1 / 83

 Pleura & Lungs 

 Pleura & Lungs . Dr. Sarwar Hossain Khan. The Pleura. Is a sac on either sides of the mediastinum. Are occupied by the lungs by invagination. Is a serous membrane, lined by the mesothelium. Has 2 layers—parietal & visceral layers.

rhoda-potter
Download Presentation

 Pleura & Lungs 

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1.  Pleura & Lungs  Dr. Sarwar Hossain Khan

  2. The Pleura Is a sac on either sides of the mediastinum. Are occupied by the lungs by invagination. Is a serous membrane, lined by the mesothelium. Has 2 layers—parietal & visceral layers. Is continuous with each other at the hilum of the lung. The 2 layers enclose between them the pleural cavity. This cavity is a site for—pneumothorax, pleural effusion,empyema & haemothorax.

  3. Cont. • Pulmonary pleura—covers the surface of lung ,is free at the hilum & along the pulmonary ligament. • Cont. with the parietal pleura. • Parietal pleura—divided into costal,diaphragmatic,mediastinal & cervical. • Cervical—covers the apex of the lung & lies about 1 inch above the medial 1/3rd of the clavical. • Is covered by the sibson’s fascia.

  4. PULMONARY LIGAMENT • Is a fold of the parietal pleura. • Around the hilum. • Acts as a dead space for the expansion of the veins. • Contains lymphatics & areolar tissues. • RECESSES: are folds of the parietal pleura making room for expansion of the lungs during breathing. • Costomediastinal & costodiaphragmatic.

  5. CLINICAL IMPORTANCE • These get filled by pleural effusion when diseased. • SURFACE MARKING: • Cervical pleura • Anterior margin • Inferior margin • Posterior margin

  6. Nerve supply • Parietal—intercostal & phrenic nerves • Is pain sensitive. • Pulmonary pleura—autonomic nerves—sympathetic nerves. • Not pain sensitive.

  7. BLOD & LYMPHATIC SUPPLY • Parietal—intercostal,internal thoracic and musculophrenic arteries. • Veins drain into azygos and internal thoracic veins. • Lymphatics—intercostal, internal mammary & diaphragmatic nodes. • Pulmonary pleura—bronchial arteries & bronchopulmonary nodes.

  8. APPLIED • Thoracocentesis • Pleurisy • Effusion • Pneumothorax • Haemothorax • Hydropneumothorax • empyema

  9. THE LUNGS

  10. LUNGS • Organs of respiration • Mediastinum separates the 2 lungs • Spongy, grey, dark later on. • 600-700gm. R>L • Has apex, base, 3 borders, 2 surfaces. • Apex—above the level of the anterior end of the 1st rib—1 inch above the medial 1/3rd end of the clavicle. • Covered by sibson,s fascia.

  11. Base—lies on the diaphragm. • Anterior border is thin—vertical on the R. • Ant. Border of L lung is notched—cardiac notch. • Here the heart is not covered by the lung & the pericardium. • Post.border is thick & corresponds to the heads of the ribs. • Extend from 7th C vert. to the 10th T vert.

  12. Inferior border—separates the base from the costal & medial surfaces. • Costal surface. • Medial surface—post. & anterior parts. • Has numerous impressions.

  13. Fissures & lobes. • R Lung—3 lobes—2 fissures; oblique & horizontal. • L Lung—2 lobes; 1 fissure. • Oblique fissure—cuts the whole thickness of the lung, except at the hilum. • Crosses post. Border, 2-3 inches below the apex. • Crosses inf. Border 2 in. from the medial plane.

  14. Cont. • Horizontal fissure of R lobe divides the middle lobe from the upper lobe. • L lobe has a lingula below the cardiac notch. • No. of lobes may vary.

  15. Structures related to the medial surfaces of the 2 lungs.

  16. ROOTS OF THE LUNG • A pedicle connecting the medial surface of the lung with the mediastinum. • Short & broad. • Various structures exit & enter here from & to the lungs. • Lies opposite 5th-7th T vertebra.

  17. CONTENTS

  18. contents • L—1-brochus, R-2-bronchi • 1 PA each. • 2 PV each. • Bronchial art.—2 on L, 1 on R • BV • Pulmonary plexuses—ant,post. • Lymphatics, LN, etc.

  19. relations

  20. Brochial tree

  21. 2 bronchi branch out from the trachea. • At the lower end of the 4th T vertebra. • R bronbus is short, wide,straight. • Infections are common.

  22. Enters lungs through the hilum. • Divides into lobar bronchi—3 on R, 2 on L.

  23. These further divide into—tertiary or segmental bronchi –10 on the R, 8 on the L(10) • These further divide into terminal bronchioles & these into respiratory bronchioles which aerates the pulmonary unit formed by—alveolar ducts,atria, air saccules, & pulmonary alveoli.

  24. Arteries,veins, lymphatics & nerve supply. • Artery—bronchial art.—R side, one art.-either from 3rd post. Intercostal or upper L bronchial art. • L side-2 in no. from desc. Aorta. • Pulmonary art. –deoxygenated blood. • PV carry oxygenated blood to the heart.

  25. veins • 2 bronchial veins on each side • R bronchial veins drain to azygos vein, • L veins-- into hemiazygos or the superior intercostal veins. • Drain blood from the 1st 1-2 divisions of the bronchi. • Rest of the blood is drained by the pulmonary veins.

  26. lymphatics • Bronchopulmonary nodes.—from superficial & deep vessels • Some connection bet. the 2 groups exists. • NERVES • Parasympathetic—vagus—motor,sensory & secretomotor. • Sympathetics—T2-T5—bronchodilation. • Form plexuses around the hilum.

  27. Bronchopulmonary segments • Sector of a lung that is aerated by a tertiary bronchus. • Pyramidal in shape with apex towards root. • There are 10 on the R, & 8 on the L. • Intersegmental planes—bet. The segments.

More Related