Thoracic Cavity: 3 compartments
- Laterally = have 2 pulmonary cavities with lungs.
- Separating them, have central mediastinum cavity with heart.
Pulmonary cavities:
- Parietal pleura = Onnermost surface of thoracic wall.
- Visceral pleura covers lung tissue. Divided into different regions. Most superior = cervical pleura, above first rib into base of neck. A knife wound to base of neck can puncture and cause lung collapse. Deep to ribs = costal pleura – lateral wall. Mediastinal pleura– against mediastinum, diaphragmatic pleura = on surface of diaphragm.
- Pleural cavity = narrow space, small amount of fluid to allow lubrication between T wall and lungs. Spaces where not filled:
- Costodiaphragmatic recess= larger, inferior recess, lungs not reach all the way down to it.
- Costomediastinal recess = between mediastinum and ribs.
- Hilum of lung- site of entry of root of lung. Where parietal pleura meets visceral pleura.
- Root of lung = structures like trachea, pulmonary vessels come and go. From mediastinum to lungs. Includes pulmonary artery / vein and primary bonchi.
- Pulmonary ligament = where parietal and visceral pleura come together
- Visceral pleura covers lungs, cannot be removed.
Lobes and fissures:
- Right lung: 3 lobes = divided by fissures. Horizontal fissure divides superior and middle lobes. Corresponds with 4th rib. Between middle and inferior = oblique fissure. Travels at acute angle downward toward anterior. Laterally, these fissures meet.
- Left lung: 2 lobes divided by oblique fissure. Superior / inferior lobes. Has inpocketing = cardiac notch, due to bulge of heart. Lingula is structure coming off superior lobe near notch.
- Right lung anatomy: Bronchi will have cartilage in wall. Pulmonary arteries have thicker walls than pulmonary veins. Pulmonary veins are very thin walled. Bronchi usually more posterior and veins most anterior. These form rootà surrounded by hylum which becomes pulmonary ligament. Continuation of junction between V and P pleura.
- Superior most part = Apex, fits into cervical part of pleura. Base has diaphragmatic surface.
3 surfaces:
- Costal
- Mediastinal
- Diaphragmatic
2 fissures (oblique, horizontal) and 3 lobes (superior, middle, inferior).
- Left lung anatomy: similar arrangement within root.
- Cardiac impression with cardiac notch / lingual on anterior edge.
Airways of respiratory tract:
- Trachea – bifurcated by ridge = Carina. Right bronchus has larger diameter and is more vertically oriented. More likely to get foreign object due to this.
- Main (primary) bonchi, Lobar (secondary) bronchi, Segmental (tertiary) bronchi. 10 tertiary on each side, each with its own segment.
- Bronchopulmonary segment – each supplied by segmental bronchi and artery
Pulmonary circulation:
- Deoxy blood from R side of heart→pulmonary trunk→R and L pulmonary arteries→into lungs→capillary bed gas exchange→pulmonary veins (2 on each side)→L atrium
- Bonchial arteries / veins supply primary / 2 /3 bronchi. These travel on posterior wall of bronchi. Originate from thoracic aorta (come off of inner curvature).
- Veins drain into Azygos system on posterior wall of Thoracic cavity.
Lymphatic drainage of lungs: 2 flow patterns
- Superficial pattern – On surface of lungs→vessels drain into bronchopulmonary nodes→follows same path as deep pattern.
- Deep pattern– Fluid goes into pulmonary nodes in lung tissue itself. Fluid flows toward root→to bronchopulmonary nodes on primary bronchi→drain into tracheal nodes→have cluster of Carinal nodes under the division of trachea into bronchi AKA inferior tracheobronchial nodes→then travels to bronchomediastinal trunks→on L→thoracic duct→venous blood system @ left subclavian vein. On R→same on Right side.
- Innervation of lungs: Autonomic Innervation, n=No somatic Innervation.
- No intercostals nerves go toward lungs.
- Have parasympathetic supply to lungs from the Vagus nerve (R and L). They travel into the chest and give off branches that run onto primary bronchi and interdigitate. Plexus of branches on primary bonchi = pulmonary plexus of nerves. Plexus also has sympathetic nerve branches coming off of paravertebral ganglion. These P and S fibers then travel into lungs to glands / smooth muscles etc of lungs.
- Cough reflex: associated with fibers of Vagus nerve. Visceral pain due to damage of tissue→afferent fibers of sympathetic nerves.
- Dilation of blood vessels, vasoconstriction, secretion = parasympathetic. Opposite is sympathetic.