Lung anatomy.

respiratory system

1. ANAWIOMY OF LUNGS

2. 2. Surfaces and Borders of
Lungs 7. Surfactant

4. Fissures and Lobes of 9. Lymphatics of Lungs
Lungs

11. Pleura

3. GROSS A

Spongy
Young — brown

Adults -- mottled black due to
deposition of carbon particles

Right lung - 600 gms
Left lung - 55028

4. _— Parietal Pleura

—Pleural Cavity

Visceral Pleura

5. Conical

(apex pulmonis)

(basis pulmonis)

6. APEX

o Blunt o Gioyyadoa
o Lies avove thie level of Suele vial eirteny
asıterior end of 1% rio. Suyelavian vain

Y Feaches 1-2 om aoove

medial 1/8 of ckiviele,
Y Coverinas =
cervical pleura
suoraolsurel penas

7. Left Lung

Brorchopulmon
(his) Iymphnode:

Lett inti

Diaphragmatic surface

Groove er Lat ib

dreaforthyanus and

arts

8. BASE

o Sarnilunar and concave.
JAests or dome of Delorirelcjen.

o rilgrit sicleel does ls yr tinc lene

9. BORDERS

Corresponds to the: anterior
(Costomediastinal) line of pleural reflection.

lt 1S} deeply notched in the left lung posterior
to 5! costal cartilage by the pericardium
and) extends vertically downwards to form
Lingula. This is called cardiac
notch(percussion in this area gives a dull
note as compared to dull note obtained over
Jung).

10. INFERIOR BORDER

o Thin and share

o li severates ine pasa Of Juno fon te
costal surfeica ainiel extericls inite)

onrenicocostell Sinus,

11. POSTERIOR BORDER

o Trick ancl ill clefinec

o Fits Into dese oalrelverieorell quitar

o Extends from G7 to Wl;

12. 1. Costal Surface - It is in contact with costal
pleura and overlying
thoracic wall.

len... Posterior / Vertebral Part

- Anterior / Mediastinal Part

13. Relations of Posterior Part

1. Vertebral Part

2. Intervertebral Discs

3. Posterior Intercostal MESS

4. Splanchic Nerves

14. enen en

= ©

RELATIONS OF ANTERIOR PART

RIGHT SIDE

Right anium
small part or RY
SVC

veinlowerpant)
ADOOS Vein)
Esophagus

Me

Wachea

Right vagus nerve
10, Right phrenic nerve.

Right brachiocephalic.

LEFT SIDE

Left ventricle
Pulmonary trunk

8 | Arch of Aorta

Descending thoracic
aorta:

Left Subclavian Artery

) Thoracic duct

Left Brachiocephalic
Vein

Left vagus nerve
Left phrenic nerve

10, Left recurrent

laryngeal nerve:

15. Right Lung
Medial View

Groovetor

Inferior border

— Right superior pul

Lower
lobe

N Pulnonaryligement

ie

arts

16. Left Lung

Brorchopulmon
(his) Iymphnode:

Lett inti

Diaphragmatic surface

Groove er Lat ib

dreaforthyanus and

arts

17. BIEUM

“lis a lange depressed area that lies
near the centre of the medial surface.

* Various structures enter and leave the
¡ng Via is root.

18. ROOT OF THE LUNG

* The root is enclosed in
@ short tubular sheet of
pleura that joins the
pulmonary and
mediastinal parts of
pleura . It extends
infeniony as a narrow
fold - The pulmonary
ligament.

It lies opposite of the
bodies of 5th, 6th and
7th thoracic vertebra

19. STRUCTURES OF THE ROOT

* Principal Bronchus on the
left side.
« Eparterial and Hyparterial
on the right side.
« One pulmonary artery .
* Two pulmonary veins -
Superior
Inferior
* Bronchial arteries
One on right side

Two on left side

20. * Bronchial veins

“ Anterior and
posterior pulmonary
plexus of nerves.

* Lymphaties

* Bronchopulmonary
Lymphnodes

+ Areolar tissue.

21. ARRANGEMENT, OF STRUCTURES IN
THE ROOT

à BEFORE BACKWARDS
1. Superior pulmonary vein.
2. Pulmonary artery.

| 3. Bronchus.

22. ARRANGEMENT, OF STRUCTURES IN
THE ROOT

Y ABOVE DOWNWARDS

A. Right Side
1. Eparterial Bronchus.
2. Pulmonary Artery.
3. Hyparterial Bronchus.

4. Inferior Pulmonary
Vein.

23. ARRANGEMENT OF STRUCTURES IN
THE ROOT

o ABOVE DOWNWARDS
B. Left Side

1. Pulmonary artery.
2. Bronchus.

3. Inferior pulmonary vein

24. FISSURES AND LOBES OF LUNGS

25. OBLIQUE FISSURE

= li begins posteriony at the levell of Sth
thoracic vertebra.

* Passes antero-inieriorly in a spiral
course to meet the inferior margin close
to 6th costochondral junction.

26. HORIZONTAL FISSURE

= li extends from anterior margin at the level of
41h costal cartilage.

= Runs honzontally backwards to meet the
oblique fissure in the mid-axillary line.

= Pulmonary pleura extends into the fissures of
the lungs so that the lobes can move on each
other during respiration.

28. BRONCHOPULMONARY
SEGMENTS

29. o
z
=)
Er
=
©
a

A

nes
LES

30. » Trachea)

Right and Leit Principal Bronchus
Lobar Bronchi(Secondary)[2L,3R]

Segmental Bronchi(Tjeriary)[8L, 10R]

Terminal Bronchioles(25000 in no.),

Respiratory Bronchioles-

Alveolar ducts

Alveolar sacs

Alveoli

31. Trachea and Major Bronchi
Anterior View

Thyroid cartilage.
y Median cricothyroid ligament

Cricoid ced :

Connective tissue sheath (visceral layer of.
pretracheal fascia) (out away)

Anular (intercartilaginous} ligaments lentes

Mucosa of posterior trachea! wall
shows longitudinal folds formed by
dense collections of elastic fibers.

Left superior lobar bronchus,

Right superior lobar (eparterial) bronchus,

Bi+2 Superior division bronchus
To superior lobe
To superior lobe

Middle lobar bronchus.

NC y Fight and left Y
. B+ i" (primary)
To miro? EN “mr RE

Inferior
lobar

bronchi À
ae

Intrapulmonary Extrapulmonary Intrapulmonary A

32. ne Ultimate pulmonary Unit trom) respiratory
brochioleiioralveoliis called Acinus,

here are about ol division; of
iracheo-oronchrall th

no. Of alveo

n 200 - 600 million, with

0 - 80 meter square.

33. Intrapulmonary Airways
Schema

Smooth muscle

(about
5 generations)

st order respiratory bronchioles

subsegmental
bronchi

2nd onder respiratory bronchioles

Cartilages become
sparser {mostly at
points of branching)

Acinus
part
of lung

No further supplied by

ju terminal
cartilages. bronchiole)

22
2.8
ade
13
& À

br = . 4 Opening of
Respiratory aon Pe alveolar duct
bronchioles y

cS
iy Pores of Kohn

» ¿NES
Subdivisions of intrapulmonary sirways Structure of intrapulmonary airways ap

@Novartis

34. BRONCHOPULMONARY SEGMENTS

Right main bronchus Left main bronchus

1. Shorter || Longer

2 Wider: 2 Narrower.

=) More in line with ©. More oblique than
trachea. the right.

35. BRONCHOPULMONARY SEGMENTS

Right Main Bronchus

ó -— —::=_—- —____—

Right upper lobe Bronchus

Right Middle lobe Bronchus

Right Lower Lobe Bronchus

rm

Segmental Bronchi

Apical
Anterior
Posterior

Segmental Bronchi

Segmental Bronchi

Medial
Lateral

Apical
Anterior
Posterior
Medial and Lateral

36. BRONCHOPULMONARY SEGMENTS

Left Main Bronchus

Left upper lobe Bronchus

Left lower lobe bronchus

Upper Branch Lower Branch

Segmental Bronchi |

Anterior Superior Lingular
Apico-posterior Inferior Lingular

Apical
Anterior
Posterior

Lateral

37. apical
\

api posterior

posterior \ f
pos en >

ant
lateral superior
Ap cal -inferior
medial lower
latera!
basal _ “medial basal

a

—lateral

posterior \ basal anterior ‘posterior

anterior
basal

basal basal basal

38. © Ihese segments are pyramidal in shape with
apex towards thie root of ung:

Each) segment is an independent respiratory unit.

+ Each segment has its own separate
artery (ranches of pulmonary artery),

“Pulmonary Veins run in inter-segmental planes
between adjoining segments.

* Thus'a bronchopulmonary segment is nota
bronchovascular segment as it does not have

its Own vein.

40. CLINICAL SIGNIFICANCE

“Segmental resection) with minimal
GESTUCHON 10 ihe! Surrounding lung
issue,

"TO visualize the interior of a bronchi
trough a bronchoscope when diseases
process is limited in a segment.

41. HISTOPATHOLOGY OF ALVEOLI
ALVEOLAR WALL

AWeolar epiiiclial Cells=
Type! pHreumocytes
Type ll pneumocytes

Basement Membrane

Interstitiall Space-

Collagen

Elastin
Unmyelinated Nerves
Macrophages

Capillary Basement
Membrane

Capillary Endothelial Cells.

42. .

.

.

Type | Pneumocyte

Pavement epithelial
cells of alveoli .

Less in no. than
type Il.

More surface
area(flattened)
Contain pinocytic
vesicles.

Specialized for
diffusion of gases.

43. .

.

Type ll Pheumocytes

More numerous than
type I.

Cuboidal in shape.
Rich in
mitochondria, ER
and vacuoles
containing

osmiophillic lamellar
bodies.

Type l are
precursors of type Il.

alveolus

bpe

44. + Most numerous .

« Presence of
pinocytic vacuoles
that meet the
luminal surface to
form caveolae.

+ Walls of caveolae
has, ACE.

+ Source of NO,
natural pulmonary
vasodilator.

45. ALVEOLAR MACROPHAGES

+ Primary defence
mechanism.

* Takes part in
inflammatory and
immunological
reactions.

« Activates lysosomes ,
proteases,complement
, thromboplastin,
cytokines - IF-a, TNF-
a, IL-1, IL-8.

46. .

SURFACTANT

Lines the inner layer of alveolar epithelium.
Synthesized by SER of type Il pneumocytes.

Function —

1. To reduce the surface tension of alveoli mainly during
expiration, thus reduces the work of lung inflation.

2. Waterproofing.
Surfactant synthesis starts after 26 weeks of

fetal life. Therefore premature infants,with
insufficient surfactant suffer from HMD.