Pleura Cavities and Lungs – Flashcards
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What is the function of the lungs?
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Site of gas exchange
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What surrounds the lungs?
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Surrounded by Pleural Sac
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What makes up the pleural sac?
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Parietal Pluera Visceral Pleura
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What is the parietal pluera?
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Lines thoracic cavity
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What is the visceral pleura?
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Direct contact with the lung
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What are the different parts of the parietal pluera?
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Costal parietal pleura Diaphragmatic parietal pleura Mediastinal parietal pleura
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What is the pleural cavity and what does it contain?
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Space between the parietal and visceral pleura, which contains a small amount of serous fluid
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Describe the pleural cavity as the chest wall contains?
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As chest wall expand, it takes the parietal pleura with it and the visceral pleura also expands this expands the thoracic cage and allows you to expand the lungs
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What is the cervical pleura of the lungs?
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Cervical pleura covers the apex of the lung, extends into the thoracic inlet, superior to the 1st rib
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What does the cervical pleura form?
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A cup-like dome over the apex, often called the cupola
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What innervates the parietal pleura?
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Somatic Afferent fibers
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What innervates the costal pleura?
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Intercostal nerves
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What innervates the diaphragmatic pleura
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Phrenic nerves
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What innervates the mediastinal pleura?
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Phrenic
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What are the dermatomes of the phrenic nere?
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C3-C5 dermatomes, which is lateral neck and supraclavicular regions
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The phrenic nerve goes _______ to the lung root
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anterior
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The phrenic nerves runs between what two structures?
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Mediastinal pleura and the pericardium
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What are the two pleura spaces?
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Costodiaphragamtic space Costomediastinal space
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The costodirapharmatic and costomediastinal recesses are extensions of ____ _____?
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pleural cavities devoid of lung tissue
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What is clinically significant about the costomediastinal and costodiaphragmatic recesses?
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Potential spaces where fluid can collect
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In the pleural sac, when the patient goes from bedridden to standing postioning, the fluid will pool in which space?
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Costodiaphragmatic positions
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At what intercostal space can you remove fluid in the costodiaphragmatic space?
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5th intercostal space
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Inferiroyl, The pleura exends:
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Rib 8: midvlaciular line Rib 10: midaxillary line Rib 12: posteriorly
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In quite respiration, the inferior margin of a lung can be approximated:
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Rib 6: the midclavicular line Rib 8: Midaxillary line Rib 10th: posteriorly
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If you need to access the costodiaphragmatic space, where should you enter? Where do you want to avoid?
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Midaxillary line, approx below rib #7 Avoid going below rib #9 on the right side due to the liver
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What is the root of the lung?
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Consists of structures which attach the lung to structues in the mediastinum (pulmonary artery, vein bronchus, etc)
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What is the hilum of the lung?
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The entrance and exit point of the root structures
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In the hilum, the pulmonary artery is ____ to the pulmonary vein?
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Pulmonary artery is superior to the pulmonary vein is inferior
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What is located in the hilum of the lung?
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Primary bronchus Pulmonary artery (superior) Pulmonary veins (inferior)
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What is the pulmonary ligament?
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Transition of parietal to visceral pleura, helps anchor the inferior lobe of the lung to the mediastinum This extends inferiorly from lung root for a variable distance
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What are the lobe of the right lung?
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Superior Middle Inferior
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What are the fissures in the right lobe?
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Oblique Horizontal
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What divides the superior and inferior lobes in the right lung?
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Oblique fissure
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What divides the superior and middle lobes in the right lung?
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Horizontal fissure
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What are the sections of the left lung?
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Superior Inferior
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What is the fissure of the left lung?
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Oblique
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The left lung contains _____ that the heart sits in.
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cardiac notch, lingual lobe
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Where is the pancoast tumor?
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Tumor involving the apex of a lung
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What structures can the pancoast tumor affect?
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May involve structures in the root of the neck: recurrent laryngeal nerve Inferior portion of the brachial plexus Sympathetic trunks Subclavian blood vessels
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Right oblique fissure on a patient can be marked by what?
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A curved line that begins approx. the spinous process of the 4th thoracic vertebra, crosses the 5th intercostal space laterally, then follows the contour of the 6th rib anterior
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Where does the horizonal fissure follows?
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the 4th intercostal space from the stenrum until it meets the oblique fissure
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Left oblique fissure on patient can be marked by what?
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A curved line that begins approximately approx at the spinous processes of the 3rd and 4th thoracic vertebrae, crosses the 5th intercostal space laterally, then follows the contour of the 6th rib anteriorly
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What impressions does the medial surface of the right lung have?
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Heart Superior Vena Cava Inferior Vena Cava Azygos Vein Esophagus Diaphragm
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What impressions does the medial surface of the left lung?
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Heart Arch of the aorta Descending Aorta Esophagus
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What is the trachae?
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Flexible tube that is held open by c-shaped rings of cartilage
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The trachae divides into what in the sternal angle?
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Primary bronchi
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Describe the right primary bronchi?
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Shorter, wider, and more vertically oriented compared to the left
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What is the clinical signifnance of the right primary bronchi?
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Foreign objects are most likely to enter the right primary bronchus
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After the primary bronchus enters the lung at the hilus, it then divides into what?
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Secondary/lobar bronchi
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The secondar/lobar bronchi then divide into?
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Tertiary or segmental bronchi
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How many segemental bronchi?
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10 segemental lung in both right/left lung
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Where does the gas exchange?
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Occurs at the level of alveoli
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What is the carina?
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The last trachael ring of cartilage is where the trachae is bifurcating and it is somewhat obliquely situated
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What type of cell does the alveoli contain?
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Thin and squamous type of epithelium
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Describe what the alveoli?
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Large lumen with smooth muscle and dividing into numerous smaller diameter
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What is the function of the pulmonary arteries?
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Deoxygenated blood from the right ventricle to the lungs
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What is the function of the pulmonary veins?
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Oxygenated blood from the lungs to the left atrium
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What is the bronchopulmonary segement?
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Area of lung supplied by a tertiarty bronchus and its accompanying pulmonary artery branch There are 10 bronchopulmonary segments in each lung
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What is the blood supply to the bronchi?
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Bronchial arteries
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How many bronchial arteries on the left?
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2 on the left from the thoracic aorta : superior bronchial artery and inferior bronchial artery
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How many bronchial arteries on the right?
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1 on the right usually form 3rd posterior intercostal artery
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What innervates the visceral pleura?
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Visceral afferent fibers that accompany bronchial vessels
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How does the pain present from visceral pleura?
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There is no pain elicited from this tissue
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What innervates the parietal pleura?
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Somatic afferent fibers
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What innervates the costal pleura and where would the pain be felt?
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Intercostal nerves, pain would be felt in relation to the thoracic wall
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What innervates the diaphragmatic and mediastinal pleura and where would the pain be felt?
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Phrenic nerves, pain would be felt lateral neck and supraclavicular region of the shoulder
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Lung structures and visceral are innervated by:
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anterior and posterior pulmonary plexuses
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Branches of the plexuses originate from?
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Sympathetic trunks and vagus nerves
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Branches of the vagus nerves does what?
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Constrict the bronchioles Increased mucous production
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Sympathetic stimulation does what?
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Dilates the bronchioles Decreased mucous production
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The phrenic nerve goes _______ to the lung structures
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anterior
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The vagus nerve goes _____ to the lung structures
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posterior
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Describes the lymphatics?
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Intrapulmonary lymph nodes to the bronchopulmonary nodes at the hilum to the trachaeobronchial nodes along trachae to the bronchomediastinal trunks into the thoracic or right lymphatic duct
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What is the pulmonary disroder that causes variable obstruction of the airway caused by spasmodic constraction of the smooth muscle in the bronchial tree.
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Asthma
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What is the pulmonary disorder is inflammation of the mucous membranes of the bronchial tree?
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Bronchitis
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What is the pulmonary disorders of the destruction of the wall of the airspaces distals to the terminal bronchioles, thus reducing the surface area for gas exchange?
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Emphysema
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What is the pulmonary disorders includes chronic bronchitis and emphysema?
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Chronic Obstructive Pulmonary Disease
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What is the pulmonary disorder of inflammation of the pleura?
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Pleurisy
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What is the pulmonary disorder of air in the pleural cavity that results in partial or total collapse of the lung?
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Pneumothorax
