Term
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Definition
| region enclosed by the thoracic wall |
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Term
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Definition
- serous sacs investing (surrounding) the lungs
- Visceral pleura lines the lung surface
- Parietal pleura lines walls of thoracic cavity
- visceral and parietal are continuous with one another
- visceral pleura has no somatic sensory (temp/touch/pain sensations) innervation
- parietal pleura is sensitive to pain/temp/touch (intercostal nerves and phrenic nerve)
- (pleurisy) inflammation of the v. and p. pleura can lead to adhesion of these layers, resulting in acute pain with elevated activity (somatic sensory)
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Term
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Definition
- potential space between the visceral and parietal pleura
- L and R pleural cavities are independant
- surfactant as a lubricant in space
- Hydrothorax - an accumulation of fluid in pleural cavity
- Pneumothorax - accumulation of air in pleural cavity
- Hemothorax - accumulation of blood in pleural cavity
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Term
| Costodiaphragmatic recesses |
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Definition
- inferolateral recesses within the pleural cavities
- with inspiration, the lungs expand and these recesses decrease in area
- with expiration, these recesses enlarge again
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Term
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Definition
- procedure to drain excess fluid or blood from pleural cavity
- needle is inserted into an intercostal space (avoiding inferior protion of superior rib and superior border of inferior rib)
- good location to perform = posterior aspect of 7-9th intercostal spaces, as the needle enters the costodiaphragmatic recess, avoiding injury to lungs and nearby organs
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Term
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Definition
- lung elasticity - if thoracic wall is breached, then lung will shrink to about 1/3 of its normal size
- root of lung = collection of structures entering/exiting the lung (eg. pulmonary vessels/ bronchi)
- apex = superior portion of the lungs
- base = inferior portion of the lungs (concave and adjacent to diaphragm)
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Term
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Definition
- Right lung
- 3 lobes (superior, middle, inferior)
- horizontal fissure - separates superior and middle lobes
- oblique fissure - separates middle and inferior lobes
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Term
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Definition
- 2 lobes (superior and inferior)
- oblique fissure - separates superior and inferior lobes
- superior lobes and cardiac notch on anterior margin
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Term
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Definition
- located inferior to the larynx
- palpable at jugular notch due to cartilaginous rings
- c- shaped hyaline cartilages
- bifurcates at sternal angle (T4-T5)
- Carnia - ridge at the bifurcation of the trachea into the right and left main bronchi (at T4-T5)
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Term
| Right and Left Main Bronchi |
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Definition
- extrapulmonary (outside the lungs)
- supported by hyaline cartilage
- right bronchus is wider, shorter, and more vertical and left main bronchus
- aspirated objects are therefore more likely to lodge in the right bronchus due to its shape
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Term
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Definition
- each main bronchus divides into lobar bronchi
- intrapulmonary (inside lungs)
- right lung has 3 lobar bronchi (superior, middle, inferior)
- left lung has 2 lobar bronchi (superior, inferior)
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Term
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Definition
| each lobar bronchi divides into segmental bronchi, corresponding to a specific bronchopulmonary segment |
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Term
| bronchopulmonary segments (10 per lung) |
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Definition
- area of lung supplied by a segmental bronchus and segmental branch of pulmonary artery
- separated from adjacent segments by connective tissue septa (therefore can be surgically resected if affected by disease)
- tributaries of pulmonary veins lie in the connective tissue between adjacent segments
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Term
| Pulmonary Vessels (name them) |
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Definition
- pulmonary trunk - exits the right ventricle of the heart and divides into L and R pulmonary arteries (enter the lungs)
- Pulmonary arteries - carry oxygen poor blood from the heart to the lungs for oxygenation
- each PA divides into lobar and segmental arteries, running parallel with bronchi
- Pulmonary veins - 2 on each side - carry Oxy rich blod from lungs to L atrium of heart
- pulmonary veins in the intersegmental connective tissue separating bronchopulmonary segments, do not course through arteries and bronchi
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Term
| Bronchial Vessels (supply lung with oxygen -- different from blood being oxygenated by the lung) |
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Definition
- bronchial arteries - carry oxygen rich blood to the tissues of lung itself, they are branches off thoracic aorta
- bronchial veins - return oxygen poor blood from tissues of lung directly to the azygos system or via intercostal veins to the azygos system
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Term
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Definition
- all organs are innervated by the autonomic NS
- ANS includes Peripheral NS and Sympathetic NS nerves
- Innervation of lungs is via the pulmonary plexuses w/ contributions from Vagus Nerves (L and R) and sympathetic splanchnic nerves
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Term
| Vagus Nerves (CN X; parasympathetic) achieve bronchoconstriction |
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Definition
- preganglionic cell bodies lie in brain
- preganglionic fibers constitute vagus nerve
- postganglionic cell bodies lie in wall of the target organ (lung)
- postganglionic fibers also lie in wall of target organ (very short in length)
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Term
| Sympathetic Innervation (bronchodilation) |
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Definition
- preganglionic cell bodies lie in lateral horn of the thoracic spinal cord
- preganglionic fibers travel from lateral horn to ventral root to spinal nerve to ventral ramus to white ramus to paravertebral ganglion of sympathetic trunk
- postganglionic fibers (pulmonary nerves) travel from paravertebral ganglia to grey ramus to ventral ramus and into the lungs
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Term
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Definition
- separates abdominal and thoracic cavities
- composed of skeletal muscle surrounding C-shaped central tendon
- 2 domes (right dome is higher than the left dome due to liver)
- heart lies on central tendon
- attachments = xiphoid process, costal margin, ribs 11-12, lumbar vertebrae (R and L crura)
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Term
| 3 openings of the diaphragm |
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Definition
- Caval Opening - T8, through central tendon, for inferior vena cava
- Esophageal hiatus - T10, for esophagus and CN X
- Aortic hiatus - T12, for aorta, thoracic duct, azygos vein
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Term
| Diaphragm Sensory Innervation |
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Definition
| Phrenic nerves (primary) and intercostal nerves (peripherally) |
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Term
| Motor Innervation of Diaphragm |
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Definition
- Phrenic nerves - ("C3, C4, C5 - keep the diaphragm alive")
- L and R phrenic nerves independantly innervate L and R domes
- Primary muscle of inspiration -- contaction = dome descends and flattens (decreasing volume of abdominal cavity); expiration = relaxation and domes rise
- lesion of phrenic nerve - paralyzes corresponding half of the diaphragm. CXR will show a depressed (active side) and domes (rasied, paralyzed side) of diaphragm
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Term
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Definition
- contraction of diaphragm (abdominal contents forced down as flattening occurs); increases vertical dimension of thorax
- contraction of muscles that elevate the ribs (external intercostals) expands thoracic cavity laterally (transversely) -- bucket handle movement
- forceful inspiration, the pectoral muscles may be recruited
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Term
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Definition
- thoracic cavity reduces in size - diaphragm relaxes and elastic recoil of lungs
- during forceful expiration, abdominal muscles (external and internal obliques, rectus abdominis) are recruited to compress abdominal viscera upward, expelling air from lungs
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