DESCRIBE THE LUNGS UNDER FOLLOWING HEADINGS A) PARTS B) FISSURES C)
a)Parts of lungs: Apex
Base
Borders: 3 borders Anterior Posterior Inferior
Surfaces: 2 surfaces Costal Medial
Apex: Blunt
2.5cm above the medial end of clavicle
Covered by cervical pleura & suprapleural membrane Grooved by subclavian artery
Base:
Concave and semilunar Rests on diaphragm
On the right side related to Right lobe of liver below the diaphragm
On the left side related to Left lobe of liver, fundus of stomach and spleen below the diaphragm.
Borders:
Anterior border:
Very thin
Right side – Straight
Left side – wide cardiac notch, below left 4th costal cartilage
Lingula- tongue like projection below the cardiac notch
Posterior border:
Thick and
Inferior border:
Separates base from costal and medial surfaces
Surfaces:
Costal surface:
Large and convex
It is in contact with the costal pleura and thoracic wall
Medial surface: 2 parts
Posterior – vertebral part
Anterior- Mediastinal part
Fissures:
Right lung divided into 3 lobes by 2 Fissure
Oblique fissure and Horizontal fissure
Left lung is divided into 2 lobes by one fissure Oblique fissure
Oblique Fissure:
Present in both lungs
Cuts into whole thickness of lung except at the hilum Cuts posterior border of lung 2.5cm lateral to T4 spine
Follows downward and forward crosses 5th intercostal space in
Horizontal Fissure:
Present only in the right lung
Extends horizontally from the oblique fissure at the midaxillary line upto 4th costal cartilage.
Well defined sectors of lungs, each one is aerated by a tertiary or segmental bronchus.
Bronchopulmonary segments of Right Lung
Lobes | Segments |
| 1. Apical |
Upper lobe | 2. Anterior |
| 3. Posterior |
Middle lobe | 4. Medial |
| 5. Lateral |
Lower lobe | 6. Superior |
| 7. Anterior |
| Basal |
| 8. Posterior Basal |
| 9. Medial Basal |
| 10. Lateral Basal |
Bronchopulmonary segments of Left Lung
Lobes | Segments |
| 1. Apical |
Upper lobe | 2. Anterior |
| 3. Posterior |
| Superior |
Lingula | 4. Lingular |
| Inferior |
| 5. Lingular |
Lower lobe | 6. Superior |
| 7. Anterior Basal |
| 8. Posterior Basal |
| 9. Medial Basal |
| 10. Lateral Basal |
Describe the lungs under the following headings:
a)Labelled diagram of mediastinal surfaces showing position of related structures including structures in both hila
b)Development
c) One congenital anomaly | (LE) |
a )Diagram of Mediastinal Surface of Right lung
Diagram of Mediastinal surface of left lung:
Structural arrangements at the hilum of right and left lungs
B&C) Development- refer embryology book
Define
Bronchopulmonary segments are -
Well defined sectors of lungs, each one is aerated by a tertiary or segmental bronchus.
Each segment is surrounded by connective tissue which is continuous with pulmonary pleura
Thus Bronchopulmonary segments are independent respiratory units
Each segment has its own artery
But segmental vein runs in the intersegmental plane
Thus each segment has more than one vein and each vein drains more than one segment Both Right and Left lungs have 10 bronchopulmonary segments each
Diagram of Bronchopulmonary segments of both right and left lung
Bronchopulmonary segments of Right Lung
Lobes | Segments |
| 1. Apical |
Upper lobe | 2. Anterior |
| 3. Posterior |
Middle lobe | 4. Medial |
| 5. Lateral |
Lower lobe | 6. Superior |
| 7. Anterior Basal |
| 8. Posterior Basal |
| 9. Medial Basal |
| 10. Lateral Basal |
Bronchopulmonary segments of Left Lung | |
Lobes | Segments |
| 1. Apical |
Upper lobe | 2. Anterior |
| 3. Posterior |
| Superior |
Lingula | 4. Lingular |
| Inferior |
| 5. Lingular |
Lower lobe | 6. Superior |
| 7. Anterior Basal |
| 8. Posterior Basal |
9. Medial Basal
10. Lateral Basal
Applied Anatomy:
Connective tissue septa around the segments acts as a natural barrier and prevents spread of infection to other segments
So infection is confined to the segment
Apical segment of the lower lobe and the posterior segment of upper lobe are the
most dependent in the supine position.
Hence aspiration pneumonia involves mainly the apical segment of lower lobe.
DEFINE
Bronchopulmonary segments are well defined sectors of lungs, each one is aerated by a tertiary or segmental bronchus. o
Each segment is surrounded by connective tissue which is continuous with pulmonary pleura
Thus Bronchopulmonary segments are independent respiratory units Each segment has its own artery
But segmental vein runs in the intersegmental plane
Thus each segment has more than one vein and each vein drains more than one segment
Diagram showing Bronchopulmonary segments of left lung
Bronchopulmonary segments of Left Lung
Lobes | Segments | |
| Apical | |
Upper lobe | Anterior | |
| Posterior | |
Lingula | Superior | |
Inferior | ||
| ||
Lower lobe | Superior | |
| Anterior Basal | |
| Posterior Basal | |
| Medial Basal | |
| Lateral Basal |
Diagram showing Medial surface of right lung:
Diagram showing medial surface of left lung:
RIGHT LUNG (SE)
Right lung:
Parts:
Apex
Base
3 Borders- Anterior, posterior and inferior borders
2 Surfaces- Costal and medial surfaces
2 fissures namely oblique fissure and horizontal fissure divide the right lung into 3 lobes.
Lobes of right lung: Upper lobe, middle lobe and lower lobe.
Diagram showing medial surface of right lung:
Diagram showing structural arrangement of right hilum:
Differences between right and left lung:
Right lung | Left lung |
Large, shorter and wider | Smaller, Longer and narrower |
Weight: 700gm | Weight: |
3 lobes, 2 fissures | 2 lobes, 1 fissure |
Anterior border- straight | Anterior border- cardiac notch present |
| Presence of lingula below cardiac |
| notch |
Cardiac impression shallow | Cardiac impression is deep |
Supplied by one bronchial artery | Supplied by two bronchial arteries |
MEDIASTINAL SURFACE OF LEFT LUNG WITH THE AID OF DIAGRAM (SE)
Hilum of left lung-
Structures at the hilum of Left Lung:
From before backwards:
Superior pulmonary vein
Pulmonary artery
Bronchus
From Above Downwards
Pulmonary artery
Bronchus
Inferior pulmonary vein
Cardiac impression:
Deeply concave
Structures related- Left ventricle, part of right ventricle, left auricle
A groove in front of hilum along upper part of cardiac impression for pulmonary trunk
A well defined groove above the hilum- for arch of aorta
A vertical groove behind the hilum- for descending thoracic aorta
A vertical groove from aortic arch towards apex- for left subclavian artery Aove the hilum behind groove for subclavian artery- impression for oesophagus and
thoracic duct
A groove between the impression for descending thoracic aorta and pulmonary ligament- for oesophagus
Left phrenic nerve is related anterior to the hilum Left vagus nerve is related posterior to the hilum
Mediastinal surface of right lung with the aid of diagram (SE)
Hilum of right lung:
Structures at the hilum of Right Lung:
From before backwards:
Superior pulmonary vein
Pulmonary artery
Bronchus
From Above downwards
Eparterial bronchus
Pulmonary artery
Hyparterial bronchus
Inferior pulmonary vein
Cardiac impression:
Shallow and concave
Structures
A groove posterior and inferior to cardiac impression and in front of pulmonary ligament- for inferior vena cava
A groove along upper part of cardiac impression- for superior vena cava in the lower part and right brachiocephalic vein in the upper part
A groove above the hilum- for arch of azygos vein
Along the apex – impression for trachea
Behind the hilum- impression for oesophagus
Right phrenic nerve is related anterior to the hilum
Right vagus nerve is related posterior to the hilum
Root of right lung- relations and structures forming it | (Short Essay/5marks) |
Structures at the hilum of Right Lung:
From before backwards:
Superior pulmonary vein
Pulmonary artery
Bronchus
From Above downwards
Eparterial bronchus
Pulmonary artery
Hyparterial bronchus
Inferior pulmonary vein
Relations of root of right lung:
Anterior: Right phrenic nerve
Anterior pulmonary plexus
Posterior: Right vagus nerve
Posterior pulmonary pexus
Above: Arch of azygos vein
Below: Pulmonary Ligament
Hilum of lungs (SE)
Hilum is a large depressed area.
Structures enter and leave the lung at the hilum.
Lies near the centre of the medial surface.
Structures at the hilum of Right Lung:
From before backwards:
Superior pulmonary vein
Pulmonary artery
Bronchus
From Above downwards
Eparterial bronchus
Pulmonary artery
Hyparterial bronchus
Inferior pulmonary vein
Structures at the hilum of Left Lung:
From before backwards:
Superior pulmonary vein
Pulmonary artery
Bronchus
From Above Downwards
Pulmonary artery
Bronchus
Inferior pulmonary vein
BRONCHOPULMONARY SEGMENTS (SE)
Bronchopulmonary segments are -
Well defined sectors of lungs, each one is aerated by a tertiary or segmental bronchus. o
Each segment is surrounded by connective tissue which is continuous with pulmonary pleura
Thus Bronchopulmonary segments are independent respiratory units
Each segment has its own artery
But segmental vein runs in the intersegmental plane
Thus each segment has more than one vein and each vein drains more than one segment Both Right and Left lungs have 10 bronchopulmonary segments each
Bronchopulmonary segments of Right Lung
Lobes | Segments |
| 1. Apical |
Upper lobe | 2. Anterior |
| 3. Posterior |
Middle lobe | 4. Medial |
| 5. Lateral |
Lower lobe | 6. Superior |
| 7. Anterior Basal |
| 8. Posterior Basal |
| 9. Medial Basal |
| 10. Lateral Basal |
Bronchopulmonary segments of Left Lung | |
Lobes | Segments |
| 1. Apical |
Upper lobe | 2. Anterior |
| 3. Posterior |
| Superior |
Lingula | 4. Lingular |
| Inferior |
| 5. Lingular |
Lower lobe | 6. Superior |
| 7. Anterior Basal |
| 8. Posterior Basal |
9. Medial Basal
10. Lateral Basal
Applied Anatomy:
Connective tissue septa around the segments acts as a natural barrier and prevents spread of infection to other segments
So infection is confined to the segment
Apical segment of the lower lobe and the posterior segment of upper lobe are the most dependent in the supine position.
Hence aspiration pneumonia involves mainly the apical segment of lower lobe.
Contents of root of lung (right) Draw and label hilum of right lung
Hilum of right lung (structures present)(SA)
Structures at the hilum of
Right Lung:
From before backwards:
Superior pulmonary vein
Pulmonary artery
Bronchus
From Above downwards
Eparterial bronchus
Pulmonary artery
Hyparterial bronchus
Inferior pulmonary vein
Blood supply of lungs (SA)
Arterial Supply:
Pulmonary artery- supply respiratory part
Bronchial artery- supply conducting part of bronchial tree Bronchial Artery:
Right side: One artery ,
Arises as a branch of right 3rd posterior intercostal artery Or from upper left bronchial artery
Left side: There are 2 bronchial arteries,
Arise from Descending thoracic aorta
Venous Drainage:
Bronchial Veins – drain venous blood from first one or two divisions of bronchi
There aretwo bronchial veins on each side.
Right Bronchial veins drain into Azygos vein
Left Bronchial veins drain into left superior intercostal vein or hemiazygos vein Pulmonary Veins - Drain Greater part of venous blood from lungs.
Mention the lymphatic drainage of lungs ( SA)
There are two sets of Lymphatics which drain the lungs Superficial Lymphatics – Drain peripheral lung tissue
Ramifies beneath the pulmonary pleura
Deep Lymphatics
Arranged around the intrapulmonary bronchi and bronchioles and around pulmonary vessels
These lymphatics converge towards hilum and drain into Bronchopulmonary lymph nodes. Applied Anatomy: Cancer cells in the lungs spread mostly by the lymphatics and involve the hilar and Mediastinal lymph nodes
Bronchial arteries ( SA)
Bronchial arteries supply - Conducting part of bronchial tree
Right side: One artery ,
Arises as a branch of right 3rd posterior intercostal artery or from upper left bronchial artery
Left side: There are 2 bronchial arteries,
Arise from Descending thoracic aorta
Differences between right and left principal bronchus and its clinical significance (Short answer)
| Right Principal Bronchus | Left Principal Bronchus |
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| 2.5 cm long | 5 cm in length |
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| Shorter, wider | It is more longer, narrower |
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| More in line with trachea | More oblique than right bronchus |
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| Makes an angle of 250 from median plane at | Makes an angle of 450 from median plane at |
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| tracheal bifurcation | tracheal bifurcation |
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| Passes below arch of azygos vein | Passes below arch of aorta |
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| At the hilum: Upper lobe (Eparterial) |
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| bronchus arises from the main bromchus | At the hilum: The whole bronchus enters |
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| before it enters the hilum | the hilum |
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Applied Anatomy: Since the right bronchus is shorter, wider and more vertical a foreign body is more likely to be aspirated into the right lung
Define a Bronchopulmonary segment ( Short answers/3marks) Bronchopulmonary segments are -
Well defined sectors of lungs, each one is aerated by a tertiary or segmental bronchus. o Each segment is pyramidal in shape with apex directed towards root of lung
Each segment is surrounded by connective tissue which is continuous with pulmonary pleura
Thus Bronchopulmonary segments are independent respiratory units
Each segment has its own artery
But segmental vein runs in the intersegmental plane
Thus each segment has more than one vein and each vein drains more than one segment Both Right and Left lungs have 10 bronchopulmonary segments each
Bronchopulmonary segments of left lung (upper lobe) | ( SA) | |
Bronchopulmonary segments of Left |
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Lung- |
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Upper lobe | 1. Apical |
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| 2. Anterior |
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| 3. Posterior |
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| 4. Superior Lingular |
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Lingula | 5. Inferior Lingular |
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