1.
THORAX
DR. SRILOY MOHANTY
BNYS, ASSISTANT PROFESSOR
THE SCHOOL OF YOGAAND NATUROPATHIC MEDICINE

2.
Dr. Sriloy Mohanty
BNYS, Assistant Professor
The School of Yoga and Naturopathic Medicine

3.
PARTS AND REGIONS OF THE
THORAX
Boundaries
• Superiorly－jugular notch,
sternoclavicular joint,
superior border of
clavicle, acromion,
spinous processes of C7
• Inferiorly－xiphoid
process, costal arch, 12th
and 11th ribs, vertebra
T12
Regions
• Thoracic wall
• Thoracic cavity

4.
THORACIC WALL
Superficial structures
• Skin
• Superficial fascia
– Superficial a
– Superficial v.
• Thoracoepigastric v.
• Lateral thoracic v.
– Superficial n.
• Supraclavicular n.
• Anterior and lateral
cutaneous branches of
intercostal n.

5.
THORACIC WALL
Deep structures
• Deep fascia
– Superficial layer
– Deep layer—clavipectoral
fascia
• Muscles of thorax
– Subclavius
– Pectoralis major
– Pectoralis minor
– Serratus anterior
– Intercostales externi
– Intercostales interni
– Intercostales intimi
• Endothoracic fascia

6.
STERNUM
• MANUBRIUM
• JUGULAR (STERNAL) NOTCH
• ARTICULATION WITH RIB #1 & 2
• CLAVICULAR ARTICULAR FACETS
• STERNAL ANGLE – 2ND RIB
• BODY (GLADIOLUS)
• ARTICULATES W/RIBS 2-7
• XIPHOSTERNAL JOINT
• XIPHOID PROCESS
• CARTILAGE-CALCIFIES THROUGH TIME
• PARTIAL ATTACHMENT OF MANY MUSCLES

7.
The Ribs
• Usually, 12 pairs
– 7 True ribs-direct attachment to sternum
– 5 False ribs-indirect or no attachment to
sternum
– Floating ribs-make up 2 of 5 False ribs, no
ventral attachment
• Typical Ribs
– Ribs # 2-9
• Atypical Ribs
– Ribs #1, 10, 11, 12

8.
• TYPICAL RIBS
• HEAD
• NECK
• TUBERCLE
• ANGLE
• SHAFT
• SUBCOSTAL GROOVE

9.
TYPICAL RIB
ARTICULATION
• Dorsal (P) Attachment Thoracic Vertebrae
– Head of Rib  2 costal facets
» Superior costal facet
» Inferior costal facet of vertebra above it
» Intervertebral disc
– Tubercle of Rib  Transverse Costal
Facet
– e.g. Rib #4 articulates with Superior
Costal Facet and Transverse Costal
Facet of T4 & Inferior Costal Facet of T3
• Ventral (A) Attachment to Sternum
– Via costal cartilage

10.
• ATYPICAL RIBS
• #1-SHORT, FLAT (S-I), WIDE,
SUPPORTS SUBCLAVIAN VESSELS
• #1, 10-12 ARTICULATE WITH ONLY =
# VERTEBRA
• #11, 12 DON’T ARTICULATE WITH
TRANSVERSE PROCESSES, OR
ANTERIORLY AT ALL

11.
POSTERIOR JOINTS
• Superior costal facet with inferior
articular facet of T vertebrae above
• Inferior costal facet with superior
facet of rib with same number
• Facet on tubercle with transverse
process of T vertebrae of same
number
• Radiate ligaments (head)
• Costotransverse ligaments (tubercle
with transverse process)

12.
MUSCLES ASSOCIATE WITH THE
RIBS
• INTERCOSTALS
• EXTERNAL
• INTERNAL
• INNERMOST
• TRANSVERSUS THORACICIS
• LEVATORES COSTARUM

13.
MUSCLES

14.
MUSCLES

15.
INTERCOSTAL MUSCLES
• EXTERNAL INTERCOSTALS
• O: INFERIOR BORDER OF RIB ABOVE
• I: SUPERIOR BORDER OF RIB BELOW
• FIBERS RUN OBLIQUE (DOWN AND FORWARD)
• AID IN INSPIRATION (LIFT RIBCAGE, INCREASE
DIMENSIONS)

16.
INTERNAL INTERCOSTALS
• O: SUPERIOR BORDER OF RIB BELOW
• I: INFERIOR BORDER OF RIB ABOVE
• FIBERS RUN AT RIGHT ANGLES TO EXTERNAL
INTERCOSTALS
• AID IN FORCED EXPIRATION (DEPRESS RIBCAGE,
DECREASE DIMENSIONS)

17.
INNERMOST INTERCOSTALS
• O: INFERIOR BORDER OF RIB ABOVE
• I: SUPERIOR BORDER OF RIB BELOW
• SMALL, VARIABLE, FUNCTION UNCLEAR

18.
MUSCLES

19.
TRANSVERSUS THORACIS
• ORIGIN - COSTAL CARTILAGES OF LAST 3-4 TRUE RIBS, BODY
OF STERNUM AND XIPHOID PROCESS
• INSERTION - RIBS/COSTAL CARTILAGES 2-6
• ACTION - DEPRESSES RIBS

20.
MUSCLES

21.
NEUROVASCULAR
BUNDLE OF
INTERCOSTAL MUSCLES
• VAN (VEIN, ARTERY, NERVE)
• INTERCOSTAL VEIN
• INTERCOSTAL ARTERY
• INTERCOSTAL NERVE
• SIT IN SUBCOSTAL GROOVE
• BETWEEN INTERNAL INTERCOSTAL
AND INNERMOST INTERCOSTAL
LAYER

22.
MUSCLES OF THORAX
Muscle Origin Insertion Action Innervation
Pectoralis
major
Sternum,
Ribs 2-6
Inter-
tubercular
groove of
humerus
Adduct,
Flex, Med
Rotate
Arm
M & L
pectorals
Pectoralis
minor
Ribs 3-5 Coracoid
process of
scapula
Depress,
Rotate
scapula
M & L
pectorals
Serratus
anterior
(ventralis)
Ribs 1-9 Scapula Protract,
Rotate
scapula
Long
Thoracic

23.
Muscle Origin Insertion Action Innervation
Trapezius Ligamentum
nuchae,
C7-T12
Clavicle,
Spine &
acromion
of scapula
Elevate,
Adduct,
Rotate,
Depress
Accessory
Levator
Scapulae
C1-C4 Medial
border of
scapula
Elevate
scapula
D. Scapular
Rhomboids C7-T5 Medial
border of
scapula
Adduct,
Elevate,
Rotate
D. Scapular
Muscles of Thorax

24.
MUSCLES OF THORAX
Muscle Origin Insertion Action Innervation
Deltoids Clavicle,
Spin &
acromion
of scapula
Deltoid
tuberosity
of
humerus
Flex,
Abduct,
Extend, Lat
& med.
rotate arm
Axillary
Latissimus
dorsi
Iliac crest,
Sacrum,
T7-12,
Lumbar
fascia
Inter-
tubercular
groove of
humerus
Extend,
Adduct,
Med. rotate
arm
Thoraco-
dorsal

25.
INNERVATION/BLOOD SUPPLY

26.
INNERVATION/BLOOD SUPPLY

27.
MUSCLES/NERVES

28.
DIAPHRAGM
• ORIGIN
• INSERTION
• NERVE SUPPLY (PHRENIC C3, C4 BILATERALLY)

29.
DIAPHRAGM

30.
DIAPHRAGM

31.
DIAPHRAGM

32.
DIAPHRAGM

33.
PHRENIC NERVE

34.
COMBINED ACTIONS OF MM OF
RESPIRATION
• INSPIRATION
• DIAPHRAGM
• EXTERNAL INTERCOSTALS
• LEVATORES COSTORUM
• ACCESSORY – SCM, SCALENES
• EXPIRATION
• MOSTLY PASSIVE
• ABDOMINALS
• INTERNAL INTERCOSTALS

35.
M OF RESPIRATION

36.
THE MEDIASTINUM
CONCEPT
• ALL OF ORGANS BETWEEN THE
LEFT AND RIGHT MEDIASTINAL
PLEURAE IS CALLED
MEDIASTINUM.
• IT EXTENDS FROM THE
STERNUM IN FRONT TO THE
VERTEBRAL COLUMN BEHIND,
AND FROM THE THORACIC
INLET ABOVE TO THE
DIAPHRAGM BELOW.

37.
SUBDIVISIONS OF MEDIASTINUM
• SUPERIOR MEDIASTINUM
• INFERIOR MEDIASTINUM
• ANTERIOR MEDIASTINUM
• MIDDLE MEDIASTINUM
• POSTERIOR MEDIASTINUM

38.
LEFT SIDE OF MEDIASTNUM
Root of lung
Pericardium
Phrenic n. &
pericardiacophrenic a.
Left vagus n.
Left recurrent n.
Thoracic aorta
Sympathetic trunk
Greater splanchnic n
Aortic arch
Thoracic duct
Left subclavian a.
Esophagus

39.
RIGHT SIDE OF MEDIASTNUM
Root of lung
Pericardium
Superior vena cava
Phrenic n. &
pericardiacophrenic a.
Right vagus n.
Azygos v.
Sympathetic trunk
Esophagus
Arch of azygos v.
Trachea
Inferior vena cava

40.
SUPERIOR MEDIASTINUM

41.
SUPERIOR MEDIASTINUM
LOCATING-FROM INLET OF
THORAX TO PLANE EXTENDING
FROM LEVEL OF STERNAL ANGLE
ANTERIORLY TO LOWER BORDER OF
T4 VERTEBRA POSTERIOLY
CONTENTS
• SUPERFICIAL LAYER
• THYMUS
• THREE VEINS
• LEFT BRACHIOCEPHELIC V.
• RIGHT BRACHIOCEPHELIC V.
• SUPERIOR VENA CAVA

42.
SUPERIOR MEDIASTINUM
CONTENTS
• MIDDLE LAYER
• AOTIC ARCH AND ITS
THREE BRANCHES
• PHRENIC N.
• VAGUS N.

43.
SUPERIOR MEDIASTINUM
CONTENTS
• POSTERIOR LAYER
• TRACHEA
• ESOPHAGUS
• THORACIC DUCT

44.
RELATIONS OF AORTIC ARCH
• ANTERIORLY AND TO THE LEFT
• PLEURA
• LUNG
• PHRENIC N.
• PERICARDIACOPHRENIC VESSELS
• VAGUS N.
• POSTERIORLY AND TO THE
RIGHT
• TRACHEA
• ESOPHAGUS
• LEFT RECURRENT N.
• THORACIC DUCT
• DEEP CARDIAC PLEXUS

45.
RELATIONS OF AORTIC ARCH
• SUPERIORLY
• ITS THREE BRANCHES
• LEFT BRACHIOCEPHALIC
V.
• THYMUS
• INFERIORLY
• PULMONARY A.
• ARTERIAL LIGAMENT
• LEFT RECURRENT N.
• LEFT PRINCIPAL
BRONCHUS
• SUPERFICIAL CARDIAC
PLEXUS

46.
TRIANGLE OF DUCTUS ARTERIOSUS
• BOUNDARIES
• PHRENIC N.
• LEFT VAGUS N.
• LEFT PULMONARY A.
• CONTENTS
• ARTERIAL LIGAMENT
• LEFT RECURRENT N.
• SUPERFICIAL CARDIAC PLEXUSES

47.
TRIANGLE OF DUCTUS
ARTERIOSUS

48.
INFERIOR MEDIASTINUM

49.
INFERIOR MEDIASTINUM
ANTERIOR MEDIASTINUM
• LOCATION－POSTERIOR TO BODY OF
STERNUM AND ATTACHED COSTAL
CARTILAGES, ANTERIOR TO HEART
AND PERICARDIUM
• CONTENTS
• FAT
• REMNANTS OF THYMUS GLAND
• ANTERIOR MEDIASTINAL LYMPH
NODES

50.
INFERIOR MEDIASTINUM
MIDDLE MEDIASTINUM
• LOCATION－BETWEEN ANTERIOR
MEDIASTINUM AND POSTERIOR
MEDIASTINUM
• CONTENTS
• HEART AND PERICARDIUM
• BEGINNING OR TERMINATION
OF GREAT VESSELS
• PHRENIC NERVES
• PERICARDIACOPHRENIC
VESSELS
• LYMPH NODES

51.
INFERIOR MEDIASTINUM
POSTERIOR MEDIASTINUM
• LOCATION－POSTERIOR TO
HEART AND PERICARDIUM,
ANTERIOR TO VERTEBRAE T5－
T12

52.
INFERIOR MEDIASTINUM
POSTERIOR MEDIASTINUM
• CONTENTS:
• ESOPHAGUS
• VAGUS N.
• THORACIC AORTA
• AZYGOS SYSTEM OF VEINS
• THORACIC DUCT
• THORACIC SYMPATHETIC TRUNK
• POSTERIOR MEDIASTINAL LYMPH
NODES

53.
RELATIONS OF ESOPHAGUS
• ANTERIORLY
• TRACHEA
• BIFURCATION OF TRACHEA
• LEFT PRINCIPAL BRANCHUS
• LEFT RECURRENT N.
• RIGHT PULMONARY A.
• ANTERIOR ESOPHAGEAL
PLEXUS
• PERICARDIUM
• LEFT ATRIUM
• DIAPHRAGM

54.
RELATIONS OF ESOPHAGUS
• POSTERIORLY
• POSTERIOR ESOPHAGEAL
PLEXUS
• THORACIC AORTA
• THORACIC DUCT
• AZYGOS V.
• HEMIAZYGOS V.
• ACCESSORY HEMIAZYGOS V.
• RIGHT POSTERIOR
INTERCOSTAL V.

55.
RELATIONS OF ESOPHAGUS
• LEFT
• LEFT COMMON CAROTID A.
• LEFT SUBCLAVIAN A.
• AORTIC ARCH
• THORACIC AORTA
• SUPERIOR PART OF
THORACIC DUCT
• RIGHT
• ARCH OF AZYGOS V.

56.
RELATIONS OF THORACIC AORTA
• ANTERIORLY
• LEFT ROOT OF LUNG
• PERICARDIUM
• ESOPHAGUS
• POSTERIOR
• HEMIAZYGOS V.
• ACCESSORY HEMIAZYGOS V.
• RIGHT
• AZYGOS V.
• THORACIC DUCT
• LEFT－MEDIASTINAL PLEURA

57.
68
THE HEART

58.
69
HEART ANATOMY
Approximately the size of your fist
Location
Superior surface of diaphragm
Left of the midline
Anterior to the vertebral column,
posterior to the sternum

59.
70
HEART ANATOMY

60.
71
COVERINGS OF THE HEART:
ANATOMY
Pericardium – a double-walled sac around
the heart composed of:
1. A superficial fibrous pericardium
2. A deep two-layer serous pericardium
a. The parietal layer lines the internal
surface of the fibrous pericardium
b. The visceral layer or epicardium
lines the surface of the heart
They are separated by the fluid-filled
pericardial cavity

61.
72
COVERINGS OF THE HEART:
PHYSIOLOGY
The Function of the Pericardium:
Protects and anchors the heart
Prevents overfilling of the heart with
blood
Allows for the heart to work in a
relatively friction-free environment

62.
73
PERICARDIAL LAYERS OF THE
HEART

63.
74
HEART WALL
Epicardium – visceral layer of the
serous pericardium
Myocardium – cardiac muscle layer
forming the bulk of the heart
Fibrous skeleton of the heart –
crisscrossing, interlacing layer of
connective tissue
Endocardium – endothelial layer of the
inner myocardial surface

64.
75
• VESSELS RETURNING BLOOD TO THE HEART
INCLUDE:
1. SUPERIOR AND INFERIOR VENAE CAVAE
2. RIGHT AND LEFT PULMONARY VEINS
• VESSELS CONVEYING BLOOD AWAY FROM THE
HEART INCLUDE:
1. PULMONARY TRUNK, WHICH SPLITS INTO
RIGHT AND LEFT PULMONARY ARTERIES
2. ASCENDING AORTA (THREE BRANCHES) –
a. BRACHIOCEPHALIC
b. LEFT COMMON CAROTID
c. SUBCLAVIAN ARTERIES
EXTERNAL HEART: MAJOR VESSELS
OF THE HEART (ANTERIOR VIEW)

65.
76
EXTERNAL HEART: VESSELS THAT
SUPPLY/DRAIN THE HEART
(ANTERIOR VIEW)
Arteries – right and left coronary (in
atrioventricular groove), marginal, circumflex,
and anterior interventricular arteries
Veins – small cardiac, anterior cardiac, and
great cardiac veins

66.
Chapter 18, Cardiovascular System 77
EXTERNAL HEART: ANTERIOR
VIEW
Figure 18.4b

67.
78
• VESSELS RETURNING BLOOD TO THE HEART INCLUDE:
1. RIGHT AND LEFT PULMONARY VEINS
2. SUPERIOR AND INFERIOR VENAE CAVAE
• VESSELS CONVEYING BLOOD AWAY FROM THE HEART INCLUDE:
1. AORTA
2. RIGHT AND LEFT PULMONARY ARTERIES
EXTERNAL HEART: MAJOR VESSELS OF THE
HEART

68.
Chapter 18, Cardiovascular System 79
EXTERNAL HEART: VESSELS THAT
SUPPLY/DRAIN THE HEART
(POSTERIOR VIEW)
Arteries – right coronary artery (in
atrioventricular groove) and the posterior
interventricular artery (in interventricular
groove)
Veins – great cardiac vein, posterior vein to
left ventricle, coronary sinus, and middle
cardiac vein

69.
Chapter 18, Cardiovascular System 80
EXTERNAL HEART: POSTERIOR
VIEW
Figure 18.4d

70.
Chapter 18, Cardiovascular System 81
GROSS ANATOMY OF HEART:
FRONTAL SECTION
Figure 18.4e

71.
82
ATRIA OF THE HEART
Atria are the receiving chambers of the heart
Each atrium has a protruding auricle
Pectinate muscles mark atrial walls
Blood enters right atria from superior and
inferior venae cavae and coronary sinus
Blood enters left atria from pulmonary veins

72.
Chapter 18, Cardiovascular System 83
VENTRICLES OF THE HEART
• VENTRICLES ARE THE DISCHARGING CHAMBERS OF THE HEART
• PAPILLARY MUSCLES AND TRABECULAE CARNEAE MUSCLES MARK
VENTRICULAR WALLS
• RIGHT VENTRICLE PUMPS BLOOD INTO THE PULMONARY TRUNK
• LEFT VENTRICLE PUMPS BLOOD INTO THE AORTA

73.
Chapter 18, Cardiovascular System 84
MYOCARDIAL THICKNESS AND FUNCTION
THICKNESS OF MYOCARDIUM VARIES ACCORDING TO THE
FUNCTION OF THE CHAMBER
ATRIA ARE THIN WALLED, DELIVER BLOOD TO ADJACENT
VENTRICLES
VENTRICLE WALLS ARE MUCH THICKER AND STRONGER
• RIGHT VENTRICLE SUPPLIES BLOOD TO THE LUNGS
• LEFT VENTRICLE WALL IS THE THICKEST TO SUPPLY
SYSTEMIC CIRCULATION

74.
Chapter 18, Cardiovascular System 85
THICKNESS OF CARDIAC WALLS
Myocardium of left ventricle is much thicker than the right.

75.
Chapter 18, Cardiovascular System 86
PATHWAY OF BLOOD THROUGH
THE HEART AND LUNGS
Figure 18.5

76.
87
CORONARY CIRCULATION
Coronary circulation is the functional
blood supply to the heart muscle itself
Collateral routes ensure blood delivery to
heart even if major vessels are occluded

77.
Chapter 18, Cardiovascular System 88
CORONARY CIRCULATION:
ARTERIAL SUPPLY
Figure 18.7a

78.
Chapter 18, Cardiovascular System 89
CORONARY CIRCULATION:
VENOUS SUPPLY
Figure 18.7b

79.
90
HEART VALVES
• HEART VALVES ENSURE UNIDIRECTIONAL BLOOD FLOW
THROUGH THE HEART
• ATRIOVENTRICULAR (AV) VALVES LIE BETWEEN THE
ATRIA AND THE VENTRICLES
• AV VALVES PREVENT BACKFLOW INTO THE ATRIA WHEN
VENTRICLES CONTRACT
• CHORDAE TENDINEAE ANCHOR AV VALVES TO
PAPILLARY MUSCLES

80.
91
HEART VALVES
Semilunar valves prevent backflow of blood
into the ventricles
Aortic semilunar valve lies between the left
ventricle and the aorta
Pulmonary semilunar valve lies between the
right ventricle and pulmonary trunk

81.
92
HEART VALVES
Figure 18.8a, b

82.
93
HEART VALVES
Figure 18.8c, d

83.
Chapter 18, Cardiovascular System 94
ATRIOVENTRICULAR VALVE
FUNCTION
Figure 18.9

84.
95
SEMILUNAR VALVE FUNCTION
Figure 18.10

85.
96
HEART PHYSIOLOGY: SEQUENCE
OF EXCITATION
Figure 18.14a

86.
97
HEART EXCITATION RELATED TO
ECG
Figure 18.17

87.
98
EXTRINSIC INNERVATION OF THE
HEART
• HEART IS STIMULATED BY
THE SYMPATHETIC
CARDIOACCELERATORY
CENTER
• HEART IS INHIBITED BY
THE PARASYMPATHETIC
CARDIOINHIBITORY
CENTER
Figure 18.15

88.
Chapter 18, Cardiovascular System 99
ELECTROCARDIOGRAPHY
Figure 18.16

89.
100
HEART SOUNDS
Heart sounds (lub-dup) are associated with closing of heart
valves
First sound occurs as AV valves close and signifies beginning
of systole (contraction)
Second sound occurs when SL valves close at the beginning
of ventricular diastole (relaxation)

90.
Chapter 18, Cardiovascular System 101
PHASES OF THE CARDIAC CYCLE
Figure 18.20

91.
LUNGS AND PLEURA

92.
RIGHT AND LEFT PLEURAL
CAVITIES
Parietal Pleura
Visceral (Pulmonary) Pleura
Parietal
Costal
Mediastinal
Diaphragmatic
clavicular
Connecting Pleura

93.
PLEURAL CAVITIES

94.
PLEURAL CAVITIES

95.
LUNGS
Light, soft, spongy
Conical in shape, apex, base, costal surface,
medial surface, hilus. Note various
impressions
Right lung
Three lobes; superior, middle and inferior
Oblique and horizontal fissure
Left Lung
Two lobes; superior and inferior also Lingula and
Cardiac notch, oblique fissure

96.
RIGHT LUNG

97.
RIGHT LUNG

98.
RIGHT LUNG

99.
RIGHT LUNG

100.
LEFT LUNG

101.
LEFT LUNG

102.
LEFT LUNG

103.
SURFACE ANATOMY

104.
SURFACE ANATOMY

105.
AIRWAYS
• TRACHEA, PRIMARY BRONCHI, SECONDARY
BRONCHI, TERTIARY BRONCHI OUT TO 25
GENERATIONS
• ALL COMPRISED OF HYALINE CARTILAGE
• TRACHEA
• BEGINS WHERE LARYNX ENDS (ABOUT C6)
• 10 CM LONG, HALF IN NECK, HALF IN MEDIASTINUM
• 20 U-SHAPED RINGS OF HYALINE CARTILAGE – KEEPS
LUMEN INTACT BUT NOT AS BRITTLE AS BONE
• LINED WITH EPITHELIUM AND CILIA WHICH WORK TO KEEP
FOREIGN BODIES/IRRITANTS AWAY FROM LUNGS

106.
AIRWAYS

107.
AIRWAYS

108.
TRACHEA

109.
AIRWAYS

110.
AIRWAYS
• PRIMARY BROCHI
• ONE TO EACH LUNG – CONTINUATION OF
TRACHEA
• RIGHT BRONCHUS IS WIDER AND SHORTER
AND BRANCHES FROM THE TRACHEA AT A
GREATER ANGLE
• SECONDARY BRONCHI – ONE TO EACH
LOBE, THREE IN RIGHT, TWO IN LEFT
• TERTIARY – ONE TO EACH
BRONCHOPULMONARY SEGMENT –
APPROXIMATELY 10 PER LUNG
• ALL OF THE ABOVE ARE HYALINE

111.
BRONCHOSCOPE

112.
IN AND OUT

113.
BRONCHOPULMONARY SEGMENTS

114.
BRONCHOPULMONARY SEGMENTS

115.
RIGHT LUNG
• RIGHT UPPER LOBE
• APICAL SEGMENT (B1)
• POSTERIOR SEGMENT (B2)
• ANTERIOR SEGMENT (B3)
• RIGHT MIDDLE LOBE (OR
MORE CORRECTLY - JUST
MIDDLE LOBE)
• LATERAL SEGMENT (B4)
• MEDIAL SEGMENT (B5)
• RIGHT LOWER LOBE
• SUPERIOR SEGMENT (B6)
• MEDIAL SEGMENT (B7)
• ANTERIOR SEGMENT (B8)
• LATERAL SEGMENT (B9)
• POSTERIOR
SEGMENT (B10)

116.
LEFT LUNG
• LEFT UPPER LOBE
• APICOPOSTERIOR
SEGMENT (B1/2)
• ANTERIOR SEGMENT (B3)
• SUPERIOR LINGULAR
SEGMENT (B4)
• INFERIOR LINGULAR
SEGMENT (B5)
• LEFT LOWER LOBE
• SUPERIOR SEGMENT (B6)
• ANTEROMEDIAL
SEGMENT (B8)
• LATERAL SEGMENT (B9)
• POSTERIOR
SEGMENT (B10)

117.
BRONCHOPULMONARY SEGMENTS

118.
BRONCHIOLES
First level of airway surrounded by smooth
muscle; therefore can change diameter as in
brocho-constriction and broncho-dilation
Terminal
Respiratory
3-8 orders
alveoli

119.
BRONCHIOLES

120.
BRONCHIOLES
Gas Exchange
Pulmonary arteries carry deoxygenated
blood to aleoli
Gas exchange occurs via diffusion
through the capillary beds
Returned to heart via pulmonary veins

121.
GAS EXCHANGE

122.
INNERVATION
• PLEURA VIA INTERCOSTAL (THORACIC) NERVES
• TRACHEOBRONCHIAL TREE
• PARASYMPATHETIC VIA CN X EFFERENT FUNCTION
= BRONCHO-CONSTRICTION VIA SMOOTH MM.,
ALSO TO EPITHELIAL CELLS IN TRACHEA;
AFFERENT = RESPONSIBLE FOR COUGH REFLEX
• SYMPATHETIC FROM T1-T5 EFFERENT = BROCHO-
DILATION

123.
INTERCOSTAL TO PLEURA

124.
INNERVATION

125.
BLOOD SUPPLY
Lungs do not receive any vascular supply
from the pulmonary vessels (pulmonary aa. or
veins)
Blood delivered to lung tissue via the
bronchiole arteries
Vessels evolve from aortic arch
Travel along the bronchial tree

126.
BLOOD SUPPLY

127.
BLOOD SUPPLY

128.
BRANCHES OF AORTA
Pericardial. Intercostal.
Bronchial. Subcostal.
Esophageal. Superior Phrenic.
Mediastinal.

129.
THANK YOU…