notch (the cardiac notch), which enters laterally behind the 4th and 5th intercostal spaces.
  11. 11. Posterior Border • Its lower end ends at the level of spine of T10 vertebra.
  12. 12. ROOT AND HILUM The lung root is a collection of structures that suspends the lung from the mediastinum. Each root contains a bronchus, pulmonary artery, two pulmonary veins, bronchial vessels, pulmonary plexus of nerves and lymphatic vessels. All these structures enter or leave the lung via the hilum – a wedge shaped area on its mediastinal surface.
  13. 13. Tracheobronchial tree • Each Segmental bronchus passes to a structurally and functionally independent unit of lung lobe called as Broncho Pulmonary Segment. • These are well defined Anatomic, Functional and surgical units of lungs
  14. 14. Alveolar sacs Alveolar ducts Respiratory bronchioles Conductory bronchioles Tertiary bronchi Secondary bronchi Trachea
  15. 15. Right main bronchus Segmental bronchus Right lower lobar bronchus
  16. 16. Right lung Left lung 1 Apical segment 2 Posterior segment 3 Anterior segment 4.Lateral segment 5.Medial segment 1+2 apicoposterior Segment 3 anterior segment 4.superior lingular segment 5.inferior lingular segment 6.Superior segment 7.Medial basal segment 8.Anterior basal segment 9.Lateral basal segment 10.Posterior basal segment 6.Superior segment 7.Absent 8.Anteromedial basal segments 9.Lateral basal segment 10.Posterior basal segment Upper lobe bronchus Medial lobe bronchus Lower lobe bronch us Superior division Inferior division Upper lobe bronchus Lower lobe bronchus
  17. 17. Airway Progression  Trachea 16-20 C- shaped hyaline cartilage rings Bifurcates at the level of sternal angle.  Carina Ridge on internal aspect of last cartilage. Point where trachea branches.  Left main bronchus Longer(5 cm),smaller diameter, more horizontal, makes an angle of 45o with trachea. Gives 2 lobar bronchi  Right main bronchus Shorter(2.5cm), larger diameter, more vertical( 45o ), more susceptible to aspiration. Gives 3 lobar bronchi. Each main or primary bronchus runs into the hilus of lung posterior to pulmonary vessels
  18. 18. Airway Progression Segmental brochi broke into sub segmental bronchus
  19. 19. Airway Progression • Respiratory Bronchiols: 2 or more branches from each terminal bronchioles with air sac buds. This is first level of gas exchange. • Respiratory bronchioles end in alveoli. • Pores of khan & channels of Lambert are present to connect two alveoli
  20. 20. Vasculature The lungs are supplied with deoxygenated blood by the paired pulmonary arteries. Once the blood has received oxygenation, it leaves the lungs via four pulmonary veins (two for each lung). The bronchi, lung roots, visceral pleura and supporting lung tissues require an extra nutritive blood supply. This is delivered by the bronchial arteries, which arise from the descending aorta. The bronchial veins provide venous drainage. The right bronchial vein drains into the azygos vein, whilst the left drains into the accessory hemiazygos vein.
  21. 21. Nerve Supply The nerves of the lungs are derived from the pulmonary plexuses. They feature sympathetic, parasympathetic and visceral afferent fibres: Parasympathetic: Derived from the vagus nerve. They stimulate secretion from the bronchial glands, contraction of the bronchial smooth muscle, and vasodilation of the pulmonary vessels. Sympathetic: Derived from the sympathetic trunks. They stimulate relaxation of the bronchial smooth muscle, and vasoconstriction of the pulmonary vessels. Visceral afferent: Conduct pain impulses to the sensory ganglion of the vagus nerve
  22. 22. Characteristic Features of BPS • Largest subdivision of lung lobe. • Pyramidal in shape with apex towards the root of hilum. • Each segment is an independent respiratory unit. • Each segment has its own separate artery [branches of pulmonary artery],segmental bronchus, autonomic nerves & lymph vessels
  23. 23. Conductory zone The conducting zone of the respiratory system is made up of the following 1. Nose 2. Pharynx 3. Larynx 4. Trachea 5. Bronchi 6. Bronchioles 7. Terminal bronchioles
  24. 24. Trachea Course the trachea commences at the level of the cricoid cartilage in the neck (C6). It terminates at the level of the angle of Louis (T4/5) where it bifurcates into right and left main bronchi Structure the trachea is a rigid fibroelastic structure. Incomplete rings of hyaline cartilage continuously maintain the patency of the lumen. The trachea is lined internally with ciliated columnar epithelium.
  25. 25. Relations behind the trachea lies the oesophagus. The 2nd, 3rd and 4th tracheal rings are crossed anteriorly by the thyroid isthmus Blood supply the trachea receives its blood supply from branches of the inferior thyroid and bronchial arteries
  26. 26. Functions Low resistance pathway for airflow Defense Warms and moistens air Filters air Phonates (vocalize sounds)
  27. 27. Respiratory zone • The respiratory zone is the site of O2 and CO2 exchange with the blood • The respiratory bronchioles and the alveolar ducts are responsible for 10% of the gas exchange.The alveoli are responsible for the other 90%. • The respiratory zone represents the 16th through the 23rd division of the respiratory tract.
  28. 28. Pleura The pleurae and lungs lie on either side of the mediastinum within the chest cavity
  29. 29. Pleura Each lung is enclosed in a serous pleural sac Serous membrane lined by flattened epithelium (mesothelium)  Outer layer Parietal pleura  Inner layer Visceral pleura (Pulmonary pleura)  Pleural cavity potential space in between two layers consists of serous pleural fluid, which lubricate pleural surfaces
  30. 30. visceral pleura Pulmonary pleura Adherent to all surfaces including those in fissures Except the root or hilum of the lung Visceral pleura is continuous with parietal pleura at the hilum of the lung
  31. 31. Parietal pleura • Outer layer of the pleura • Lines the corresponding half of the thoracic wall, mediastinum and diaphragm • It is divided into four parts Cervical pleura lies over the apex of the lungs Costal pleura covers the internal surface of the thoracic wall Mediastinal pleura covers the lateral aspect of the mediastinum Diaphragmatic pleura lies on the thoracic surface of the diaphragm
  32. 32.  EMPYEMA collection of pus in pleural cavity without air  COMPRESSION OF THE TRACHEA bilateral enlargement of thyroid gland  AORTIC ARCH ANERYSM dilation of aortic arch  TRACHEITIS OR BRONCHITIS give rise to a raw burning sensation felt deep to the sternum instead of actual pain  INHALED FOREIGN BODIES common in children, tend to enter right bronchus instead of left because the right bronchus is wider & more direct continuation of the trachea  BRONCHOSCOPY examination of interior of trachea through bronchoscope  TRACHEOSTOMY cutting the trachea Clinical Notes
  33. 33. Which of the following structures separates the lung into lobes A. ? B. mediastinum C. fissure D. root E. pleura
  34. 34. A section of the lung that receives its own tertiary bronchus is called the ________. A. bronchopulmonary segment B. pulmonary lobule C. interpulmonary segment D. respiratory segment
  35. 35. The ________ circulation picks up oxygen for cellular use and drops off carbon dioxide for removal from the body. A. pulmonary B. interlobular C. respiratory D. bronchial
  36. 36. What does structure R relate to? A. Groove for azygos vein B. Oblique fissure C. Groove for arch of aorta D. Diaphragmatic surface
  37. 37. The apex of the lungs is covered by: A. Cervical pleura B. Diaphragmatic pleura C. Mediastinal pleura D. Costal pleura
  38. 38. Which of the following vessels supplies the lungs themselves with oxygen? A. Bronchial artery B. Bronchial vein C. Pulmonary artery D. Pulmonary vein
  39. 39. The walls between neighbouring alveoli are known as: A. Alveolar septa B. Alveolar ducts C. Alveolar epithelia D. Alveolar sacs
  40. 40. A 'stony dull' sound on percussion is typically suggestive of: A. Pleural effusion B. Fibrosis C. Emphysema D. Pneumothorax
  41. 41. The lungs and visceral pleura receive parasympathetic innervation from A. the vagus nerve B. cranial nerve IX C. spinal nerve II D. the phrenic nerve
  42. 42. The pleura that surrounds the lungs consists of two layers, the ________. A. visceral and parietal pleurae. B. mediastinum and parietal pleurae. C. visceral and mediastinum pleurae. D. none of the above
  43. 43. • A 36-year-old man was taken to the emergency department after having been found lying unresponsive in a local park with an empty whisky bottle nearby. He was given oxygen by an open face mask during the 15-minute ride in the ambulance. The paramedic decided to improve the airway by passing a soft nasal tube. On attempting to pass the well-lubricated tube into the patient’s nose, the paramedic found it impossible to push it much beyond the nasal vestibule on either side.What are the common anatomic causes of obstruction of the nasal airway? Answers; The most common cause for difficulty in passing a nasal tube is a deflected nasal septum. This occurs more commonly in the male, and is thought to be due to previous trauma to the septum during the period of active growth. Nasal spurs and polyps may cause difficulty and swelling of the mucous membrane secondary to infection or chemical irritation, and can also cause blockage. The widest part of the nasal cavity is near the floor.
  44. 44. Because of the rapid increase in the size of the tumor, the following lymph nodes were examined for metastases: A. Superficial inguinal nodes B. Anterior axillary nodes C. Posterior axillary nodes D. External iliac nodes E. Deep cervical nodes
  45. 45. BIBILIOGRAPHY ESSIENTIALS OF ANATOMY AND PHYSIOLOGY BY STEPHENS ROSS AND WILSON ANATOMY AND PHYSIOLOGY LASTs ANATOMY BY R.M.H MEMINN  GREY ANATOMY

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