benish islam coordinator lecturer surgical (ipms) kmu trachea, bronchi and lungs
TRANSCRIPT
BENISH ISLAM COORDINATOR LECTURER SURGICAL
( IPMS) KMU
Trachea, Bronchi and Lungs
Trachea
Mobile cartilaginous,membranous tube.Begins at neck, lower
border of cricoid cartilage.
(at level of 6th cervical vertebra)In thorax trachea ends
at Carina by dividing into principle (main) bronchi.
(Level of sternal angle, 4th 5th thoracic vertebra)
Cont.
In adults:4 ½ inch long 1 inch diameter.U shped bars (rings) of
hyaline crtilage embedded in wall.
Anterior: sternum,thymus,lt. bracheocephalic vein,lt. bcommon caroti arteries,arch of aorta
Posterior: esophagus, lt recurrent laryngeal nerve
Right: azygous vein,rt. Vagus nerve, pleura
Left: arch of aorta, lt subclavian, lt common carotid,phrenic nerves, pleura.
Arterial supply:upper 2/3 inf. Thyroid arteries
Lower 1/3 bronchial arteriesLymph nodes:pre
tracheal,para tracheal,deep cervical nodes.
Nerve Supply: sessory supply from vagi and recurrent laryngeal nerves.
Bronchi
Trachea bifurcates into rt. and lt. principal (primary) bronchi.
Rt. Principal bronchi is wider shorter, vertical 1inch.
Before entering hilum gives superior lobar bronchus.
On entering hilum it divides into: Middle, inferior lobar bronchus
Left principal bronchi: narrow, longer, more horizontal, 2 inch
On entering hilum divides into:
Superior, inferior lobar bronchus
Lungs
Lungs
Apex: projects upward into neck 1 inch above clavicle.
Costal surface: convexMediastinal surface: concave,molds to pericardiumHilum: bronchi vessels
and nerves form root,enter and leave lung.
Anterior border is thin,overlaps heart
Cardiac notch on lt. lung.
Lobes and fissures of lungs
Bronchopulmonary segment
Bronchopulmonary segment
Lobar secondary bronchus Segmental (tertiary) bronchi (for each bronco pulmonary segment)
Bronchioles(1 mm diameter)
Terminal bronchioles-(Respiratory bronchioles 0.5mm)
Alveolar ducts
Alveolar sacs (gaseous exchange)
Bronchi, lung, pleura Alveoli
Arterial supply: bronchial artery
(Branches of descending
aorta)Bronchial veins-
communicates with pulmonary veins (drains into hemizygos
Azygos veins)
Alveoli receives deoxygenated blood from branches of pulmonary arteries.
Oxygenated blood drains into tributaries of pulmonary veins.
Blood Supply
Lymphatic supply
Superficial plexus drains to broncho pulmonary nodes at hilum.
Deep plexus travels along bronchi, pass through pulmonary nodes.
All lymph from lungs drains to tracheobronchial nodes and then to bronchomediastinal lymph trunk.
Nerve supply
Pulmonary plexusSympathetic trunk
+Para sympathetic fibers
from vagus nerveSympathetic efferent
fibers cause bronchodilation and vasoconstriction
Parasympathetic efferent fibers: bronchoconstrition,vasodilation, inc.glandular secretion,
Afferent impulse from both sympathtic and parasym.
Derives from stretch receptors in alveoli walls to central nervous system.
Summary