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Thorax

  1. 1. THORAX DR. SRILOY MOHANTY BNYS, ASSISTANT PROFESSOR THE SCHOOL OF YOGAAND NATUROPATHIC MEDICINE
  2. 2. Dr. Sriloy Mohanty BNYS, Assistant Professor The School of Yoga and Naturopathic Medicine
  3. 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. 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. 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. 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. 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. 8. • TYPICAL RIBS • HEAD • NECK • TUBERCLE • ANGLE • SHAFT • SUBCOSTAL GROOVE
  9. 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. 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. 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. 12. MUSCLES ASSOCIATE WITH THE RIBS • INTERCOSTALS • EXTERNAL • INTERNAL • INNERMOST • TRANSVERSUS THORACICIS • LEVATORES COSTARUM
  13. 13. MUSCLES
  14. 14. MUSCLES
  15. 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. 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. 17. INNERMOST INTERCOSTALS • O: INFERIOR BORDER OF RIB ABOVE • I: SUPERIOR BORDER OF RIB BELOW • SMALL, VARIABLE, FUNCTION UNCLEAR
  18. 18. MUSCLES
  19. 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. 20. MUSCLES
  21. 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. 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. 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. 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. 25. INNERVATION/BLOOD SUPPLY
  26. 26. INNERVATION/BLOOD SUPPLY
  27. 27. MUSCLES/NERVES
  28. 28. DIAPHRAGM • ORIGIN • INSERTION • NERVE SUPPLY (PHRENIC C3, C4 BILATERALLY)
  29. 29. DIAPHRAGM
  30. 30. DIAPHRAGM
  31. 31. DIAPHRAGM
  32. 32. DIAPHRAGM
  33. 33. PHRENIC NERVE
  34. 34. COMBINED ACTIONS OF MM OF RESPIRATION • INSPIRATION • DIAPHRAGM • EXTERNAL INTERCOSTALS • LEVATORES COSTORUM • ACCESSORY – SCM, SCALENES • EXPIRATION • MOSTLY PASSIVE • ABDOMINALS • INTERNAL INTERCOSTALS
  35. 35. M OF RESPIRATION
  36. 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. 37. SUBDIVISIONS OF MEDIASTINUM • SUPERIOR MEDIASTINUM • INFERIOR MEDIASTINUM • ANTERIOR MEDIASTINUM • MIDDLE MEDIASTINUM • POSTERIOR MEDIASTINUM
  38. 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. 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. 40. SUPERIOR MEDIASTINUM
  41. 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. 42. SUPERIOR MEDIASTINUM CONTENTS • MIDDLE LAYER • AOTIC ARCH AND ITS THREE BRANCHES • PHRENIC N. • VAGUS N.
  43. 43. SUPERIOR MEDIASTINUM CONTENTS • POSTERIOR LAYER • TRACHEA • ESOPHAGUS • THORACIC DUCT
  44. 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. 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. 46. TRIANGLE OF DUCTUS ARTERIOSUS • BOUNDARIES • PHRENIC N. • LEFT VAGUS N. • LEFT PULMONARY A. • CONTENTS • ARTERIAL LIGAMENT • LEFT RECURRENT N. • SUPERFICIAL CARDIAC PLEXUSES
  47. 47. TRIANGLE OF DUCTUS ARTERIOSUS
  48. 48. INFERIOR MEDIASTINUM
  49. 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. 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. 51. INFERIOR MEDIASTINUM POSTERIOR MEDIASTINUM • LOCATION-POSTERIOR TO HEART AND PERICARDIUM, ANTERIOR TO VERTEBRAE T5- T12
  52. 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. 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. 54. RELATIONS OF ESOPHAGUS • POSTERIORLY • POSTERIOR ESOPHAGEAL PLEXUS • THORACIC AORTA • THORACIC DUCT • AZYGOS V. • HEMIAZYGOS V. • ACCESSORY HEMIAZYGOS V. • RIGHT POSTERIOR INTERCOSTAL V.
  55. 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. 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. 57. 68 THE HEART
  58. 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. 59. 70 HEART ANATOMY
  60. 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. 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. 62. 73 PERICARDIAL LAYERS OF THE HEART
  63. 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. 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. 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. 66. Chapter 18, Cardiovascular System 77 EXTERNAL HEART: ANTERIOR VIEW Figure 18.4b
  67. 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. 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. 69. Chapter 18, Cardiovascular System 80 EXTERNAL HEART: POSTERIOR VIEW Figure 18.4d
  70. 70. Chapter 18, Cardiovascular System 81 GROSS ANATOMY OF HEART: FRONTAL SECTION Figure 18.4e
  71. 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. 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. 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. 74. Chapter 18, Cardiovascular System 85 THICKNESS OF CARDIAC WALLS Myocardium of left ventricle is much thicker than the right.
  75. 75. Chapter 18, Cardiovascular System 86 PATHWAY OF BLOOD THROUGH THE HEART AND LUNGS Figure 18.5
  76. 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. 77. Chapter 18, Cardiovascular System 88 CORONARY CIRCULATION: ARTERIAL SUPPLY Figure 18.7a
  78. 78. Chapter 18, Cardiovascular System 89 CORONARY CIRCULATION: VENOUS SUPPLY Figure 18.7b
  79. 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. 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. 81. 92 HEART VALVES Figure 18.8a, b
  82. 82. 93 HEART VALVES Figure 18.8c, d
  83. 83. Chapter 18, Cardiovascular System 94 ATRIOVENTRICULAR VALVE FUNCTION Figure 18.9
  84. 84. 95 SEMILUNAR VALVE FUNCTION Figure 18.10
  85. 85. 96 HEART PHYSIOLOGY: SEQUENCE OF EXCITATION Figure 18.14a
  86. 86. 97 HEART EXCITATION RELATED TO ECG Figure 18.17
  87. 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. 88. Chapter 18, Cardiovascular System 99 ELECTROCARDIOGRAPHY Figure 18.16
  89. 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. 90. Chapter 18, Cardiovascular System 101 PHASES OF THE CARDIAC CYCLE Figure 18.20
  91. 91. LUNGS AND PLEURA
  92. 92. RIGHT AND LEFT PLEURAL CAVITIES Parietal Pleura Visceral (Pulmonary) Pleura Parietal Costal Mediastinal Diaphragmatic clavicular Connecting Pleura
  93. 93. PLEURAL CAVITIES
  94. 94. PLEURAL CAVITIES
  95. 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. 96. RIGHT LUNG
  97. 97. RIGHT LUNG
  98. 98. RIGHT LUNG
  99. 99. RIGHT LUNG
  100. 100. LEFT LUNG
  101. 101. LEFT LUNG
  102. 102. LEFT LUNG
  103. 103. SURFACE ANATOMY
  104. 104. SURFACE ANATOMY
  105. 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. 106. AIRWAYS
  107. 107. AIRWAYS
  108. 108. TRACHEA
  109. 109. AIRWAYS
  110. 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. 111. BRONCHOSCOPE
  112. 112. IN AND OUT
  113. 113. BRONCHOPULMONARY SEGMENTS
  114. 114. BRONCHOPULMONARY SEGMENTS
  115. 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. 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. 117. BRONCHOPULMONARY SEGMENTS
  118. 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. 119. BRONCHIOLES
  120. 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. 121. GAS EXCHANGE
  122. 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. 123. INTERCOSTAL TO PLEURA
  124. 124. INNERVATION
  125. 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. 126. BLOOD SUPPLY
  127. 127. BLOOD SUPPLY
  128. 128. BRANCHES OF AORTA Pericardial. Intercostal. Bronchial. Subcostal. Esophageal. Superior Phrenic. Mediastinal.
  129. 129. THANK YOU…

Editor's Notes

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