Lungs and clinical Correlations By Dr Rabia Inam Gandapore.pptx

Lungs and Clinical Correlations

1. Lungs Dr. Rabia Inam Gandapore Assistant Professor Head of Department Anatomy (Dentistry-BKCD) B.D.S (SBDC), M.Phil. Anatomy (KMU), Dip. Implant (Sharjah, Bangkok, ACHERS) , CHPE (KMU),CHR (KMU), Dip. Arts (Florence, Italy)

2. Teaching Methodology LGF (Long Group Format) SGF (Short Group Format) LGD (Long Group Discussion, Interactive discussion with the use of models or diagrams) SGD (Short Group) SDL (Self-Directed Learning) DSL (Directed-Self Learning) PBL (Problem- Based Learning) Online Teaching Method Role Play Demonstrations Laboratory Museum Library (Computed Assisted Learning or E-Learning) Assignments Video tutorial method

3. Describe the major components of the (upper and lower) respiratory system. Describe the general and anatomical features of trachea and bronchi. Describe the anatomical features of lungs . Goal/Aim (Main Objective)

4. Specific Learning Objectives (cognitive) At the end of the lecture the student will able to : Describe the anatomical features of lungs .

5. Psychomotor Objective: (Guided response) A student to draw labelled diagram of Histology of Trachea and its layers

6. Affective domain To be able to display a good code of conduct and moral values in the class. To cooperate with the teacher and in groups with the colleagues. To demonstrate a responsible behavior in the class and be punctual, regular, attentive and on time in the class. To be able to perform well in the class under the guidance and supervision of the teacher. Study the topic before entering the class. Discuss among colleagues the topic under discussion in SGDs. Participate in group activities and museum classes and follow the rules. Volunteer to participate in psychomotor activities. Listen to the teacher's instructions carefully and follow the guidelines. Ask questions in the class by raising hand and avoid creating a disturbance. To be able to submit all assignments on time and get your sketch logbooks checked.

7. Lesson contents Clinical chair side question: Students will be asked if they know what is the function of Outline: Activity 1 Describe the anatomical features of lungs .

8. Recommendations Students assessment: MCQs, Flashcards, Diagrams labeling. Learning resources: Langman’s T.W. Sadler, Laiq Hussain Siddiqui, Snell Clinical Anatomy , Netter’s Atlas , BD Chaurasia’s Human anatomy, Internet sources links.

9. Lungs M a j or org a ns of resp i rat i on L o c ate d i n c hest , e i ther s i de of med i ast i num O xygenate blood : Achieve this by bringing inspired air into close contact with oxygen-poor blood in pulmonary capillaries Anatomical Position and Relations L i e e i ther s i de of med i a s t inum , w i t h i n thorac i c ca v i ty Each lung is surrounded by a pleural ca v i t y , formed b y v i scera l & par i et a l pleur a . Suspended from mediastinum by l ung root – a c ollec t i on of structures entering & leaving lungs

10. Lungs Conti… M edial surfaces of both lungs lie in close proximity to se v eral med i a s t ina l str u ctures: Lung Structure L ungs are roughly cone shaped , with an apex, base, 3 s u rfaces & 3 b o rde r s L eft lung is slightly smaller than right – this is due to presence of heart

11. Lung structure conti.. Eac h lung cons i st s of: Apex – Bl u nt s u per i or end of lung Projects upwards, above level of 1s t r i b & i nto floor of ne c k Bas e – I nfer i or s u rface of lun g , wh i ch s i ts on d i aphra g m Lobes (two or three) – Separated by f i s s ures w i th i n lung Surfaces (three) – Correspond t o area of thorax that they face , Na m ed c os t al , med i a s t ina l & diaphragmatic Border s (three ) – edges of l ung s , na m ed anter i or, i nfer i or & poster i or borders

12. Surfaces of lung 3 lung surfaces , each corresponding to area of thorax M ediastina l surface of lung faces latera l a s pe c t of m i ddl e med i a s t i num . L ung h i lu m i s locate d on th i s s u rfac e . 2. B as e of lung i s formed b y the diaphragmatic surface . Rests on dom e of d i aphra g m & has a c onca v e shape . Concavity is deeper in right lung , due to higher pos i t i on of r i ght dom e o v erly i n g l i v er 3. C osta l surface i s smoot h & c o n v ex . F aces i nternal s u rface of chest wall . Related to costal pleura , which separates it from r i b s & i nnermo s t i ntercosta l m u scles .

13. Borders of the lung A nterior border: formed by convergence of med i ast i nal & c ostal surfac e s On left lung , anterior border is marked by a deep notch, created by apex of heart ( cardiac notch) Inferior border separates base of lung from costal & med i ast i nal surfac e s Posterior border is smooth & rounded (in contrast to anterior & inferior borders, which are sharp) . F ormed b y costal & med i ast i nal surfac e s meeting posteriorly

14. Right Lung

15. Left lung

16. Lung root is a collection of structures that suspends lung from med i a s t inum Eac h root conta i ns O br o nchus o pul m onary ar t ery o t w o pul m onary v e i n s o bron chi a l v essels o pulmonar y plexu s of ner v es o l y mp h at i c v essels All these structures enter or leave lung via the h i lu m – a we d ge shape d are a on i ts med i ast i n a l surface Ro o t and Hilum

17. Hilum of right & left lung

18. Vasculature of lungs Supplied with deoxygenated blood by the paired pulmon a ry arter i es Once the blood has received oxygenation , it leaves the lungs via four pulmonary veins (two for each lung) B ronchi , lung roots, visceral pleura & supporting lung tissues require an extra nutritive blood supply Del i v ered b y b r onchi al arter i es , wh i ch ar i s e from descending aorta B r o nch i al v e i ns pr o v i de v enous drainage R i ght br o nch i al v e i n dra i ns i nto the azyg os v e i n , left dra i ns i nto a c c e s s ory hem i azyg os v e i n

19. Nerve Supply of lungs Derived from the pulmonary plexuses Parasympathetic Sympathetic V iscera l af fere nt f i bres Par a s ymp a the t ic: Der i v ed f r o m v agu s ne r v e Stimulate secretion from bronchial glands, con t rac t i o n of br o nchial smooth muscle, & vasodilation of p u l monary v e s se l s Sympathetic: Derived from the sympathetic trunks Stimulate relaxation of bronchial smooth muscle, & vasoconstriction of pulmonary vessels Visceral afferent: Conduct pain impulses to the sensory ganglion of v agu s ne r v e

20. Bronchial Tree A ser i es of pa s s a g es t h a t s u ppl i es a i r to a l v eo l i of l u n g s . I t beg i ns w i t h tr a che a , wh i ch d i vi d es i nto lef t & r i g ht bronchus Each bronchus enters the root of lung, pa s s i ng thro u g h h i l u m . I ns i de lun g , the y d i vi d e to form loba r bronch i – one s u pply i ng e a ch lob e . Eac h lob a r bronch u s the n furt h er d i v ides i nto se v eral tert i ar y se g ment a l bron c hi Eac h s e g m e nt a l bronch i pro v i de s a i r to a bronchop u l m on a ry s e g m e nt – the s e are funct i onal un i ts of lung s

21. Bronchi conti… S e g ment al br o nchi g i v e r i s e to ma ny conduct i ng bronchioles , which eventually lead into terminal bronchioles Each terminal bronchiole gives off respiratory bronchioles , which feature thin walled outpocketings that extend from the i r lumens T hese ar e al v eo l i – the s i te of ga seo u s exchange

22. Bronchopulmonary segments

23. Clinical Relevance

24. Clinical Relevance – Pulmonary Embolism Refers to obstruction of a pulmonary artery by a substance that has travelled from elsewhere in body M ost commo n emb oli ar e : Thrombus – responsible for majority of cases & usually arises i n a d is t ant v ein Fat – following a bone fracture or orthopaedic surgery Air – fo ll ow i ng cann u l atio n i n ne ck Red u ct i on i n lun g perf u s i on Results in decreased blood oxygenation , & accumulation of blood in right ventricle of heart Clinical features : dyspnoea, chest pain, cough, haemop t y s i s & t a c h y pnoea Definitive treatment involves anticoagulation & thrombolytic therapy T h i s red u ces s i ze o f embo l us , & pre v en t s clotting

25. Bronchogram

26. Bronchograms conti…

27. Thank You