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ANA 534 T2 Lungs
learning objective answers to lungs
| Question | Answer |
|---|---|
| What are the boundaries of the thoracic inlet? | The manubrium, rib 1 (+ its costal cartilage), and the body of vertebra T1. |
| What are the boundaries of the thoracic outlet? | The body of T12, the costal margin and the xiphisternal joint. |
| What is the suprapleural membrane? | A dome-shaped thickening of the endothoracic fascia over the thoracic inlet occupied by the cupola of each lung. |
| What serous membrane lines each thoracic cavity? | The pleural membrane (parietal pleura). |
| What are the various divisions of the parietal pleura? | Costal, mediastinal, diaphragmatic and cervical pleura. |
| How does parietal pleura differ from visceral with regard to innervation? | Parietal pleura is highly innervated, visceral pleura is not innervated. |
| Where does parietal pleura become visceral pleura? | Where it reflects off the mediastinum (as the mediastinal division of parietal pleura) onto the surface of the lung at the root of the lung. |
| What is the pulmonary | A cuff-like extension of this reflection of parietal/visceral pleura at the root of the lung inferiorly along the mediastinum. ligament? |
| What attaches the costal pleura to the back of the thoracic cage? | Endothoracic fascia. |
| What is a pleural recess? | A reflection of parietal pleura off one aspect of the body wall onto another forming a thin slit-like serous lined region into which the sharp borders of the lung rarely insert - even during deep inspiration. |
| What is the function of the pleural recesses? | A region for expansion of the lung duyng deep inspiration. |
| Name two pleural recesses. | Costodiaphragmatic and costomediastinal. |
| Which specific aspect of the lung would insert into each recess? | The sharp anterior border of the lung slips into the costomediastinal recess; the sharp inferior border of the lung inserts down into the costodiaphragmatic recess. |
| Cite a clinical implication of these recesses. | Fluid accumulates in these regions (specifically the costodiaphragmatic) in pathological conditions. It is generally removed from these regions by thoracocentresis so that the lung is not pierced by the needle withdrawing the fluid. |
| What is meant by negative pressure of the thoracic cavity? | It keeps the moist visceral pleura of the lung adherent to the moist parietal pleura of the thoracic wall. Movement of the wall pulls the lung with it - inspiration and expiration. |
| What causes the visceral pleura to adhere to the parietal pleura? | A thin layer of pleural fluid and the negative pressure. |
| What is a pneumothorax? | Air enters the pleural cavity causing the two pleural layers to separate (and the lung to collapse). |
| What is a hemothorax? | Blood enters the pleural cavity and forces the two pleural layers apart. |
| Which aspect of the thorax would you apply the stethoscope to in order to listen to the airways in the upper lobe of each lung? | To listen to the airway sounds in the upper lobe of either lung, you would place the stethescope on the anterior thoracic wall. |
| Which aspect of the thorax would you apply the stethoscope to in order to listen to the airways in the lower lobe of each lung? | On the posterior thoracic wall. |
| Which aspect of the thorax would you apply the stethoscope to in order to listen to the airways in the apical region? | In the thoracic inlet. |
| Which aspect of the thorax would you apply the stethoscope to in order to listen to the airways in the middle lobe of the right lung? | On the lateral thoracic wall. |
| What vessels supply lung tissue with oxygenated blood? | The bronchial aa. |
| From where do the vessels that supply lung tissue arise? | Off the aorta. |
| What is the relationship between bronchi and pulmonary aa.? | The pulmonary aa. follow the bronchial tree - most commonly above it. |
| What is the relationship between bronchi and pulmonary vv.? | Pulmonary vv. lie below the bronchi at the hilus/root of the lung. |
| Which main bronchus is longer and why? | The left is longer and more horizontal as it passes over the heart. |
| Which main brochus is explored first when objects are aspirated? Why? | The right bronchus is always explored first with the bronchoscope. Because it is more vertical and in-line with the trachea so objects tend to enter it rather than the more horizontal left main bronchus. |
| What does a main (primary) bronchus supply? | A lung. |
| What does a secondary bronchus supply? | A lobe. |
| What does a tertiary bronchus supply? | A bronchopulmonary segment (BPS). |
| What is a bronchopulmonary segment? | The smallest surgically resectable portion of a lung. |
| How many BPS's are found in each lung? | There are 10 BPS in each lung. |
| What is the clinical implication of BPS’s? | They are the smallest surgically resectable portion of a lung as well as the knowledge of their position in the lung is important for positioning the patient for postural drainage. |
| What clinical implication does the autonomic innervation of the lungs have? | The parasympathetic innervation (vagus nerve) constricts the smooth muscle in the walls of the bronchioles - asthma (highly atypical as the sympathetic division normally constricts smooth muscle). |
| To what nodes do the superficial and deep lymphatics of the lung drain? | The bronchopulmonary nodes. |
| Where are these nodes located? | At the root of the lung. |
| From here the lymph passes to what other groups located along the bronchus and trachea? | To the tracheobronchial and paratracheal nodes respectively. |
Created by:
wiechartm
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