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Thorax
Pulmonary Cavities & Mediastinum
239
Anatomy
Graduate
09/09/2013

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Term
thorax
Definition
between root of neck and abdomen
musculoskeletal wall
mediastinum & 2 pulmonary cavities
Term
superior thoracic aperture
Definition
thoracic inlet
manubrium, 1st ribs, 1st thoracic vertebra
lateral: supra pleura membrane, scalene muscles
central opening
Term
inferior thoracic aperture
Definition
thoracic outlet
xiphoid process, costal margin, ribs 11 and 12, 12th thoracic vertebra
inferior: diaphragm
Term
diaphragm
(general structure, action, superior borders, innervation)
Definition
general: muscular boundary with tendinous central area
action: primary breath muscle
superior border: 5th ICS right, 6th ICS left
innervation: vagus, C3,4,5
Term
sternum
Definition
sword-shaped bone
Term
manubrium
Definition
"handle" of sword on sternum
has jugular notch, 2 clavicular notches
articulates with rib 1
Term
body of sternum
Definition
has sternal angle and costal notches for ribs 2-7
Term
Angle of Louis
Definition
sternal angle, lies at T4/5 level, rib 2 articulates here
Term
xiphoid process
Definition
inferior point of sternum, xiphisternal joint, articulates with rib 7
Term
median sternotomy
Definition
sternum divided during open heart procedures
Term
fractured sternum
Definition
common in auto accidents; most common at manubriosternal joint
Term
bone biopsies (common site)
Definition
sternum, contains red marrow, site for hematopoiesis
Term
# pair of ribs
Definition
12 pairs
Term
true ribs
Definition
ribs 1-7
costal cartilage attaches directly to sternum
Term
false ribs
Definition
ribs 8-10
costal cartilage attaches to rib above
Term
floating ribs
Definition
ribs 11 and 12
anterior ends don't attach to sternum
Term
rib head
Definition
end of rib closest to vertebral column, articulates with superior and inferior demifacets of vertebrae
Term
rib neck
Definition
flattened portion of rib that extends lateral from head, placed in front of transverse process of lower 2 of vertebrae with which the head articulates
Term
rib tubercle
Definition
projection off the posterior surface at the junction of head and neck; more inferiorly located on rib; articulates with transverse process of matching thoracic vertebra number
Term
rib shaft
Definition
long portion of rib from lateral to the neck and tubercle to the anterior attachment to costal cartilage
Term
rib angle
Definition
costal angle, sharpest bending point of rib, weakest poing, located on posterior portion
Term
costal groove
Definition
groove or depression on the inferior, internal border of the rib; contains intercostal vessels and nerve
Term
costal cartilage
Definition
bars of hyaline cartilage; servet to prolong ribs forward and contribute to elasticity of the thoracic wall; only found anteriorly
Term
cervical rib - "thoracic outlet syndrome"
(explain, symptoms)
Definition
at the superior thoracic aperture; can compress subclavian atery and lower parts of brachial plexus
symptoms: cold clammy skin, numbness and tingling in C8 and T1 dermatomes
Term
rib fracture
Definition
weakest point is just anterior to the angle, sharp edges can puncture lungs, spleen; can be a complication of CPR
Term
typical thoracic vertebra
Definition
heart-shaped body; round vertebral foramen; long, downward pointing spinous process; 3 facets (superior and inferior demifacet, transverse costal)
Term
costal vertebral joints
Definition
head of rib with superior and inferior demifacets of adjacent vertebrae
tubercle with transverse costal facet (corresponding #)
Term
surface anatomy: superior sternum
Definition
surface anatomy: T2 level
Term
surface anatomy: sternal angle
Definition
surface anatomy: T4/5 level
Term
surface anatomy: inferior tip of xiphoid process
Definition
surface anatomy: T9/10
Term
dermatome: horizontal through nipple
Definition
dermatome: T4
Term
dermatome: horizontal through umbilicus
Definition
dermatome T10
Term
midsternal line
Definition
anterior vertical, through middle of sternum
Term
midclavicular line
Definition
anterior vertical, through midpoint of each clavicle, also passes through nipple
Term
midaxillary line
Definition
lateral vertical, through center of axilla
Term
midvertebral line
Definition
posterior vertical, through the spinous processes of vertebral column
Term
scapular line
Definition
posterior vertical, through inferir angle of each scapula
Term
surface anatomy: lung and pleura anterior
Definition
surface anatomy:
midclavicular line
lung: rib 6
pleura: rib 8
Term
surface anatomy: lung and pleura lateral
Definition
surface anatomy:
midaxillary line
lung: rib 8
pleura: rib 10
Term
surface anatomy: lung and pleura posterior
Definition
surface anatomy:
scapular line
lung: rib 10
lung: T12
Term
intercostal spaces
Definition
spaces between adjacent ribs
named for rib superior to space
11 total
muscles, arteries, veins, and nerves
Term
external intercostal muscles

(origin, insert, nerve, action, fiber direction)
Definition
origin: lower border of rib
insert: upper border of rib
nerve: intercostal
action: raise ribs, inhalation
fiber direction: inferomedially
end anteriorly before sternum
Term
internal intercostal m.

(origin, insert, nerve, action, fiber direction)
Definition
origin: lower border rib
insert: upper border rib
nerve: intercostal
action: depress ribs, exhalation
fiber direction: superomedially
extend throughout intercostal space
Term
innermost intercostal m.

(origin, insert, nerve, action, fiber direction)
Definition
origin: lower border of rib
insert: upper border of rib
nerve: intercostal
action: elevate ribs
fiber direction: superomedially
only found laterally
Term
transverse thoracis m

(origin, insert, nerve, action)
Definition
origin: posterior of lower sternum and xiphoid
insert: inner surface of costal cartilages 2-6
nerve: intercostal
action: depress ribs, exhalation
Term
neurovascular bundle
Definition
intercostal n., a., v.
located between internal and innermost intercostal m., travels in costal groove
Term
posterior intercostal a.
Definition
arise from thoracic aorta
supply posterior to lateral ICS
Term
anterior intercostal a.
Definition
arise from internal thoracic a.
musculophrenic branch of ITA gives rise to AIC a. fro ICS 8,9,10
supplies anterior to lateral ICS
Term
internal thoracic aa.
Definition
arise from subclavian a.
one on each side of sternum
give rise to anterior intercostal aa.
2 branches inferiorly: musculophrenic, superior epigastric
Term
musculophrenic a.
Definition
one of the inferior branches of internal thoracic a.
gives rise to 8, 9, and 10 anterior intercostal aa.
Term
superior epigastric a.
Definition
one of the inferior branches of the internal thoracic a.
Term
intercostal arterial anastomsosis
Definition
allows collateral circulation between thoracic aorta and internal thoracic arteries to the ICS
Term
anterior intercostal v.
Definition
drains into the musculophrenic and internal thoracic v.
Term
posterior intercostal v.
Definition
drain into azygos v on right
drain into hemiazygos v on left
Term
intercostal n.
Definition
anterior primary rami of T1-T11
contain GSA and GSA fibers
innervate intercostal m. and transversus thoracis
give off lateral and anterior cutaneous branches to skin
Term
subcostal n.
Definition
T12 nerve that is like the intercostal n.
Term
mediastinum borders
Definition
anterior: sternum
posterior: vertebral bodies
superior: superior thoracic aperture
inferior: diaphragm
Term
mediastinum divisions
Definition
superior, inferior anterior, inferior middle, inferior posterior
Term
inferior middle mediastinum contents
Definition
pericardium, heart, root of great vessels, nerves and smaller vessels
Term
great vessels
Definition
SVC, ascending aorta, pulmonary trunk
Term
fibrous pericardium
Definition
sac of dense, fibrous CT
attaches to diaphragm
surrounds entire heart
Term
serous pericardium
Definition
has two layers: parietal and visceral
Term
parietal serous pericardium
Definition
attach to the in inside of fibrous pericardium
Term
visceral serous pericardium
Definition
aka epicardium; intimately adhered to the outer surface of the heart
Term
pericardial cavity
Definition
potential space around heart created by the fibrous and serous pericardium that are continuous with one another
Term
pericardial sinuses
Definition
lines of reflection where the visceral pericardium becomes continuous with the parietal pericardium aroudn the roots of the great vessels
Term
transverse pericardial sinus
Definition
passage between inflow channel (SVC and pulm. v) and the outflow changesl (aorta and pulm trunk)
Term
oblique pericardial sinus
Definition
recess posterior to the heart between the right and left pulmonary veins
Term
pericardium innervateion
Definition
phrenic n., C3,4,5
somatic = sensitive to pain
Term
percariacophrenic a.
Definition
runs with phrenic n. between pleura and pericardium
long, slender branch from internal thoracic a.
Term
percardiacophrenic v.
Definition
runs with phrenic n. between pleura and pericardium
drains to barchiocephalic v.
Term
pericarditis
Definition
inflamation of the pericardium
presents as sharp pain posterior to sternum
pericardial friction rub can be heard on auscultation
can lead to pericardial effusion or cardiac tamponade
Term
cardiac tamponade
Definition
acute inflammation of fluid or air in the pericardial cavity
compresses heart, reduces venous return, decreases cardiac output
potentially fatal
Term
pericardiocentesis
Definition
needle inserted into pericardial sac to remove fluid
insert needle to left of xiphoid and aim to left shoulder
usually done with ultrasound guidance
Term
epicardium
Definition
1 layer of heart wall
aka visceral serous pericardium, adheres intimately agasinst surface of heart
Term
mysocardium
Definition
middle layer of heart wall
cardiac muscle (thicker in ventricles than atria)
Term
endocardium
Definition
innermost layer of heart wall
endothelial lining of chambers
Term
pulmonary circuit
Definition
right ventricle pumps oxygen-poor blood to lungs via pulmonary arteries
returns oxygen rich blood to left atrium via pulmonary vv.
Term
systemic circuit
Definition
left ventricle pumps oxygen-rich blood to the body via aorta(s)
returns oxygen-poor blood to right atrium via superior and inferior vena cavas
Term
radiographic borders of heart
Definition
right: right atrium, SVC
left: aortic arch (knob), pulmonary trunk, left atrium, left ventricle
apex: left ventricle tip'
inferior: left ventricle and right ventricle
Term
surface anatomy borders of heart
Definition
right superior: 3rd costal cartilage at sternal margin
right inferior: 5th/6th costal cartilage at sternal margin
left superior: 2nd ICS at sternal margin
left inferior (apex): 5th ICS at midclavicular line
Term
surface anatomy heart chambers
Definition
right atrium: right 3rd-5th costal cartilages and sternal border
left ventricle: left 3rd-5th ribs toward midclavicular line
Term
coronary sulcus
Definition
depression between atria and ventricles, wraps around entire heart (not visible anteriorly)
Term
anterior interventricular sulcus
Definition
depression between ventricles anteirorly
in this runs anterior IV a. (LAD) and great cardiac v.
Term
apex
Definition
tip of left ventricle, most inferior point of heart
Term
right auricle
Definition
small conical muscular pouch attached to the right atrium
can be seen on anterior view of heart
Term
left auricle
Definition
small conical muscular pouch attached to left atrium
can be seen on anterior view of heart
Term
coronary sinus
Definition
sits in coronary sulcus
major vein of heart
drains directly into right atrium
Term
ascending aorta
Definition
starts from left ventricle
located deep to 3rd costal cartilage
obliquely upward, forward, and to the right
gives off left and right coronary aa.
Term
pulmonary trunk
Definition
begins at base of right ventricle
short and wide
branches into right and left pulmonary a.
Term
pulmonary veins
Definition
carry re-oxygenated blood to the left atrium
enter from right and left sides at two veins each
Term
inferior vena cava
Definition
large veins carries de-oxygenated blodo from lower half of body into right atrium
enters right atrium at the lower right, back side of heart
Term
superior vena cava
Definition
large, short vein that carries deoxygenated blood from upper half of body to right atrium
enters the right atrium at upper, right, front portion
Term
pulmonary arteries
Definition
carries deoxygenated blood from heart to respective lung
arise from pulmonary trunk
bifurcation occurs on posterior, superior heart inferior to the arch of aorta
Term
crux of heart
Definition
where posteiror interventricualr sulcus meets with coronary sulcus
where coronary sinus enters right atrium
marks intersection of all 4 chambers
Term
posterior interventricular sulcus
Definition
groove or depression between ventricles posteriorly
where the posterior interventricular a. and middle cardiac v. run
Term
interatrial septum
Definition
wall of tissue that separates the right and left atria
Term
fossa ovalis
Definition
oval-shaped depression in the interatrial septum; represents the site of the foramen ovale
Term
crista terminalis
Definition
vertical muscular ridge running anteriorly along the right atrial wall from the opening of the SVC to the opening of the IVC
provides the origin of the petinate m.
Term
pectinate muscles
Definition
prominent ridges of atrial myocardium
located in the interior of auricles of both atria and on anterior surface of right atrium
Term
pulmonary valve
Definition
located between right ventricle and pulmonary trunk
semilunar valve
right, left, and anterior cusps
Term
cornus arteriosus
Definition
smooth area just inferior to pulmonary trunk of right ventricle
Term
tricuspid valve
Definition
located between right atrium and ventricle
attaches inferiorly to papillary m.
anterior, posterior, and septal cusps
Term
papillary muscle
Definition
cone-shaped enveloped by endocardium
extend from the anterior and posterior ventricular walls and the septum to the chordae tendineae
tighten to prvent the cuspos from being everted by pressure developed in pumping action
Term
septomarginal trabecula
Definition
aka moderator band
only in right ventricle
extends between septum and anterior papillary m.
helps to conduct electric signal for contraction
Term
trabeculae carneae
Definition
anatomosing muscular ridges of myocardium in the ventricles
Term
chordae tendinae
Definition
extend fro mon papillary muscle to more than one cusp of AV valves, prevent eversion of valve cusps during ventricular contraction
Term
valve of foramen ovale
Definition
remnant of foramen ovale in the left atrium
Term
bicuspid (mitral) valve
Definition
located between left atrium and ventricle
attaches inferiorly to papillary m.
anterior and posterior cusps
Term
interventricular septum
Definition
place of origin of the papillary muscles
mostly muscular but has small membrous upper part
Term
right atrium
Definition
larger of two atria, thinner wall of two, has lower atrial pressure
Term
left atrium
Definition
smaller of two atria, thicker wall of two, smooth walls except in auricle, higher atrial pressure
most posterior of four chambers
Term
right ventricle
Definition
major portion of the anterior surface of heart
contains the septomarginal trabecula
Term
left ventricle
Definition
lies at the back of heart and has apex that points downward, forward, and to the left
performs harder work, and has a thicker wall, is longer and narrower, more conical
Term
aortic valve
Definition
lies between left ventricle and aorta
makes the second heart sound ("dub")
semilunar valve
right, left, and posterior cusps
Term
atrioventricular valves
Definition
think cusps connected to the cordae tendinae
active valves (muscles hold them closed)
right = tricuspid
left = bicuspid
Term
semilunar valves
Definition
consist of 3 semilunar cusps
sinus is created between each cusp and vessel wall
Term
lunule
Definition
thickened edge of the cusps of a semilunar valve
Term
nodule
Definition
center thickening of semilunar cusp edges where the cusps touch
Term
auscultation of aortic valve
Definition
anterior surface
right 2nd ICS at sternal margin
Term
auscultation of pulmonary valve
Definition
anterior surface
left 2nd ICS at sternal margin
Term
auscultation of tricuspid valve
Definition
anterior surface
left 5th ICS at sternal margin
Term
auscultation of mitral valve
Definition
anterior surface
left 5th ICS at midclavicular line
Term
valve stenosis
Definition
condition in which opening of the valve is narrowed due to calcification or scarring on the valve leaflets
causes a murmur
Term
valve insufficiency
Definition
condition in which a valve does not close completely, allowing blood to regurgitate backwards through the valve
causes a murmur
Term
mitral valve prolapse
Definition
condition in which one or both leaflets of the mitral valve evert into left atrium, allowing blood to regurgitate back into left atrium during systole
causes midsystolic click
Term
cardiac skeleton
Definition
separates chambers of the heart
provides attachment for cardiac muscle and valve cusps
insulates electrical impulses of heart's conduction system
Term
fibrous annulus
Definition
part of cardiac skeleton
one surrounds each valve
Term
trigone
Definition
part of cardiac skeleton
triangular area between the aortic and AV valves
has opening for bundle of His
Term
sinuatrial (SA) node
Definition
"pacemaker"
initiates contraction, sets pace to 60-70 bpm
Term
atroventricular (AV) node
Definition
stimulated by SA node
propagates signal to AV bundle of His
Term
AV bundle (of His)
Definition
transmits impulse to walls of ventricles
Term
right and left bundles of His
Definition
descend toward apex on either side of interventricular septum
right bundle passes through right ventricle via the septomarginal trabecula
Term
early diastole
Definition
atria and ventricles relaxed
all valves closed
atria filling --> forces AV valves open
Term
late diastole
Definition
AV valves open
ventricles fill
SA node initiates atrial contraction
Term
early systole
Definition
AV valves close
AV node initiates ventricular contraction
forces semilunar valves open
Term
late systole
Definition
semilunar valves open
ventricles contract
AV valves held closed by papillary m.
Term
coronary aa.
Definition
arise from right and left aortic sinuses
supply blood to heart and give off branches
Term
left coronary a.
Definition
arise posterior ot pulmonary trunk
gives off anterior IV branch and circumflex a.
sometimes gives off sinuatrial node branch (40%)
Term
anteior interventricular a.
Definition
aka left anterior descending (LAD), branch of left coronary a.
supplies left ventricle, most of IV septum and AV bundle of His
Term
circumflex a.
Definition
branch of left coronary a.
supplies left atrium and left ventricle
sometimes gives off posterior interventricular a.
Term
sinuatrial nodal a.
Definition
normally comes from right coronary a. (60%)
sometimes(40%) LCA via circumflex a. branch
supplies the SA node
Term
right coronary a.
Definition
descend with coronary sulcus around right side of heart
supplies right atrium
gives off sinuatrial nodal a., right marginal a., and posterior interventricualr a. (usually)
Term
right marginal a.
Definition
branch off of right coronary a.
supplies right ventricle and apex
Term
posterior interventricular a.
Definition
normally from RCA (60-70%)
sometimes from LCA via circumflex a. (15%)
sometimes from LCA and RCA (15%)
determines atrial dominance
supplies right and left ventricles and posterior 1/3 of IV septum
supplies the AV node
Term
atrial dominance
Definition
defined by coronary artery that gives rise to the posterior interventricualr a.
Term
right dominance
Definition
60-70% of population
posterior IV arises from RCA
Term
left dominance
Definition
15% of population
posterior IV a. arises from LCA
LCA then supplies all of IV septum
Term
shared dominance
Definition
15% of population
posterior IV a. from RCA and LCA
Term
great cardiac v.
Definition
accompanies left anterior descending a.
drains IV septum and right/left ventricles
wraps around in the coronary sulcus to drain into/become the coronary sinus
Term
anterior cardiac v.
Definition
accompanies RCA by right auricle
drains the anterior surface of right ventricle
empties directly into right atrium
Term
coronary sinus
Definition
travels in posterior coronary sulcus
empties into right atrium near opening of IVC
Term
small cardiac v.
Definition
accompanies right coronary a.
drains the posterior right atrium and ventricle
drains into the coronary sinus
Term
middle cardiac v.
Definition
accompanies posterior IV a.
drains into coronary sulcus
Term
cardiac plexus
Definition
located aroudn teh birfucation of the trachea and arch of the aorta
has sympathetic and parasympathetic innervation along with visceral afferent fibers
Term
sympathetic innervation of heart
Definition
cardiac branches from cervical and upper thoracic levels of sympathetic chain
increases heart rate and force of contraction
dilates coronary aa.
Term
parasympathetic innervation of heart
Definition
cardiac branches from vagus n. (CN X)
decrease heart rate and force of contraction
constricts coronary aa.
Term
visceral afferent innervation of heart
Definition
convey reflexive and nociceptive signals (in the case of ischemia)
Term
myocardial infarction
Definition
"heart attack"
sudden occlusion of coronary vessel, ischemia causes necrosis of myocardium
most common in LAD (40-50%), RCA (30-40%), circumflex a. (15-20%)
Term
referrred pain
Definition
phenomenon where noxious stimuli from heart (or other visceral organ) are perceived as pain
brain mixes up visceral afferent with somatic pain of same level nerve
Term
atherosclerosis
Definition
progressive narrowing of the arteries caused by accumulation of fatty deposits in the wall of the arteries
Term
coronary angiogram
Definition
used to visualize coronary arteries
catheter is placed in femoral a. and threaded up to the aorta to the coronary aa. to inject radiopaque contrast
Term
coronary a. bypass graft (CABG)
Definition
vessels from other regions of the body are sued to bypass the occluded coronary a.
Term
trachea
Definition
begins below the larynx at C6 level
composed of C-shaped rings of hyaline cartilage
closed posteriorly by trachealis m.
bifurcates into right and left primary bronhi (T4/5 level)
Term
right main bronchus
Definition
shorter, wider, 25-30* from vertical, aspirate objects
gives off superior, middle, and inferior 2ndary bronchi
posterior most structure in the root of the lung
Term
left main bronchus
Definition
longer, narrower, 45* from vertical
gives off superior and inferior secondary bronchi
posterior most structure in the root of lung
Term
right superior secondary bronchus
Definition
respiration to bronchopulmonary segments I, II, II
rigth
Term
right middle secondary bronchus
Definition
respiration to bronchopulmonary segments IV, V
right
Term
right inferior secondary bronchus
Definition
respiration to bronchopulmonary segments VI, VII, VIII, IX, X
right
Term
left superior secondary bronchus
Definition
respiration to bronchopulmonary segments I thru V
left
Term
left inferior secondary bronchus
Definition
respiration to bronchopulmonary segments VI thru X
left
Term
carina
Definition
cartilage piece that is found where the trachea bifurcates
T4/5 level
Term
conducting bronchial tree
Definition
brings air into lungs
trachea, primary bronchi, secondary bronchi, tertiary bronchi, terminal bronchi, bronchioles, terminal bronchioles, respiratory bronchioles
Term
respiratory bronchial tree
Definition
site of gas exchange
respiratory bronchioles, alveoli
Term
last site of cartilage in bronchial tree
Definition
terminal bronchi
after structures by smooth muscle
Term
alveoli
Definition
site of gas exchange
alveolar walls are thin squamous cell epithelium
surrounded by pulmonary capillaries and elastic fibers which allow recoil during exhalation
Term
pulmonary cavities
Definition
located on each side of mediastinum
contain the lungs and plurae
Term
plurae
Definition
form a membranous sac that surrounds lung
composed of single layer of mesothelial cells
produce serous fluid to lubricate movements of lungs
2 layers that are continuous with each other
Term
visceral pleura
Definition
intimately attached to the surface of the lung
Term
parietal pleura
Definition
lines thoracic wall, lateral portion of mediastinum, and superior surface of diaphragm
has somatic innervation from intercostal and phrenic nn. - sensitive to pain
Term
cervical pleura
Definition
superior of the parietal pleura, helps to close lateral portion of thoracic inlet
Term
costal pleura
Definition
part of parietal pleura, lines the internal surface of the ribs
Term
mediastinal pleura
Definition
part of parietal pleura, lines the lateral portion of the mediastinum
Term
diaphragmatic pleura
Definition
part of parietal pleura, lines the superior surface of the diaphragm
Term
pleural cavity
Definition
potential space created between visceral and parietal layers
normally contains serous fluid
fluid facilitates movement between layers during breathing
Term
pneumothorax
Definition
condition in which air enters the pleural cavity, may result from injury to chest wall or lung
Term
hemothorax
Definition
condition in which blood enters the pleural cavity, in an upright patient the blood accumulates in costodiaphragmatic
Term
pleural effusion
Definition
condition in which there is excess fluid in the pleural cavity, may be caused by congestive heart failure, pneumonia, TB or lung cancer
Term
pulmonary collapse (atelectasis)
Definition
air in the pleural cavity reduces the negative pressure that normally keeps the lung inflated, lung then collapses due to its inherent elasticity
Term
tension pneumothorax
Definition
air accumulates and becomes trapped in pleural cavity
injured tissue acts as one-way valve
causes complete lung collapse and mediastinal shift toward opposite side
compromises cardiac output, venous return, and compress opposite lung
Term
thoracocentesis (thoracentesis)
Definition
procedure in which a needle is inserted into the pleural cavity to drain fluid, blood, or pus
in upright patient, fluid accumulates in costadiaphragmatic recess
Term
pleura recess
Definition
area where lung does not completely fill the thoracic cavity
opposing layers of pleura are in contact with each other
accommodates expansion of lung
Term
costodiaphragmatic recess
Definition
where the diaphragmatic pleura reflects from the perimeter of the diaphragm to meet the costal pleura
Term
costomediastinal recess
Definition
where the mediastinal pleura reflects to meet the costal pleura, large on the left because of heart
Term
pleuritis
Definition
inflammation of the pleura, creates friction between visceral and parietal layers, produces sharp, stabbing pain during respiration
Term
mesothelioma
Definition
malignancy of the mesothelium of the lungs, associated with asbestos exposure
Term
apex of lung
Definition
superior point to of the lung
Term
diaphragmatic surface of lung
Definition
inferior surface of the lung
Term
right lung
Definition
3 lobes: superior, middle, inferior
2 fissures: horizontal oblique
Term
horizontal fissure
Definition
between superior and middle lobe on right lung
Term
oblique fissure
Definition
between superior/middle and inferior lobes on right lung
between superior and inferior lobes on left lung
Term
cardiac notch
Definition
cut out near the infero-anterior border of the superior lobe of the left lung
Term
lingula
Definition
inferior part of the superior lobe, "tongues" wraps around heart anteriorly
Term
hilum (hilus)
Definition
site of the mediastinal surface where structures enter and exit the lung
Term
root of lung
Definition
structures that pass through the hilus
Term
pulmonary arteries
Definition
superior-most structure of root of lung
carrly poorly oxygenated blood away from heart to lung
accompany respective bronchi to supply BP segments
intrasegmental distribution
Term
pulmonary veins
Definition
inferior-most structure of root of lung
carry well-oxygenated blood back toward heart
intersegmental distribution
Term
intrasegmental distributtion
Definition
supply to a single bronchopulmonary segment
Term
intersegmetnal distribution
Definition
supply to adjacent bronchopulmonary segments
Term
bronchial vessels
Definition
arteries arise from thoracic aorta and intercostal a.
enter hilum with the bronchi and supply oxygen and nutrient to the bronchial tree
veins drain into the azygos or hemiazygos vv.
Term
pulmonary ligament
Definition
fold of pleura that extends from the hilum to the diaphragm along the mediastinal surface
Term
bronchopulmonary segments
Definition
each is supplied by a segmental bronchus (tertiary) and branch of pulmonary a.
Term
segmentnectomy
Definition
removal of one or more segments of the lung
Term
lobectomy
Definition
removal of an entire lobe of lung
Term
pneumonectomy
Definition
complete resection of a lung
Term
rhonchus
Definition
indicates obstruction in the central airways of lung
sounds like snoring or rattling
Term
wheezing
Definition
high-pitched sound due to obstruction of bronchioles; common in ashmatics
Term
crackles (rales)
Definition
caused by popping open of alveoli and terminal bronchiles due to pneumonia, bronchitis, or pulmonary fibrosis
Term
auscultation: right apex of lung
Definition
anterior root of neck
Term
auscultation: right superior lobe
Definition
anterior, right 2nd ICS
auscultation
Term
auscultation: right middle lobe
Definition
anterior, right 4th ICS
auscultation
Term
auscultation: right inferior lobe
Definition
anterior, right 6th ICS
auscultation
Term
auscultation: left apex of lung
Definition
posterior, left 1st rib
auscultation
Term
auscultation: left superior lobe
Definition
posterior, left 2nd ICS
auscultation
Term
auscultation: left inferior lobe
Definition
posterior, left 7th ICS
auscultation
Term
pneumonia
Definition
inflammatory condition of the lung, usually caused by bacteria or viral infection
pus formation - appears white because it is full of leukocytes
Term
lobar pneumonia
Definition
affects a large and continuous area of the lobe of a lung
Term
bronchopneumonia
Definition
affects the walls of the bronchioles; characterized by multiple foci and alveolar infiltration
Term
pulmonary embolism
Definition
blockage of artery by blood clot; often DVT complication;
symptoms: diffiulty breathing, chest pain or inspiration, tachycardia, palpitations, cyanosis, low O2 saturation, rapid HR
treatment: anticoagulant, IVC filter
Term
chronic obstructive pulmonary disease (COPD)
Definition
progressive lung disease, characterized by narrowing of airways or inflammation or destruction of lung tissue, makes breathing difficult
Term
chronic bronchitis
Definition
cough with increased mucus production, accompanied by inflammation, causes narrowing of airways, caused by smoking
Term
emphysema
Definition
progressive disease that destroys the lung tissue; bronchioles collapse during exhalation trapping air in alveoli; caused by smoking and alpha1-antitrypsin deficiency
Term
asthma
Definition
chronic disease that results in narrowing of the airways due to inflammation or bronchoconstriction; functional issue --> can be reversed with sympathomimetic medicine
Term
bronchopulmonary nodes
Definition
located at hilum, receive lymph from lung parenchyma, transmit lymph to tracheobronchial nodes
Term
tracheobronchial nodes
Definition
located around bifurcation of trachea, transmit lymph to paratracheal nodes
Term
paratracheal nodes
Definition
located along trachea, transmit lympth to: bronchomediastinal trunk
Term
bronchomediastinal trunk
Definition
right trunk empties into right lymphatic duct
left trunk empties into thoracic duct
Term
parasympathetic to lung
Definition
via vagus n. (CN X)
motor to smooth muscle in bronchial tree (constrict)
dilate pulmonary vessels
stimulate secretion of gland in bronchial tree
provide visceral afferents associated with cough reflex
Term
sympathetic to lung
Definition
via sympathetic chain
dilates smooth muscle of bronchial tree
constrict pulmonary vessels
inhibit secretion of glands in bronchial tree
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