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ANATOMY OF LUNGS
ANATOMY OF LUNGS
-
-
1. Gross Anatomy of Lungs
2. Surfaces and Borders of
Lungs
3. Hilum and Root of Lungs
4. Fissures and Lobes of
Lungs
5. Bronchopulmonary
segments
6. Histopathology of
Alveoli
7. Surfactant
8. Blood supply of lungs
9. Lymphatics of Lungs
10. Nerve supply of Lungs
11. Pleura
12. Mediastinum
GROSS ANATOMY OF LUNGS
GROSS ANATOMY OF LUNGS
Lungs are a pair of respiratory organs situated in a thoracic cavity.
Right and left lung are separated by the mediastinum.
Texture -- Spongy
Color – Young – brown
Adults -- mottled black due to
deposition of carbon particles
Weight-
Right lung - 600 gms
Left lung - 550 gms
THORACIC CAVITY
THORACIC CAVITY
SHAPE - Conical
Apex (apex pulmonis)
Base (basis pulmonis)
3 Borders - anterior (margo anterior)
- posterior (margo posterior)
- Inferior (margo inferior)
2 Surfaces - costal (facies costalis)
- medial (facies mediastinus)
- anterior (mediastinal)
- posterior (vertebral)
APEX
APEX
Blunt
Blunt
Lies above the level of
Lies above the level of
anterior end of 1
anterior end of 1st
st Rib.
Rib.
Reaches 1
Reaches 1-
-2 cm above
2 cm above
medial 1/3
medial 1/3rd
rd of clavicle.
of clavicle.
Coverings
Coverings –
–
cervical pleura.
cervical pleura.
suprapleural
suprapleural membane
membane
Grooved b
Grooved by-
-
Subclavian
Subclavian artery
artery
Subclavian
Subclavian vein
vein
BASE
BASE
Semilunar
Semilunar and concave.
and concave.
Rests on dome of Diaphragm.
Rests on dome of Diaphragm.
Right sided dome is higher than left.
Right sided dome is higher than left.
BORDERS
BORDERS
ANTERIOR BORDER
ANTERIOR BORDER –
–
1.
1. Corresponds to the anterior
Corresponds to the anterior
(
(Costomediastinal
Costomediastinal) line of pleural reflection.
) line of pleural reflection.
2.
2. It is deeply notched in the left lung posterior
It is deeply notched in the left lung posterior
to 5
to 5th
th costal cartilage by the pericardium
costal cartilage by the pericardium
and extends vertically downwards to form
and extends vertically downwards to form
Lingula
Lingula. This is called
. This is called cardiac
cardiac
notch
notch(percussion in this
(percussion in this area gives a dull
area gives a dull
note as compared to dull note obtained over
note as compared to dull note obtained over
lung).
lung).
INFERIOR BORDER
INFERIOR BORDER
Thin and sharp
Thin and sharp
It
It seperates
seperates the base of lung from the
the base of lung from the
costal surface and extends into
costal surface and extends into
phrenicocostal
phrenicocostal sinus.
sinus.
POSTERIOR BORDER
POSTERIOR BORDER
Thick and ill defined
Thick and ill defined
Fits into deep
Fits into deep paravertebral
paravertebral gutter.
gutter.
Extends from C7 to T10.
Extends from C7 to T10.
SURFACES OF THE LUNG
1. Costal Surface - It is in contact with costal
pleura and overlying
thoracic wall.
2. Medial Surface - Posterior / Vertebral Part
- Anterior / Mediastinal Part
Relations of Posterior Part
1. Vertebral Part
2. Intervertebral Discs
3. Posterior Intercostal Vessels
4. Splanchic Nerves
RELATIONS OF ANTERIOR PART
RELATIONS OF ANTERIOR PART
RIGHT SIDE
RIGHT SIDE
1.
1. Right atrium
Right atrium
2.
2. Small part of RV
Small part of RV
3.
3. SVC
SVC
4.
4. Right
Right brachiocephalic
brachiocephalic
vein(lower part)
vein(lower part)
5.
5. Azygos
Azygos vein
vein
6.
6. Esophagus
Esophagus
7.
7. IVC
IVC
8.
8. Trachea
Trachea
9.
9. Right
Right vagus
vagus nerve
nerve
10.
10. Right
Right phrenic
phrenic nerve
nerve
LEFT SIDE
LEFT SIDE
1.
1. Left ventricle
Left ventricle
2.
2. Pulmonary trunk
Pulmonary trunk
3.
3. Arch of Aorta
Arch of Aorta
4.
4. Descending thoracic
Descending thoracic
aorta
aorta
5.
5. Left
Left Subclavian
Subclavian Artery
Artery
6.
6. Thoracic duct
Thoracic duct
7.
7. Left
Left Brachiocephalic
Brachiocephalic
Vein
Vein
8.
8. Left
Left vagus
vagus nerve
nerve
9.
9. Left
Left phrenic
phrenic nerve
nerve
10.
10. Left recurrent
Left recurrent
laryngeal nerve
laryngeal nerve
HILUM
HILUM
It is a large depressed area that lies
It is a large depressed area that lies
near the centre of the medial surface.
near the centre of the medial surface.
Various structures enter and leave the
Various structures enter and leave the
lung via its root.
lung via its root.
ROOT OF THE LUNG
ROOT OF THE LUNG
The root is enclosed in
The root is enclosed in
a short tubular sheet of
a short tubular sheet of
pleura that joins the
pleura that joins the
pulmonary and
pulmonary and
mediastinal
mediastinal parts of
parts of
pleura . It extends
pleura . It extends
inferiorly as a narrow
inferiorly as a narrow
fold
fold -
- The pulmonary
The pulmonary
ligament
ligament.
.
It lies opposite of the
It lies opposite of the
bodies of 5th, 6th and
bodies of 5th, 6th and
7th thoracic vertebra
7th thoracic vertebra
STRUCTURES OF THE ROOT
STRUCTURES OF THE ROOT
Principal Bronchus on the
Principal Bronchus on the
left side.
left side.
Eparterial
Eparterial and
and Hyparterial
Hyparterial
on the right side.
on the right side.
One pulmonary artery .
One pulmonary artery .
Two pulmonary veins
Two pulmonary veins -
-
Superior
Superior
Inferior
Inferior
Bronchial arteries
Bronchial arteries
One on right side
One on right side
Two on left side
Two on left side
Bronchial veins
Bronchial veins
Anterior and
Anterior and
posterior pulmonary
posterior pulmonary
plexus of nerves.
plexus of nerves.
Lymphatics
Lymphatics
Bronchopulmonary
Bronchopulmonary
Lymphnodes
Lymphnodes
Areolar tissue.
Areolar tissue.
ARRANGEMENT OF STRUCTURES IN
ARRANGEMENT OF STRUCTURES IN
THE ROOT
THE ROOT
BEFORE BACKWARDS
BEFORE BACKWARDS
1. Superior pulmonary vein.
1. Superior pulmonary vein.
2. Pulmonary artery.
2. Pulmonary artery.
3. Bronchus.
3. Bronchus.
ARRANGEMENT OF STRUCTURES IN
ARRANGEMENT OF STRUCTURES IN
THE ROOT
THE ROOT
ABOVE DOWNWARDS
ABOVE DOWNWARDS
A.
A. Right Side
Right Side
1.
1. Eparterial
Eparterial Bronchus.
Bronchus.
2. Pulmonary Artery.
2. Pulmonary Artery.
3.
3. Hyparterial
Hyparterial Bronchus.
Bronchus.
4. Inferior Pulmonary
4. Inferior Pulmonary
Vein.
Vein.
.
.
ARRANGEMENT OF STRUCTURES IN
ARRANGEMENT OF STRUCTURES IN
THE ROOT
THE ROOT
ABOVE DOWNWARDS
ABOVE DOWNWARDS
B.
B. Left Side
Left Side
1. Pulmonary artery.
1. Pulmonary artery.
2. Bronchus.
2. Bronchus.
3. Inferior pulmonary vein
3. Inferior pulmonary vein
FISSURES AND LOBES OF LUNGS
FISSURES AND LOBES OF LUNGS
OBLIQUE FISSURE
OBLIQUE FISSURE
It begins
It begins posteriorly
posteriorly at the level of 5th
at the level of 5th
thoracic vertebra.
thoracic vertebra.
Passes
Passes antero
antero-
-inferiorly in a spiral
inferiorly in a spiral
course to meet the inferior margin close
course to meet the inferior margin close
to 6th
to 6th costochondral
costochondral junction.
junction.
HORIZONTAL FISSURE
HORIZONTAL FISSURE
It extends from anterior margin at the level of
It extends from anterior margin at the level of
4th costal cartilage.
4th costal cartilage.
Runs horizontally backwards to meet the
Runs horizontally backwards to meet the
oblique fissure in the mid
oblique fissure in the mid-
-axillary
axillary line.
line.
Pulmonary pleura extends into the fissures of
Pulmonary pleura extends into the fissures of
the lungs so that the lobes can move on each
the lungs so that the lobes can move on each
other during respiration.
other during respiration.
BRONCHOPULMONARY
BRONCHOPULMONARY
SEGMENTS
SEGMENTS
These are well defined areas of the
These are well defined areas of the
lungs, each of which is aerated by a
lungs, each of which is aerated by a
segmental / tertiary bronchus.
segmental / tertiary bronchus.
Trachea
Trachea
Right and Left Principal Bronchus
Right and Left Principal Bronchus
Lobar Bronchi(Secondary)[2L,3R]
Lobar Bronchi(Secondary)[2L,3R]
Segmental Bronchi(Tertiary)[8L,10R]
Segmental Bronchi(Tertiary)[8L,10R]
Terminal Bronchioles(25000 in no.)
Terminal Bronchioles(25000 in no.)
Respiratory Bronchioles
Respiratory Bronchioles
Alveolar ducts
Alveolar ducts
ACINUS
ACINUS
Alveolar sacs
Alveolar sacs
Alveoli
Alveoli
The ultimate pulmonary unit from respiratory
The ultimate pulmonary unit from respiratory
brochiole to alveoli is called
brochiole to alveoli is called Acinus
Acinus.
.
There are about 28 orders of division of
There are about 28 orders of division of
tracheo
tracheo-
-bronchial tree.
bronchial tree.
Total no. of alveoli has been estimated to be
Total no. of alveoli has been estimated to be
between 200
between 200 -
- 600 million, with a total surface
600 million, with a total surface
area of 40
area of 40 -
- 80 meter square.
80 meter square.
BRONCHOPULMONARY SEGMENTS
BRONCHOPULMONARY SEGMENTS
Right main bronchus
Right main bronchus
1.
1. Shorter
Shorter
2.
2. Wider.
Wider.
3.
3. More in line with
More in line with
trachea.
trachea.
Left main bronchus
Left main bronchus
1.
1. Longer
Longer
2.
2. Narrower.
Narrower.
3.
3. More oblique than
More oblique than
the right.
the right.
BRONCHOPULMONARY SEGMENTS
BRONCHOPULMONARY SEGMENTS
Right Main Bronchus
Right upper lobe Bronchus Right Middle lobe Bronchus Right Lower Lobe Bronchus
Segmental Bronchi
Apical
Anterior
Posterior
Segmental Bronchi
Medial
Lateral
Segmental Bronchi
Apical
Anterior
Posterior
Medial and Lateral
BRONCHOPULMONARY SEGMENTS
BRONCHOPULMONARY SEGMENTS
Left Main Bronchus
Left upper lobe Bronchus
Upper Branch Lower Branch
Anterior
Apico-posterior
Superior Lingular
Inferior Lingular
Left lower lobe bronchus
Segmental Bronchi
Apical
Anterior
Posterior
Lateral
These segments are pyramidal in shape with
These segments are pyramidal in shape with
apex towards the root of lung.
apex towards the root of lung.
Each segment is an independent respiratory unit.
Each segment is an independent respiratory unit.
Each segment has its own separate
Each segment has its own separate
artery(branches of pulmonary artery).
artery(branches of pulmonary artery).
Pulmonary Veins run in inter
Pulmonary Veins run in inter-
-segmental planes
segmental planes
between adjoining segments.
between adjoining segments.
Thus a bronchopulmonary segment is not a
Thus a bronchopulmonary segment is not a
bronchovascular segment as it does not have
bronchovascular segment as it does not have
its own vein
its own vein.
.
CLINICAL SIGNIFICANCE
CLINICAL SIGNIFICANCE
Segmental resection with minimal
Segmental resection with minimal
destruction to the surrounding lung
destruction to the surrounding lung
tissue.
tissue.
To visualize the interior of a bronchi
To visualize the interior of a bronchi
through a bronchoscope when diseases
through a bronchoscope when diseases
process is limited in a segment.
process is limited in a segment.
HISTOPATHOLOGY OF ALVEOLI
HISTOPATHOLOGY OF ALVEOLI
ALVEOLAR WALL
ALVEOLAR WALL
1.
1. Alveolar epithelial cells
Alveolar epithelial cells-
-
Type I
Type I pneumocytes
pneumocytes
Type II
Type II pneumocytes
pneumocytes
2.
2. Basement Membrane
Basement Membrane
3.
3. Interstitial Space
Interstitial Space-
-
Collagen
Collagen
Elastin
Elastin
Unmyelinated
Unmyelinated Nerves
Nerves
Macrophages
Macrophages
4.
4. Capillary Basement
Capillary Basement
Membrane
Membrane
5.
5. Capillary Endothelial Cells.
Capillary Endothelial Cells.
.
.
Type I
Type I Pneumocyte
Pneumocyte
Pavement epithelial
cells of alveoli .
Less in no. than
type II.
More surface
area(flattened)
Contain pinocytic
vesicles.
Specialized for
diffusion of gases.
Type II
Type II Pneumocytes
Pneumocytes
More numerous than
type I.
Cuboidal in shape.
Rich in
mitochondria, ER
and vacuoles
containing
osmiophillic lamellar
bodies.
Type I are
precursors of type II.
ENDOTHELIAL CELLS
ENDOTHELIAL CELLS
Most numerous .
Presence of
pinocytic vacuoles
that meet the
luminal surface to
form caveolae.
Walls of caveolae
has, ACE.
Source of NO,
natural pulmonary
vasodilator.
ALVEOLAR MACROPHAGES
ALVEOLAR MACROPHAGES
Primary
Primary defence
defence
mechanism.
mechanism.
Takes part in
Takes part in
inflammatory and
inflammatory and
immunological
immunological
reactions
reactions.
.
Activates
Activates lysosomes
lysosomes ,
,
proteases,complement
proteases,complement
,
, thromboplastin
thromboplastin,
,
cytokines
cytokines -
- IF
IF-
-α
α, TNF
, TNF-
-
α
α, IL
, IL-
-1, IL
1, IL-
-8.
8.
SURFACTANT
SURFACTANT
Lines the inner layer of alveolar epithelium.
Synthesized by SER of type II pneumocytes.
Function –
1. To reduce the surface tension of alveoli mainly during
expiration, thus reduces the work of lung inflation.
2. Waterproofing.
Surfactant synthesis starts after 26 weeks of
fetal life. Therefore premature infants,with
insufficient surfactant suffer from HMD.
All the best
All the best…
…

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lungs pdf.pdf

  • 2. 1. Gross Anatomy of Lungs 2. Surfaces and Borders of Lungs 3. Hilum and Root of Lungs 4. Fissures and Lobes of Lungs 5. Bronchopulmonary segments 6. Histopathology of Alveoli 7. Surfactant 8. Blood supply of lungs 9. Lymphatics of Lungs 10. Nerve supply of Lungs 11. Pleura 12. Mediastinum
  • 3. GROSS ANATOMY OF LUNGS GROSS ANATOMY OF LUNGS Lungs are a pair of respiratory organs situated in a thoracic cavity. Right and left lung are separated by the mediastinum. Texture -- Spongy Color – Young – brown Adults -- mottled black due to deposition of carbon particles Weight- Right lung - 600 gms Left lung - 550 gms
  • 5. SHAPE - Conical Apex (apex pulmonis) Base (basis pulmonis) 3 Borders - anterior (margo anterior) - posterior (margo posterior) - Inferior (margo inferior) 2 Surfaces - costal (facies costalis) - medial (facies mediastinus) - anterior (mediastinal) - posterior (vertebral)
  • 6. APEX APEX Blunt Blunt Lies above the level of Lies above the level of anterior end of 1 anterior end of 1st st Rib. Rib. Reaches 1 Reaches 1- -2 cm above 2 cm above medial 1/3 medial 1/3rd rd of clavicle. of clavicle. Coverings Coverings – – cervical pleura. cervical pleura. suprapleural suprapleural membane membane Grooved b Grooved by- - Subclavian Subclavian artery artery Subclavian Subclavian vein vein
  • 7.
  • 8. BASE BASE Semilunar Semilunar and concave. and concave. Rests on dome of Diaphragm. Rests on dome of Diaphragm. Right sided dome is higher than left. Right sided dome is higher than left.
  • 9. BORDERS BORDERS ANTERIOR BORDER ANTERIOR BORDER – – 1. 1. Corresponds to the anterior Corresponds to the anterior ( (Costomediastinal Costomediastinal) line of pleural reflection. ) line of pleural reflection. 2. 2. It is deeply notched in the left lung posterior It is deeply notched in the left lung posterior to 5 to 5th th costal cartilage by the pericardium costal cartilage by the pericardium and extends vertically downwards to form and extends vertically downwards to form Lingula Lingula. This is called . This is called cardiac cardiac notch notch(percussion in this (percussion in this area gives a dull area gives a dull note as compared to dull note obtained over note as compared to dull note obtained over lung). lung).
  • 10. INFERIOR BORDER INFERIOR BORDER Thin and sharp Thin and sharp It It seperates seperates the base of lung from the the base of lung from the costal surface and extends into costal surface and extends into phrenicocostal phrenicocostal sinus. sinus.
  • 11. POSTERIOR BORDER POSTERIOR BORDER Thick and ill defined Thick and ill defined Fits into deep Fits into deep paravertebral paravertebral gutter. gutter. Extends from C7 to T10. Extends from C7 to T10.
  • 12. SURFACES OF THE LUNG 1. Costal Surface - It is in contact with costal pleura and overlying thoracic wall. 2. Medial Surface - Posterior / Vertebral Part - Anterior / Mediastinal Part
  • 13. Relations of Posterior Part 1. Vertebral Part 2. Intervertebral Discs 3. Posterior Intercostal Vessels 4. Splanchic Nerves
  • 14. RELATIONS OF ANTERIOR PART RELATIONS OF ANTERIOR PART RIGHT SIDE RIGHT SIDE 1. 1. Right atrium Right atrium 2. 2. Small part of RV Small part of RV 3. 3. SVC SVC 4. 4. Right Right brachiocephalic brachiocephalic vein(lower part) vein(lower part) 5. 5. Azygos Azygos vein vein 6. 6. Esophagus Esophagus 7. 7. IVC IVC 8. 8. Trachea Trachea 9. 9. Right Right vagus vagus nerve nerve 10. 10. Right Right phrenic phrenic nerve nerve LEFT SIDE LEFT SIDE 1. 1. Left ventricle Left ventricle 2. 2. Pulmonary trunk Pulmonary trunk 3. 3. Arch of Aorta Arch of Aorta 4. 4. Descending thoracic Descending thoracic aorta aorta 5. 5. Left Left Subclavian Subclavian Artery Artery 6. 6. Thoracic duct Thoracic duct 7. 7. Left Left Brachiocephalic Brachiocephalic Vein Vein 8. 8. Left Left vagus vagus nerve nerve 9. 9. Left Left phrenic phrenic nerve nerve 10. 10. Left recurrent Left recurrent laryngeal nerve laryngeal nerve
  • 15.
  • 16.
  • 17. HILUM HILUM It is a large depressed area that lies It is a large depressed area that lies near the centre of the medial surface. near the centre of the medial surface. Various structures enter and leave the Various structures enter and leave the lung via its root. lung via its root.
  • 18. ROOT OF THE LUNG ROOT OF THE LUNG The root is enclosed in The root is enclosed in a short tubular sheet of a short tubular sheet of pleura that joins the pleura that joins the pulmonary and pulmonary and mediastinal mediastinal parts of parts of pleura . It extends pleura . It extends inferiorly as a narrow inferiorly as a narrow fold fold - - The pulmonary The pulmonary ligament ligament. . It lies opposite of the It lies opposite of the bodies of 5th, 6th and bodies of 5th, 6th and 7th thoracic vertebra 7th thoracic vertebra
  • 19. STRUCTURES OF THE ROOT STRUCTURES OF THE ROOT Principal Bronchus on the Principal Bronchus on the left side. left side. Eparterial Eparterial and and Hyparterial Hyparterial on the right side. on the right side. One pulmonary artery . One pulmonary artery . Two pulmonary veins Two pulmonary veins - - Superior Superior Inferior Inferior Bronchial arteries Bronchial arteries One on right side One on right side Two on left side Two on left side
  • 20. Bronchial veins Bronchial veins Anterior and Anterior and posterior pulmonary posterior pulmonary plexus of nerves. plexus of nerves. Lymphatics Lymphatics Bronchopulmonary Bronchopulmonary Lymphnodes Lymphnodes Areolar tissue. Areolar tissue.
  • 21. ARRANGEMENT OF STRUCTURES IN ARRANGEMENT OF STRUCTURES IN THE ROOT THE ROOT BEFORE BACKWARDS BEFORE BACKWARDS 1. Superior pulmonary vein. 1. Superior pulmonary vein. 2. Pulmonary artery. 2. Pulmonary artery. 3. Bronchus. 3. Bronchus.
  • 22. ARRANGEMENT OF STRUCTURES IN ARRANGEMENT OF STRUCTURES IN THE ROOT THE ROOT ABOVE DOWNWARDS ABOVE DOWNWARDS A. A. Right Side Right Side 1. 1. Eparterial Eparterial Bronchus. Bronchus. 2. Pulmonary Artery. 2. Pulmonary Artery. 3. 3. Hyparterial Hyparterial Bronchus. Bronchus. 4. Inferior Pulmonary 4. Inferior Pulmonary Vein. Vein. . .
  • 23. ARRANGEMENT OF STRUCTURES IN ARRANGEMENT OF STRUCTURES IN THE ROOT THE ROOT ABOVE DOWNWARDS ABOVE DOWNWARDS B. B. Left Side Left Side 1. Pulmonary artery. 1. Pulmonary artery. 2. Bronchus. 2. Bronchus. 3. Inferior pulmonary vein 3. Inferior pulmonary vein
  • 24. FISSURES AND LOBES OF LUNGS FISSURES AND LOBES OF LUNGS
  • 25. OBLIQUE FISSURE OBLIQUE FISSURE It begins It begins posteriorly posteriorly at the level of 5th at the level of 5th thoracic vertebra. thoracic vertebra. Passes Passes antero antero- -inferiorly in a spiral inferiorly in a spiral course to meet the inferior margin close course to meet the inferior margin close to 6th to 6th costochondral costochondral junction. junction.
  • 26. HORIZONTAL FISSURE HORIZONTAL FISSURE It extends from anterior margin at the level of It extends from anterior margin at the level of 4th costal cartilage. 4th costal cartilage. Runs horizontally backwards to meet the Runs horizontally backwards to meet the oblique fissure in the mid oblique fissure in the mid- -axillary axillary line. line. Pulmonary pleura extends into the fissures of Pulmonary pleura extends into the fissures of the lungs so that the lobes can move on each the lungs so that the lobes can move on each other during respiration. other during respiration.
  • 27.
  • 28. BRONCHOPULMONARY BRONCHOPULMONARY SEGMENTS SEGMENTS These are well defined areas of the These are well defined areas of the lungs, each of which is aerated by a lungs, each of which is aerated by a segmental / tertiary bronchus. segmental / tertiary bronchus.
  • 29.
  • 30. Trachea Trachea Right and Left Principal Bronchus Right and Left Principal Bronchus Lobar Bronchi(Secondary)[2L,3R] Lobar Bronchi(Secondary)[2L,3R] Segmental Bronchi(Tertiary)[8L,10R] Segmental Bronchi(Tertiary)[8L,10R] Terminal Bronchioles(25000 in no.) Terminal Bronchioles(25000 in no.) Respiratory Bronchioles Respiratory Bronchioles Alveolar ducts Alveolar ducts ACINUS ACINUS Alveolar sacs Alveolar sacs Alveoli Alveoli
  • 31.
  • 32. The ultimate pulmonary unit from respiratory The ultimate pulmonary unit from respiratory brochiole to alveoli is called brochiole to alveoli is called Acinus Acinus. . There are about 28 orders of division of There are about 28 orders of division of tracheo tracheo- -bronchial tree. bronchial tree. Total no. of alveoli has been estimated to be Total no. of alveoli has been estimated to be between 200 between 200 - - 600 million, with a total surface 600 million, with a total surface area of 40 area of 40 - - 80 meter square. 80 meter square.
  • 33.
  • 34. BRONCHOPULMONARY SEGMENTS BRONCHOPULMONARY SEGMENTS Right main bronchus Right main bronchus 1. 1. Shorter Shorter 2. 2. Wider. Wider. 3. 3. More in line with More in line with trachea. trachea. Left main bronchus Left main bronchus 1. 1. Longer Longer 2. 2. Narrower. Narrower. 3. 3. More oblique than More oblique than the right. the right.
  • 35. BRONCHOPULMONARY SEGMENTS BRONCHOPULMONARY SEGMENTS Right Main Bronchus Right upper lobe Bronchus Right Middle lobe Bronchus Right Lower Lobe Bronchus Segmental Bronchi Apical Anterior Posterior Segmental Bronchi Medial Lateral Segmental Bronchi Apical Anterior Posterior Medial and Lateral
  • 36. BRONCHOPULMONARY SEGMENTS BRONCHOPULMONARY SEGMENTS Left Main Bronchus Left upper lobe Bronchus Upper Branch Lower Branch Anterior Apico-posterior Superior Lingular Inferior Lingular Left lower lobe bronchus Segmental Bronchi Apical Anterior Posterior Lateral
  • 37.
  • 38. These segments are pyramidal in shape with These segments are pyramidal in shape with apex towards the root of lung. apex towards the root of lung. Each segment is an independent respiratory unit. Each segment is an independent respiratory unit. Each segment has its own separate Each segment has its own separate artery(branches of pulmonary artery). artery(branches of pulmonary artery). Pulmonary Veins run in inter Pulmonary Veins run in inter- -segmental planes segmental planes between adjoining segments. between adjoining segments. Thus a bronchopulmonary segment is not a Thus a bronchopulmonary segment is not a bronchovascular segment as it does not have bronchovascular segment as it does not have its own vein its own vein. .
  • 39.
  • 40. CLINICAL SIGNIFICANCE CLINICAL SIGNIFICANCE Segmental resection with minimal Segmental resection with minimal destruction to the surrounding lung destruction to the surrounding lung tissue. tissue. To visualize the interior of a bronchi To visualize the interior of a bronchi through a bronchoscope when diseases through a bronchoscope when diseases process is limited in a segment. process is limited in a segment.
  • 41. HISTOPATHOLOGY OF ALVEOLI HISTOPATHOLOGY OF ALVEOLI ALVEOLAR WALL ALVEOLAR WALL 1. 1. Alveolar epithelial cells Alveolar epithelial cells- - Type I Type I pneumocytes pneumocytes Type II Type II pneumocytes pneumocytes 2. 2. Basement Membrane Basement Membrane 3. 3. Interstitial Space Interstitial Space- - Collagen Collagen Elastin Elastin Unmyelinated Unmyelinated Nerves Nerves Macrophages Macrophages 4. 4. Capillary Basement Capillary Basement Membrane Membrane 5. 5. Capillary Endothelial Cells. Capillary Endothelial Cells. . .
  • 42. Type I Type I Pneumocyte Pneumocyte Pavement epithelial cells of alveoli . Less in no. than type II. More surface area(flattened) Contain pinocytic vesicles. Specialized for diffusion of gases.
  • 43. Type II Type II Pneumocytes Pneumocytes More numerous than type I. Cuboidal in shape. Rich in mitochondria, ER and vacuoles containing osmiophillic lamellar bodies. Type I are precursors of type II.
  • 44. ENDOTHELIAL CELLS ENDOTHELIAL CELLS Most numerous . Presence of pinocytic vacuoles that meet the luminal surface to form caveolae. Walls of caveolae has, ACE. Source of NO, natural pulmonary vasodilator.
  • 45. ALVEOLAR MACROPHAGES ALVEOLAR MACROPHAGES Primary Primary defence defence mechanism. mechanism. Takes part in Takes part in inflammatory and inflammatory and immunological immunological reactions reactions. . Activates Activates lysosomes lysosomes , , proteases,complement proteases,complement , , thromboplastin thromboplastin, , cytokines cytokines - - IF IF- -α α, TNF , TNF- - α α, IL , IL- -1, IL 1, IL- -8. 8.
  • 46. SURFACTANT SURFACTANT Lines the inner layer of alveolar epithelium. Synthesized by SER of type II pneumocytes. Function – 1. To reduce the surface tension of alveoli mainly during expiration, thus reduces the work of lung inflation. 2. Waterproofing. Surfactant synthesis starts after 26 weeks of fetal life. Therefore premature infants,with insufficient surfactant suffer from HMD.
  • 47. All the best All the best… …