Transcript 20-trachea& Bronchopulmonary Seg

Dr. Vohra
Trachea
A fibroelastic mobile tube
about 5 in long & 1 in
diameter with U-shaped
hyaline cartilage that keep
the lumen patent. The
posterior end of the
cartilage is connected by
smooth muscle
TRACHEALIS. Begins in
the neck below the cricoid
cartilage at the level of C6
and terminates in thorax at
the level of the sternal
angle (T4), where it divides
into right & left principal
(main) bronchi. The
bifurcation is called as
CARINA.
Relations in the superior
mediastinum
Anterior: Sternum, thymus, the
left brachiocephalic vein, origin
of brachiocephalic artery &
common carotid arteries & arch
of aorta
Posterior: Esophagus & left recurrent laryngeal nerve
Right side: Azygos vein, the right vagus nerve & pleura
Left side: Arch of aorta, the left CCA, subclavian artery, left
vagus & left phrenic nerves & pleura
Nerve Supply Vagus, recurrent laryngeal & sympathetic
Principal Bronchi
Right (1cm)
The right principal bronchus wider shorter & more vertical
than left. Before entering the hilum of the right lung it give of
superior lobar bronchus. On entering the hilum, it
divides into a middle & an inferior lobar bronchus.
Left (2cm)
The left principal bronchus is narrower, longer & more
horizontal than right. Passes to the left below the arch of
aorta & in front of esophagus. On entering the hilum left
bronchus divides into a superior & an inferior lobar
bronchus.
A bronchopulmonary
segments:
Are the anatomical, functional &
surgical units of the lungs. Each lobar
(secondary) bronchus give off
branches called segmental (tertiary)
bronchi. Each segmental bronchus
passes to a structurally & functionally
independent unit of a lung lobe called
bronchopulmonary segment
A bronchopulmonary
segment
Is pyramid shaped, with the
apex at the lung root;
Is the largest subdivision of a
lobe;
Is surrounded by connective
tissue;
Has separate segmental artery,
segmental (tertiary) bronchus,
lymph vessels & autonomic
nerves;
Segmental veins lie in the
connective tissue b/w adjacent
bronchopulmonary segment;
Diseased segment can be
removed surgically without
affecting the function of other
segments
The main bronchopulmonary segment are:
Right Lung
Superior Lobe: a three-piece
lobe - a posterior and an
anterior segment next to one
another with an apical
segment on top
Middle Lobe: a flat, twopiece lobe that sits on the
anterior aspect of the lung
a medial and a lateral
segment next to one
another
Right Lung
Left Lung
Clinical Notes
PLEURAL EFFUSION The pleural normally contains 5- 10ml of clear fluid.
The formation results from hydrostatic & osmotic pressures. The pleural
fluid is normally absorbed by the capillaries of visceral pleura. Any condition
that increases the production of fluid result in abnormal accumulation of
fluid called as.
PLEURISY or PLEURITIS is the inflammation of pleura
PNEUMONIA inflammation of lungs
PLEURAL RUB pleural surfaces become rough & produce friction & a can
be heard with stethoscope
PLEURAL ADHESIONS visceral & parietal pleura adhere to each other
PNEUMOTHORAX air in the pleural cavity (from lungs or chest wall)
HYDROPNEUMOTHORAX air in pleural cavity associated with serous fluid
PYOPNEUMOTHORAX air in pleural cavity associated pus
HEMOPNEUMOTHORAX air in pleural cavity associated with blood
EMPYEMA collection of pus in pleural cavity without air
Clinical Notes
COMPRESSION OF THE TRACHEA bilateral enlargement of thyroid gland
AORTIC ARCH ANERYSM dilation of aortic arch
TRACHEITIS OR BRONCHITIS give rise to a raw burning sensation felt
deep to the sternum instead of actual pain
INHALED FOREIGN BODIES common in children, tend to enter right
bronchus instead of left because the right bronchus is wider & more direct
continuation of the trachea
HBRONCHOSCOPY examination of interior of trachea through
bronchoscope
TRACHEOSTOMY cutting the trachea