Transcript ANATOMY OF LUNG & PLEURA

CLINICAL
ANATOMY OF
LUNG & PLEURA
Iman Galal, MD
Pulmonary Medicine Department
Ain Shams University
Borders of the lung:
 The apex is about 2-3 cms (1 inch) above the medial 1/3 of the
clavicle, then the anterior border of both lungs run downwards &
medially meeting each other in the middle line behind the angle of
Louis.
 The anterior border of right lung continues running downwards till the
6th costochondral junction.
 The anterior border of left lung continues running downwards till the
4th costal cartilage then curves laterally ½ inch forming the cardiac
notch then descends downwards till the 6th costochondral junction.
Page  2
Borders of the lung:
 The lower border of the lungs represented by a line
starting from 6th rib in the MCL, 8th rib in the MAL & 10th
rib in the scapular line.
Page  3
Right Lung
Page  4
Lung Fissures:
Oblique fissure (Right & Left):
It starts at the 3rd thoracic spine while the arms are elevated,
descends downwards, laterally & anteriorly along the medial border of
the scapula touching the inferior angle of the scapula) cutting the
midaxillary line in the 5th rib & ending at the 6th costal cartilage 3 inches
from the midline.
In cadaver it arise at the 2nd thoracic spine.
The transverse fissure (Right):
It arises at the 4th costal cartilage, runs horizontally to meet the
th rib.
oblique
fissure
in
the
midaxillary
line
in
the
5
Page  5
Fissures & Lobes of the Lungs
Page  6
Fissures & Lobes of the Right Lung
Page  7
Right Upper Lobe
Page  8
Right Middle Lobe
Page  9
Right Lower lobe
Page  10
Left Lung
Page  11
Fissures of the Left Lung
Page  12
Left Upper Lobe
Page  13
Left Lower Lobe
Page  14
Segmental Bronchi
Page  15
Segmental Bronchi
Page  16
Segmental Bronchi (Anterior)
1
2
3
1-2
3
4
4
5
5
8
8
Page  17
Segmental Bronchi (Posterior)
1-2
1
2
3
6
6
3
4
4
9
Page  18
10
10
9
Pleura
Page  19
The borders of the Pleura:
 The pleura runs close to the lung except at the lower
border which extends for 3-5 cm below it both anteriorly
& posteriorly & 9-10 cm below in the axilla.
 The lower border cuts the 8th rib in MCL, 10th rib in
MAL and 12th rib in Scapular line.
Page  20
Page  21
Pleura
Page  22
Parietal Pleura
Costal pleura:
Lines thoracic wall (ribs, intercostal
spaces)
Mediastinal pleura:
Lines corresponding surface of
mediastinum; reflected over root of lung
& becomes continuous with visceral
pleura around hilum
Cervical pleura:
Extends into neck about 2 inches above
1st costal cartilage & one inch above
medial 1/3 clavicle; covers apex of lung
Diaphragmatic pleura:
Lines superior surface of diaphragm
Page  23
Page  24
Page  25
Traube’s area:
4 points:
Left 6th rib in the MCL to 8th costal cartilage in the
parasternal line ,then along the left costal margin to the
11th rib in the MAL, then the 9th rib in the MAL.
Page  26
Kronig’s Isthmus :

It is a band of resonance representing lung apex.

Laterally it is marked by a line joining 2 points:
1.
The junction of the medial 2/3 of the clavicle with the
lateral 1/3.
2.
The junction of the medial 1/3 of the scapular spine with
the lateral 2/3.

Medially marked by a line between the sternal end of
clavicle and the 7th cervical spine.
Page  27
Bare area of the heart :
 Medial border: left lateral border of the sternum
 Lateral border: left parasternal line
 Superior border: lower border of Lt 4th rib.
 Inferior border: upper border of Lt 6th rib
Page  28
Surface anatomy of liver:
Upper border:
It starts from the left 6th rib just inside the MCL, passing to
the Rt and slightly upwards to the 5th rib in the MCL, then
the 7th rib in anterior axillary line, to the 9th rib in midaxillary line.
Page  29
Page  30
Thank You