Post on 19-Dec-2015
Trachea and Bronchi
Dr.Hassan Shaibah
Tracheobronchial anatomy
3Tracheal Displacement Due to Goiter
Images downloaded from From www.vh.org
a mobile cartilaginous and membranous tube
Right bronchs•Wider•Shorter C6C6
T4/5T4/5
Left bronchus•Narrower•Longer•More horizontal
• C shaped rings of hyaline cartilages
• Free Posteriorly. Cartilages are connected by a muscle
11.25 cm
TrachealisMuscle
LTMain
bronchus
RTMain
bronchusLT
Upper lobar
bronchus
LTlower lobar
bronchus
RTlower lobar
bronchus
RTUpper lobar
bronchus
RTmiddle lobar
bronchus
Cricoid Cartilage
Main carina: Concepts of anterior and posterior
RTSegmantal
bronchiLT
Segmantal bronchi
Relations of the Trachea
At Level of superior Mediastinum• Anteriorly: The sternum, thymus, left brachio-
cephalic v., origins of the brachiocephalic and left common carotid a., & arch of the aorta
• Posteriorly: esophagus & left recurrentlaryngeal n.
• Right side: azygos v., right vagus n., & the pleura
• Left side: arch of the aorta, left common carotid &left subclavian a., the left vagus & left phrenic n., & the pleura.
sternum
thymus
LT brachiocephalic v.
Brachiocephalic truck
LT common carotid a.
Anterior the level of T1
Posteriorly at level of T1
esophagus
LTRecurrent
laryngeal N
Right at level of T1
RT vagus n.
Pleura
Left at level of T1
Pleura
LT common carotid a
LT subclavian a.
left vagus n.
LT phrenic n.
The sternum
thymus
LT brachiocephalic v.
BrachiocephalicTrunk
LT common carotid a.
The sternum
thymus
LT brachiocephalic v.
BrachiocephalicTrunk
LT common carotid a.
anterior
Left at level of T1
Pleura
LT common carotid a
LT subclavian a.
left vagus n.
LT phrenic n.
Right
RT vagus n.
Pleura
sternumthymus
Arch of aorta
Anterior at level of T4
Left at level of T1
Pleura
Arch of aorta
left vagus n.
LT phrenic n.
Right at level of T1
RT vagus n.
Pleura
Azygos v.
Posterior at level of T4
At level T4
At level T3
At Level of the neck• Anterior: thyroid gland, inf. Thyroid vein with some neck
muscles• Posterior : right and left recurrent laryngeal nerve• Lateral: lobes of the thyroid gland and carotid sheath
thyroid gland
inf. Thyroid vein
Posterior• right and left recurrent laryngeal nerve
Lateral
Lobes of the thyroid gland & carotid sheath
48
Intraluminal disease and extrinsic compression
• Tumor invading through posterior wall.
• Tumor invading left and right main bronchi
• Narrowing of lower third of trachea
BI,
All R
ight
s Re
serv
ed, 2
005
50
Tracheal appearances
A
B
C
D
E
F
Saber sheath Dynamic collapse Crescent shape collapse
Normal shape expansion during inhalation circumferential collapse
Nerve Supply of the Trachea
• sensory nerve supply is from the vagi and the recurrent laryngeal nerves.
• Sympathetic nerves supply the trachealis muscle
Blood Supply of the Trachea
• upper 2/3 are supplied by the inferior thyroid arteries • lower 1/3 is supplied by the bronchial arteries.