أسئلة الـ Lung (ريتين ثانية أناتومي)

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Questions and Answers

Describe the path of the left phrenic nerve in relation to the left common carotid and subclavian arteries.

The left phrenic nerve passes between the left common carotid and subclavian arteries.

What anatomical structures are located behind the hilum of the lung?

The structures located behind the hilum include the esophagus, azygous vein, and descending aorta.

What distinguishes the inferior border of the right lung from the left lung?

The right lung descends vertically to the 6th costal cartilage, while the left lung deviates 4 cm to the left before descending to the 6th costal cartilage.

What levels do the anterior borders of the lungs meet at the sternal angle?

The anterior borders of the lungs meet at the sternal angle where both borders descend vertically together until the 4th costal cartilage. Signup and view all the answers

What is the significance of the apex of the lung and its relation to the cervical pleura?

The apex of the lung is marked by the cervical pleura, which is located one inch above the medial third of the clavicle. Signup and view all the answers

Where should a thoracentesis be performed to minimize injury to underlying organs?

In the 8th and 9th intercostal space at the mid-axillary line. Signup and view all the answers

What is the significance of the oblique fissure in the lungs?

The oblique fissure is found in both lungs and extends from T3 to the 6th costo-chondral junction. Signup and view all the answers

Describe the location of the horizontal fissure in the lungs.

The horizontal fissure is located in the right lung, extending from the anterior border at the 4th costal cartilage. Signup and view all the answers

What are the two types of pleural recesses, and where are they found?

The two types are costo-mediastinal and costo-diaphragmatic recesses, found between the costal and mediastinal surfaces, and between the costal and diaphragmatic surfaces, respectively. Signup and view all the answers

What is the anatomical landmark for drawing the oblique fissure when the arm is raised?

The medial border of the scapula serves as the landmark. Signup and view all the answers

What is the significance of the apico-posterior segment in the left lung?

It indicates that the apical and posterior segments of the superior lobe may fuse. Signup and view all the answers

How does the size of the right lung compare to the left lung?

The right lung is larger than the left lung. Signup and view all the answers

What differentiates the bronchial arteries of the right lung from those of the left lung?

The right lung has 1 bronchial artery from the right 3rd posterior ICA, while the left lung has 2 from the descending thoracic aorta. Signup and view all the answers

What is the role of the lingula in the left lung?

The lingula is present in the left lung but is absent in the right lung. Signup and view all the answers

How many lobes does the left lung have as compared to the right lung?

The left lung has 2 lobes, while the right lung has 3 lobes. Signup and view all the answers

What is broncho-pulmonary segmentation and why is it clinically important?

Broncho-pulmonary segmentation refers to a functional independent unit of the lung that can be isolated and removed without affecting nearby segments. Signup and view all the answers

How many segments are found in the right lung and what are the segments of the superior lobe?

The right lung has 10 segments, and the superior lobe is formed of 3 segments: apical, anterior, and posterior. Signup and view all the answers

List the segments that make up the inferior lobe of both the right and left lungs.

Both the right and left inferior lobes consist of 5 segments: apical, medial basal, anterior basal, lateral basal, and posterior basal. Signup and view all the answers

What structures are contained in each broncho-pulmonary segment?

Each segment contains a segmental bronchus, bronchioles, alveoli, and a segmental branch of the pulmonary artery and vein. Signup and view all the answers

Describe the segments of the lingual in the left lung.

The lingual of the left lung is formed of 2 segments: superior and inferior. Signup and view all the answers

What distinguishes the visceral pleura from the parietal pleura?

The visceral pleura covers the lungs except at the hilum, while the parietal pleura lines the thoracic wall. Signup and view all the answers

Explain why the right lung is shorter than the left lung.

The right lung is shorter due to the presence of the liver beneath it, while the left lung is affected by the heart's position. Signup and view all the answers

What is the purpose of the pleural cavity?

The pleural cavity provides a space between the visceral and parietal pleura, allowing for lung expansion and contraction during breathing. Signup and view all the answers

Identify the arterial supply to the right lung.

The right lung receives blood from the pulmonary artery and the bronchial artery, specifically from the right 3rd posterior intercostal artery. Signup and view all the answers

Describe the drainage system for venous blood in the left lung.

The left lung drains venous blood into the superior hemiazygous vein via the bronchial veins. Signup and view all the answers

What role do the internal thoracic and intercostal arteries play in the parietal pleura?

These arteries supply blood to the parietal pleura, assisting in its vascularization and function. Signup and view all the answers

What is a notable feature of the anterior border of the left lung?

The anterior border of the left lung has a cardiac notch that accommodates the heart. Signup and view all the answers

What are the surfaces of the lung and their relationships?

The lung has costal surfaces related to the sternum, ribs, and intercostal muscles, and medial surfaces that will be discussed further. Signup and view all the answers

What nerves supply the parietal pleura, making it sensitive to pain?

The parietal pleura is supplied by the phrenic and intercostal nerves. Signup and view all the answers

Which lymph nodes are responsible for draining the lung and visceral pleura?

The lung and visceral pleura drain into pulmonary, broncho-pulmonary, trachea-bronchial, and broncho-mediastinal lymph nodes. Signup and view all the answers

What structure is the most anterior in the hilum of the right lung?

The superior pulmonary vein is the most anterior structure in the hilum of the right lung. Signup and view all the answers

Identify the most superior structure at the hilum of the left lung.

The pulmonary artery is the most superior structure at the hilum of the left lung. Signup and view all the answers

Which bronchus is described as 'eparterial' and where is it located in relation to the pulmonary artery?

The superior lobar bronchus is labeled as 'eparterial' and is located above the pulmonary artery. Signup and view all the answers

List the structures found above the hilum of the right lung.

The structures above the hilum of the right lung include the right BCV with the right phrenic nerve, trachea with the right vagus nerve, and esophagus. Signup and view all the answers

What type of nerve supply characterizes the lung and visceral pleura, and how does it differ from the parietal pleura?

The lung and visceral pleura are supplied by the autonomic nervous system, in contrast to the parietal pleura which is sensitive to pain due to somatic nerve supply. Signup and view all the answers

What lymph drainage pathway is linked to the parietal pleura?

The parietal pleura drains into the cervical, intercostal, diaphragmatic, and mediastinal lymph nodes. Signup and view all the answers

What anatomical landmarks define the location of the apex of the lung in relation to the clavicle?

The apex of the lung is located one inch above the medial one-third of the clavicle. Signup and view all the answers

How does the anterior border of the left lung differ in its descent compared to the right lung?

The anterior border of the left lung deviates 4 cm to the left before descending to the 6th costal cartilage, while the right lung descends vertically to the 6th costal cartilage. Signup and view all the answers

At which rib levels does the inferior border of the lungs intersect the mid-clavicular and mid-axillary lines?

The lungs cut the 6th rib at the mid-clavicular line and the 8th rib at the mid-axillary line. Signup and view all the answers

What is the anatomical significance of the cardiac impression on the medial surface of the right lung?

The cardiac impression accommodates the shape of the heart, distinguishing the anatomical surface features of the right lung. Signup and view all the answers

Describe how the right and left pleurae differ in their descent towards the 6th costal cartilage.

The right pleura descends vertically to the xiphisternal joint, whereas the left pleura deviates to the left sternal margin before descending to the 6th costal cartilage. Signup and view all the answers

How many segments are found in the left lung, and what are the names of the segments in the superior lobe?

The left lung has 8-10 segments, and the superior lobe contains three segments: apical, anterior, and posterior. Signup and view all the answers

What structures run between the segments of the lungs?

Each segment contains a segmental bronchus, segmental branch of the pulmonary artery, and segmental radical of the pulmonary vein. Signup and view all the answers

List the segments found in the inferior lobe of the right lung.

The inferior lobe of the right lung includes the apical, medial basal, anterior basal, lateral basal, and posterior basal segments. Signup and view all the answers

What is the clinical significance of broncho-pulmonary segmentation?

Broncho-pulmonary segmentation allows for isolated removal of segments without affecting adjacent segments. Signup and view all the answers

Explain the segment structure of the middle lobe in the right lung.

The middle lobe of the right lung is formed by two segments: medial and lateral segments. Signup and view all the answers

What type of nerves supply the parietal pleura, making it sensitive to pain?

The parietal pleura is supplied by the phrenic and intercostal nerves. Signup and view all the answers

Identify the most inferior structure at the hilum of the right lung.

The most inferior structure at the hilum of the right lung is the inferior pulmonary vein. Signup and view all the answers

What structure is situated most posteriorly in the hilum of both lungs?

The principal bronchus is the most posterior structure at the hilum of both lungs. Signup and view all the answers

What lymph nodes are associated with the lymph drainage of the parietal pleura?

The parietal pleura drains into the cervical, inter-costal, diaphragmatic, and mediastinal lymph nodes. Signup and view all the answers

Which structure lies between the two bronchi in the right lung's hilum?

The pulmonary artery lies between the two bronchi in the right lung's hilum. Signup and view all the answers

What is the relationship between the right pulmonary artery and the respective bronchus?

The right pulmonary artery is positioned superiorly to the right principal bronchus. Signup and view all the answers

What lies above the pulmonary hilum on the left lung?

Above the hilum of the left lung are the left common carotid artery, left subclavian artery, and esophagus with the thoracic duct. Signup and view all the answers

How does the nerve supply differ between the visceral and parietal pleura?

The visceral pleura is supplied by the autonomic nervous system, while the parietal pleura receives somatic innervation from the phrenic and intercostal nerves. Signup and view all the answers

What anatomical feature is present in the left lung that accounts for its smaller size compared to the right lung?

The cardiac notch is present in the left lung, which gives it a smaller size compared to the right lung. Signup and view all the answers

What is unique about the bronchial arteries of the right lung compared to the left lung?

The right lung has one bronchial artery from the right 3rd posterior intercostal artery, while the left lung has two bronchial arteries from the descending thoracic aorta. Signup and view all the answers

How many bronchopulmonary segments are typically found in the left lung, and how does this compare to the right lung?

The left lung has 8-10 bronchopulmonary segments, while the right lung has 10 segments. Signup and view all the answers

What happens to the medial basal segment in the left lung's inferior lobe?

The medial basal segment in the inferior lobe of the left lung may be absent. Signup and view all the answers

What distinguishes the fissures found in the left lung compared to those in the right lung?

The left lung has only an oblique fissure, while the right lung has both oblique and horizontal fissures. Signup and view all the answers

What is the function of the pleural cavity?

The pleural cavity reduces friction between the lungs and thoracic wall during respiration. Signup and view all the answers

Explain the reason the right lung is shorter than the left lung.

The right lung is shorter due to the position of the liver underneath it. Signup and view all the answers

Describe the role of the pulmonary artery in relation to the lungs.

The pulmonary artery carries deoxygenated blood from the right ventricle to the lungs for oxygenation. Signup and view all the answers

What arteries supply the parietal pleura?

The parietal pleura is supplied by the internal thoracic, pericardiophrenic, and intercostal arteries. Signup and view all the answers

Name the two bronchial arteries supplying the left lung and their origin.

The left lung is supplied by two bronchial arteries originating from the descending aorta. Signup and view all the answers

Identify the most notable feature of the anterior border of the left lung.

The anterior border of the left lung features the cardiac notch. Signup and view all the answers

What type of blood do the pulmonary veins carry and from where?

Pulmonary veins carry oxygenated blood from the lungs to the heart. Signup and view all the answers

Explain the significance of the visceral pleura.

The visceral pleura covers the lungs, providing a protective layer and participating in the pleural fluid's role. Signup and view all the answers

What are the anatomical landmarks for the oblique fissure of the lung?

The oblique fissure extends from the posterior border at the spine of T3 to the inferior border 3 inches from the midline at the 6th costo-chondral junction. Signup and view all the answers

What is the purpose of the pleural recesses, and what are the two main types?

Pleural recesses are extensions of the pleural cavity that allow for lung expansion; the two types are costo-mediastinal and costo-diaphragmatic. Signup and view all the answers

Describe the significance of performing thoracentesis at the mid-axillary line.

Thoracentesis is performed at the 8th and 9th intercostal spaces at the mid-axillary line to minimize the risk of injury to the liver and spleen. Signup and view all the answers

What distinguishes the horizontal fissure in the lungs and where does it extend?

The horizontal fissure is found only in the right lung, extending from the anterior border at the 4th costal cartilage and intersecting the oblique fissure at the mid-axillary line. Signup and view all the answers

Where should the needle be inserted during a thoracentesis to avoid injury to the intercostal nerve?

A needle should be inserted on the upper border of the rib during thoracentesis to avoid injury to the intercostal nerve. Signup and view all the answers

Study Notes

Lung & Pleura

The lung is covered by a double-layered membrane called the pleura
Visceral pleura: the inner layer covering the lung
Parietal pleura: the outer layer lining the thoracic wall
Pleural cavity: the space between the visceral and parietal layers
The apex of the lung is covered by cervical pleura and supra-pleural membrane
The base of the lung is covered by diaphragmatic pleura
The diaphragm separates the lung from the liver on the right and liver, stomach, and spleen on the left
The right lung is shorter than the left
The right lung is wider than the left
Costal surfaces: related to the sternum, ribs, and intercostal muscles
Medial surface: will be discussed later
The lung has anterior, posterior, and inferior borders

Arterial Supply of Lungs & Visceral Pleura

Pulmonary artery carries deoxygenated blood from the right ventricle
Bronchial arteries: one for the right lung (from the right 3rd posterior intercostal artery), two for the left lung (from descending aorta)
Parietal pleura is supplied by internal thoracic, pericardiophrenic, intercostal arteries, superior phrenic, and musculophrenic arteries

Venous Drainage of Lungs & Visceral Pleura

Pulmonary veins carry oxygenated blood from the lungs
Bronchial veins: drain into the azygous vein (right lung) or superior hemiazygous vein (left lung)
Parietal pleura venous drainage: similar to arterial supply, draining into the same venous systems

Nerve Supply of Lungs & Visceral Pleura

Painless, supplied by the autonomic nervous system
Parietal pleura is painful, supplied by phrenic and intercostal nerves

Lymph Drainage of Lungs & Visceral Pleura

Pulmonary, bronchopulmonary, tracheobronchial, broncho-mediastinal lymph nodes
Parietal pleura: cervical, intercostal, diaphragmatic, and mediastinal lymph nodes

Mediastinal Surface of Both Lungs

Right lung: The superior pulmonary vein is the most anterior structure, followed by the inferior pulmonary vein. The principle bronchus is the most posterior, the superior lobar is the most superior, and the pulmonary artery lies between the two bronchi.
Left lung: has an analogous structure but with the important difference of the cardiac notch, located opposite the 4th and 5th intercostal spaces.
Arch of azygous vein, SVC & IVC with Right phrenic nerve, cardiac impression for right atrium,
Descending aorta, pulmonary trunk, esophagus.

Surface Anatomy of Lungs & Pleura

Apex of lung = cervical pleura
Anterior border: from the sterno-clavicular joint to the sternal angle, then descending vertically till the 4th or 6th costal cartilage to the angle between xiphisternal joint in right and left.
Inferior border: of lung and pleura: at 6th rib mid-clavicular line, 8th rib mid-axillary, 10th rib para-vertebral
Posterior border: vertical line from the medial end of the inferior border to the apex
Important anatomical points can be seen by visualizing the oblique and horizontal fissures and associated structures, and the presence of lung lobes.

Fissures of the Lungs

Oblique fissure: found in both lungs, extending from the posterior border at the level of the spine of T3—until it cuts oblique fissure in mid-axillary line
Horizontal fissure: only found in the right lung, extending from the anterior border at the 4th costal cartilage
Costo-mediastinal, and costo-diaphragmatic pleural recesses

Broncho-Pulmonary Segmentation

Functional independent unit of the lung
Structures: segmental bronchus, bronchioles & alveoli, segmental branch of pulmonary artery & vein, and segmental radicals of pulmonary vein.
Segmental bronchus, bronchioles, alveoli, segmental branch of pulmonary artery, segmental radical of pulmonary vein (lying between segments).

Distribution

Right lung: 10 segments (superior lobe 3; middle lobe 2; inferior lobe 5)
Left lung: 8-10 segments (superior lobe 3; inferior lobe 5; lingual lobe 2)

Right Lung vs. Left Lung

Right lung is larger
Right lung has an absent cardiac notch and lingula
Right lung is shorter
Right lung is more concave
Right lung divides before entering hilum. 1 bronchus from the right 3rd posterior ICA
Right lung has 3 lobes and 10 segments
Left lung is smaller
Left lung has a present cardiac notch and lingula
Left lung is longer
Left lung is less concave
Left lung divides after entering hilum—2 bronchi from descending thoracic aorta
Left lung has 2 lobes and 8-10 segments

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