Term
| What separates the costal part of the parietal pleura from the thoracic wall |
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Definition
| The endothoracic fascia separates the costal parietal pleura from the thoracic wall |
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Term
| What reinforces the cervical parietal pleura |
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Definition
| The suprapleural membrane (Sibson’s fascia) supports the cervical parietal pleura |
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Term
| What spinal nerves do the phrenic nerves arise from, and what do they innervate |
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Definition
| The phrenic nerves arise from C3, C4, and C5. They innervate the diaphgragm (motor) and provide sensory innervation for many components of the mediastinum and parietal pleura. |
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Term
| Describe pain in the parietal pleura |
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Definition
| Pain in the parietal pleura is very, very localized, especially when breathing deeply |
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Term
| What is the innervation of the visceral pleura |
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Definition
| The visceral pleura is innervated by visceral afferents that don’t detect pain |
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Term
| What arteries and veins supply the visceral and parietal layers |
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Definition
| The visceral pleura is supplied by bronchial arteries and pulmonary veins, and the parietal pleura is supplied by intercostal arteries and veins |
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Term
| What are the three lines of pleural reflection |
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Definition
Sternal: Costal pleura becomes continuous with mediastinal pleura anteriorly – costomediastinal recess
Costal: costal pleura becomes continuous with diaphragmatic pleura – costodiaphragmatic recess
Vertebral: costal pleura becomes continuous with mediastinal pleura posteriorly |
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Term
| Describe the lines of pleural reflection |
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Definition
| The left pleura changes direction at around the 4th intercostal space, leaving a bare gap not covering the heart. Here is where a pericardiocentesis can be done without hitting the pleura, from beneath the costal margin |
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Term
| Where is a thoracocentesis done |
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Definition
| A thoracocentesis is done at the costodaphragmatic recess – the area between where the costal parietal pleura and the diaphragmatic parietal pleura meet |
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Term
| What is a lateral decubitus film |
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Definition
| A lateral decubitus film is an x-ray taken of a patient lying on his side, to determine if lung obstruction is fluid in nature. It will show a different obstruction due to shifting of the fluid if there is fluid in the pleural space |
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Term
| What is the difference between the pulmonary cavity and the pleural cavity |
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Definition
| The pulmonary cavity holds the lungs inside the visceral pleura. The pleural cavity is the potential space between visceral and parietal pleura |
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Term
| What are the components of the pulmonary root |
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Definition
| The pulmonary root is composed of the main bronchi (primary), the pulmonary artery, the superior and inferior pulmonary veins, and the pulmonary plexuses (ANS, VA) |
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Term
| Describe the relationship of the pulmonary arteries with the right and left lungs |
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Definition
| RALS: Right lung – the artery is anterior to the primary bronchus. Left lung – the artery is superior to the primary bronchus. |
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Term
| Describe the blood supply of the lung |
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Definition
| The lung has a dual blood supply, the respiratory portion is the pulmonary arteries, and there are bronchial arteries (2 left, 1 right, for non-respiratory tissue) such as parenchyma. Anastomoses do exist between these two supplies at the pre-capillary level. |
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Term
| What do the left and right main bronchial arteries arise from |
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Definition
| The left bronchial arteries (superior and inferior) arise directly from the thoracic aorta, the right bronchial artery arises from any number of the right intercostal arteries |
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Term
| What shape are the rings supporting the trachea and why |
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Definition
| The rings of the trachea are C-shaped due to the placement of the esophagus |
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Term
| Where does the trachea bifurcate |
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Definition
| The trachea bifurcates at the sternal angle of louis into two primary bronchi |
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Term
| What vertebre separate the superior and inferior mediastinum |
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Definition
| The line between t4 and t5 separates the superior and inferior mediastinum |
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Term
| What is the name of the object separating the right and left primary bronchi |
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Definition
| The Carina separates the right and left primary bronchi |
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Term
| Describe the differences between the right and left main bronchi |
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Definition
Right: Wider, shorter, runs more vertical
Left: inferior to arch of aorta, longer, anterior to esophagus. Has a closer relationship with the aorta |
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Term
| What is the analogue to the middle lobe in the left lung, and what are the names of the segments in each of them |
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Definition
| The middle lobe of the right lung’s analogue is the lingula of the left lung. Segments IV and V in the middle lobe are the lateral and medial segment, while segments IV and V in the lingula are the superior lingular segment and the inferior lingular segment. |
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Term
| What is the superficial plexus of the lung |
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Definition
| The superficial plexus of the lung (subpleural) is the lymphatic drainage of the lung tissue (parenchyma) + visceral pleura, it drains into bronchopulmonary nodes |
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Term
| What is the deep lymphatic plexus of the lung |
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Definition
| The deep lymphatic plexus of the lung is the lymphatic drainage of the bronchi and peribronchial connective tissues, it drains to the pulmonary nodes to the bronchopulmonary nodes. |
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Term
| What do the deep and superficial plexi drain into |
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Definition
| The superficial plexus drains into the bronchopulmonary nodes, whereas the deep plexus drains into the pulmonary nodes, which drain into the bronchopulmonary nodes. These then together drain into the tracheobronchial nodes (superior and inferior), and then into the bronchomediastinal lymph trunks |
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Term
| Describe the right / left drainage of the lung system |
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Definition
| The right lung and the inferior left lung lobe drain into the right lymphatic bronchomediastinal trunk, whereas the upper lobe of the left lung is the only part to drain into the left lymphatic bronchomediastinal trunk. This is important because of the metastasis of lung cancer |
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Term
| What is the parasympathetic innervation of the lungs |
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Definition
| The vagus nerve does all of the parasympathetic innervation of the lungs |
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Term
| Do splanchnic nerves synapse in the sympathetic chain? |
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Definition
| Splanchnic nerves do not synapse in the sympathetic chain. |
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