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What is the visceral pleura?
Pleura covering the lung tissue closely -- in all the fissures and lobar division
What is the parietal pleura?
Applied to the inside of the ribs, sternum, diaphragm, mediastinum and apex of the lung
What is the parietal pleura applied to the apex of the lung called?
What fluid is located within the pleural cavity?
- Small amount of lubricating pleural fluid
- Secreted by: Mesothelial lining
- Function: Movement of opposing membranes
What are pleural reflections?
Formed where parietal pleura fold back or change directions from one wall to another
What is the pulmonary ligament formed by?
Anterior and posterior mediastinal pleura
What are the 2 important pleural recesses?
- Costodiaphragmatic recess
- Costomediastinal recess
What is thoracocentesis?
Removal of fluid from the costodaiphragmatic recess
What enters the costomediastinal recess during inspiration?
Lingula of the left lung
What is the vascular supply of the parietal pleurae?
Intercostal, internal thoracic and musculophrenic
What is the innervation fo the parietal pleurae? Mention pain sensitivity/insensitivity.
- Innervation is from the phrenic nerve and intercostal nerves
- Pain sensitive
What is the vascular supply of the visceral pleura?
- Arteries: Bronchial arteries (branches of thoracic aorta)
- Veins: Pulmonary veins
What is the innervation for the visceral pleura? Mention pain sensitivity/insensitivity.
- Sympathetic and PS of pulmonary plexus
- Pain insensitive
Describe the 4 regions of each lung
- Apex: Superior, rounded
- Base: Concave, contacts diaphragm
- Hilum: Where root attaches to lung
How many lobes are found in the right lung and what fissures create them?
- 3 lobes: superior, middle, inferior
- Horizontal fissure: Seperates superior and middle
- Oblique fissure: Seperates middle and inferior
How many lobes are found in the left lung and what fissures create them?
- 2 lobes: Superior and inferior
- Oblique fisure seperates them
What 2 special structures are found on the left lung?
- Superior lobe has a cardiac notch due to the pericardium
- Lingula is inferior to it
What is the best place to listen for breath sounds on a patient?
Posterior thoracic wall
Where does the trachea end?
At the sternal angle
What is the carina?
Ridge between the broncheal orfices at the point of bifurcation
Where are the lobar/secondary bronchi going to?
Each individual lobe of the lung - 3 in the R and 2 in the L
What are the segmental (tertiary) bronchi going to?
The bronchopulmonary segments - 10 in the R and 8 in the L
What type of blood are the pulmonary arteries and veins?
- Pulm Arteries: Deoxygenated blood
- Pulm Vein: Oxygenated blood
Explain how the pulmonary vein drainage is distributed in the lungs?
- Left Superior Vein: left superior lobe
- Right Superior Vein: right superior and middle lobe
- Inferior Vein: Inferior lobes
What supplies/drains the connective tissue to the bronchial tree? Mention both sides and where they arise from.
- Bronchial arteries
- - Left: From thoracic aorta
- - Right: Intercostal arterioal branches from the aorta
- Bronchial veins
- - Left: Hemiazygous
- - Right: Azygous
What are the 2 lymphatic plexuses of the lungs?
- Superficial Plexus
- Deep lymphatic plexus
How does the superficial lymphatic plexus drain and where is it located?
- Location: Beneath visceral pleura
- Drainage: Bronchopulmonary lumph node then to the Thoracobronchial nodes at trachial bifurcation
How does the deep lymphatic plexus drain and where is it located?
- Location: Submucosal of the bronchi and trachea
- Drainage: Pulmonary lymph node to the bronchopulmonary nodes