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Questions and Answers

What is the primary sensory supply of the central part of the diaphragm?

  • Lumbar plexus
  • Celiac plexus
  • Phrenic nerve (correct)
  • Lower intercostal nerves

Which artery is NOT a branch of the internal thoracic artery?

  • Inferior phrenic artery (correct)
  • Musculophrenic artery
  • Pericardiophrenic artery
  • Superior phrenic artery

Which condition is characterized by the inward growth of the ribs and sternum?

  • Funnel chest (correct)
  • Flail chest
  • Pigeon chest
  • Barrel chest

What could severe cases of funnel chest potentially affect?

<p>Heart and lungs (B)</p> Signup and view all the answers

Which of the following is true regarding pigeon chest?

<p>It may be associated with rickets. (C)</p> Signup and view all the answers

What is the shape of the inlet of the thorax?

<p>Kidney shaped (D)</p> Signup and view all the answers

Which structures are allowed to pass through the thoracic inlet?

<p>Trachea, Oesophagus, and Lung apices (A)</p> Signup and view all the answers

Which boundary is NOT associated with the inlet of the thorax?

<p>Costal margin (D)</p> Signup and view all the answers

What is the configuration of the diaphragm's peripheral part?

<p>Striated muscle (B)</p> Signup and view all the answers

Which of the following is NOT a muscle associated with the structures passing through the inlet of the thorax?

<p>Pectoralis major (B)</p> Signup and view all the answers

Where is the diaphragm located relative to the thoracic outlet?

<p>Below the thoracic cage (C)</p> Signup and view all the answers

What is the anatomical position of the right cupolae of the diaphragm compared to the left?

<p>Higher due to presence of liver (D)</p> Signup and view all the answers

Which of the following arteries is included in the structures passing through the inlet of the thorax?

<p>Brachiocephalic artery (C)</p> Signup and view all the answers

What is the origin of the diaphragm's costal part?

<p>From the deep surfaces of the lower six ribs and their costal cartilages (D)</p> Signup and view all the answers

Which nerve passes through the vena caval opening of the diaphragm?

<p>Right phrenic nerve (D)</p> Signup and view all the answers

What structure is located at the aortic opening?

<p>Azygos vein (B), Thoracic duct (C)</p> Signup and view all the answers

Which part of the diaphragm is responsible for surrounding the esophageal orifice?

<p>Muscle fibers of the right crus (D)</p> Signup and view all the answers

What is a characteristic of the sphincter-like fibers surrounding the esophageal orifice?

<p>They help prevent regurgitation of stomach contents (D)</p> Signup and view all the answers

Where is the esophageal opening located?

<p>At the level of the T 10 vertebra (B)</p> Signup and view all the answers

Which of the following structures is associated with the minor openings of the diaphragm?

<p>Right crus (B)</p> Signup and view all the answers

What occurs when the minor opening known as the foramen of Morgagni is enlarged?

<p>It conveys the superior epigastric vessels (B)</p> Signup and view all the answers

What structures form the lung root that enters and leaves at the hilum?

<p>Primary bronchus, pulmonary artery, and two pulmonary veins (D)</p> Signup and view all the answers

Which surface of the lungs is concave and characterized by the presence of the hilum?

<p>Medial surface (C)</p> Signup and view all the answers

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

<p>The right lung has 3 lobes while the left lung has 2 lobes (B)</p> Signup and view all the answers

What is the apex of the lung located above?

<p>The first rib (D)</p> Signup and view all the answers

Which structures are included in the mediastinum?

<p>Heart, great vessels, and trachea (C)</p> Signup and view all the answers

What distinguishes the parietal pleura from the visceral pleura?

<p>Parietal pleura lines the thoracic cavity while visceral pleura covers the lungs (C)</p> Signup and view all the answers

What is the primary physiological role of the lungs?

<p>Gas exchange for respiration (A)</p> Signup and view all the answers

What is the pleural cavity filled with, and what is its function?

<p>Serous fluid, to reduce friction during respiration (C)</p> Signup and view all the answers

Which of the following correctly identifies the components forming the thoracic cage?

<p>Ribs, vertebral column, sternum, and costal cartilages (D)</p> Signup and view all the answers

What is the classification of ribs based on their attachment to the sternum?

<p>True ribs, false ribs, and floating ribs (D)</p> Signup and view all the answers

Which of the following describes the function of the thoracic cage?

<p>Protecting the heart and lungs (A)</p> Signup and view all the answers

Which structure is NOT a part of the sternum?

<p>Costal cartilage (C)</p> Signup and view all the answers

Which characteristic is specifically true for atypical ribs?

<p>They include ribs 1, 2, and 9-12. (D)</p> Signup and view all the answers

What anatomical feature distinguishes typical thoracic vertebrae?

<p>Heart-shaped body (B)</p> Signup and view all the answers

Regarding the boundaries of the apertures of the thoracic cage, which statement is true?

<p>The anterior boundary is formed by the sternum. (D)</p> Signup and view all the answers

Which part of the sternum lies at the level of the 2nd rib?

<p>Manubrium (D)</p> Signup and view all the answers

Which ribs are classified as 'floating ribs'?

<p>Ribs 11 and 12 (C)</p> Signup and view all the answers

Which thoracic vertebrae are typically classified as atypical?

<p>1st and 9th to 12th vertebrae (D)</p> Signup and view all the answers

What is a significant clinical feature of the sternum?

<p>Its location makes it vulnerable to fracture. (B)</p> Signup and view all the answers

Which of the following describes the typical anatomy of a rib?

<p>Head, neck, tubercle, angle, and shaft (A)</p> Signup and view all the answers

What role does the diaphragm have in respiration?

<p>Actively assisting in inhalation and exhalation (B)</p> Signup and view all the answers

The presence of transverse costal facets is characteristic of which type of vertebrae?

<p>Thoracic vertebrae (A)</p> Signup and view all the answers

Which statement best describes the pleura and pleural cavity?

<p>It is a fluid-filled space allowing for lung expansion. (B)</p> Signup and view all the answers

What is the primary reason the right bronchus is more likely to be obstructed by inhaled objects compared to the left bronchus?

<p>It is wider, shorter, and more vertical. (A)</p> Signup and view all the answers

At which rib level does the inferior margin of the parietal pleura take an oblique path laterally in the midclavicular line?

<p>Rib 8 (D)</p> Signup and view all the answers

What type of epithelium is found in the alveolar ducts and alveoli?

<p>Squamous epithelium (C)</p> Signup and view all the answers

What structure primarily supports the alveoli and maintains their shape during respiration?

<p>Elastic fibers (C)</p> Signup and view all the answers

Which nerve supply is responsible for bronchoconstriction?

<p>Vagus nerve (D)</p> Signup and view all the answers

Which feature characterizes the conducting passages of the bronchial tree?

<p>Thick walled (D)</p> Signup and view all the answers

What is the function of septal cells (type II pneumocytes) in the alveoli?

<p>Produce surfactant to reduce surface tension (A)</p> Signup and view all the answers

Where does the trachea divide into the left and right bronchi?

<p>At the level of the 5th thoracic vertebra (D)</p> Signup and view all the answers

Which of the following correctly describes the bronchial arteries?

<p>They supply blood to the lungs. (A)</p> Signup and view all the answers

What happens to the cartilage as the air passages become smaller towards the bronchioles?

<p>It becomes absent (D)</p> Signup and view all the answers

Which cells in the lung tissue are primarily involved in the defense against microbes?

<p>Macrophages (B)</p> Signup and view all the answers

Which statement best describes the airway as it divides and decreases in size?

<p>The wall becomes thinner. (A)</p> Signup and view all the answers

What type of epithelium transitions occur in the bronchial tree as it narrows?

<p>There is a transition from ciliated columnar to non-ciliated cuboidal. (B)</p> Signup and view all the answers

Flashcards

Thoracic Inlet (Superior Aperture)

The superior opening of the thoracic cavity, bordered by the manubrium sterni, T1 body, and the 1st ribs with their cartilages.

Thoracic Outlet (Inferior Aperture)

The inferior opening of the thoracic cavity, closed by the diaphragm, bordered by the infrasternal angle, T12 body, and the costal margin.

Diaphragm

A dome-shaped muscular partition between the thorax and abdomen, with a central tendon.

Right Cupolae

The highest part of the diaphragm on the right side, elevated due to the presence of the liver.

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Left Cupolae

The highest part of the diaphragm on the left side.

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Muscular Part of Diaphragm

The peripheral region of the diaphragm, composed of striated muscle.

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Central Tendon of Diaphragm

The central portion of the diaphragm, composed of fibrous tissue.

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Structures Passing Through Thoracic Inlet

The structures that pass through the Thoracic Inlet:

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Thorax

The region of the body located between the neck and abdomen.

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Thoracic cage

The bony structure that forms the protective cage around the heart, lungs, and other organs in the chest.

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Sternum

Serves as the anterior (front) part of the thoracic cage. It is composed of three fused bones: the manubrium, body, and xiphoid process.

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Manubrium

The upper portion of the sternum, articulating with the clavicle and the first two ribs.

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Body of the sternum

The middle and largest part of the sternum, articulating with ribs 2-7.

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Xiphoid Process

The lowermost part of the sternum which is cartilaginous and gradually ossifies over time.

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Ribs

A series of 12 pairs of curved bones that form the lateral (side) walls of the thoracic cage.

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True ribs

The top 7 ribs that articulate directly with the sternum.

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False ribs

The bottom 5 ribs. The top 3 attach to the costal cartilage of the 7th rib, and the bottom 2 (floating ribs) don't attach to the sternum.

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Floating ribs

The lowermost two false ribs that are unattached to either the sternum or the costal cartilage of the 7th rib.

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Vertebral column

The vertebral column, specifically the thoracic vertebrae, forms the posterior (back) portion of the thoracic cage.

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Transverse costal facets

These facets are located on the transverse processes of the thoracic vertebrae. They serve as attachment points for the ribs.

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Costal facets on vertebral bodies

These are found on the body of the thoracic vertebrae; they articulate with the heads of the ribs.

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Vertebral foramen

These are the holes in the vertebrae that allow for the passage of the spinal cord.

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Classifications of thoracic vertebrae

This refers to the arrangement of the thoracic vertebrae, where they are typically divided into typical (2nd-8th) and atypical (1st, 9th-12th), which have structural differences.

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Phrenic Nerve Function

The phrenic nerve provides motor innervation to the diaphragm, responsible for breathing.

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Diaphragm Innervation

The central part of the diaphragm is innervated by the phrenic nerve, while the peripheral part receives sensory input from lower intercostal nerves.

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Diaphragm Blood Supply

The musculophrenic artery, a branch of the internal thoracic artery, and the pericardiophrenic artery supply blood to the diaphragm.

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Funnel Chest (Pectus Excavatum)

A funnel-shaped chest deformity where the ribs and sternum grow inward, potentially affecting heart and lung function.

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Pigeon Chest (Pectus Carinatum)

A chest deformity characterized by an outward protrusion of the sternum, giving the chest a 'pigeon-breast' appearance.

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What is the diaphragm?

The diaphragm is a dome-shaped muscle that separates the chest cavity from the abdominal cavity. It plays a crucial role in breathing by contracting and relaxing to change the volume of the chest cavity.

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Where does the diaphragm originate from?

The diaphragm has three main origins: the sternal part, the costal part, and the vertebral/lumbar part.

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Where does the diaphragm insert?

The diaphragm inserts into a central tendon, which is a strong, fibrous sheet.

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What structures pass through the vena caval opening?

The vena caval opening allows passage for the inferior vena cava and branches of the right phrenic nerve.

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What structures pass through the esophageal opening?

The esophageal opening allows passage for the esophagus, vagus nerves, gastric vessels, and lymph vessels.

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What structures pass through the aortic opening?

The aorta, thoracic duct, and azygos vein pass through the aortic opening.

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What structures pass through the space of Larrey?

The space of Larrey allows passage for the superior epigastric vessels and lymphatic vessels of the liver.

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What structures pass through the minor openings?

The diaphragm has minor openings that allow passage for the splanchnic nerves, phrenic nerve, sympathetic trunk, and least splanchnic nerve.

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What is the apex of the lung?

The apex of the lung is the uppermost part, situated above the first rib, close to important blood vessels and nerves in the neck.

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Where is the base of the lung located?

The base of the lung rests on the diaphragm, the muscular partition between the chest and abdomen.

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What is the shape of the costal surface of the lung?

The costal surface of the lung is convex, facing the ribs, costal cartilages, and intercostal muscles.

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What is the shape of the medial surface of the lung?

The medial surface of the lung is concave and contains the hilum, where structures enter and leave the lung.

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What is the hilum of the lung?

The hilum is a slit-like opening on the medial surface of the lung, where crucial structures like the bronchus, pulmonary artery, and veins enter and exit.

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How many lobes does each lung have?

The right lung has three lobes, while the left lung has two lobes.

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What are the pleura and their types?

The pleura is a membrane lining the lungs and thoracic cavity. The parietal pleura lines the cavity, while the visceral pleura covers the lungs.

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What is the pleural cavity and its contents?

The pleural cavity is the space between the parietal and visceral pleura, filled with serous fluid that allows for smooth lung movement.

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Left Costal Margin

The level of the lower border of the left lung may be indicated by drawing a shallow curved line joining the sternal end of the 7th rib in the midclavicular line, 8th rib in the mid axillary line and 11th rib adjascent to the vertebral column.

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Inferior Margin of Parietal Pleura

Refers to the point where the diaphragm attaches to the ribs, specifically the 8th rib in the midclavicular line, 10th rib in the midaxillary line, and the T12 vertebra at the vertebral column.

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Pleural Layers

The two layers of pleura can be separated, but with some resistance due to the surface tension between them.

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Alveoli

The smallest air passages in the lungs, responsible for gas exchange.

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Trachea

The main airway that branches into two smaller airways, the left and right bronchi, at the level of the 5th thoracic vertebrae.

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Right Bronchus

The right bronchus is wider, shorter, and more vertical than the left bronchus, which makes it more susceptible to blockage by foreign objects.

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Left Bronchus

The left bronchus is longer, narrower, and oblique compared to the right bronchus, and it branches into two lobes.

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Conducting Passage Structure

The conducting passages within the lung, including the bronchi and bronchioles, have thick walls.

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Bronchiole Structure

As the airways branch and become smaller, the amount of cartilage decreases, while smooth muscle increases, making them responsive to nervous system stimulation.

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Epithelial Change in the Lung

The lining of the airways changes as they become smaller, transitioning from ciliated columnar to non-ciliated cuboidal and finally to squamous epithelium.

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Pulmonary Blood Supply & Drainage

The blood supply to the lungs is provided by the right and left bronchial arteries, while the venous drainage occurs through the azygos vein (right side) and the superior intercostal vein (left side).

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Nerve Supply to the Lung

The vagus nerve (parasympathetic) causes bronchoconstriction, while the sympathetic nervous system causes bronchodilation.

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Lung Lobules

Fine sheets of connective tissue divide the lung into lobules, which are further subdivided into smaller compartments.

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Airway Wall Changes

The walls of the airways become thinner as they branch, with less smooth muscle and connective tissue.

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Alveolar Structure

The respiratory bronchioles and alveoli are lined with a single layer of squamous epithelium and supported by elastic fibers.

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Study Notes

Respiratory System - Lower Respiratory Tract Anatomy

  • Learning Outcomes:
    • Identify and describe the bones of the thoracic cage.
    • Define the boundaries and structures of the thoracic cage apertures.
    • Explain the anatomy of the diaphragm.
    • Outline the clinical significance of the sternum.
    • Detail the anatomy of the pulmonary cavities, mediastinum, pleura, and pleural cavity.
    • Describe the anatomy of the lungs.

Thoracic Cage Bones

  • Thorax:
    • The region between the neck and abdomen.
    • Flattened front to back, rounded on the sides.
    • Forms the bony framework of the thoracic cage.
  • Formation:
    • Posteriorly: Vertebral column
    • Laterally: Ribs and intercostal spaces
    • Anteriorly: Sternum and costal cartilages
  • Protection: The thoracic cage protects the heart, lungs, and other vital organs.

Sternum

  • Composition: Fused sternebrae
    • Manubrium: Jugular notch, articulation with rib 1 and 2, clavicular articulating facets, and Sternal angle (articulation with rib 2).
    • Body: Articulates with ribs 2-7
    • Xiphoid Process: Cartilage that calcifies over time, partial attachment of many muscles; the xiphisternal joint is the articulation of the body of the sternum and the xiphoid process.

Ribs

  • Types:
    • True Ribs (1-7): Directly attached to the sternum
    • False Ribs (8-10): Indirectly attached to the sternum via costal cartilage
    • Floating Ribs (11-12): No anterior attachment

Ribs Anatomy

  • Typical Ribs (3-9):

    • Head: Articulates with vertebral column
    • Neck: Between head and tubercle
    • Tubercle: Articulates with transverse process of the vertebra
    • Angle: Change in rib curvature
    • Shaft: Main part of the rib
    • Subcostal Groove: Protects neurovascular bundles
  • Atypical Ribs (1, 2, 10, 11, 12): Variations in structure

Thoracic Vertebrae

  • Characteristics:
    • Transverse costal facets
    • Costal facets on vertebral body
    • Spinous processes are long and point inferiorly
    • Superior and inferior articular facets (face dorsally/posteriorly and ventrally/anteriorly)
    • Circular vertebral foramen
    • Heart-shaped body

Thoracic Apertutes Boundaries

  • Inlet (Superior Aperture):
    • Anteriorly: Manubrium sterni
    • Posteriorly: Body of T1 vertebra
    • Laterally: First rib and costal cartilage
  • Outlet (Inferior Aperture):
    • Anteriorly: Xiphoid process (infrasternal angle)
    • Posteriorly: Body of T12 vertebra.
    • Laterally: Costal margin of ribs 7-12

Thoracic Outlet Structures

  • Inlet structures:

    • Trachea
    • Esophagus
    • Lung apices
    • Remains of thymus
    • Major vessels
  • Outlet Structures:

    • Major vessels -nerves -major organs

Diaphragm Anatomy

  • Description: Muscular and aponeurotic partition between thorax and abdomen. Dome-shaped
    • Convex superior surface faces thorax
    • Depressed in the middle, summits are known as cupolas (right is higher due to liver)
  • Structure:
    • Peripheral part is muscular (striated)
    • Central part is tendinous (central tendon)

Diaphragm Origins

  • Sternal Part: Arises from the posterior surface of the xiphoid process.
  • Costal Part: Arises from the deep surfaces of the lower ribs and costal cartilages.
  • Vertebral/Lumbar Part: Arises from the upper three lumbar vertebrae, the crura and the arcuate ligaments(med&lat)

Diaphragm Insertion

  • Diaphragm insertion is into the central tendon.
    • Some muscle fibres of the right crus pass up to the left and surround the esophageal orifice in a slinglike loop.
  • These fibers act like a sphincter and assist preventing stomach contents from entering the thorax.

Diaphragm Openings

  • Major Openings:
    • Vena Caval Opening: For inferior vena cava, at T8 vertebra
    • Esophageal Opening: For esophagus, at T10 vertebra, vagus nerves, esophageal branches of left gastric vessels, and lymph vessels
    • Aortic Opening: For aorta, at T12 vertebra, thoracic duct, and azygos vein
  • Minor Opening:
    • Larrey Space: At the sterna origin and 7th costal cartilage, superior epigastric vessels, and lymphatics of liver.

Lungs

  • Location: In the thoracic cavity on either side of the mediastinum

  • Divisions: Lobes: Right lung has 3 lobes, left lung has 2 lobes

  • Surfaces: Apex, base, costal, medial.

  • Important Features:

  • Apex: Above the first rib, close to the blood vessels/nerves of the neck

  • Base: Related to the thoracic surface and diaphragm

  • Costal Surface: Convex, against the ribs and intercostal muscles

  • Medial Surface: Concave, has a hilum at T5-T7, where the root of the lung enters/exits.

Pleura and Pleural Cavity

  • Composition: Two membranes (visceral pleura and parietal pleura), lined by serous membrane (fluid)
  • Pleural Cavity (potential space): Filled with serous fluid that separates the pleural layers, reduces friction during breathing

Lung Interior

  • Features:
    • Bronchi: Air passages
    • Alveoli: Tiny air sacs for gas exchange
    • Blood vessels: Deliver oxygen and nutrients, removes carbon dioxide.

Bronchi and Bronchioles

  • Trachea Division: Divides at the level of the 5th thoracic vertebra
  • Right Bronchus: Wider, shorter, and more vertical. More prone to obstruction.
    • Divides into 3 lobar bronchi once entering lung.
  • Left Bronchus: Longer, narrower, and more oblique.
    • Divides into 2 lobar bronchi once entering lung.

Nerve and Blood Supply of the Lungs

  • Nerves: Vagus nerve causes bronchoconstriction and sympathetic nerves cause bronchodilatation
  • Blood Supply: Right and left bronchial arteries supply blood. Right sided venous drainage is via the azygos vein and left side drainage is via the superior intercostal vein.

Clinical Importance

  • Clinical conditions: Funnel chest (pectus excavatum) Pigeon chest (pectus carinatum)

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Test your knowledge on the anatomy of the thorax and diaphragm with this quiz. Questions cover sensory supply, arterial branches, and various thoracic conditions. Perfect for students studying human anatomy in detail.

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