thoracic cavity lungs and pleura pleura visceral pleura: visceral pleura: covers and follows...

THORACIC CAVITYTHORACIC CAVITY

LUNGS and LUNGS and PLEURAPLEURA

PleuraPleura

Visceral pleura:Visceral pleura:Covers and follows indentations of lung.Covers and follows indentations of lung.

Parietal pleura:Parietal pleura:Lines thoracic cavity.Lines thoracic cavity.

Text: p 113, Fig. 1.23Text: p 113, Fig. 1.23

Parietal Pleura DivisionsParietal Pleura Divisions

Costal pleura lines the ribs.Costal pleura lines the ribs.Diaphragmatic pleura covers the Diaphragmatic pleura covers the

diaphragm.diaphragm.Mediastinal pleura lies against the Mediastinal pleura lies against the

mediastinum.mediastinum.Cervical pleura extends above the level of Cervical pleura extends above the level of

the first rib.the first rib.Text: p 115, Fig. 1.24Text: p 115, Fig. 1.24

Pleural ReflectionsPleural Reflections

Costodiaphragmatic recess (space):Costodiaphragmatic recess (space):Space where costal and diaphragmatic Space where costal and diaphragmatic

pleura meet.pleura meet.Costomediastinal recess (space):Costomediastinal recess (space):

Space where mediastinal and costal pleura Space where mediastinal and costal pleura meet.meet.

Pulmonary ligament:Pulmonary ligament:Transition between visceral and parietal Transition between visceral and parietal

pleura at root of the lung.pleura at root of the lung.

Pleural Lines of ReflectionPleural Lines of Reflection

Cervical dome of pleura:Cervical dome of pleura:Level with neck of the first rib.Level with neck of the first rib.Anteriorly, 1.5-2.5 cm above the sternal Anteriorly, 1.5-2.5 cm above the sternal

end end of the clavicle.of the clavicle.Anterior margin extends obliquely behind Anterior margin extends obliquely behind

the the sternoclavicular joint.sternoclavicular joint.At sternal angle, the pleura is at the At sternal angle, the pleura is at the

median median line and two sides stay in contact line and two sides stay in contact until the until the fourth costal cartilage.fourth costal cartilage.

Text: p 115, Fig. 1.24AText: p 115, Fig. 1.24A

Pleural Lines of ReflectionPleural Lines of Reflection Right side:Right side:

Leaves sternum at 7Leaves sternum at 7thth costal cartilage.costal cartilage.

At 8At 8thth costal cartilage costal cartilage at midclavicular line.at midclavicular line.

At 10At 10thth rib at axillary rib at axillary line.line.

At 11At 11thth rib at scapular rib at scapular line.line.

Extends to level of Extends to level of

body of T12body of T12 and and then ascends.then ascends.

Pleural Lines of ReflectionPleural Lines of Reflection Left side:Left side:

Leaves sternum at Leaves sternum at IC space 5.IC space 5.

1.5 cm from sternal 1.5 cm from sternal margin at 6margin at 6thth costal costal cartilage.cartilage.

Follows same Follows same landmarks as right landmarks as right side from this side from this point.point.

Right Lung ProjectionsRight Lung Projections

Follows rib 1 to sternoclavicular joint.Follows rib 1 to sternoclavicular joint.Located at median plane at sternal angle.Located at median plane at sternal angle.Extends along median plane from 2Extends along median plane from 2ndnd

costal cartilage to 4costal cartilage to 4thth costal cartilage. costal cartilage.Leaves sternum at 6Leaves sternum at 6thth costal cartilage. costal cartilage.At 6At 6thth rib at midclavicular line. rib at midclavicular line.

Right Lung ProjectionsRight Lung Projections

At 8At 8thth rib at axillary line. rib at axillary line.At 10At 10thth rib at scapular line. rib at scapular line.Ends opposite T11.Ends opposite T11.

Left Lung ProjectionsLeft Lung Projections

Same as right lung except:Same as right lung except:Cardiac notch begins at 4Cardiac notch begins at 4thth costal cartilage. costal cartilage.

Horizontal at parasternal line.Horizontal at parasternal line.

Medial to costochondral junction at 6Medial to costochondral junction at 6 thth cartilage.cartilage.

Right Lung MorphologyRight Lung Morphology

Oblique fissure :Oblique fissure :Separates superior and inferior lobes.Separates superior and inferior lobes.

Begins at base of scapular spine.Begins at base of scapular spine.

At 5-6At 5-6thth rib at midaxillary line. rib at midaxillary line.

Ends at 6Ends at 6thth costochondral junction. costochondral junction.Text: p 122: Fig. 1.27Text: p 122: Fig. 1.27

Right Lung MorphologyRight Lung Morphology

Horizontal fissure :Horizontal fissure :

Separates superior and middle lobes.Separates superior and middle lobes.

Begins at axillary line.Begins at axillary line.

Follows rib 4.Follows rib 4.

Left Lung MorphologyLeft Lung Morphology

Oblique fissure:Oblique fissure:Same as for right lung.Same as for right lung.

No horizontal fissure.No horizontal fissure.

Lobes of the LungsLobes of the Lungs

LobesLobes3 on right3 on right

2 on left2 on left

Supplied by secondary bronchiSupplied by secondary bronchi

Lobes of the LungsLobes of the Lungs

Lobules (bronchopulmonary segments)Lobules (bronchopulmonary segments)10 on right10 on right

8 on left8 on left

Supplied by tertiary bronchiSupplied by tertiary bronchiText: p 125 and 126, Fig. 1.28Text: p 125 and 126, Fig. 1.28

Lobes of the Right LungLobes of the Right Lung

Superior lobe:Superior lobe:Apical lobuleApical lobule

Posterior lobulePosterior lobule

Anterior lobuleAnterior lobuleMiddle lobe:Middle lobe:

Lateral lobuleLateral lobule

Medial lobuleMedial lobule

Lobes of the Right LungLobes of the Right Lung

Inferior lobe:Inferior lobe:Superior lobuleSuperior lobule

Anterior basal lobuleAnterior basal lobule

Medial basal lobuleMedial basal lobule

Lateral basal lobuleLateral basal lobule

Posterior basal lobulePosterior basal lobule

Lobes of the Left LungLobes of the Left Lung

Superior lobe:Superior lobe:Apicoposterior lobuleApicoposterior lobule

Anterior lobuleAnterior lobule

Lingular lobule:Lingular lobule:

Homologous to middle lobe of right lung.Homologous to middle lobe of right lung.

Superior lobule.Superior lobule.

Inferior lobule.Inferior lobule.

Lobes of the Left LungLobes of the Left Lung

Inferior lobe:Inferior lobe:Superior lobuleSuperior lobule

Anterior basal lobuleAnterior basal lobule

Medial basal lobuleMedial basal lobule

Lateral basal lobuleLateral basal lobule

Posterior basal lobulePosterior basal lobule

Bronchopulmonary TreeBronchopulmonary Tree

TracheaTracheaSupported by cartilaginous ringsSupported by cartilaginous rings

Primary bronchiPrimary bronchiSupported by cartilaginous ringsSupported by cartilaginous rings

Secondary bronchiSecondary bronchiSupported by cartilaginous ringsSupported by cartilaginous rings

Tertiary bronchiTertiary bronchi


Respiratory bronchiRespiratory bronchiAlveolar sacsAlveolar sacsAlveoliAlveoli

TracheaTrachea

Supported by “C”-shaped cartilage Supported by “C”-shaped cartilage segments.segments.

In superior mediastinum.In superior mediastinum.Anterior to esophagus.Anterior to esophagus.Bifurcates into primary bronchi at sternal Bifurcates into primary bronchi at sternal

angle.angle.Carina.Carina.Text: p 125, Fig. 1.28Text: p 125, Fig. 1.28

Right Primary BronchusRight Primary Bronchus

Shorter, straighter, and larger than left:Shorter, straighter, and larger than left:Aspirated objects more commonly follow Aspirated objects more commonly follow right bronchus.right bronchus.

Gives off three secondary bronchi:Gives off three secondary bronchi:Superior to superior lobe of right lung.Superior to superior lobe of right lung.

Middle to middle lobe of right lung.Middle to middle lobe of right lung.

Inferior to inferior lobe of right lung.Inferior to inferior lobe of right lung.

Left Primary BronchusLeft Primary Bronchus

Twice as long as right primary bronchus.Twice as long as right primary bronchus.Gives off two secondary bronchi:Gives off two secondary bronchi:

Superior to superior lobe of right lung.Superior to superior lobe of right lung.

Inferior to inferior lobe of right lung.Inferior to inferior lobe of right lung.Angle between primary bronchi is 62 Angle between primary bronchi is 62

degrees.degrees.


Secondary bronchi:Secondary bronchi:Supply lobes.Supply lobes.

Tertiary bronchi:Tertiary bronchi:Supply lobules (bronchopulmonary Supply lobules (bronchopulmonary

segments)segments)Respiratory bronchiRespiratory bronchiAlveolar sacsAlveolar sacsAlveoliAlveoli

Lung Vascular SupplyLung Vascular Supply

One pulmonary artery to each lung:One pulmonary artery to each lung:Part of root of lung:Part of root of lung:

Lobar arteries:Lobar arteries:One to each lobeOne to each lobe

Segmental arteries:Segmental arteries:To segmentsTo segments

Intrasegmental Intrasegmental

Lung Vascular SupplyLung Vascular Supply

Two pulmonary veins from each lung:Two pulmonary veins from each lung:IntersegmentalIntersegmental


Bronchial ArteriesBronchial Arteries

Supply bronchiSupply bronchi IntrasegmentalIntrasegmentalSupply tissues of lungsSupply tissues of lungsTwo left bronchial arteries from thoracic Two left bronchial arteries from thoracic

aortaaortaRight bronchial artery origin is variable but Right bronchial artery origin is variable but

usually from first aortic intercostal artery.usually from first aortic intercostal artery.Text: p 127, Fig. 1.29Text: p 127, Fig. 1.29

Bronchial VeinsBronchial Veins

Right to azygos vein.Right to azygos vein.Left to accessory hemiazygos vein or left Left to accessory hemiazygos vein or left

superior intercostal veins.superior intercostal veins.

Innervation of the LungsInnervation of the Lungs

Anterior and posterior plexus:Anterior and posterior plexus:Lie anterior and posterior to roots of lungs.Lie anterior and posterior to roots of lungs.

Contain parasympathetic fibers:Contain parasympathetic fibers:From vagus nerve (CN X).From vagus nerve (CN X).

Contain sympathetic fibers:Contain sympathetic fibers:From T1-4.From T1-4.

Related to esophageal and aortic plexuses Related to esophageal and aortic plexuses posteriorly.posteriorly.


thoracic cavity lungs and pleura pleura visceral pleura: visceral pleura: covers and follows...

Documents