12.b. LUNGS - RS

LUNGS
MUTALIFE F. MWEEMBA
Objectives
By the end of the lecture,
learners should be able to;
Describe the lung
Discuss the lobes and segments
of the lungs
Outline the blood supply to the
lungs
Clinical anatomy
Lungs
essential organs of respiration.
situated on either side of the heart
Each lung is free in its pleural
cavity, except at the hilum and
pulmonary ligament.
fresh lung is light soft and spongy,
highly elastic and so it recoils on
removal from the thorax.
Its surface is smooth and shiny
Lungs
PLEURA
 Each lung is housed in the pulmonary cavity

 invested by and enclosed in a serous pleural sac
that consists of 2 continuous membranes:
◦ visceral pleura, which invests all surfaces of
the lungs forming their shiny outer surface
◦ parietal pleura, which lines the pulmonary
cavities
 The pleural cavity is the potential space
between the layers of pleura
 contains a thin layer of serous pleural fluid
which,
◦ lubricates the pleural surfaces and
◦ allows smoothly movement during respiration.
Cont…
At birth the lungs are pink, in adults
are dark grey and patchily
mottled.
The adult right lung usually weighs
625g, and the left 565g,
lungs are heavier in men than in
women.
Surface features
 Each lung has a half-cone shape, with;
◦ a base, apex, 2 surfaces, and 3 borders
 The base sits on the diaphragm.
 Theapex projects above 1st rib and into the root of
the neck.
 The 2 surfaces;
◦ costal surface lies adjacent to the ribs and
intercostal spaces
◦ mediastinal surface lies against the
mediastinum and the vertebral column
 contains the comma-shaped hilum of the
lung through which structures enter and leave.
Cont…
The three borders;
◦ inferior border
◦ anterior
◦ posterior borders
the anterior and inferior borders
are sharp,
the posterior border is smooth
and rounded
Cont…
lungs lie directly adjacent to, and are
indented by, structures contained in
the overlying area.
heart and major vessels form
bulges in the mediastinum that
indent the medial surfaces of the
lung
the ribs indent the costal surfaces.
Pathology, such as tumors, or
abnormalities in one structure can
affect the related structure
Root and hilum
root of each lung is a short tubular
collection of structures that together
attach the lung to structures in the
mediastinum.
Hilum is a wedge-shaped area on the
mediastinal surface of each lung
structures enter and leave the lung.
Pulmonary ligament consists of a
double layer of pleura separated by a
small amount of connective tissue.
Cont…
Cont…
Within each root and located in
the hilum are:
◦ a pulmonary artery
◦ two pulmonary veins
◦ a main bronchus
◦ bronchial vessels
◦ nerves
◦ lymphatics.
PULMONARY FISSURES AND LOBES
Right lung
 has 3 lobes and 2 fissures
 divided into superior,
middle and inferior
lobes by;
◦ oblique and a horizontal
fissure
 oblique fissure separates
the inferior from the middle
and upper lobes
 horizontal fissure
separates the superior
lobe (upper lobe) from
the middle lobe.
Cont…
 medial surface of the
right lung lies adjacent
to a number of
important structures in
the mediastinum and
the root of of the neck.
 These include the:
◦ heart,
◦ inferior vena cava,
◦ superior vena cava,
◦ azygos vein, and
◦ esophagus.
Left lung
smaller than the right lung

has 2 lobes separated by an oblique
fissure
From the anterior border of the lower part of
the superior lobe a tongue-like extension
(the lingula) projects over the heart bulge.
Cont….
The medial surface
of the left lung lies
adjacent to a
number of important
structures in the
mediastinum and
root of the neck.
These include the:
◦ heart
◦ aortic arch
◦ thoracic aorta
◦ esophagus.
Bronchopulmonary segments
the smallest, functionally independent

region of a lung
smallest area of lung that can be isolated
and removed without affecting adjacent
regions.
shaped like an irregular cone with the apex
and the base
There are ten (10) bronchopulmonary
segments in each lung some of them fuse in
the left lung
supplied by a segmental bronchus and its
accompanying pulmonary artery branch.
Lateral basal segment (s ix)
Pleural recesses
The lungs do not completely fill the anterior
or posterior inferior regions of the pleural
cavities.
resulting in recesses (gutters) in which two
layers of parietal pleura become opposed.
Expansion of the lungs into these spaces
usually occurs only during forced
inspiration;
the recesses also provide potential spaces
in where fluids can collect and from which
fluids can be aspirated
2 recesses are;
◦ costomediastinal
◦ costodiaphragmatic
Blood supply
Supplied by;
◦ Bronchial arteries
◦ Intercostal
arteries
◦ Pulmonary
arteries
Drained by the;
◦ pulmonary veins
◦ Intercostal veins
◦ Bronchial veins
Nerve Supply
 The parietal pleura is
sensitive to pain,
temperature, touch and
pressure, and is supplied as
follows:
 The costal pleura is
segmentally supplied by the
intercostal nerves
 The mediastinal pleura is
supplied by the phrenic
nerve
Innervation
 Structuresof the lung, and the visceral
pleura, are supplied by
◦ visceral afferents and efferents distributed
through the anterior and posterior
pulmonary plexus .
 plexuseslie anteriorly and posteriorly to the
tracheal bifurcation and main bronchi.
 Theanterior plexus is much smaller than
the posterior plexus.
◦ Visceral efferents from: the vagus nerves
constrict the bronchioles;
◦ the sympathetic system dilates the
bronchioles
Lymphatic drainage
Applied Anatomy
Laryngitis
Emphysema
Pneumothorax
Lung cancer
Atelectasis
Asthma
Bronchitis
Anosma / hyposma
Clinical anatomy
 Bronchoscopy Patients who have a lesion within
a bronchus may undergo bronchoscopic
evaluation of the trachea and its main branches.
 A biopsy may be obtained through this
procedure
Lung cancer
Lung collapse
Cont…
Thoracocentesis
A procedure done either to obtain a sample
of fluid or to remove blood or pus
the needle is inserted superior to the rib,
high enough to avoid the collateral branches
of nerves
Inserting the needle into the 9th intercostal
space in the midaxillary line during
expiration.
The needle should be angled upward, to
avoid penetrating the deep side of the
recess
Pleural tap
Muscles of respiration
 The expansion of the chest during inspiration
occurs as a result of muscular activity, partly
voluntary and partly involuntary.
 The main muscles of respiration in normal quiet
breathing are the intercostal muscles and
the diaphragm.
 During difficult or deep breathing they are
assisted by the muscles of the neck,
shoulders and abdomen.
 Intercostal muscles
 There are 11 pairs of intercostal muscles that
occupy the spaces between the 12 pairs of ribs.
 They are arranged in two layers, the external
and internal intercostal muscles
Cont..
External intercostal muscle fibres.

extend in a downwards and forwards
direction from the lower border of the rib
above to the upper border of the rib below.
internal intercostal muscle fibres.
extend in a downwards and backwards
direction from the lower border of the rib
above to the upper border of the rib below,
crossing the external intercostal muscle
fibres at right angles.
The first rib is fixed.
intercostal muscles contract they pull all the
other ribs towards the first rib.
DIAPHRAGM
is a thin musculotendinous structure
that fills the inferior thoracic aperture
separates the thoracic cavity from the
abdominal cavity.
It is attached peripherally to the:
◦ xiphoid process of the sternum;
◦ costal margin of the thoracic wall;
◦ ends of ribs XI and XII;
◦ ligaments that span across structures of the
posterior abdominal wall; and
◦ vertebrae of the lumbar region.
T12
Cont..
From these peripheral attachments, muscle
fibers converge to join the central tendon.
When the muscle of the diaphragm is
relaxed, the central tendon is at the level
of the 8th thoracic vertebra.
When it contracts, its muscle fibres
shorten and the central tendon is pulled
downwards to the level of the 9th thoracic
vertebra,
◦ enlarging the thoracic cavity in length.
This decreases pressure in the thoracic
cavity and increases it in the abdominal and
pelvic cavities.
T12
Cont…
The diaphragm is supplied by the
phrenic nerves.
The intercostal muscles and the
diaphragm contract
simultaneously ensuring the
◦ enlargement of the thoracic cavity in all
directions, that is from back to front, side
to side and top to bottom
Activity
State the anatomical structures
that make up the RS.
What is the functions of the RS
Differentiate between the
conduction and the respiratory
part of the RS
Apply the knowledge to clinical
areas
Thank you

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LUNGS

 Each lung is housed in the pulmonary cavity

smaller than the right lung

the smallest, functionally independent

External intercostal muscle fibres.

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