Podcast
Questions and Answers
Describe the path of the left phrenic nerve in relation to the left common carotid and subclavian arteries.
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?
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?
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?
What levels do the anterior borders of the lungs meet at the sternal angle?
What is the significance of the apex of the lung and its relation to the cervical pleura?
What is the significance of the apex of the lung and its relation to the cervical pleura?
Where should a thoracentesis be performed to minimize injury to underlying organs?
Where should a thoracentesis be performed to minimize injury to underlying organs?
What is the significance of the oblique fissure in the lungs?
What is the significance of the oblique fissure in the lungs?
Describe the location of the horizontal fissure in the lungs.
Describe the location of the horizontal fissure in the lungs.
What are the two types of pleural recesses, and where are they found?
What are the two types of pleural recesses, and where are they found?
What is the anatomical landmark for drawing the oblique fissure when the arm is raised?
What is the anatomical landmark for drawing the oblique fissure when the arm is raised?
What is the significance of the apico-posterior segment in the left lung?
What is the significance of the apico-posterior segment in the left lung?
How does the size of the right lung compare to the left lung?
How does the size of the right lung compare to the left lung?
What differentiates the bronchial arteries of the right lung from those of the left lung?
What differentiates the bronchial arteries of the right lung from those of the left lung?
What is the role of the lingula in the left lung?
What is the role of the lingula in the left lung?
How many lobes does the left lung have as compared to the right lung?
How many lobes does the left lung have as compared to the right lung?
What is broncho-pulmonary segmentation and why is it clinically important?
What is broncho-pulmonary segmentation and why is it clinically important?
How many segments are found in the right lung and what are the segments of the superior lobe?
How many segments are found in the right lung and what are the segments of the superior lobe?
List the segments that make up the inferior lobe of both the right and left lungs.
List the segments that make up the inferior lobe of both the right and left lungs.
What structures are contained in each broncho-pulmonary segment?
What structures are contained in each broncho-pulmonary segment?
Describe the segments of the lingual in the left lung.
Describe the segments of the lingual in the left lung.
What distinguishes the visceral pleura from the parietal pleura?
What distinguishes the visceral pleura from the parietal pleura?
Explain why the right lung is shorter than the left lung.
Explain why the right lung is shorter than the left lung.
What is the purpose of the pleural cavity?
What is the purpose of the pleural cavity?
Identify the arterial supply to the right lung.
Identify the arterial supply to the right lung.
Describe the drainage system for venous blood in the left lung.
Describe the drainage system for venous blood in the left lung.
What role do the internal thoracic and intercostal arteries play in the parietal pleura?
What role do the internal thoracic and intercostal arteries play in the parietal pleura?
What is a notable feature of the anterior border of the left lung?
What is a notable feature of the anterior border of the left lung?
What are the surfaces of the lung and their relationships?
What are the surfaces of the lung and their relationships?
What nerves supply the parietal pleura, making it sensitive to pain?
What nerves supply the parietal pleura, making it sensitive to pain?
Which lymph nodes are responsible for draining the lung and visceral pleura?
Which lymph nodes are responsible for draining the lung and visceral pleura?
What structure is the most anterior in the hilum of the right lung?
What structure is the most anterior in the hilum of the right lung?
Identify the most superior structure at the hilum of the left lung.
Identify the most superior structure at the hilum of the left lung.
Which bronchus is described as 'eparterial' and where is it located in relation to the pulmonary artery?
Which bronchus is described as 'eparterial' and where is it located in relation to the pulmonary artery?
List the structures found above the hilum of the right lung.
List the structures found above the hilum of the right lung.
What type of nerve supply characterizes the lung and visceral pleura, and how does it differ from the parietal pleura?
What type of nerve supply characterizes the lung and visceral pleura, and how does it differ from the parietal pleura?
What lymph drainage pathway is linked to the parietal pleura?
What lymph drainage pathway is linked to the parietal pleura?
What anatomical landmarks define the location of the apex of the lung in relation to the clavicle?
What anatomical landmarks define the location of the apex of the lung in relation to the clavicle?
How does the anterior border of the left lung differ in its descent compared to the right lung?
How does the anterior border of the left lung differ in its descent compared to the right lung?
At which rib levels does the inferior border of the lungs intersect the mid-clavicular and mid-axillary lines?
At which rib levels does the inferior border of the lungs intersect the mid-clavicular and mid-axillary lines?
What is the anatomical significance of the cardiac impression on the medial surface of the right lung?
What is the anatomical significance of the cardiac impression on the medial surface of the right lung?
Describe how the right and left pleurae differ in their descent towards the 6th costal cartilage.
Describe how the right and left pleurae differ in their descent towards the 6th costal cartilage.
How many segments are found in the left lung, and what are the names of the segments in the superior lobe?
How many segments are found in the left lung, and what are the names of the segments in the superior lobe?
What structures run between the segments of the lungs?
What structures run between the segments of the lungs?
List the segments found in the inferior lobe of the right lung.
List the segments found in the inferior lobe of the right lung.
What is the clinical significance of broncho-pulmonary segmentation?
What is the clinical significance of broncho-pulmonary segmentation?
Explain the segment structure of the middle lobe in the right lung.
Explain the segment structure of the middle lobe in the right lung.
What type of nerves supply the parietal pleura, making it sensitive to pain?
What type of nerves supply the parietal pleura, making it sensitive to pain?
Identify the most inferior structure at the hilum of the right lung.
Identify the most inferior structure at the hilum of the right lung.
What structure is situated most posteriorly in the hilum of both lungs?
What structure is situated most posteriorly in the hilum of both lungs?
What lymph nodes are associated with the lymph drainage of the parietal pleura?
What lymph nodes are associated with the lymph drainage of the parietal pleura?
Which structure lies between the two bronchi in the right lung's hilum?
Which structure lies between the two bronchi in the right lung's hilum?
What is the relationship between the right pulmonary artery and the respective bronchus?
What is the relationship between the right pulmonary artery and the respective bronchus?
What lies above the pulmonary hilum on the left lung?
What lies above the pulmonary hilum on the left lung?
How does the nerve supply differ between the visceral and parietal pleura?
How does the nerve supply differ between the visceral and parietal pleura?
What anatomical feature is present in the left lung that accounts for its smaller size compared to the right lung?
What anatomical feature is present in the left lung that accounts for its smaller size compared to the right lung?
What is unique about the bronchial arteries of the right lung compared to the left lung?
What is unique about the bronchial arteries of the right lung compared to the left lung?
How many bronchopulmonary segments are typically found in the left lung, and how does this compare to the right lung?
How many bronchopulmonary segments are typically found in the left lung, and how does this compare to the right lung?
What happens to the medial basal segment in the left lung's inferior lobe?
What happens to the medial basal segment in the left lung's inferior lobe?
What distinguishes the fissures found in the left lung compared to those in the right lung?
What distinguishes the fissures found in the left lung compared to those in the right lung?
What is the function of the pleural cavity?
What is the function of the pleural cavity?
Explain the reason the right lung is shorter than the left lung.
Explain the reason the right lung is shorter than the left lung.
Describe the role of the pulmonary artery in relation to the lungs.
Describe the role of the pulmonary artery in relation to the lungs.
What arteries supply the parietal pleura?
What arteries supply the parietal pleura?
Name the two bronchial arteries supplying the left lung and their origin.
Name the two bronchial arteries supplying the left lung and their origin.
Identify the most notable feature of the anterior border of the left lung.
Identify the most notable feature of the anterior border of the left lung.
What type of blood do the pulmonary veins carry and from where?
What type of blood do the pulmonary veins carry and from where?
Explain the significance of the visceral pleura.
Explain the significance of the visceral pleura.
What are the anatomical landmarks for the oblique fissure of the lung?
What are the anatomical landmarks for the oblique fissure of the lung?
What is the purpose of the pleural recesses, and what are the two main types?
What is the purpose of the pleural recesses, and what are the two main types?
Describe the significance of performing thoracentesis at the mid-axillary line.
Describe the significance of performing thoracentesis at the mid-axillary line.
What distinguishes the horizontal fissure in the lungs and where does it extend?
What distinguishes the horizontal fissure in the lungs and where does it extend?
Where should the needle be inserted during a thoracentesis to avoid injury to the intercostal nerve?
Where should the needle be inserted during a thoracentesis to avoid injury to the intercostal nerve?
Flashcards
Visceral Pleura
Visceral Pleura
The inner layer of the pleura that directly covers the lung, except at the hilum.
Parietal Pleura
Parietal Pleura
The outer layer of the pleura that lines the thoracic wall.
Pleural Cavity
Pleural Cavity
The potential space between the visceral and parietal pleura, containing a small amount of fluid.
Apex of the Lung
Apex of the Lung
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Base of the Lung
Base of the Lung
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Cardiac Notch
Cardiac Notch
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Pulmonary Artery
Pulmonary Artery
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Bronchial Arteries
Bronchial Arteries
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Mediastinal Surface of the Lungs
Mediastinal Surface of the Lungs
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Superior Pulmonary Vein
Superior Pulmonary Vein
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Inferior Pulmonary Vein
Inferior Pulmonary Vein
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Principal Bronchus
Principal Bronchus
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Pulmonary Artery (Right Lung)
Pulmonary Artery (Right Lung)
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Left phrenic and vagus nerve pathway
Left phrenic and vagus nerve pathway
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Structures behind the hilum
Structures behind the hilum
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Structures anterior to the hilum
Structures anterior to the hilum
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Cardiac impressions on lungs
Cardiac impressions on lungs
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Surface anatomy of lungs & pleurae
Surface anatomy of lungs & pleurae
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Which lung is larger?
Which lung is larger?
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What is the cardiac notch?
What is the cardiac notch?
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What is the lingula?
What is the lingula?
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How many lobes do each lung have?
How many lobes do each lung have?
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When do bronchi divide in each lung?
When do bronchi divide in each lung?
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Pleural Recess
Pleural Recess
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Costo-mediastinal Recess
Costo-mediastinal Recess
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Costo-diaphragmatic Recess
Costo-diaphragmatic Recess
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Thoracentesis (Pleural Tap)
Thoracentesis (Pleural Tap)
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Horizontal Fissure of the Lung
Horizontal Fissure of the Lung
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What is a bronchopulmonary segment?
What is a bronchopulmonary segment?
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What is the clinical significance of bronchopulmonary segments?
What is the clinical significance of bronchopulmonary segments?
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How many segments are in the right lung?
How many segments are in the right lung?
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How many segments are in the left lung?
How many segments are in the left lung?
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What structures are found within a bronchopulmonary segment?
What structures are found within a bronchopulmonary segment?
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What is the Apex of the Lung?
What is the Apex of the Lung?
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What is the Base of the Lung?
What is the Base of the Lung?
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What are the Bronchial Arteries?
What are the Bronchial Arteries?
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What is the Principal Bronchus?
What is the Principal Bronchus?
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What structures lie behind the lung hilum?
What structures lie behind the lung hilum?
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What structures sit anterior to the lung hilum?
What structures sit anterior to the lung hilum?
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What creates the cardiac notch in the left lung?
What creates the cardiac notch in the left lung?
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Why is the right lung larger than the left?
Why is the right lung larger than the left?
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Visceral Pluera Pain
Visceral Pluera Pain
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Parietal Pleura Pain
Parietal Pleura Pain
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What is the Hilum?
What is the Hilum?
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What is the Superior Pulmonary Vein?
What is the Superior Pulmonary Vein?
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What is the Inferior Pulmonary Vein?
What is the Inferior Pulmonary Vein?
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Where is the Pulmonary Artery?
Where is the Pulmonary Artery?
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What Structures are Above the Hilum?
What Structures are Above the Hilum?
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What is a Pleural Recess?
What is a Pleural Recess?
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What is the Costo-mediastinal Recess?
What is the Costo-mediastinal Recess?
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What is the Costo-diaphragmatic Recess?
What is the Costo-diaphragmatic Recess?
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What is Thoracentesis?
What is Thoracentesis?
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What is the posterior border of the lung?
What is the posterior border of the lung?
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Bronchopulmonary Segment
Bronchopulmonary Segment
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Clinical Importance of Bronchopulmonary Segments
Clinical Importance of Bronchopulmonary Segments
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Segments in the Right Lung
Segments in the Right Lung
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Segments in the Left Lung
Segments in the Left Lung
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Distribution of Bronchopulmonary Segments
Distribution of Bronchopulmonary Segments
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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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