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LUNG Bronchial Tree The right main bronchus Wider More vertical Bronchial Tree trachea Right main bronchus Lobar bronchus Segmental bronchus Left main bronchus Lobar bronchus Bronchopulmonary Segment Bronchopulmonary Segment Segmental bronchus and its accompanying pulmonary artery branch 10 in each lung (some fuse in the left lobe) Bronchopulmonary Segment Position Midclavicular Midaxillary Scapular line line line Paravertebral line Inferior border of the lung Rib 6 Rib 8 Rib 10 T10 Inferior border of the pleura Rib 8 Rib 10 Rib 11 T12 Lung Base: the diaphragm Apex: rib I, into the root of the neck Surfaces: costal surface, mediastinal surface Borders: inferior border, anterior border, posterior border Hilum and Root Root of the lung (Anterior to posterior) superior pulmonary vein pulmonary artery main bronchus inferior pulmonary vein Pulmonary ligament Right Lung 2 fissures, 3 lobes oblique fissure horizontal fissure superior lobe middle lobe inferior lobe Right Lung The root of the lung (superior to inferior) bronchus to superior lobe pulmonary artery bronchus to middle and inferior lobes superior pulmonary vein inferior pulmonary vein Right Lung Structures adjacent to the medial surface of the right lung the heart the inferior vena cava the superior vena cava the azygos vein the esophagus Left Lung 1 fissure, 2 lobes oblique fissure superior lobe inferior lobe Left Lung The root of the lung (superior to inferior) pulmonary artery main bronchus superior pulmonary vein inferior pulmonary vein Left Lung Structures adjacent to the medial surface of the left lung the heart the aortic arch the thoracic aorta the esophagus Lung right left Pulmonary Vessels Pulmonary arteries ← the pulmonary trunk Pulmonary veins → back into the left atrium Bronchial Vessels Bronchial arteries and veins interconnect within the lung with braches of the pulmonary arteries and veins “Nutritive” vascular system Bronchial Vessels Bronchial arteries ← thoracic aorta or one of its branches on the posterior surfaces of the bronchi and ramify in the lungs to supply pulmonary tissues. Bronchial Vessels Pulmonary veins or left atrium Bronchial veins Azygos veins or superior intercostal veins or hemiazygos veins Innervation Innervation The vagus nerves constrict the bronchioles The sympathetic system dilate the bronchioles Lymphatic drainage tracheobronchial parasternal brachiocephalic nodes nodes nodes right or left bronchomediastinal trunks deep veins at the base of the neck, or right lymphatic trunk or thoracic duct The lungs The lung is covered, over most of its surface, by a thin and smooth membrane, the visceral pleura. On the medial surface of the lung, at the hilum (L., a little thing) this smooth membrane reflects away from the surface of the lung and folds back to line the internal surface of the cavity in which the lung is suspended. This latter layer is known as the parietal pleura and covers the inner surface of the chest wall, the superior surface of the diaphragm, and the lateral surface of the mediastinum. Specialized regions of the parietal pleural membrane are named for the structures they cover. The mediastinal pleura covers the lateral surface of the mediastinum. The diaphragmatic pleura covers the superior surface of the diaphragm. The costal pleura lines the internal surface of the ribcage. The most superior portion of the pleural membrane, the cervical pleura, or dome of the pleura, extends 1 to 2 cm into the neck above the level of the clavicle and first rib. All of these portions of the parietal pleura are, of course, continuous with each other. The visceral and parietal pleurae are continuous with each other at the hilum, where a slightly elongated "collar" of pleura forms. Encircled by this collar are the structures that connect the lung to the mediastinum: the pulmonary and bronchial vessels, the airways, nerves, lymphatics, and the connective tissue. A small inferior extension of this pleural collar is known as the pulmonary ligament, and, in the living, it may be palpated during surgery as a firm shelf of tissue on the medial surface of the lung. The pleural cavity is the potential space between the visceral and parietal pleurae. Inferolaterally on each side of the chest, where the lateral edge of the diaphragm meets the chest wall, is the costodiaphragmatic (costophrenic) recess. This recess is very lucent (i.e., dark) on an x-ray when the lung expands fully to fill it; at expiration, however, the lung recedes upward and the diaphragm and chest wall move near to each other once again, and the lucency disappears. If, however, a patient has blood or inflammatory fluid in the pleural cavity, the fluid flows down into this recess, and in such a patient's x-ray at inspiration the angle is "blunted" by the accumulated fluid. There is another normally widened area of the pleural cavity anterior to the heart, on the left side, known as the costomediastinal recess. It becomes lucent at inspiration when the lingula of the left lung expands into it.