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Lungs/Pleura/Mechanics of Breathing
Rinaldi 2/25 lecture - 2 hrs
75
Anatomy
Undergraduate 4
02/23/2011

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Cards

Term
1/3 because lungs are elastic
Definition
when the thoracic cavity is opened what fraction of their uncollapsed size do they recoil to? why?
Term
heart and great vessels (middle mediastinum)
Definition
what separates the lungs?
Term
no, they are in separate pleural sacs ->no continuous airflow externally
Definition
are the lungs in a continuous space with each other?
Term
right: upper, middle, lower
left: upper, lower
Definition
what are the lobes of the right lung? the left?
Term
right: horizontal and oblique fissure
left: oblique fissure
Definition
what are the fissures of the right lung? the left lung?
Term
no, but know that lobe number does vay among vertebrae
Definition
is there a functional relationship between the number of lobes or variation of number of lobes?
Term
the lingula is on the left lobe where the heart lays on top, and it corresponds to the middle lobe of right lung
Definition
what does the lingula correspond to and on which lung is it?
Term
cervical pleura
Definition
what covers the apex of the lung?
Term
2-3cm through the superior thoracic aperture into the root of the neck

injuries here can open the pleura, affecting the lungs
Definition
what does the apex of the lung project 2-3cm through? why is this significant?
Term
the sternum, costal cartilages, and ribs
Definition
what is the costal surface of the lungs adjacent to?
Term
mediastinum and sides of the vertebrae
Definition
what is the mediastinal surface of the lungs adjacent to?
Term
costal, mediastinal, diaphragmatic
Definition
what are the 3 surfaces of the lung?
Term
anterior: where costal and mediastinal surfaces meet anteriorly and overlap the heart

inferior:

posterior: where costal and mediastinal surfaces meet posteriorly (broad and rounded)
Definition
what are the borders of the lungs and what are they between
Term
against the dome of the diaphragm
Definition
what is the diaphragmatic surface adjacent to?
Term
the STRUCTURES contained in the pulmonary sleeve and entering the hilum of the lung
Definition
what is the root of the lung?
Term
the AREA where the structures forming the root of the lung actually touch lung tissue
Definition
what is the hilum of the lung?
Term
pulmonary ligament
Definition
where the mediastinal pleura passes laterally as a double layer from immediately anterior to the esophagus of the lung
Term
superior: artery, 1 vein(in the right root, the bronchus to the superior lobe is the most superior structure)
posterior: bronchus, 1 vein
Definition
what are the structures that form the root of the lung?
Term
no
Definition
do non-preserved lungs have impressions on them?
Term
pulmonary ligament
Definition
what ligament secures the lungs inferiorly
Term
thoracic aorta, esophagus, heart
Definition
what leaves impressions on the left lung?
Term
azygous vein
superior vena cava
inferior vena cava
esophagus
heart
Definition
what structures are in contact with the right lung?
Term
posterior -it's against the espohagus
Definition
on which side of the trachea is there no cartilage?
Term
it is right at the bifurcation of the main bronchi
Definition
where is the carina?
Term
lobar (secondary bronchi)
Definition
what do main bronchi divide into?
Term
segmental bronchi (tertiary bronchi)
Definition
what do lobar bronchi divide into?
Term
right: superior, middle, inferior
left: superior, inferior

just like the lobes
Definition
name the lobar bronchi
Term
the right one, it's also easier to see down.
Definition
which bronchi is often the site of aspiration pneumonia because it is more vertically oriented?
Term
swollen lymph nodes full of cancerous emboli pressing on it(yum)
Definition
what can cause the carina to tilt sideways?
Term
triangular with the apex toward the lung root and the base at the pleural surface
Definition
what shape are bronchopulmonary segments?
Term
bronchopulmonary segments, segments have their own blood and air supply
Definition
what is the largest surgical subdivision of a lobe? why?
Term
connective tissue septa with veins in them
Definition
what separates lung segements?
Term
segmental, they correspond to the airways
Definition
pulmonary veins are intersegmental, but arteries are ___
Term

superior lobe:
Apical
Posterior
Anterior

middle lobe:
Lateral
Medial

inferior lobe:
Superior
Medial-basal
Anterior-basal
Lateral-basal
Posterior-basal

Pneumonic: A PALM Seed Makes Another Little Palm

Definition
what bronchopulmonary segments are in the right lung?
Term

superior lobe:
Apico-posterior (merger of "apical" and "posterior")
Anterior
lingula of superior lobe:
Inferior lingular
Superior lingular

inferior lobe:
Superior
Anteromedial basal (merger of "anterior basal" and "medial basal")
Posterior basal
Lateral basal

 pneumonic: ASIA ALPS

Definition
what bronchopulmonary segments are in the left lung?
Term
lower lobes of each lung
Definition
when you listen to a persons lungs on their back, what lobe are you listening to?
Term
pulmonary arteries = anterior to the bronchus

note: bronchial arteries are on the posterior side
Definition
PULMONARY arteries run parallel to the bronchi, anteriorly or posteriorly?
Term
BRONCHIAL arteries
Definition
small arteries that suply blood for nutrition of the root structures, supporting tissue of the lungs, and VISCERAL pleura
Term
intercostal arteries
Definition
supplies blood to the parietal pleura of the lungs
Term
left-thoracic aorta
right-either posterior intercostal artery or a left bronchial artery
Definition
what do the LEFT bronchial arteries arise from? RIGHT?
Term
the upper esophagus
Definition
BRONCHIAL arteries provide branches to _______ before following along the posterior aspects of the main bronchi
Term
pulmonary arteries
Definition
what do bronchial arteries anastamose with in the walls of the bronchioles?
Term
some by the bronchial veins, some by the pulmonary veins
(Rinaldi said the mixing of unoxygenated blood is minimal)
Definition
what veins drain blood away from the PULMONARY arteries?
Term
they carry deoxygenated blood from the heart(pulmonary trunk) to the alveoli following the bronchi and splitting with them
Definition
what do PULMONARY arteries supply blood to?
Term
right drains to Azygous vein
left to hemiazygous
Definition
what vein do the right and left bronchial veins drain to?
Term
pericardioperitoneal canals
Definition
lungs develop as invaginations of _____
Term
somatopleure, receives somatic innervatino (touch, pain, temperature)
Definition
what is the parietal pleura derived from, and what kind of innervation does it receive?
Term
embryonic splanchnopleure - receives autonomic innervation (ischemia and tension increase)
Definition
what is the visceral pleura derived from and what innervation does it receive?
Term
tension ones move the mediastinum
Definition
what separates a tension and non-tension pneumothorax?
Term
they separate
Definition
what happens to the pleura in a pneumothorax?
Term
costal
diphragmatic
mediastinal
cervical
Definition
4 parts of the parietal pleura:
Term
sternal, costal, vertebral

-lines along which the parietal pleura changes direction from one wall of pleural cavity to another relativly abruptly
Definition
what are the lines of parietal pleural reflection?
Term
mediastinal and diaphragmatic
Definition
what parts of the parietal pleura receive phrenic innervation?
Term
costal, cervical, and periphery of the diaphragm
Definition
what parts of the parietal pleura receive intercostal innervation?
Term
costodiaphragmatic recess
Definition
potential space where diaphragmatic pleura is in contact with the costal pleura
Term
costomediastinal recess

(it is larger on left, anterior to the heart)
Definition
potential space where costal pleura is in contact with mediastinal pleura
Term
anterior and posterior(mainly) to the root of the lungs
Definition
where are the pulmonary plexi located?
Term
parasympathetics fro Vagus nerve
sympathetics from sympathetic trunk lateral horns, no gray rami(T1-T5)
Definition
what nerve fibers are contained in pulmonary plexi?
Term
pre
Definition
are the parasympathetic nerve fibers seen in the pulmonary plexus pre or post ganglionic?
Term
parasympathetic: plexi along branches of the bronchial tree

sympathetic: paravertebral ganglia
Definition
where are parasympathetic ganglion cells located? sympathetic?
Term
bronchoconstriction, vasodilation, secretomotor glands

(sympathetics are opposite)
Definition
what are the functions of parasympathetics in the lungs?
Term
post
Definition
are the sympathetic nerve fibers seen in the pulmonary plexus pre or post ganglionic?
Term
around the hilum
Definition
where are the bronchopulmonary lymph nodes found?
Term
superior and inferior sets above the bifurcation
Definition
where are the trachial/bronchial lymph nodes found?
Term
black
Definition
what color are bronchopulmonary nodes typically?
Term
on either side of the trachea
Definition
where are the paratrachial lymph nodes found?
Term
above the clavicle (around subclavian vein/artery)
Definition
where are the supraclavicular lymph nodes found?
Term
midline between costal cartilages 2-4
Definition
where do left and right parietal pleural lines of reflection contact each other?
Term
costal cartilages 4-6
Definition
where does the left parietal pleura have an indentation due to the heart?
Term
1)rib 10 in the mid axillary line
2)costal cartilage 8 in the mid clavicular line
3)rib 12 on the back (this is actually higher than rib 10 on the side due to angle of the ribs)
Definition
where are the places the pleura of each side cross?
Term
the sternal angle
Definition
where does the trachea bifurcate?
Term
about 2 ribs higher (lungs at 8, ribs at 10)
Definition
where do the lungs lay in relation to the pleura?
Term
begins deep to the mid axillary line at rib 5 to sternocostal joint 4
Definition
where is the horizontal fissure of the right lung found with surface anatomy?
Term
begin adjacent to spine of T3, pass deep to ribs 5 at the mid-axillary lines and end deep to ribs 6 at the mid-clavicular lines
Definition
where are the oblique fissures of the right and left lungs found(using surface anatomy)?
Term
oblique fissures
Definition
what can be visualized by having the patient place their hands on their head with elbows facing laterally, then using the vertebral borders of the scapulae
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