Lung & Pleura Final 2022 PDF

Lungs& Pleura Upper and lower respirato tracts:  oracic cavity is classi ed into: 1- Middle area (Mediastinum): containing hea and other structures. 2- Two lateral spaces: containing lungs and pleurae. Lungs Def in ition: T he lungs are the organs of respiration. Anatomical Position and Re...

Lungs& Pleura Upper and lower respirato tracts:  oracic cavity is classi ed into: 1- Middle area (Mediastinum): containing hea and other structures. 2- Two lateral spaces: containing lungs and pleurae. Lungs Def in ition: T he lungs are the organs of respiration. Anatomical Position and Relations: T hey are located in the thorax, either side of the mediastinum. Function: T he function of the lungs is to oxygenate blood. T hey achieve this by bringing inspired air into close contact with oxygen- poor blood in the pulmona capillaries. Anatomical Position and Relations: e lungs lie either side of the mediastinum, within the thoracic cavity. Each lung is surrounded by a pleural cavity, which is formed by the visceral and parietal pleura. T hey are suspended from the mediastinum by the lung root – a collection of structures entering and leaving the lungs. T he medial sur faces of both lungs lie Left Lung in close proximity to several Right Lung mediastinal structures: Hea Hea Oesophagus Oesophagus Arch of ao a Inferior vena cava oracic ao a Superior vena cava Azygous vein Anatomical Position and Relations: e left Side Left Lung Right Lung Hea Hea Oesophagus Oesophagus Arch of ao a Inferior vena cava oracic ao a Superior vena cava Azygous vein Anatomical Position and Relations: e right Side Left Lung Right Lung Hea Hea Oesophagus Oesophagus Arch of ao a Inferior vena cava oracic ao a Superior vena cava Azygous vein Lung Structure Lung Structure  e lungs are roughly cone shaped, which has:  an apex, base, three su aces, three borders. T h e left lung is slightly smaller than the right – this is due to the presence of the hea.  Each lung consists of: Apex: T he blunt superior end of the lung. It projects upwards, above the level of the 1st rib into the neck. Base – T he inferior sur face of the lung, which sits on the diaphragm. Lobes (2 or 3):separated by f issures within the lung. TWO: costal, mediastinal.(T he y are named correspond to the area of the thorax they face). THREE Borders: T he edges of the lungs, named the anterior, inferior and posterior borders.  Lobes e right and left lungs do not have an identical lobular structure. e right lung has three lobes; superior, middle and inferior. e lobes are divided from each other by two ssures: Oblique ssure: Runs from the inferior border of the lung in a superoposterior direction, until it meets the posterior lung border. Horizontal ssure: Runs horizontally from the sternum, at the level of the 4th rib, to meet the oblique ssure. e left lung contains superior and inferior lobes, which are separated by a similar oblique ssure. Bronchial Tree  e bronchial tree is a series of passages that supplies air to the alveoli of the lungs. It begins with the trachea, which divides into a left and right bronchus.  Note: e right bronchus has a higher incidence of foreign body inhalation due to its wider shape and more ve ical course.  Each bronchus enters the root of the lung, passing through the hilum. Inside the lung, they divide to form lobar bronchi – one supplying each lobe.  Each lobar bronchus then fu her divides into several te ia segmental bronchi. Each segmental bronchus provides air to a bronchopulmona segment – these are the functional units of the lungs.  e segmental bronchi give rise to many conducting bronchioles, which eventually lead into terminal Ove iew of the tracheobronchial tree. bronchioles. Each terminal bronchiole gives o respirato Key: bronchioles, which feature thin walled outpocketings that Green – upper lobe, extend from their lumens. ese are the alveoli – the site of yellow – middle lobe, gaseous exchange. blue – lower lobe What is the correct order of the bronchial tree?  T he correct order of the par ts of the bronchial tree is:  Trachea,  Prima bronchus,  Seconda bronchus,  Te ia bronchus,  Terminal bronchioles,  Respirato bronchioles,  Alveoli. Pleura Parietal Pleura:  T he parietal pleura is a membrane that covers the internal su ace of the thoracic cavity.  It is thicker than the visceral pleura.  It is a serous membrane consists of a single layer of f lat, cuboidal, mesothelial cells suppor ted by loose connective tissue.  It receives blood & N. supply as chest wall:  It is sensitive to pressure, pain, and temperature.  It can be subdivided according to the par tof the body that it is contact with:  Mediastinal pleura: Covers the lateral aspect of the structures in the mediastinum.  Cer vical pleura: Lines the extension of the pleural cavity into the neck.  Costal pleura: Covers the inner aspect of the ribs, costal ca ilages, and intercostal muscles.  Diaphragmatic pleura: Covers the superior sur face of the diaphragm. Visceral Pleura: e visceral pleura is a thin membrane that tightly adheres to the outer su ace of the lungs and deep in the ssures. It receives the same blood supply and ne e supply as the lung. It is continuous with the parietal pleura at the hilum and also covers blood vessels, ne es, and bronchi associated with the lungs. T he two par ts of the pleurae receive a dif ferent neurovascular supply: Parietal Pleura (As chest wall): T he parietal pleura is sensitive to pressure, pain, and temperature. It produces a well localised pain, and is inner vated by the phrenic and intercostal ne es. T he blood supply is derived from the intercostal a eries. Visceral Pleura (As lung): T he visceral pleura is not sensitive to pain, temperature or touch. Its senso bres only detect stretch. It also receives autonomic inne ation from the pulmona plexus (a network of ne es derived from the sympathetic trunk and vagus ne e). Ar te rial supply is via the bronchial ar te ries (branches of the descending aor ta), which also supply the parenchyma of the lungs (not from pulmona a e ) Pleural Cavity:  e pleural cavity is a potential space between the parietal and visceral pleura.  It contains a small volume of serous uid, which has two major functions. (about 5-10 cc in each side). 1) It lubricates the su aces of the pleurae, allowing them to slide over each other. 2) It produces a su ace tension, pulling the parietal and visceral pleura together. is ensures that when the thorax expands, the lung also expands, lling with air. Inferior border of the lung: 6 –6- 8- 10. Inferior border of the pleura: 6 –8- 10-12. 6 - 6: Sterno-costal junction 6 - 8: Midclavicular line. Purple Numbers: 8 - 10: Mid-axilla line. lung 10 - 12: oracic ve ebra. Red Numbers: pleura Applied anatomy Lung 1- Bronchial Asthma In Normal condition: 1- e lumen is clear and opened. 2- e wall is average thickness. 3- e muscle contract normally. What is an asthma attack? During an asthma attack, three things can happen: Bronchospasm: T he muscles around the airways constrict (tighten). T his makes your airways narrow. Inf lammation: T he lining epithelium of the airways becomes swollen. Make inspiration and expiration di cult. Mucus production: During the attack, more mucus is produced, closing the airways. a sound called wheezing is heard during breathing. 2- Resection all or pa of the lung 3- Regular and Emergency tracheostomy Pleura 1- Pleurisy A pleural friction rub, is characterized by its sound like:  Creaking leather.  Squeaking shoes on wet su aces. is a valuable diagnostic clue for pleural in ammation (pleurisy) 2- Pneumothorax 3- Pleural e usion  A https://www.registerednursern.com/lung-anatomy-and-physiology-quiz/ light cured ac l 1. True or False: T he left lung has three lobes and the right lung has two lobes. 2. e inner layer that surrounds the lung itself is called the? A. Parietal Pleura B. Visceral pleura C. Pleuracardium D. Lobar Bronchi 3. e trachea splits at the _________ to form the ____________. A. Cricoid ca ilage, seconda bronchi B. yroid ca ilage, prima bronchi C. Carina, prima bronchi D. Hilum, seconda bronchi 4. Gas exchange in the lungs occurs in the? A. Bronchioles B. Alveolar sinus C. Alveolar sacs D. Segmental Bronchi 5. ______________ delivers unoxygenated blood to the lungs. A. Pulmona vein B. Ao a C. Left ventricle D. Pulmona a e 6. e right & left bronchus along with the pulmona a e & vein enter into the lungs at the? A. Hilum B. Carina C. Alveolar ducts D. Right middle lobe 7. True or False: During inhalation, the diaphragm contracts upward to create a positive pressure in the chest which allows the body to inhale oxygen. 8. True or False: During gas exchange, carbon dioxide is transpor te d across the capilla membrane to be exhaled while oxygen is transpor te d across the capillar ymembrane to attach to the red blood cells. 9. Eve thing below is pa of the lower respirato system EXCEPT? A. Trachea B. Carina C. Pha nx D. Bronchioles 10. True or False: Inhaled oxygen travels down through the trachea, into the right and left bronchus, then into the segmental bronchi which branches even fur ther into the lobar bronchi.