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THORACIC CAVITY

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THORACIC CAVITY. LUNGS and PLEURA. Pleura. Visceral pleura: Covers and follows indentations of lung. Parietal pleura: Lines thoracic cavity. Text: p 113, Fig. 1.23. Parietal Pleura Divisions. Costal pleura lines the ribs. Diaphragmatic pleura covers the diaphragm. - PowerPoint PPT Presentation

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THORACIC CAVITYTHORACIC CAVITY

LUNGS and LUNGS and PLEURAPLEURA

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PleuraPleuraVisceral pleura:Visceral pleura:

Covers and follows indentations of lung.Covers and follows indentations of lung.Parietal pleura:Parietal pleura:

Lines thoracic cavity.Lines thoracic cavity.Text: p 113, Fig. 1.23Text: p 113, Fig. 1.23

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Parietal Pleura DivisionsParietal Pleura DivisionsCostal pleura lines the ribs.Costal pleura lines the ribs.Diaphragmatic pleura covers the Diaphragmatic pleura covers the

diaphragm.diaphragm.Mediastinal pleura lies against the Mediastinal pleura lies against the

mediastinum.mediastinum.Cervical pleura extends above the level of Cervical pleura extends above the level of

the first rib.the first rib.Text: p 115, Fig. 1.24Text: p 115, Fig. 1.24

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Pleural ReflectionsPleural ReflectionsCostodiaphragmatic recess (space):Costodiaphragmatic recess (space):

Space where costal and diaphragmatic Space where costal and diaphragmatic pleura meet.pleura meet.

Costomediastinal recess (space):Costomediastinal recess (space):Space where mediastinal and costal pleura Space where mediastinal and costal pleura meet.meet.

Pulmonary ligament:Pulmonary ligament:Transition between visceral and parietal Transition between visceral and parietal

pleura at root of the lung.pleura at root of the lung.

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Pleural Lines of ReflectionPleural Lines of ReflectionCervical dome of pleura:Cervical dome of pleura:

Level with neck of the first rib.Level with neck of the first rib.Anteriorly, 1.5-2.5 cm above the sternal Anteriorly, 1.5-2.5 cm above the sternal

end end of the clavicle.of the clavicle.Anterior margin extends obliquely behind Anterior margin extends obliquely behind

the the sternoclavicular joint.sternoclavicular joint.At sternal angle, the pleura is at the At sternal angle, the pleura is at the

median median line and two sides stay in contact line and two sides stay in contact until the until the fourth costal cartilage.fourth costal cartilage.

Text: p 115, Fig. 1.24AText: p 115, Fig. 1.24A

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Pleural Lines of ReflectionPleural Lines of Reflection Right side:Right side:

Leaves sternum at 7Leaves sternum at 7thth costal cartilage.costal cartilage.

At 8At 8thth costal cartilage at costal cartilage at midclavicular line.midclavicular line.

At 10At 10thth rib at axillary rib at axillary line.line.

At 11At 11thth rib at scapular rib at scapular line.line.

Extends to level of Extends to level of body of T12body of T12 and then and then ascends.ascends.

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Pleural Lines of ReflectionPleural Lines of Reflection Left side:Left side:

Leaves sternum at Leaves sternum at IC space 5.IC space 5.

1.5 cm from sternal 1.5 cm from sternal margin at 6margin at 6thth costal costal cartilage.cartilage.

Follows same Follows same landmarks as right landmarks as right side from this side from this point.point.

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Right Lung ProjectionsRight Lung ProjectionsFollows rib 1 to sternoclavicular joint.Follows rib 1 to sternoclavicular joint.Located at median plane at sternal angle.Located at median plane at sternal angle.Extends along median plane from 2Extends along median plane from 2ndnd

costal cartilage to 4costal cartilage to 4thth costal cartilage. costal cartilage.Leaves sternum at 6Leaves sternum at 6thth costal cartilage. costal cartilage.At 6At 6thth rib at midclavicular line. rib at midclavicular line.

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Right Lung ProjectionsRight Lung ProjectionsAt 8At 8thth rib at axillary line. rib at axillary line.At 10At 10thth rib at scapular line. rib at scapular line.Ends opposite T11.Ends opposite T11.

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Left Lung ProjectionsLeft Lung ProjectionsSame as right lung except:Same as right lung except:

Cardiac notch begins at 4Cardiac notch begins at 4thth costal cartilage. costal cartilage.

Horizontal at parasternal line.Horizontal at parasternal line.

Medial to costochondral junction at 6Medial to costochondral junction at 6thth cartilage.cartilage.

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Right Lung MorphologyRight Lung MorphologyOblique fissure :Oblique fissure :

Separates superior and inferior lobes.Separates superior and inferior lobes.Begins at base of scapular spine.Begins at base of scapular spine.At 5-6At 5-6thth rib at midaxillary line. rib at midaxillary line.Ends at 6Ends at 6thth costochondral junction. costochondral junction.

Text: p 122: Fig. 1.27Text: p 122: Fig. 1.27

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Right Lung MorphologyRight Lung MorphologyHorizontal fissure :Horizontal fissure :

Separates superior and middle lobes.Separates superior and middle lobes.Begins at axillary line.Begins at axillary line.Follows rib 4.Follows rib 4.

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Left Lung MorphologyLeft Lung MorphologyOblique fissure:Oblique fissure:

Same as for right lung.Same as for right lung.No horizontal fissure.No horizontal fissure.

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Lobes of the LungsLobes of the LungsLobesLobes

3 on right3 on right2 on left2 on leftSupplied by secondary bronchiSupplied by secondary bronchi

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Lobes of the LungsLobes of the LungsLobules (bronchopulmonary segments)Lobules (bronchopulmonary segments)

10 on right10 on right8 on left8 on leftSupplied by tertiary bronchiSupplied by tertiary bronchi

Text: p 125 and 126, Fig. 1.28Text: p 125 and 126, Fig. 1.28

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Lobes of the Right LungLobes of the Right LungSuperior lobe:Superior lobe:

Apical lobuleApical lobulePosterior lobulePosterior lobuleAnterior lobuleAnterior lobule

Middle lobe:Middle lobe:Lateral lobuleLateral lobuleMedial lobuleMedial lobule

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Lobes of the Right LungLobes of the Right Lung Inferior lobe:Inferior lobe:

Superior lobuleSuperior lobuleAnterior basal lobuleAnterior basal lobuleMedial basal lobuleMedial basal lobuleLateral basal lobuleLateral basal lobulePosterior basal lobulePosterior basal lobule

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Lobes of the Left LungLobes of the Left LungSuperior lobe:Superior lobe:

Apicoposterior lobuleApicoposterior lobuleAnterior lobuleAnterior lobuleLingular lobule:Lingular lobule:

Homologous to middle lobe of right lung.Homologous to middle lobe of right lung.Superior lobule.Superior lobule.Inferior lobule.Inferior lobule.

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Lobes of the Left LungLobes of the Left Lung Inferior lobe:Inferior lobe:

Superior lobuleSuperior lobuleAnterior basal lobuleAnterior basal lobuleMedial basal lobuleMedial basal lobuleLateral basal lobuleLateral basal lobulePosterior basal lobulePosterior basal lobule

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Bronchopulmonary TreeBronchopulmonary TreeTracheaTrachea

Supported by cartilaginous ringsSupported by cartilaginous ringsPrimary bronchiPrimary bronchi

Supported by cartilaginous ringsSupported by cartilaginous ringsSecondary bronchiSecondary bronchi

Supported by cartilaginous ringsSupported by cartilaginous ringsTertiary bronchiTertiary bronchi

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Bronchopulmonary TreeBronchopulmonary TreeRespiratory bronchiRespiratory bronchiAlveolar sacsAlveolar sacsAlveoliAlveoli

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TracheaTracheaSupported by “C”-shaped cartilage Supported by “C”-shaped cartilage

segments.segments. In superior mediastinum.In superior mediastinum.Anterior to esophagus.Anterior to esophagus.Bifurcates into primary bronchi at sternal Bifurcates into primary bronchi at sternal

angle.angle.Carina.Carina.Text: p 125, Fig. 1.28Text: p 125, Fig. 1.28

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Right Primary BronchusRight Primary BronchusShorter, straighter, and larger than left:Shorter, straighter, and larger than left:

Aspirated objects more commonly follow Aspirated objects more commonly follow right bronchus.right bronchus.

Gives off three secondary bronchi:Gives off three secondary bronchi:Superior to superior lobe of right lung.Superior to superior lobe of right lung.Middle to middle lobe of right lung.Middle to middle lobe of right lung.Inferior to inferior lobe of right lung.Inferior to inferior lobe of right lung.

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Left Primary BronchusLeft Primary BronchusTwice as long as right primary bronchus.Twice as long as right primary bronchus.Gives off two secondary bronchi:Gives off two secondary bronchi:

Superior to superior lobe of right lung.Superior to superior lobe of right lung.Inferior to inferior lobe of right lung.Inferior to inferior lobe of right lung.

Angle between primary bronchi is 62 Angle between primary bronchi is 62 degrees.degrees.

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Bronchopulmonary TreeBronchopulmonary TreeSecondary bronchi:Secondary bronchi:

Supply lobes.Supply lobes.Tertiary bronchi:Tertiary bronchi:

Supply lobules (bronchopulmonary Supply lobules (bronchopulmonary segments)segments)

Respiratory bronchiRespiratory bronchiAlveolar sacsAlveolar sacsAlveoliAlveoli

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Lung Vascular SupplyLung Vascular SupplyOne pulmonary artery to each lung:One pulmonary artery to each lung:

Part of root of lung:Part of root of lung:Lobar arteries:Lobar arteries:

One to each lobeOne to each lobe

Segmental arteries:Segmental arteries:To segmentsTo segmentsIntrasegmental Intrasegmental

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Lung Vascular SupplyLung Vascular SupplyTwo pulmonary veins from each lung:Two pulmonary veins from each lung:

IntersegmentalIntersegmentalText: p 129, Fig. 1.30Text: p 129, Fig. 1.30

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Bronchial ArteriesBronchial ArteriesSupply bronchiSupply bronchi IntrasegmentalIntrasegmentalSupply tissues of lungsSupply tissues of lungsTwo left bronchial arteries from thoracic Two left bronchial arteries from thoracic

aortaaortaRight bronchial artery origin is variable but Right bronchial artery origin is variable but

usually from first aortic intercostal artery.usually from first aortic intercostal artery.Text: p 127, Fig. 1.29Text: p 127, Fig. 1.29

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Bronchial VeinsBronchial VeinsRight to azygos vein.Right to azygos vein.Left to accessory hemiazygos vein or left Left to accessory hemiazygos vein or left

superior intercostal veins.superior intercostal veins.

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Innervation of the LungsInnervation of the LungsAnterior and posterior plexus:Anterior and posterior plexus:

Lie anterior and posterior to roots of lungs.Lie anterior and posterior to roots of lungs.Contain parasympathetic fibers:Contain parasympathetic fibers:

From vagus nerve (CN X).From vagus nerve (CN X).

Contain sympathetic fibers:Contain sympathetic fibers:From T1-4.From T1-4.

Related to esophageal and aortic plexuses Related to esophageal and aortic plexuses posteriorly.posteriorly.Text: p 133, Fig. 1.33Text: p 133, Fig. 1.33