Anatomy- Pleurae And Lungs

Front 1

What is contained in the thoracic cavity?

Back 1

1. right and left pleural cavities
2. right and left lungs
3. mass of the mediastinum

Front 2

What is contained in the mediastinum?

Back 2

1. heart
2. pericardium and associated great vessels
3. trachea
4. structures transversing the thorax: esophagus, vagus nerves, phrenic nerves, and thoracic duct

Front 3

What is a pneumothorax?

Back 3

change in pressure in one pleural cavity which may deflect the mediastinum to the side

Front 4

What cavities are the lungs and heart inside and what separates them from the abdomen?

Back 4

1. heart in pericardial cavity
2. lungs in pleural cavity
3. diaphragm separates them from the abdomen

Front 5

An imaginary line that runs between what separates the mediastinum into superior and inferior parts?

Back 5

1. line between manubriosternal joint and T4

Front 6

The visceral pleura is where and what makes it up?

Back 6

1. over surface of lung
2. layer of simple squamous epithelium

Front 7

What innervates the visceral pleura?

Back 7

nothing, so insensitive to pain

Front 8

Which pleural layer is superficial and which is deep to the other?

Back 8

1. visceral pleura is deep to parietal pleura

Front 9

What is the purpose of the visceral pleura?

Back 9

provides a moistening and lubricated surface for lung movement

Front 10

What would cause adhesions between the parietal and visceral pleura?

Back 10

1. infections
2. inflammatory reactions
3. lung immobility

Front 11

What is the parietal pleura attached to what and by what is it attached to these surfaces?

Back 11

1. costal surfaces
2. diaphragmatic surfaces
3. mediastinal surfaces
4. attached by endothoracic fascia to these surfaces

Front 12

The parietal pleura projects into the neck as what?

Back 12

cupola

Front 13

Puncture of the parietal pleura will lead to what?

Back 13

pneumothorax

Front 14

What is the pressure in the pleural cavity compared to atmospheric pressure and what is it referred to as?

Back 14

1. slightly below atmospheric pressure
2. referred to as negative pressure

Front 15

What innervates the parietal pleura?

Back 15

free sensory nerve ending of the intercostal and phrenic nerves

Front 16

Pain in the parietal pleura may be referred to what?

Back 16

1. dermatomes served by specific thoracic intercostal and phrenic (C3,4,5) nerves

Front 17

Severe pain caused possibly by adhesions of the pleura is called what?

Back 17

pleurisy

Front 18

Visceral and Parietal pleura continue into each other where?

Back 18

at the roots of the lungs

Front 19

Where is the pulmonary ligament and what does it do?

Back 19

1. found inferior to the root of the lungs
2. it's a segment of pleura which forms a sleeve

Front 20

What is the vertebral reflection of the parietal pleura?

Back 20

1. on the costal surface where the parietal pleura turns inward anterior to the vert. column and becomes the mediastinal pleura

Front 21

What is the sternal reflection of the parietal pleura?

Back 21

the mediastinal pleura posterior to the sternum

Front 22

What is the costal reflection of the parietal pleura?

Back 22

the diaphragmatic pleura near the thoracic wall

Front 23

Where do the separate parietal pleurae touch and where are they separated and why?

Back 23

1. touch at level of ribs 2-4
2. separated between ribs 4-6 due to heart indentation

Front 24

Where is the base of the parietal pleura found in the midclavicular line, midaxillary line, and dorsally?

Back 24

1. midclavicular- at the level of 8th costal cartilage
2. midaxillary- at level of 10th costal cartilage
3. dorsally- level of rib 12

Front 25

What is contained in the pleural cavity?

Back 25

pleural fluid

Front 26

What procedures can be done in the costodiaphragmatic recesses of the pleura?

Back 26

sampling of pleural fluids between R8-10 without lung penetration

Front 27

The costal and diaphragmatic pleurae are in contact during what type of breathing?

Back 27

expiration

Front 28

What are the pleural recesses?

Back 28

1. costodiaphragmatic recesses
2. sternocostal recesses
3. costomediastinal recesses

Front 29

Where is the costomediastinal recess of the pleura found?

Back 29

over the heart and pericardium

Front 30

What shape are the anterior and posterior borders of the lungs and what makes them that shape?

Back 30

1. posterior borders rounded by shape of ribs
2. anterior borders sharp since fit between heart and the chest

Front 31

What shape of bases do the lungs have?

Back 31

concave

Front 32

Which side of the dome of the diaphragm is higher and what does this mean for the lungs?

Back 32

1. the dome is higher on the right side
2. means the right lung is shorter (T8/9) than the left lung (T8)

Front 33

Where is the base of the lungs found in the mid-clavicular line, midaxillary line, and dorsally?

Back 33

1. mid-clavicular line- level of 6th costal cartilage
2. midaxillary line- level of 8th costal cartilage
3. dorsally- level of rib 10

Front 34

The base of which lung is broader and for what reason?

Back 34

1. base of right lung is broader
2. this is due to the position of the heart

Front 35

The apex of the lungs forms what?

Back 35

cupola

Front 36

The medial surface of the lungs have what 2 parts?

Back 36

1.vertebral
2. mediastinal

Front 37

The mediastinal surface of the lungs contains what?

Back 37

root or hilus of the lung

Front 38

Where is the cardiac impression in relation to the hilus and which side is larger?

Back 38

1. lies anterior to hilus
2. impression is larger on left lung

Front 39

What is the hilus?

Back 39

point of entry of vessels, nerves, and bronchi

Front 40

What is the uppermost structure in the hilus and what is the most posterior structure?

Back 40

1. uppermost-pulmonary artery
2. most posterior- bronchus

Front 41

What is the only structure traversing the thorax that passes anterior to the hilus?

Back 41

phrenic nerve

Front 42

How does the azygos arch pass in relation to the hilus?

Back 42

1. on right side azygos arch passes from post. to ant. above the right hilus to reach the superior vena cava

Front 43

How does the arch of the aorta pass in relation to the hilus?

Back 43

1. on the left side the arch of the aorta passes ant. to post. above the left hilus

Front 44

How many lobes does the right lung have?

Back 44

3

Front 45

What separates the superior and inferior lobes of the right lung and at what rib level does this lie?

Back 45

1.oblique fissure
2. lies in line with R6 and medial border of scapula(when arm is raised)

Front 46

Examination of the superior lobe is done where? inferior lobe?

Back 46

1. superior lobe- done on anterior chest wall
2. inferior lobe- done posteriorly, below the scapula

Front 47

What divides the superior lobe and middle lobe of right lung and what rib is it in line with?

Back 47

1. horizontal fissure
2. in line with R4

Front 48

How many lobes does the left lung have?

Back 48

2

Front 49

What divides the superior and inferior lobes of the left lung?

Back 49

oblique fissure

Front 50

What is the lingula and what does it overlie?

Back 50

1. anterior projection of the superior lobe of left lung
2. overlies the anterior aspect of the heart

Front 51

Where is the examination of superior and inferior lobes of left lung performed?

Back 51

1. superior lobe- done anteriorly
2. inferior lobe- posteriorly, below level of R6

Front 52

Where does the branching of the trachea begin (vert. level)?

Back 52

T4/5

Front 53

What part of the bronchial tree begins in the mediastinum and enters the hilus of the lung?

Back 53

primary bronchus

Front 54

What do the primary bronchi divide into (specific to each side)?

Back 54

1. secondary or lobar bronchi
2. right lung (3: upper, middle, lower)
3. left lung (2: upper and lower,lingular)

Front 55

The lobar bronchi divide into what and what do these divisions supply?

Back 55

1. tertiary or segmental bronchi
2. supply bronchopulmonary segments of the lung

Front 56

The tertiary bronchus is joined by what?

Back 56

a tertiary division of the pulmonary artery

Front 57

The right lung has how many bronchopulmonary segments and the left lung has how many?

Back 57

Right: 10
Left: 8 (apicoposterior, and basal anteromedial are differences)

Front 58

How must the patient be positioned to drain the base of the lung?

Back 58

pt must have head down

Front 59

How must the patient by positioned to drain the upper lobe of the lung?

Back 59

pt must be sitting down

Front 60

Objects aspirated when in a vertical postion tend to be found where and why is this?

Back 60

1. right lung (posterior basal segment)
2. the right bronchus is almost in line with the trachea

Front 61

Objects aspirated with pt lying on right side tend to be found where?

Back 61

1. bronchopulmonary segments of the right posterior or middle lobes

Front 62

Objects aspirated with pt lying on left side tend to be found where?

Back 62

superior or inferior bronchopulmonary segments of the lingula

Front 63

Objects aspirated with pt lying supine tend to be found where?

Back 63

superior bronchopulmonary segment of lower lobe

Front 64

What is atelectasis?

Back 64

1. diminished volume affecting all or part of a lung.

Front 65

What is bronchiectasis?

Back 65

1. chronic obstructive pulmonary lung disease manifested by airways that are inflamed and easily collapsible
2. results in air flow obstruction, SOB, and impaired clearance of secretions often with disabling cough

Front 66

What is chylothorax?

Back 66

1. presence of lymphatic fluid in the pleural space secondary to leakage from the thoracic duct or one of its main tributaries

Front 67

What is a tension pneumothorax?

Back 67

1. air within the pleural space that is under pressure
2. this displaces mediastinal structures and compromises cardiopulmonary function

Front 68

What is a traumatic pneumothorax?

Back 68

1. pneumo resulting from blunt or penetrating injury that disrupts parietal or visceral pleura

Front 69

Where do the pulmonary arteries arise from?

Back 69

bifurcated pulmonary trunk

Front 70

Where do the pulmonary arteries lie in relation to the bronchi as the enter the hilus?

Back 70

anterior

Front 71

The right PA is crossed over by what and the left is crossed over by what?

Back 71

RPA- crossed over by azygos vein
LPA- crossed over by arch of aorta at T5

Front 72

The pulmonary arteries divide into what and that divides into what and what runs with that last division?

Back 72

1. divide into lobar branches
2. those divide into tertiary branches
3. tertiary branches of PA and bronchi run close together in bronchopulmonary segments

Front 73

What is the purpose of the pulmonary arteries?

Back 73

1. bring deoxygenated blood which will be oxygentated at the level of the terminal alveolar ducts and the bronchial sacs

Front 74

How is oxygenated blood returned to the heart from the alveoli?

Back 74

pulmonary veins

Front 75

How many pulmonary veins are delivered from each lobe of each side?

Back 75

1. each sides inferior lobe has 2 pulmonary veins
2. the upper RPV from superior and middle lobes of right lung
3. the upper LPV from superior lobe of left lung

Front 76

What do the bronchial arteries arise from and what do they do?

Back 76

1. arise from descending aorta or 3rd intercostal branch
2. supply oxygenated blood to lung tissue

Front 77

What is the order of lymph drainage from inside right lung coming out?

Back 77

1. lymph filtered by pulmonary lymph nodes
2. then enters right lymphatic duct
3. that joins the right subclavian and right internal jugular veins

Front 78

What is the order of lymph drainage from inside left lung coming out?

Back 78

1. lymph enters the thoracic duct which dumps into the intersection between left subclavian and left internal jugular veins

Front 79

What does the bonchopulmonary plexus suppyl to the bronchial and vascular trees?

Back 79

parasympathetic and sympathetic nerves

Front 80

Parasympathetic fibers to the bronchial tree are made of what?

Back 80

preganglionic vagal and secretomotor to glands in the bronchial mucosa

Front 81

Sympathetic fibers in the bronchial and vascular tree area are made up of what?

Back 81

postganglionic fibers and vasomotor to arterial system

Front 82

Bronchodilation can be attained how and what does this mimic?

Back 82

1. attained by epinephrine
2. mimics the sympathetic nervous system