Anatomy of bronchial tree, lungs and pleura

1. ANATOMY OF THEANATOMY OF THE
CHEST WALLCHEST WALL
BRONCHIAL TREE,BRONCHIAL TREE,
LUNGS & PLEURALUNGS & PLEURA
BY-
DR.APURVA PATEL

2. ANATOMY OF THE CHESTANATOMY OF THE CHEST
WALLWALL

3.  Thoracic cavity - manubrium,
sternum, ribs and thoracic vertebra
 Sternal notch - 2nd
thoracic vertebra
 In child - arch of aorta lies at upper
border of manubrium
 In adult - arch of aorta lies just
above the center of manubrium

4.  Angle of Louis:
- slight transverse prominence
formed by junction of manubrium
with body of sternum
- used for counting ribs
- 2nd
costal cartilage articulates with
both these bones at this angle
- corresponds to - lower border of
T4, bifurcation of trachea, site where
pleural sacs meet, arch of aorta
begins to ascent & ends its descent
at this level

5.  Intercostal spaces are widest at
medial ends of 2nd
& 3rd
costal
cartilages
 Become narrower b/w lower ones
 Internal Mammary artery:
- supplies - upper 5 spaces on each
side, pectoralis major & breast
- best ligated in 2nd
or 3rd
space

6. ANATOMICAL DEVELOPMENTANATOMICAL DEVELOPMENT
OF LUNGSOF LUNGS
 Derived from an outpouching of the
primitive foregut during 4th
wk.of IUL
 Bud becomes a two-lobed structure,
ends of which ultimately develops
into lungs
 Lobar arrangement is defined early
in fetal life
 Primitive lung  Cardinal veins
(pulmonary veins)  Lt. Atrium

7. ANATOMY OF TRACHEO-ANATOMY OF TRACHEO-
BRONCHIAL TREEBRONCHIAL TREE

8.  Trachea:
- cartilaginous & muscular tube
extending from lower part of larynx
at C6 to T5 vertebra
- bifurcates into 2 bronchi one for
each lung at the level of T5
- almost cylindrical but flattened
posteriorly
- length - 11 cms
- diameter - 2-2.5 cms

9.  Right Bronchus:
- shorter, wider & more vertical
- 2.5 cm long & enters Rt. Lung at T5
- related to Azygous vein & Rt.
Pulmonary artery
 Left Bronchus:
- smaller but longer, 5 cm long
- enters Lt. Lung at T6
- related to arch of aorta, esophagus,
thoracic duct, descending aorta & Lt.
Pulmonary artery

10. HISTOLOGY OF TRACHEO-HISTOLOGY OF TRACHEO-
BRONCHIAL TREEBRONCHIAL TREE

11.  Cartilages: 16-20 in number, form
incomplete ring occupying ant.2/3rd
of
trachea, posterior deficiency made
up by fibrous tissue & muscle fibres
 Fibrous Membrane: cartilages
enclosed within 2 layers of fibrous
membrane, it connects one ring with
another

12.  Muscular tissue: non striated, outer
longitudinal & inner transverse
 Mucous membrane: stratified ciliated
epithelium
 Vessels & Nerves:
- trachea is supplied by inferior
thyroid arteries
- veins drain into thyroid venous
plexus
- nerves are derived from vagus &
recurrent laryngeal nerves

13. ANATOMY OF LUNGSANATOMY OF LUNGS

14.  Lungs  Lobes  Segments
 Left lung is divided into 2 lobes by
the oblique fissure
 Right lung is divided into 3 lobes by
the oblique & the horizontal fissure
 Importance of Segments:
- segmental architecture uniform
- infections & neoplasms localised to
one or more segments
- lung resection done segmentwise

15. SEGMENTAL ANATOMY OFSEGMENTAL ANATOMY OF
LUNGSLUNGS

16.  Each lung - 10 segments
 Each segment has its own bronchus,
artery & vein
 Little anastomosis b/w 2 adjacent
segments
 Individual segments can be excised
without much blood loss or air leak

17.  Arterial supply:
- Rt. Pulmonary Artery
- Lt. Pulmonary Artery
 Venous drainage:
- Superior Pulmonary vein
- Inferior Pulmonary vein
 Lymphatic drainage:
- Rt. Lung - intertracheobronchial
- pretracheobronchial
- Lt. Lung - pretracheobronchial
- subcarinal
- inferior deep cervical
In each
lung

18. ANATOMY OF PLEURAANATOMY OF PLEURA
 Lung enclosed in 2 layers of pleura -
visceral & parietal
 Space b/w them - pleural space
 Turn over of pleural fluid - 1-2 L/Day
 5-10 ml fluid present at any time
 Normally no free gas in pleural space
 There is a negative pressure in
pleural space

19. THANK YOUTHANK YOU