ANAT30008 Airways, Pleura and Lungs PDF

Lungs, Pleura and Bronchial Tree Professor Jason Ivanusic Room E724 7th Floor, East Wing, Medical Building Email: [email protected] Phone: 83447254  WARNING This material has been provided to you pursuant to section 49 of the Copyright A...

Lungs, Pleura and Bronchial Tree Professor Jason Ivanusic Room E724 7th Floor, East Wing, Medical Building Email: [email protected] Phone: 83447254  WARNING This material has been provided to you pursuant to section 49 of the Copyright Act 1968 (the Act) for the purposes of research or study. The contents of the material may be subject to copyright protection under the Act. Further dealings by you with this material may be a copyright infringement. To determine whether such a communication would be an infringement, it is necessary to have regard to the criteria set out in Part 3, Division 3 of the Act.  Trachea and Lower border of larynx bronchi (cricoid cartilage) Cartilagenous rings Bifurcation Right main (T4/5) bronchus Left main Cartlagenous A bronchus ring Lumen Lobar Lobar bronchi bronchi Segmental bronchi P Oesophagus Trachealis muscle Hilum Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. Author’s own New Jersey, Icon Learning Systems, 2003, ISBN: 1- 929007-15-9, Plate #190B  Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1- 929007-15-9, Plate #192 Lower airways Up to 25 orders of Bronchus branching to alveoli (for gas exchange) Cartilage lost Bronchiole Terminal bronchiole Respiratory brochiole Alveoli  Common triggers Asthma Involves spasm of smooth muscle around the lower airways - bronchioles http://health.allrefer.com/health/asthma-common-asthma-triggers.html http://health.allrefer.com/health/asthma-asthma.html http://health.allrefer.com/health/asthma-normal-versus-asthmatic-bronchiole.html  Lungs Right Left Apex Superior lobe Superior lobe Horizontal fissure Cardiac notch Middle lobe Inferior lobe Inferior lobe Oblique fissure Author’s own 2 systems of blood supply to lungs Pulmonary artery Pulmonary veins Pulmonary blood supply used for gaseous exchange with airways (respiratory) Eizenberg N, Briggs C, Barker P, Grkovic I. An@tomedia: Thorax module. Melbourne An@tomedia Publishing, 2001, ISBN: 0646 407 317  Pulmonary Pulmonary blood supply follows arteries superior similar branching patterns to airways and posterior Pulmonary veins inferior and anterior Pulmonary artery Pulmonary veins Eizenberg N, Briggs C, Barker P, Grkovic I. An@tomedia: Thorax module. Melbourne An@tomedia Publishing, 2001, ISBN: 0646 407 317  Bronchial supply for lung parenchyma (non-respiratory) Bronchial arteries Descending aorta Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1-929007-15-9, Plate #196A Azygous vein Bronchial veins Hemiazygous vein Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1-929007-15-9, Plate #196C Bronchopulmonary segements Are pyramid shaped with the apex directed to hilum and base on the surface. Are supplied by a segmental bronchus, artery and vein. Represent zones of functionally distinct lung tissue. May be surgically resected without disrupting other lung units. Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Pryor J A, Webber B A (ed). Physiotherapy For Respiratory And Cardiac Problems. 2nd ed. Learning Systems, 2003, ISBN: 1-929007-15-9, Plate #188A Churchill Livingstone: 1998 ISBN 044305815. Ch.8 p.152-153. Right lung, Apex Hilum medial Pulmonary artery (superior surface and posterior to veins) Pulmonary veins (anterior and inferior to arteries) Lobar bronchi (x2) P Bronchial arteries A A P Pulmonary ligament Author’s own Lymph node  Right brachiocephalic vein Superior Vena Cava Azygous vein Shallow cardiac Note colours of impression blood vessels!!! Be careful!!! Diaphragm Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1- 929007-15-9, Plate #187A  Left lung, Apex medial surface Hilum P A Cardiac notch Author’s own Cardiac impression  Arch of aorta Descending aorta Deep cardiac impression Diaphragm Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1-929007-15-9, Plate #187B  Sympathetic Parasympathetic Originates from spinal Vagus nerve cord and sympathetic Motor to smooth chain (T1-4) muscles of bronchial Inhibit smooth muscles tree around bronchi (bronchoconstrictor) (bronchodilate) Anterior pulmonary plexus Visceral sensory nerves travel along sympathetics Nerve (nociceptive) and supply to parasympathetic (reflexes from lungs bronchiole mucosa eg. Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1-929007-15-9, Plate #198 cough)  Bronchomediastinal trunks Lymphatics of lungs Tracheal nodes Deep pulmonary vessels Lymph vessels in visceral pleura Hilar (bronchopulmonary) nodes  Hilar lymph nodes Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. Author’s own New Jersey, Icon Learning Systems, 2003, ISBN: 1- 929007-15-9, Plate #187A Hilar lymph Lymph vessels node in visceral pleura Author’s own  Closed, double layered Pleura Pleural cavity membrane surrounding each lung Parietal pleura Visceral pleura Costal Costodiaphragmatic recess Mediastinal Diaphragmatic Costomediastinal A recess T Pulmonary ligament P Author’s own  Space Early in development, Cells lining space form organ/viscera develops in membrane body wall Body wall Viscera Author’s own  Viscera Body wall Space Membrane Membrane surrounds viscera Space enlarges and viscera moves into cavity Author’s own  Body wall Double layered membrane Space Viscera grows to size of cavity Viscera Membrane now surrounds whole organ Author’s own  Parietal layer Visceral layer Space contains fluid Viscera Reflection of parietal and visceral layers (ligament) Author’s own Pleura Pleural cavity Parietal pleura Visceral pleura Costal Costodiaphragmatic recess Mediastinal Diaphragmatic Costomediastinal A recess Note: T Pulmonary Sensory nerve supply to ligament parietal pleura from intercostal nerves and phrenic nerve Sensory nerve supply to P visceral pleura follows sympathetics (same as lung) Author’s own  Surface tension of membranes results in only a “potential” pleural cavity Parietal Pleura If surface tension is broken then lung recoils Visceral pleura lining lung Costodiaphragm atic recess Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. Diaphragm New Jersey, Icon Learning Systems, 2003, ISBN: 1- 929007-15-9, Plate #186 Pulmonary collapse Due to substance entering pleural cavity Air – pneumothorax Blood – hemothorax http://www.patient.co.uk/showdoc/21692516/ Apex particularly prone to injury http://anatomy.uams.edu/AnatomyHTML/xrays/xra_atlas52.html