Anatomy of Bronchial Tree PDF

Upper Airway: From Pharynx to Larynx Larynx Epiglottis Lingual Tonsil Uvula Mi...

Upper Airway: From Pharynx to Larynx Larynx Epiglottis Lingual Tonsil Uvula Midline guidance: “The uvula points to the epiglottis, the epiglottis leads into the larynx”. BI, All Rights Reserved, 2005 1  The Larynx The larynx is a 5-7 cm long structure. Its upper boundary starts at the tip of the grey? epiglottis, opposite the 3rd to 4th, cervical vertebra. Its lower end is at the lower border of the cricoid cartilage. This lies opposite the 6th cervical vertebra. www.phon.ox.ac.uk BI, All Rights Reserved, 2005 2  The Larynx Posterior Wall of Hypopharynx (Leading to Esophagus) Lateral Glossoepiglottic Folds Superior surface anatomy: Major Landmarks I Superior Surface of Epiglottis Median Vallecula Glossoepiglottic Base of Fold Tongue http://www.nyee.edu/top#top BI, All Rights Reserved, 2005 3  The Cricoid cartilage Thyroid Thyroid gland cartilage Cricothyroid membrane Cricoid cartilage Cricoid Cartilage BI, All Rights Reserved, 2005 4  The Larynx: Anatomy The structural rigidity of the larynx is provided by the three median cartilages: The epiglottis Thyroid cartilage Cricoid cartilage , along with the hyoid bone. The thyrohyoid membrane forms a C-shaped barrier around the anterior and lateral walls of the supraglottis, and inferiorly becomes confluent with the connective tissue in the perichondrium of the tracheal cartilaginous rings. www.throat-cancer-symptoms.com/ 5  The Larynx: Critical Structures The Larynx neighbors major critical structures: Carotid arteries and jugular veins, and the vagus nerve Superior and inferior thyroid arteries Superior and recurrent laryngeal nerves  Laryngeal function: Airway Protection The glottis: open for inspiration and closed for swallowing Open Closed 7 Tracheal and subglottic anatomy The trachea is a cylindrical tube that projects onto the spine from C6 to the level of T5. As it passes downwards, it follows the curvature of the spine, and courses slightly backward. Near the tracheal bifurcation, it deviates slightly to the right. The subglottis ends 2 cm below the level of the vocal cords. This corresponds cranially to the inferior margin of the cricoid cartilage, which is the inferior margin of the larynx and forms the only complete cartilage ring in the airway. 8 Tracheobronchial anatomy Tracheal Displacement Due to Goiter  Anatomy of the trachea Length: 9-15 cm Outer diameter: 21-27 mm Internal diameter: 12-18 mm Distance infracricoid-carina about 11 cm Elastic tubes keep dividin  Anatomy of the trachea 18-22 cartilaginous rings There are 2.1 rings/cm Becomes intrathoracic at 6th cartilaginous ring Intrathoracic portion: 6-15 cm The membranous posterior membrane allows esophageal expansion during deglutition Contains glands, Trachealis small muscle arteries, overlies nerves, esophageal lymph muscle and vessels and epithelium elastic fibers 12  Main carina: Concepts of anterior and posterior Widened main carina Large subcarinal lymphadenopathy present Posterior membrane 14  Tracheal appearances Normal shape expansion during inhalation circumferential collapse A C E B D F Saber sheath Dynamic collapse Crescent shape collapse 15  Lobar and segmental anatomy 3 2 Lobes Lobes lso there R L Functional unit should have bronchia air supply, segmented arterial supply,  Right bronchial anatomy The right main bronchus is 2 cm long on average and has an internal diameter of 10-16 mm. This is slightly larger than the diameter of the left main bronchus. The bronchus intermedius of the right bronchial tree is actually quite short, extending for 1.0-2.5 cm until its anterior wall extends into and becomes the middle lobe bronchus. Its posterior wall extends into and becomes the right lower lobe bronchus. Volume loss caused by pleural effusion, atelectasis, elevated right hemidiaphragm, as well as traction or torsion from a fibrotic or scarred upper lobe often cause shortening of this bronchus.  Left bronchial Anatomy The left main bronchus is usually 4-5 cm long. its lumen is narrow and relatively L R horizontal. The usual length of the left lower lobe bronchus beyond the origin of the superior segmental bronchus is 1 cm.  Segmental anatomy sure 19 functional units = Broncho-pulmonary segments=FEV1 gs ‹#› 11  Squamous cell carcinoma obstructing Right main bronchus Restored patency to Widened Carina and Laser Right main bronchus bleeding tumor vaporization and right upper lobe Oesophageal cancer invading through airway wall