pleural cavities

what kind of epithelium in the trachea

ciliated pseudo-stratified (respiratory) epithelium with abundant goblet cells (mucus secretion)

what is a pneumothorax

collapsed lung from air that got into the pleural space

the structures located at the hilar region of the lungs {} are observed as a dense shadow

combination of vascular, bronchial, lymphatic and connective tissue

the pleural spaces fill with air, which may further

compress the lung

a bronchopulmonary segment is separated from adjacent segments by

connective tissue septa

smooth muscle of the trachea what happens during coughing

contracts while coughing

pulmonary arteries follow bronchi and bronchioles but

do not nourish them

{} gives rise to lobar and segmental arteries

each pulmonary artery

thoracic duct (or left lymph duct) carries {}

much more fluid than right lymph duct

parietal pleura has {} pain sensation is chiefly from parietal pleura

profuse sensory innervation

bronchi are lined with {}

pseudostratified ciliated epithelium with abundant goblet cells

the branching pattern of {} inside each lung follows the bronchial tree

pulmonary arteries

gas exchange (low pressure) includes

pulmonary arteries and veins

each lung is supplied by a {}, which carries non-oxygenated blood from the pulmonary trunk leaving the right ventricle of the heart

pulmonary artery

pulmonary venules carry oxygenated blood from {} to {} they DO NOT {}

pulmonary capillaries small pulmonary veins the bronchial tree

at alveoli, arterioles break up into {} where gas exchange occurs

pulmonary capillaries around alveoli

name the three right lobar bronchi

right upper lobar bronchus right middle lobar bronchus right inferior lobar bronchus

hilum: area of the lung located at its medial aspect that contains the inflow and out flow structures (aka {})

root of the lungs

clinical implications of pleural recesses

safe point to access pleural cavities without injuring the lungs

horner's syndrome can be {} to local invasion of {} by tumors located in the lung apex

secondary sympathetic ganglia

right and left bronchi enter the corresponding lung through its hilum and immediately start bifurcating into {}

secondary (aka lobar) bronchi

a bronchopulmonary segment has its own {} and {} of the pulmonary artery

segmental bronchus segmental branch

a bronchopulmonary segment is {} from adjacent segments by connective tissue septa

separated

in the clinic: compensatory dilation of the azygous venous system secondary to {}

superior/inferior vena cava occlusion

describe the lingula

tongue shaped projection close to the cardiac notch - remnant of a middle lobe

secondary or lobar bronchi: - right lung has {} - left lung has {}

- 3 lobar bronchi - 2 lobar bronchi

lung surfaces. each lung contains (5)

- apex - hilum - costal surfaces (anterior, lateral, posterior) - mediastinal surface - diaphragmatic surface

sympathetic and parasympathetic (of vagal origin) fibers - sympathetic fibers supply {}

- blood vessels and bronchial smooth muscle (bronchodilator effect)

the inferior lobe of the left lung has two unique features: {}

- cardiac notch - lingula

cervical (parietal) pleura aka {} - dome shaped parietal pleura located {} and that covers the lung apexes

- cupula - superior to the thoracic inlet

what are the three circuits of pulmonary circulation

- gas exchange - blood supply (nutrition) to pulmonary tissue - lymphatic drainage

autonomic pulmonary plexuses supply - motor to (3) - sensory to (3) - somatosensory (1)

- motor: bronchial tree, glands, blood vessels - sensory: bronchial tree (touch, pain), baro and chemoreceptors (viscerosensory) - parietal pleura (somatosensory)

symptoms of horner's syndrom (4)

- myosis - moderate ptosis - enophtlamia - hemiface anhydrosis

the right side drains into the {} the left side drains into the {}

- right lymphatic duct - thoracic duct at vein junction of (right/left) internal jugular with subclavian veins (venous angle)

why don't the structures below leave an impression on the right lung? -right vagus n. - right phrenic nerve - thoracic aorta - right common carotid artery

- too small to leave an imprint - too small - leaves on on the left (is on the left?) - because of the bifurcation earlier in the neck root

what are the main structures forming the root of each lung (5)

1. main bronchus and surrounding bronchial vessels 2. one pulmonary artery 3. two pulmonary veins 4. lymphatic vessels and nodes 5. nerves

the right lung has how many bronchopulmonary segments

10

the left lung is made up of how many lobes

2

segmental veins converge into

2 pulmonary veins per lung

the left lung has how many bronchopulmonary segements

8-10

each lobar bronchus divides again into {}

8-10 tertiary bronchi

trachea: 16-20 {} rings of hyaline cartilage

C- shaped

what veins drain the posterior thoracic wall

Drainage is largely by tributaries of the azygos system of veins (intercostal veins).

the branching pattern of pulmonary arteries inside the lungs follows the bronchial tree 1. each lobe of the lung gets {} 2. each bronchopulmonary segment {}

a branch from a pulmonary artery - gets a branch

when air is introduced into the pleural cavity, what happens

a pneumothorax develops and the lung collapses because of its own elastic recoild

where are the pulmonary lymph nodes

along the lobar bronchi

where are the bronchopulmonary (hilar) lymph nodes

along the main stem bronchi

azygous system provides {}

alternative routs of venous return to the heart

costal surfaces: lung surface in contact with thoracic wall - name the three

anterior, lateral, posterior lung costal surfaces

{} - superior part of the upper lobe of the lung that projects through the thoracic inlet into the root of the neck

apex

{} into the right bronchus or into one of its branches because it is wider, shorter and descends in a more vertical plane than the left bronchus

aspirated foreign objects are more likely to lodge

anterior and posterior {} located in the hilar region of the lungs

autonomic pulmonary plexuses

what structure below leaves the highest impression in the right lung a. right vagus n. b. azygous vein c. right phrenic nerve d. thoracic aorta e. right common carotid artery

b. azygous vein

visceral pleura cannot {}

be dissected away from the lung

why is the left costomediastinal recess larger

because of the presence of the cardiac notch in the left lung

pleural recesses are located at the the pleural reflection points and represent the areas where {} during forced inspiration

both inferior lung borders move into

pulmonary arteries follow {} but do not nourish them

bronchi and bronchioles

{} branch off the thoracic aorta directly (or an intercostal artery) and carry oxygenated blood to the lung tissue and visceral pleura.

bronchial arteries

blood supply (nutrition) to pulmonary tissue includes

bronchial arteries and veins

what is true regarding the histology of the bronchial tree

cartilage are lost at the bronchiole level

parasympathetic fibers supply

bronchial smooth muscle (bronchoconstrictor)

bronchi, bronchioles, and their subsequent divisions form the

bronchial tree

beyond segmental or (tertiary) bronchi, there are ~25 generations of smaller bronchi, which then give rise to {} and terminal bronchioles

bronchioles

each lobar bronchus branches into 8-10 segmental (ie. tertiary) bronchi. each one of these tertiary bronchi supplies a single

bronchopulmonary segment

{} are areas of a lung supplied by the same segmental bronchus and same segmental branch of the pulmonary artery

bronchopulmonary segments

bronchioles do not have

cartilage in their walls

for description purposes, parietal pleura can be subdivided into {4}

costal parietal diaphragmatic parietal mediastinal parietal cervical (cupula)

{} - lung surface in contact with thoracic wall - there are three: anterior, lateral and posterior

costal surfaces

what are the pleural recesses

costodiaphragmatic costomediastinal

diaphragmatic (parietal) pleura:

covers diaphragm

describe bronchiole histology

cuboidal epithelium some ciliated no cartilage plates

{}- inferior surface of the lung. in contact with underlying diaphragm

diaphragmatic surface

each terminal bronchiole gives rise to

different generations of respiratory bronchioles

these bronchial arteries (and veins) travel along the posterior surface of the bronchi but do not reach the level of terminal bronchioles where they {}

establish profuse anastomosis with branches from pulmonary arteries

lung loves are defined by {}

fissures

clinical focus of the pleural cavities includes aspiration of

foreign objects

at alveoli, arterioles break up into pulmonary capillaries around alveoli where {}

gas exchange occurs

what characteristic of epithelia ends at the segmental bronchus

goblet cells, glands, hyaline cartilage

anterior and posterior autonomic pulmonary plexuses located in {}

hilar region of the lungs

{}- area of the lung located at its medial aspect that contains the inflow and out flow structures (aka. root of the lungs)

hilum

mediastinal (parietal) pleura - covers lateral side of mediastinum and at {} (where parietal pleura is directly continuous with visceral pleura) forms a pleura sleeve and a "pulmonary ligament"

hilum of lung

parietal pleural lines the inner aspects of the thoracic wall and is continuous with visceral layer of the pleura at the {}

hilum of the lungs

lung cancer can appear as

horner's syndrome

what are the three types of pleural effusions

hydrothorax hemothroax chylothorax

contours of the neighboring structures can be observed in fixed lungs as {}

impressions

which lobe of the left lung has two unique features

inferior

costal (parietal) pleura attached to

inner side of ribs (anterior and posteriorly)

thoracic wall and cavity lymph nodes include (4)

intercostal parasternal mediastinal phrenic lymph nodes

explain how pulmonary venules don't follow the bronchial tree starting with intrasegmental veins

intrasegmental veins --> intersegmental veins -->>>> segmental veins

aspirated foreign objects are more likely to lodge into the right main bronchus or into one of its branches because {}

it is wider, shorter and descends in a more vertical plane than the left bronchus

much of lymph thorax drains in {}

left and right bronchomediastinal lymphatic trunks (BMTs)

name the two left lobar bronchi

left upper lobar bronchus left lower lobar bronchus

left BMT ends at {} or into {}

left vein junction thoracic duct

each pulmonary artery gives rise to

lobar and segmental arteries

basic unit for gas exchange:

lung alveolus

each tertiary bronchi supply one of the 8-10 divisions of the {}

lung parenchyma aka "bronchopulmonary segements"

parts of the {}: apex hilum costal surfaces mediastinal surface diaphragmatic surface

lung surface

lymphatic vessels of visceral pleura and lung carry lymph to be filtered by {} located inside lungs along the bronchial tree

lymph nodes

left and right: {} - one per lung

main bronchi

trachea bifurcates inferiorly into a right and a left {} at the level of the T4/T5 intervertebral disc (sternal angle)

main bronchi

{} - in contact with mediastinal pleura

mediastinal surface

under certain conditions, air may enter the pleural cavity at such a rate that it shift and pushes the {} to {}

mediastinum to the opposite side of the chest wall

what is the name of the simple squamous epithelium present in the pleurae

mesothelium

each lung is supplied by a pulmonary artery, which carries {} from {} leaving the right ventricle of the heart

non-oxygenated blood pulmonary trunk

left lung has two lobes (superior and inferior) defined by an

oblique fissure

pulmonary venules carry {} from pulmonary capillaries to small pulmonary veins they DO NOT follow the bronchial tree

oxygenated blood

pulmonary veins carry what and where

oxygenated blood to the left atrium of the heart

lymph from the {} drains into lymph nodes in the thoracic wall and cavity before entering the bronchomediastinal trunk

parietal pleura

pain sensation is chiefly from {} due to profuse sensory innervation

parietal pleura

pleural reflections: regions at which the {} reflects off one surface and extend onto another (eg. costal to diaphragmatic pleura. or costal to mediastinal pleura)

parietal pleura

{} lines the inner aspects of the thoracic wall and is continuous with visceral layer of the pleura at the hilum of the lungs

parietal pleura

pleural recesses: regions where two areas of {}

parietal pleura are in contact

a penetrating wound or a fractured rib allows the entry of air into a pleural cavity --> pneumothorax and a subsequent

partial or total collapse of the lung

x ray examinations chief methods

plain films ct scans

visceral afferent fibers from {} also have vagal (CN X) and sympathetic origin

pleura and bronchial tree

pleural cavities contain a small amount of serous fluid secreted by {} that lubricates the surfaces and {} during respiratory movements

pleura layers prevent friction

{} identifies a "potential space" present between both layers (ie. visceral and parietal) of pleura

pleural cavity

{} regions where two areas of parietal pleura are in contact

pleural recesses

{} regions at which the parietal pleura reflects off one surface and extend onto another

pleural reflections

the lung root structures are located at hilum and are surrounded by {}

pleural sleeve

a penetrating wound or a fractured rib allows entry of air into a pleural cavity --> {} and a subsequent partial or total collapse of the lung

pneumothorax

the most common view employed in radiological examination of the thorax is the {}

poster-anterior (PA)

the azygous venous system drains the {} and forms an important venous conduit between the {} and {}

posterior thorax IVC and SVC

pleural cavity identifies a {} present between both layers (ie. visceral and parietal) of pleura

potential space

a necrotic area in the lung due to the presence of a medium size embolus that blocks blood supply to a bronchopulmonary segment

pulmonary infarct

lymph from lungs drains to --> {} --> {} -->{}

pulmonary lymph nodes bronchopulmonary (hilar) lymph nodes superior and inferior tracheobronchial lymph nodes

{} carry oxygenated blood to the left atrium of the heart

pulmonary veins

list the generations following respiratory bronchioles

respiratory bronchioles --> alveolar ducts --> alveolar sacs --> alveolus

pneumothorax

results in partial or total collapse of the lung

the lungs have a {} of lymphatic vessels

rich, freely connecting network

costodiaphragmatic reccesses move

right and left

costomediastinal recesses move {} - the {} is larger because of the presence of the cardiac notch in the {}

right and left left costomediastinal recess left lung

which lung is heavier

right lung - since it has three logs (superior, middle, inferior)

which of the two lung lobes is bigger

right lung is larger than left

right BMT joins right lymph duct, which carries lymph from {2} into internal jugular/subclavian vein junction - alternatively, right BMT may also drain {} in this vein junction

right side of head/neck (jugular trunk) right upper limb (subclavian trunk) - independently

pleural cavities contain a small amount of {} secreted by pleural layers that lubricates the surfaces and prevents friction during respiratory movements

serous fluids

visceral and parietal pleura are {} histologically identical

serous membranes

describe alveoli histology

simple squamous epithelium capillaries "sandwhiched" between alveolar walls

trachea: {} posteriorly- contracts while coughing

smooth muscle

lungs consist of {} which expands and contracts to adapt to the (little) available space inside the thoracic cage

spongy and elastic tissue

serous membrane of visceral and parietal pleura - what kind of epithelium, what does it secrete - {} deep to mesothelium

squamous epithelium (ie. mesothelium) secretes serous fluid that fills pleural cavities - delicate pleural connective tissue

what are the three pleural reflections

sternal costal vertebral lines

where are the superior and inferior tracheobronchial lymph nodes

superior and inferior to the bifurcation of the trachea

bronchial veins usually drain to the azygos and accessory hemiazygos veins (azygos system) into {} but a portion of this nonoxygenated venous blood from the bronchial circulation is also drained by {}

superior vena cava pulmonary veins into left atrium

each bronchopulmonary segment can be {}

surgically resected, independent of adjacent segments

there are two pleural cavities. Each one {} a lung

surrounds

each {} gives rise to different generations of respiratory bronchioles

terminal bronchiole

these bronchial arteries (and veins) travel along the posterior surface of the bronchi but do not reach the level of {} where they establish profuse anastomosis with branches from pulmonary arteries

terminal bronchioles

the trachea bifurcates inferiorly into a right and a left main bronchi at the level of {}

the T4/T5 intervertebral disc (sternal angele)

bronchial veins usually drain to the {2} into superior vena cava but a portion of this nonoxygenated venous blood from the bronchial circulation is also drained by pulmonary veins into left atrium

the azygos and accessory hemiazygos veins (azygos system)

the branching pattern of pulmonary arteries inside each lung follow

the bronchial tree

the horizontal fissure of the right lung defines

the middle lobe (not present in the left lung)

apex: superior part of the upper lobe of the lung that projects through the thoracic inlet into {}

the root of the neck

the oblique fissure defines

the superior and inferior lobes - present in the right and left lungs

bronchial arteries branch off the {} and carry oxygenated blood to {}

thoracic aorta directly lung tissue and visceral pleura

how many lobes does the right lung contain

three lobes - superior, middle, inferior

the right lung is defined by {} fissures name them

two fissures - horizontal fissure - oblique fissure

define pleura

two layered serous membrane that encloses the lungs

how many lobes does the left lung contain

two lobes superior and inferior

generally lesion that produce horner's syndrome is

unilateral

visceral afferent fibers from pleura and bronchial tree also have {}

vagal (CN X) and sympathetic origin

a bronchopulmonary segement is a pyramidal shaped section of the lung with its base covered by

visceral pleura

{} adheres or lines external lung tissue, lines fissures and becomes continuous with mediastinal pleura at lung root of hilum (as the pulmonary ligament)

visceral pleura

{} envelopes each lung

visceral pleura

lungs are invested by {} and attached to mediastinal structures (trachea and heart) through their {}

visceral pleura hilum (hilus)

lymphatic vessels of {2} carry lymph to be filtered by lymph nodes located {}

visceral pleura and lung inside lungs along the bronchial tree

costodiafragmatic recess - measures {} - located along the {}

~5cm vertically - mid-axillary line from the eighth to the tenth rib