Download Slide 1 - mcstmf

The Lung
Objectives
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Explain pleura.
Define mediastinum.
Discuss the anatomical structure of lungs.
Enlist the relations of right and left lungs.
Give the blood and nerve supply of the lungs.
• The pleura:
• Has two parts:
• A parietal layer, which
lines the thoracic wall,
covers the diaphragm, the
lateral aspect of the
mediastinum, & line the
suprapleural membrane.
• A visceral layer, which
covers the outer surfaces
of the lungs and extends
into the interlobar
fissures.
• The parietal and visceral
pleura are separated by
the pleural cavity.
• The parietal pleura is
divided into:
• Cervical pleura.
• Costal pleura.
• Mediastinal pleura.
• Diaphragmatic pleura.
• The pulmonary
ligament is a pleural
fold surrounding
structures entering
and leaving the lung.
• Nerve Supply of the Pleura:
• The parietal pleura is sensitive
to pain, temperature, touch,
and pressure and is supplied
as follows:
• The costal pleura by the
intercostal nerves.
• The mediastinal pleura by the
phrenic nerve.
• The diaphragmatic pleura over
the domes by the phrenic
nerve and around the
periphery by the lower six
intercostal nerves.
• The visceral pleura covering
the lungs is sensitive to stretch
but is insensitive to common
sensations such as pain and
touch. It receives an
autonomic nerve supply from
the pulmonary plexus.
• The mediastinam is the space
between the two pleural
cavities.
• The mediastinum is divided
into superior and inferior
mediastina by an imaginary
plane passing from the sternal
angle anteriorly to the lower
border of the body of the
fourth thoracic vertebra
posteriorly.
• The superior mediastinum is
bounded in front by the
manubrium sterni and behind
by the first four thoracic
vertebrae.
• Superior mediastinum contains
thymus, large veins, large
arteries, trachea, esophagus ,
thoracic duct, and sympathetic
trunks.
• The inferior mediastinum
is bounded in front by the
body of the sternum and
behind by the lower eight
thoracic vertebrae.It is
divided into:
• Anterior mediastinum
contains the thymus.
• Middle mediastinum
contains the pericardium,
heart & phrenic nerves .
• Posterior mediastinum
contains esophagus,
thoracic duct, descending
aorta, and sympathetic
trunks.
• The lungs are situated one
on each side of the
mediastinum.
• Each lung has:
• An apex.
• A concave base.
• A convex costal surface.
• A concave mediastinal
surface.
• At about the middle of
mediastinal surface is the
hilum, a depression in
which the bronchi, vessels,
and nerves that form the
root of the lung enter and
leave the lung.
• Each lung has:
• An anterior thin border
that overlaps the heart.
• A posterior thick border
that lies beside the
vertebral column.
• The right lung is slightly
larger than the left and
is divided by the oblique
and horizontal fissures
into three lobes:
• Upper, middle, and
lower lobes.
• The medial surface
of the right lung
related to:
• Inferior vena cava.
• Superior vena
cava.
• Azygos vein.
• Esophagus.
• The left lung is
divided by an
oblique fissure into
two lobes:
• The upper and lower
lobes. There is no
horizontal fissure in
the left lung.
• The medial surface
of the left lung
related to:
• The heart.
• Aortic arch.
• Thoracic aorta.
• Esophagus.
• Bronchopulmonary
Segments:
• The bronchopulmonary
segments are the anatomic,
functional, and surgical
units of the lungs.
• Each lobar (secondary)
bronchus gives off
segmental (tertiary)
bronchi.
• Each segmental bronchus
passes to a structurally and
functionally independent
unit of a lung lobe called a
bronchopulmonary
segment, .
• The main bronchopulmonary
segments are:
• Right lung:
• Superior lobe: Apical, posterior
& anterior segments.
• Middle lobe: Lateral, medial
segments.
• Inferior lobe: Superior (apical),
medial basal, anterior basal,
lateral basal, posterior basal
segments.
• Left lung:
• Superior lobe: Apical,
posterior, anterior, superior
lingular, inferior lingular
segments.
• Inferior lobe: Superior (apical),
medial basal, anterior basal,
lateral basal, posterior basal
segments.
• Blood Supply of the Lungs:
• The bronchi, the
connective tissue of the
lung, and the visceral
pleura receive their blood
supply from the bronchial
arteries.
• The bronchial veins drain
into the azygos and
hemiazygos veins.
• The alveoli receive
deoxygenated blood from
the terminal branches of
the pulmonary arteries.
• Lymph from the lung
drains into the
tracheobronchial nodes
and then into the
bronchomediastinal lymph
trunks.
• Nerve supply of the lungs
is by a pulmonary plexus
which is formed from
branches of the
sympathetic trunk and
receives parasympathetic
fibers from the vagus
nerve.