Transcript Surface anatomy of the lungs - University of Nottingham

SURFACE ANATOMY OF
THE LUNGS
Katerina Kyprianou
Surface anatomy of the anterior
thoracic wall





Clavicle
Jugular notch
Sternal angle
Xiphoid process
Ribs
Anterior lung surface markings





REMEMBER: 2,4,6,8,10 Lungs
Each lung extends 3cm above the
clavicle (apex)
Anterior borders of lungs are closest
at the sternal angle – 2nd costal
cartilage (cc)
Both reach to 4thcc
Left:


Right:



Moves away from the midline at the
4th cc
Moves away from the midline at the
6th cc
Both cross the midclavicular line at
the 8th cc
Both cross the midaxillary line at the
10th cc
Note about pleura: They have the same
surface markings as the lungs but reach
further down to the 12th cc
REMEMBER: 2,4,6,8,10,12 Pleura
Lungs & pleura


Each lung is enclosed in a pleural
sac consisting of 2 continuous
membranes:
Visceral pleura:



covers the lungs & is adherent to
all of its surfaces, including the
surfaces of horizontal and
oblique fissures
Can NOT be dissected from the
lungs
Parietal pleura:



Lines the pulmonary cavities
Adheres to the thoracic wall,
mediastinum & diaphragm
CAN be dissected from the lungs
Parietal pleura

The parietal pleura consists of 4
parts:

Costal part:


Mediastinal part:


Covers the central compartment of the
thoracic cavity (lateral aspects of
mediastinum)
Diaphragmatic part:


Covers the internal surfaces of the
thoracic wall
Covers the superior/thoracic surface
of the diaphragm
Cervical pleura:

Extends into the root of the neck
Lines of pleural reflections

Pleural reflections:
sharp lines where
pleura changes
direction from one
wall of the pleural
cavity to the other
Lines of pleural reflections

Sternal line


Costal line


Occurs where costal pleura
becomes continuous with
mediastinal pleura ANTERIORLY
Occurs where the costal pleura
becomes continuous with the
diaphragmatic pleura
INFERIORLY
Vertebral line

Occurs where the costal pleura
becomes continuous with the
mediastinal pleura
POSTERIORLY
Clinical relevance – Normal chest X-ray
Clinical relevance – Tension
Pneumothorax





Pneumothorax: entry of air
into the pleural cavity
Tension pneumothorax: life
threatening condition resulting
from worsening of simple
pneumothorax
Air becomes trapped between
the pleural cavity and lung &
keeps it from fully inflating
Treatment: insertion of
needle/cannula to release
pressure from the lung
In this Xray: Mediastinal shift
to the Right