Download - Lungs 2014
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1. GROSS ANATOMY OF LUNGS
2. SURFACES AND BORDER OF LUNGS
3. HILUM AND ROOT OF LUNGS
4. FISSURES AND LOBES OF LUNGS5. BRONCHOPULMONARY SEGMENT
6. BLOOD SUPPLY OF LUNGS
7. LYMPHATICS OF LUNGS
8. NERVE SUPPLY OF LUNGS9. PLEURA
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T!"#$ % &'()*+
C(,($ %
- +(#)* /$(0)
- #,"& ("", /,# "( '(&"() ($/() '$",&
*:" %
- $*:" ,#)* 6;; *$
- ," ,#)* 55; *$
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1. Apex : projects 1 inch abovemedial 1/3 of clavicle
2. Base: it is concave, rests onthe copula of diaphragm
3. urfaces : costal ! mediala. "ostal . : is convex , related
to ribs ! intercostal spacesb. #edial . : is formed of 2
parts : A$ Anterior mediastinal part
% hilum lies in its posterior&B$ 'osterior vertebral part(. Borders :
1 ! 2 $Anterior ! inferior :sharp
3- P(&"$($ % ": < $(#)
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B,#)"
L& /(= ": ,=, ()"$($ ) ( 1&" $/
R:& 1-2 /(= , 1>3$ (,=,
C(=$ /+ $=,',#$
G$(= /+ % - /,=) $"$+
- /,=) =)
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S,#)$ )()=
R&" ) ( (':$*
R*:" & ( &:*:$ ":) ,"
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ANTERIOR BORDER %
1. C($$&'()& "( ":)"$($?(&"(&"),@ ,)
( ',#$, $"()2. I" & ',+ )(": )
": ," ,#)* '(&"$($"( 5": (&", $",*/+ ": '$$#
) !")& =$",,+(0)0$& "( ($ Lingula. T:& & ,, cardiac notched
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T:) ) &:$'
I" &'$"& ":
/& ( ": ,#)*$( ": (&",$ )!")& )"(
':$)((&",&)#&
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T: ) ,,)
F"& )"( ''$=$"/$,*#""$
E!") $( C7 "( T1;
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1. C(&", $ %
I" & ) ()""0": (&", ',#$
) (=$,+)*":($ 0,,
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2. M, $ %
.P(&"$($>=$"/$,
'$" /. A)"$($>
&"-
), '$"
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1. V$"/$, (,#)
2. I)"$=$"/$, &
3. P(&"$($ )"$(&", =&&,&
4. S',):) )$=&
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RIGHT SIDE LEFT SIDE
1. R*:" A"$#
2. S,, '$"& ( R*:"=)"$,
3. SVC
4. R*:" /$:(':, =)?,(0$ '$"@
5. A+*(& =)
6. E&(':*#&
7. IVC
8. T$:9. R*:" =*#& )$=
1;. R*:" ':$) )$=
1. L" =)"$,
2. P#,()$+ "$#)
3. A$: ( ($"
4. T:($ ( ($"
5. L" /,=) $"$+6. T:($ #"
7. L" /$:(':, =)
8. L" =*#& )$=
9. L" ':$) )$=1;. L" $#$$)" ,$+)*,
)$=
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I" & ,$*'$&& $":" ,& )$ ":)"$ ( ":, $.
V$(#& &"$#"#$&)"$ ) ,= ":,#)* = "& $((".
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T: $((" & ),(& ) &:($" "#/#,$ &:"( ',#$ ":" ()"&": '#,()$+ )
&"), '$"& (',#$. I" !"))$($,+ & )$$(0(,- The pulmonaryligament.
I" ,& (''(&" ( ":/(& ( 5": 6": )7": ":($ =$"/$
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1. P$)', /$():#& ()": ," &
2. E'$"$, ):+'$"$, () ":$*:" &
3. O) '#,()$+ $"$+
4. T0( '#,()$+ =)& '$($ ) )$($
5.
B$():, $"$& ()() $*:" & ) "0(() ," &
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6. B$():, =)&
7. A)"$($ )'(&"$($
'#,()$+ ',!#&( )$=&
8. L+':"&
9. B$():('#,()$+
,+':()(&1;. A$(,$ "&&
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ABOVE DONARDS%
1. EPARTERIALBRONCHUS
2. PULMONARY ARTERY
3. HYPARTERIALBRONCHUS
4. INFERIOR PULMONARYVEIN
RIGHT SIDE
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ABOVE DONARDS%
1. PULMONARY ARTERY
2. BRONCHUS
3. INFERIORPULMONARY VEIN
LEFT SIDE
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F&$& = ": ,#)*& )"( ,(/& E: ,#)* :& ) (/,# &$ &'$")*
": #''$ ,(/ $( ": ,(0$ ,(/ () ": ,") ": #''$ ) , ,(/& $( ":,(0$ ,(/ () ": $*:"
T: $*:" ,#)* :& :($()", &$&'$")* ": , ,(/ $( ":
#''$
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$#)& $( ": 2) ":($ =$"/$'(&"$($,+ "( ": 6": (&", $",*)"$($,+ ($ ,()* ": , /($$ (
": &'#, 0:) ": $ & $& /(=": :.
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I" !") $( )"$($ $*) " ,=, ",=, ( 4": (&", $",*.
R#)& :($()",,+ /0$& "( " ":
(/,# &$ ) ": -!,,$+ ,). P#,()$+ ',#$ !") )"( ": &$
( ": ,#)*& &( ":" ": ,(/& ) (=() : (":$ #$)* $&'$"()
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T: $*:" ,#)* & ,$*$ ":) ": ," ):& ":$ ,(/&% S#'$($ ($ #''$
M, I)$($ ($ ,(0$
T: ," ,#)* :& "0( ,(/& S#'$($ ($ #''$
I)$($ ($ ,(0$
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I& '+$,,+ &:' &"() ( ": ,#)*0": "& /& (=$ /+ =&$, ',#$
I& &'$" $( )" &*)"& /+())"= "& &'"
I& )& ($ ": &*)", /$():#& ":"'',& "
H& "& (0) /$():#& ) &*)", /$):( ": '#,()$+ $"$+
E: /$():('#,()$+ &*)" ) /$*,,+ $&" )'))" ()" &*)"&
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Each segment is surroundedby a delicate C.T. septum
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T: #,"" '#,()$+ #)" $($&'$"($+ /$():(, "( ,=(, & ,,Acinus.
There are about 28 ordes o di!isions otracheobronchial tree.
Total no. o al!eoli has been estimatedto bet"een 2##$%## million& "ith atotal surace area o '#$8# meters(uare.
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T$:
R*:" ) ," '$)',/$():#&
L(/$ /$(): ?&()$+@
S*)", /$(): ?"$"$+@
T$), /$():(,&
R&'$"($+ /$():(,&
A,=(,$ #"
A,=(,$ &&
A,=(,
ACINUS
Di!isions o bronchi
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?2rybronchus)
?*ry bronchus)
Di!isions o bronchi
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RIGHT BRONCHUS LEFT BRONCHUS
1. S:($"$
2. $
3. M($ ) ,) 0":"$:
1. L()*$
2. N$$(0$
3. M($ (,/,# ":)": $*:"
+ight lung Let lung
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+ight lung Let lung
Slightly larger & shorter , "ider Slightly smaller & longer ,narro"er
-o cardiac notch The anterior border has a cardiac
notch , belo" it lies tongue lieprocess called / lingula”
It is di!ided by 2 0ssures1 obli(ue , horiontal ) into *lobes 1 upper & middle , lo"er )
It is di!ided by one 0ssures1 horiontal ) into 2lobes 1 upper, lo"er )
The hilum contains :1-2bronchi 1 eparterial ,
3yparterial )2-4ulmonary artery3-2pulmonary !eins
The hilum contains:1-one bronchus
2-4ulmonary artery3-2pulmonary !eins
It recei!es one bronchial artery inthe posterior part o the hilum
It recei!es 2 bronchial arteries inthe posterior part o the hilum
It has * lobar bronchi , 5#segmental bronchi 1 5#bronchopulmonary segments )
It has 2lobar bronchi , 8$5#segmental bronchi 18$5#bronchopulmonary segments )
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RIGHT MAIN BRONCHUS LEFT MAIN BRONCHUS
U''$,(/ /$():#&% - A', &*)", /$():#& - A)"$($ &*)", /$(). - P(&"$($ &*)", /$(). M, ,(/ /$():#&%- M, &*)", /$():#&- L"$, &*)", /$():#& L(0$ ,(/ /$():#&%- A', &*)", /$():#&- A)"$($ &*)", /$():#&- P(&"$($ &*)", /$():#&- M, &*)", /$():#&- L"$, &*)", /$():#&
U''$ ,(/ /$():#&%• U''$ /$): %
- A)"$($ &*)", /$():#&
- A'(-'&"$($ &*. /$():#&• L(0$ /$): %- S#'$($ ,)*#,$ &*. B$():#&- I)$($ ,)*#,$ &*. /$():#& L(0$ ,(/ /$():#&%- A', &*)", /$():#&- A)"$(-, &*)",
/$():#&- P(&"$($ &*)", /$():#&- L"$, &*)", /$():#&
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6ronchopulmonary segments7 A'& A)4(&& *:" L*:" LA4S
• 9pper lobe7 A', A)"$($ 4(&"$($
•
iddle lobe% , ) L"$,
• L(0$ ,(/% L"$, A)"$($ ,4(&"$($
S#'$($@
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E: /$():('#,()$+ &*)" ) /$*,,+ $&" )'))" (
)" &*)"& . S*)", $&"()0": ), &"$#"() "( ":$$(#))* ,#)* "&.
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A. SYSTEMIC % Vasa privata
ARTERIES → BRONCHIALARTERIES (supplies walls of bronchi & bronchioles) →BRONCHIAL VEIN
! RI"H# BRONCHIAL VEIN→ A$%"O VEIN
! LE'# BRONCHIAL VEIN →HI"H"E# IN#ERCO#ALVEIN
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B. PULMONARY %Vasa publica
PULMONARY TRUN → RI"H# AN
LE'# *L+ONAR%AR#ERIE ,-→CAILAR% NE#ARO*N ALVEOLI →,-- *L+ONAR% VEIN→ LE'# A#RI*+
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L+': $( ": ,#)*&$)& "(
P#,()$+ ,+':)(& ?,()* ": ,(/$/$():@
B$():('#,()$+,+': )(& ?,()*": ) &" /$():@
S#'$($ ) )$($"$:(/$():, ,+':
)(& ?'$($ ))$($ "( ": /#$"()( ": "$:@
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I))$="() & = ": '#,()$+ ',!#&&,(" )"$($ ) '(&"$($ "( ": ,#)*
$(("&. T: ',!#&& ()") '(&"*)*,()&+'":" /$& $( ": &+'":""$#)& ":" ))$=" ": &((": #&, (": /$():, "$ '#,()$+ =&&,& )*,)& ( ": /$():, "$.
S+'":" /$& $ /$():(,"($&=&(()&"$"($& ) ):/" *,)#,$
&$"(). T: ',!#&& ()") '$*)*,()'$&+'":" /$& $( ": =*#&)$= ?CN J@ &,, '$&+'":"*)*, ) '(&"*)*,()'$&+'":" )$=& ":" ))$=" ":&((": #&, ( ": /$():, "$'#,()$+ =&&,& ) *,)& ( ":/$():, "$.
P$&+'":" /$& $/$():(()&"$"($& =&(,"($& )&$"(("($ "( ": *,)&.
V&$, K$)" /$& $$+ )($"())=(,= ) (#*: $!& &"$":$'"() /,(( '$&$ :($'"()) )('"().
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E: ,#)* & $$(#) /+ ) (=$0": ()")#(#& /$) 0:: &) & ": =&$, ',#$ 0:: (=$& ": ,#)*& )
))(" / &&" $( ": ,#)* ": '$", ',#$ 0:: ,)& ": ',#$, ="&
T: =&$, ) '$", ',#$ $()")#(#& " ": :,# ( ": ,#)* 0:$
&"$#"#$& )"$ ) ,= ": ,#)*?/$():#& '#,()$+ =&&,& /$():,=&&,& ,+':"&@
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Subdi!isions o the pleura %5$ :isceral pleura
2$ T: '$", ',#$ :& (#$ ) '$"&% C(&", ',#$ ,))* ": )"$), $ ( ":
":($ 0,, M&"), ',#$ (=$)* ": && ( ":
&")#
D':$*" ',#$ (=$)* ": '$($ $
( ": ( ( : :':$* C$=, ',#$ ( ( ',#$ !"))*
'$($,+ )"( ": '$($ ":($ '$"#$
*$ 4ulmonary ligament
Costal pleuraCervical pleura Let lung
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Pulmonary ligament
Diaphragmatic pleura
Mediastinal
pleura
g
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T: ',#$, ="+ & ": '(")", &'/"0) ": '$", ) =&$, ',#$. T: ',#$, ="+ ()")& ") ,+$ (
&$(#& ',#$, # 0:: ,#/$"& ),,(0& ": ',#$ "( (= &((":,+ (=$: (":$ #$)* $&'$"().
S#$ ")&() '& ": ,#)* $ )()"" 0": ": ":($ 0,,.
T: ,#)* !')& ) ,,& 0": $ 0:)": ":($ ="+ !')&.
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T:($()"&& & ": )&$"() ( ), )"( ": ',#$, ="+ "( 0":$0 &', ( # ($ /,((. T( =(* "( ": )"$(&", =) $"$+
) )$= ":" $#) ) ": (&", *$((= ()": )$($ $ ( : $/ ": ),& )&$" 0,, /,(0 ": $/. T: ),,&( #&" / ', )",+ /(= ":
$/ /,(0 "( =( ": (,,"$, /$):&( )"$(&", )$= ) =&&,& ":" $#),()* ": '$($ $ ( : $/.
S9+FACE A-AT;< ;F T3E 4LE9+A
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Cer!ical pleura 1ape=) 7 ,& one inch /(= ": medial 5>* o thecla!icle.
Anterior border: ,) & $0) '&&)* (0)0$& ) ,,+ %
1-F$( ": &"$)(,=#,$ ()" "( '()" () ": &"$), )*, ,(& "( ":) ',).
2-T:) " & !") =$",,+ "( ": ,=, ( ": 'th (&", $",*.
. ;n the right side ":& ,) & !") =$",,+ "( %th (&", $",*.
/. ;n the let side ": ,) ="& ($ /(#" () ): "( ": ," ( ":&"$)# ?($ $ )(":@ ":) " )& " %th (&", $",*
Inerior border: ,) '&&)* $(#) ": :&" 0,,. I" /*)& $( ":,=, ( %th costal cartilage close to the median plane . Then itcrossing 7
1-T: 8th rib in the midcla!icular line
2-T: 5#th rib in the mid$a=illary line
3-T: " $:)* ": 52th spine to ends .
4osterior border : ,()* ": =$"/$, (,#) $( ": '! ( ":',#$ "( ": )$($ /($$
ung
: 2 spaces less than pleura below the 6
th
rib .
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L)& ( ',#$, $"() $ ,)& ,()* 0:: ": '$", ',#$ :)*& $"()& $( ()0,, "( )(":$. T: &"$), ,) ( ',#$, $"() & ": &:$' ,) ,()* 0:: ": (&", ',#$
/(& ": &"), ',#$ T: (&", ,) ( ',#$, $"() & ": &:$' ,) ,()* 0:: ": (&", ',#$ /(&
": ':$*" ',#$ T: =$"/$, ,) ( ',#$, $"() & &((": $"() ( ": (&", ',#$ ()"( ":
=$"/$ '(&"$($,+. T: ,)& ( ',#$, $"() () ": ," & ) / $/$ & 4-6-8-1;-12.
T: ,) ( ',#$, $"() () ": ," &)& ) ": ,) ( ": &"$)# "( ": 'th costal cartilage 0:$ " ="& "( ": ," $*) ( ": &"$)# " ": %th costalcartilage "( ((" ": '$$# ) ": :$" ?$ )(":@.
T:& ,) ":) ="& "( $(&& ": 8th rib " ": ,=#,$ ,). I" $(&&& ": 5#th rib " ": !,,$+ ,) I" ":) $(&&& ": 52th rib " ''$(!",+ ": ).
O) ": $*:" & ": ,) ( ',#$, $"() &)& " ": ,) ( ": &"$)# "( ":!':( '$(&& ) ":) ="& 8-1;-12.
T: ,#)*& ( )(" #,,+ (#'+ ": ',#$, ="& #$)* !'$"() T:$ $ '$':$, $& 0:$ ": ':$*" ) (&", ',#$ ( ) ()"" )
":& $ ,, ": (&"(':$*" $&&&. T:$ $ $& '(&"$($ "( ": &"$)# 0:$ ": (&", ) &"), ',#$ ( )
()"" 0": : (":$ ) ":& $ ,, (&"(&"), $&&&. T: (&"(&"), $&& & ,$*$ () ": ," /#& ( ": $ )(":. D#$)* !'$"() ": ,(0$ ," ( ": ,#)*& & "0( (&", &'& /(= ": ,) ( ',#$,
$"()% 6-8-1;% ": &!": $/ " ": ,=#,$ ,) ": 8": $/ " ": !,,$+ ,) ) ":
1;": $/ " ": ). T:#& ": (&"(':$*" $&& & ''$(!",+ "0( (&", &'& '.
Surace
Cer!ical pleura
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Anatomy
;
4leura
8th rib1th rib
12th thoracic spine
Inerior border
!th costal
cartilage
Anterior bord
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In ull inspirationthe anterior bordo the lung e=teninto this recess
Costomediastinal rec
In ull inspiration&the inerior bordero the lung e=tends
into this recess
Costodiaphragmatic recess
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V&$, ',#$ (& )(" := )+*)$, &)&($+ ))$="() ) &)&)&"= "( ')
T: '$", ',#$ & =$+ &)&"= "(') /#& ( "& &)&($+ '',+ /+/$):& ( ": )"$(&", ) ':$))$=&
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ediastinal pleur
Diaphragmatic ple
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R(=, ( :&"
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R(=, ( :&"
0,, $=, ":(,,(0)* %
1-I)"$), ":($A
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