Transcript Trachea, bronchi & bronchopulmonary segment

Dr. Mujahid Khan
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The trachea is a mobile cartilaginous and
membranous tube
It begins in the neck as a continuation of the
larynx at the lower border of the cricoid
cartilage at the level of the sixth cervical
vertebra
It descends in the midline of the neck
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In the thorax the trachea ends below at the
carina by dividing into right and left principal
(main) bronchi
During expiration the bifurcation rises by
about one vertebral level
During deep inspiration may be lowered as far
as the sixth thoracic vertebra
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In adults the trachea is about 4½ in. (11.25 cm)
long and 1 in. (2.5 cm) in diameter
The fibroelastic tube is kept patent by the
presence of U-shaped rings of hyaline cartilage
embedded in its wall
The posterior free ends of the cartilage are
connected by smooth muscle, the trachealis
muscle
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Anteriorly: The sternum, the thymus, the left
brachiocephalic vein, the origins of the
brachiocephalic and left common carotid
arteries, and the arch of the aorta
Posteriorly: The esophagus and the left
recurrent laryngeal nerve
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Right side: The azygos vein, the right vagus
nerve, and the pleura
Left side: The arch of the aorta, the left
common carotid and left subclavian arteries,
the left vagus and left phrenic nerves, and the
pleura
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The upper two thirds are supplied by the
inferior thyroid arteries
The lower third is supplied by the bronchial
arteries
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The lymph drains into the pretracheal and
paratracheal lymph nodes and the deep
cervical nodes
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The sensory nerve supply is from the vagi and
the recurrent laryngeal nerves
Sympathetic nerves supply the trachealis
muscle
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The trachea bifurcates behind the arch of the
aorta into the right and left principal (primary,
or main) bronchi
The bronchi divide into several million
terminal bronchioles that terminate in one or
more respiratory bronchioles
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Each respiratory bronchiole divides into 2 to 11
alveolar ducts that enter the alveolar sacs
The alveoli arise from the walls of the sacs as
diverticula
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Is wider, shorter, and more vertical than the left
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Is about 1 in. (2.5 cm) long
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Before entering the hilum of the right lung, it
gives off the superior lobar bronchus
On entering the hilum, it divides into a middle
and an inferior lobar bronchus
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Is narrower, longer, and more horizontal than
the right and is about 2 in. (5 cm) long
It passes to the left below the arch of the aorta
and in front of the esophagus
On entering the hilum of the left lung, the
principal bronchus divides into a superior and
an inferior lobar bronchus
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Two lungs are soft, spongy and elastic
In the child, they are pink, but with age, they
become dark and mottled because of the
inhalation of dust particles
These particles are trapped in the phagocytes
of the lung
The lungs are situated so that one lies on each
side of the mediastinum
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Two lungs are separated from each other by
the heart and great vessels and other structures
in the mediastinum
Each lung is conical, covered with visceral
pleura and suspended free in its own pleural
cavity
Attached to the mediastinum only by its root
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A blunt apex projects upward into the neck for
about 1 in. (2.5 cm) above the clavicle
A concave base that sits on the diaphragm
A convex costal surface, which corresponds to
the concave chest wall
A concave mediastinal surface, which is
molded to the pericardium and other
mediastinal structures
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Hilum is a depression in which the bronchi, vessels,
and nerves that form the root enter and leave the lung
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The anterior border is thin and overlaps the heart
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It is here on the left lung that the cardiac notch is found
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The posterior border is thick and lies beside the
vertebral column
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The right lung is slightly larger than the left
Divided by the oblique and horizontal fissures
into three lobes: upper, middle, and lower
The oblique fissure runs from the inferior
border upward and backward across the
medial and costal surfaces until it cuts the
posterior border about 2.5 in. (6.25 cm) below
the apex
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The left lung is divided by a similar oblique
fissure into two lobes: upper and lower
There is no horizontal fissure in the left lung
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The bronchopulmonary segments are the
anatomic, functional, and surgical units of the
lungs
Each lobar (secondary) bronchus gives off
branches called segmental (tertiary) bronchi
Each segmental bronchus passes to a
structurally and functionally independent unit
of a lung lobe called a bronchopulmonary
segment, surrounded by connective tissue
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The segmental bronchus is accompanied by a
branch of the pulmonary artery
Each segment has its own lymphatic vessels
and autonomic nerve supply
On entering a bronchopulmonary segment,
each segmental bronchus divides repeatedly
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As the bronchi become smaller, the U-shaped
bars of cartilage found in the trachea are
gradually replaced by irregular plates of
cartilage
The smallest bronchi divide and give rise to
bronchioles, which are less than 1 mm in
diameter
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Bronchioles possess no cartilage in their walls
and are lined with columnar ciliated
epithelium
The submucosa possesses a complete layer of
circularly arranged smooth muscle fibers
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The bronchioles then divide and give rise to
terminal bronchioles which show delicate
outpouchings from their walls
Gaseous exchange between blood and air takes
place in the walls of these outpouchings, which
explains the name respiratory bronchiole
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The diameter of a respiratory bronchiole is
about 0.5 mm
The respiratory bronchioles end by branching
into alveolar ducts, which lead into tubular
passages with numerous thin-walled
outpouchings called alveolar sacs
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The alveolar sacs consist of several alveoli
opening into a single chamber
Each alveolus is surrounded by a rich network
of blood capillaries
Gaseous exchange takes place between the air
in the alveolar lumen through the alveolar wall
into the blood within the surrounding
capillaries
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It is a subdivision of a lung lobe
It is pyramid shaped, with its apex toward the
lung root
It is surrounded by connective tissue
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It has a segmental bronchus, a segmental
artery, lymph vessels, and autonomic nerves
The segmental vein lies in the connective tissue
between adjacent bronchopulmonary segments
Because it is a structural unit, a diseased
segment can be removed surgically
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Superior lobe: Apical, posterior, anterior
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Middle lobe: Lateral, medial
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Inferior lobe: Superior (apical), medial basal,
anterior basal, lateral basal, posterior basal
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Superior lobe: Apical, posterior, anterior,
superior lingular, inferior lingular
Inferior lobe: Superior (apical), medial basal,
anterior basal, lateral basal, posterior basal
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The bronchi and the connective tissue of the
lung receive their blood supply from the
bronchial arteries, which are branches of the
descending aorta
The bronchial veins communicate with the
pulmonary veins and drain into the azygos and
hemiazygos veins
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The alveoli receive deoxygenated blood from
the terminal branches of the pulmonary arteries
The oxygenated blood leaving the alveolar
capillaries drains into the tributaries of the
pulmonary veins
Two pulmonary veins leave each lung root to
empty into the left atrium of the heart
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The lymph vessels originate in superficial and
deep plexuses
They are not present in the alveolar walls
The superficial (subpleural) plexus lies beneath
the visceral pleura and drains over the surface
of the lung toward the hilum, where the lymph
vessels enter the bronchopulmonary nodes
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The deep plexus travels to the hilum of the
lung and enters the bronchopulmonary nodes
All the lymph from the lung leaves the hilum
and drains into the tracheobronchial nodes and
then into the bronchomediastinal lymph trunks
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At the root of each lung is a pulmonary plexus composed of
efferent and afferent autonomic nerve fibers
The plexus is formed from branches of the sympathetic trunk and
receives parasympathetic fibers from the vagus nerve
The sympathetic efferent fibers produce bronchodilatation and
vasoconstriction
The parasympathetic efferent fibers produce bronchoconstriction,
vasodilatation, and increased glandular secretion