Lecture 3- Anatomy of the Pleura and Lung

Lecture about lung and pleura

1. By Prof.
Saeed Abuel Makarem

2. Pleura
يوئرلا ءاشغلا
•Double-layered serous
membrane enclosing the
lung.
•Has two layers:
–Parietal layer, which
lines the thoracic walls.
–Visceral layer, which
covers the surfaces of
the lung.
•The two layers continue with
each other around the root
of the lung هروصلا رظنا,
where it forms a loose cuff
hanging down called the
pulmonary ligament.
•The space between the two
layers, the pleural cavity,
contains a thin film ادج قيقد
of pleural fluid ( 5-10 ml.).
Root of the lung:
هيعولااو نييارشلا لوخد هقطنم
هقطنملا هذه يفو هئرلل تابصقلاو
يوئرلا ءاشغلا يتقبط محتلا متي
هدحاو هقبطب
Pulmonary
ligament

3. Parietal Pleura
•Divided according to the region in which it lies
and the surfaces it covers, into:
1-Cervical يقنع
2-Costal
3-Mediastinal
4-Diaphragmatic
همداقلا حئارشلاب لاصفم حرشت

4. Parietal Pleura
•Cervical Pleura:
•Projects up زربتinto the neck
about 1-1.5 inches above the
medial1/3
rd
of clavicle.
•It lines the under surface of
the suprapleuralmembrane
يوئرلا ءاشغلا قوف ءاشغ.
•Costal pleura:
•lines, the back of the:
•1-sternum,
•2-Ribs & costal cartilages,
•3-Intercostal spaces &
•4-Sides of vertebral bodies

5. Parietal Pleura
•Mediastinal pleura:
covers the mediastinum
هروصلا رظنا.
•At the hilum لوخد هقطنم
هيعولاا ( اهحرش قبس) , it is
reflected on to the
vessels and bronchi, to
become continuous
with the visceral pleura
•Diaphragmatic pleura:
covers the thoracic
(upper) surface of the
diaphragm

6. Pleural Recesses
: تافيوجت
•1-Costodiaphragmatic:
•Slit قيمع قيقد فيوجتlike
space between costal
and diaphragmatic
pleurae. The inferior
border اقحلا يتايof the
lung descends لزنيinto it
during deep inspiration
•2-Costomediastinal:
•Slit like space between
costal and mediastinal
pleurae, is filled by the
anterior border of the
lung during deep
inspiration

7. Costophrenic
هلاح هروصلا
هيازلا نلا هيضرم
ءاوه اهلصي لا

8. Pleura: Nerve Supply
•Parietal pleura:
•is sensitive to pain, temperature,
touch & pressure and is supplied
as follows:
Costal pleura segmentally
supplied by the intercostal
nerves.
Mediastinal pleura supplied by
phrenic nerves.
Diaphragmatic pleura supplied
over the domes by phrenic
nerves, around the periphery by
lower six intercostal nerves.
•Visceral pleura sensitive to
stretchonly and is supplied by the
autonomic fibers from the
pulmonary plexus

9. Lungs

10. Lungs
•Located in the thoracic
cavity, one on each
side of the
mediastinum
•Each lung is:
Conical in shape.
Covered by the
visceral pleura.
Suspended هقلعم
free in its own
pleural cavity.
Attached to the
mediastinum only
by its root.

11. Borders
دودح اهانعم
ينعي هئرلا
اهفارطا
•Each lung has:
1-A thin anterior
يماماborder that
overlaps the heart.
The left lung shows
cardiac notch along
this border.
2-A thick posterior
يفلخborder that lies
beside the vertebral
column.
3-A thin inferior يلفس
border, that is
related to diaphragm
cardiac notch

12. Surfaces ينعي هئرلا حوطس
دودحلا ريغ هيقابلا ءازجلاا
Each lung has:
•An apex همق, which
projects upward into
the neck for about 1
inch دمتي فلاغلا ركذت
فصنو شنلاabove the
clavicle.
•A concave base,
which rests on the
diaphragm.
•A convex costal
surface, which
corresponds to the
concave chest wall.

13. •A mediastinal surface,
which is molded عبطت
اهيلع ( يللاو هروصلا لثم
يلمعلاب انورو) to the
mediastinal structures.
•At bout ضرم-هبون the
middle of this surface is
a depression طغضنت, the
hilum, where the
structures enter the
lung:
•(bronchi, bronchial &
pulmonary arteries) or
leave (bronchial &
pulmonary veins,
nerves & lymphatics)

14. Mediastinal
surface
ءازجلاا
هئرلل هرواجملا
يتلاو ىنميلا
مك اهيلع عبطت ا
تاعبرملا يف
همقرملاof
the right
lung
1
2
3
Right
atrum
4
ظفحت همهم
صوصف ثلاث اهب ىنميلا هئرلا
همقرملا رئاودلا يف امك
1
2
3

15. Mediastinal
surface of
the left lung
1
2
Left
ventricle
ناسللا : دجوي
طقف ىرسيلا هئرلاب
بلقلا دوجو ببسب
شتون كيدراك : دجوي
طقف ىرسيلا هئرلاب
بلقلا دوجو ببسب
3
اهل ىرسيلا هئرلا
طقف نيصف
2
1

16. Fissures لصافلا طخلا&
Lobes صوصفلا
•Right Lung:
•Divided by two
fissures, the oblique &
horizontal, into:
•1-Superior,
•2-Middle and
•3-Inferior
•Left lung:
•Divided by only one
oblique fissure into:
•1-Superior and
•2-Inferior

17. Fissures
•Oblique fissure:
•Runs from the
inferior border
upward and
backward across the
medial and costal
surfaces until cuts
the posterior border
about 2½ inches
below the apex
•Horizontal fissure:
runs horizontally
across the costal
surface at the level of
right 4th costal
cartilage to meet the
oblique fissure in the
midaxillary طخلا
يطبلاا لصافلاline

18. Blood Supply هئرلل
•Arterial supply:
•By bronchial arteries,
branches of the
descending thoracic
aorta.
•Venous Drainage
هدرولاا:
•By bronchial veins,
which drain into
azygos & hemiazygos
veins.

19. Nerve Supply
•Through pulmonary
plexuses located at
the root of each lung,
and composed of:
–Sympathetic
fibers from the
sympathetic trunk
–Parasympathetic
fibers from the
vagus nerve

20. Root of the Lung
•Formed by the structures
entering or leaving the lung:
bronchi, pulmonary vessels,
lymphatics, bronchial vessels
and nerves.
•Surrounded by a tubular sheath
of pleura which hangs down to
form pulmonary ligament.
•The pulmonary ligament
provides a potential space for
the movement of pulmonary
vessels and large bronchi

21. Surface Anatomy of Pleurae
& Lungs
هئرلل باتكلا ارقا
هحفص68
ارقا يوئرلا ءاشغللو
هحفص72

24. حضوت هروص
سفنلا عامس نكاما
ةروصلاو هئرلل
اهسفن حرشت
همهم

25. عبات

26. Bronchopulmonary segments: هئرلل بعشلا لخدت امدنع
ش تنمقيس لكل نا اهتدئاف تنيمقيسلا هذه نوكت هئرلاب طبترت امدنع هئرلاب طبترت ىتح عرفتت ناير
هئرلا لمع ىلع رثؤت لاو اهتلازا نكمي هب هلكشم ثودح دنعف هب صاخ بصعو
•Definition: Are the smallest
anatomic, surgical, and
functional units of the
lung.
Each segment is pyramidal in shape
with its apex directed medially
toward the lung root, and its base
toward the lung surface.
Each segment receives segmental
bronchus, branch of pulmonary
artery, its own lymphatic vessels,
and autonomic nerve.
The branch of pulmonary vein lie in
the connective tissue between the
segment.

29. Clinical Notes•Pleural effusion
•Pleuritis, pleural rub,
pleural adhesions
•Pneumothorax
•Empyema
• سردلا اهحرشاب روتكدلا لاق
ياجلا