Trachea, Bronchial Tree & Pleura Dr. Sama ul Haque Dr Rania Gabr.
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Transcript of Trachea, Bronchial Tree & Pleura Dr. Sama ul Haque Dr Rania Gabr.
Trachea, Bronchial Tree & Pleura
Dr. Sama ul Haque
Dr Rania Gabr
Objectives
Discuss the anatomical structure of the trachea with its relations.
Define the term bronchial tree.
Describe bronchopulmonary segments.
Explain pleura.
Lower Respiratory Tract
Trachea
Bronchi
Bronchial Tree
Terminal Bronchioles
Respiratory Bronchioles
Alveolar Sacs
Lungs
Conducting zone of lower Respiratory Tract
Trachea
Definition:
It is a fibro-muscular tube (Windpipe) 10 cm long
containing incomplete cartilaginous rings.
Continuation of the Larynx.
Posterior part of tube lined by trachealis muscle.
Anterior and lateral walls of the trachea supported
by 16 to 20 C-shaped tracheal cartilages.
Trachea
Cartilage rings reinforce and provide rigidity to
the tracheal wall to ensure that the trachea remains
open at all times.
Beginning: At the lower border of the cricoid
cartilage (at the level of C 6).
It begins in the midline and terminates slightly to
the right of the midline.
Trachea
Termination: At the level T4 (sternal angle),
the trachea bifurcates into two smaller tubes at the
level opposite T4-T5, called the CARENA
the right and left primary bronchi are the result of
the bifurcation.
Each primary bronchus projects laterally towards
each lung.
Trachea
Blood supply:
a. Inferior thyroid arteries.
b. Bronchial arteries from the descending thoracic aorta (left side).
c. Right superior intercostal artery (right side).
- It is drained by the inferior thyroid veins.
Nerve supply:
Sympathetic: Sympathetic trunk.
Parasympathetic: Vagi nerves.
Bronchi
Right primary bronchus is shorter, wider, and
more vertically oriented than the left primary
bronchus.
Foreign particles are more likely to lodge in the
right primary bronchus.
Bronchial tree
A highly branched system of air-conducting
passages that originate from the left and right
primary bronchi.
Progressively branch into narrower tubes as they
diverge throughout the lungs before terminating in
terminal bronchioles.
Bronchial tree
The primary bronchi enter the hilus of each lung together
with the pulmonary vessels, lymphatic vessels, and
nerves.
Each primary bronchus branches into several secondary
bronchi (or lobar bronchi).
The left lung has two secondary bronchi. The right lung
has three secondary bronchi.
They further divide into tertiary bronchi.
Bronchial Tree
Each tertiary bronchus is
called a segmental bronchus
because it supplies a part of
the lung called a
bronchopulmonary segment.
Secondary bronchi tertiary
bronchi bronchioles
terminal bronchioles
Thoracic Cavity
The thoracic cavity consists of:
I. Lung and its pleura: on each side.
II. Mediastinum:
In the middle part.
The mediastinum contains the heart, great vessels, and other structures.
Pleura
Definition:
-It is a closed serous sac which is invaginated by the lung from its medial side.
Layers:
I. Visceral layer ----------------- Lines the surfaces and fissures of the lung.
II. Parietal layer ---------------- Lines the thoracic wall and other structures.
SUFACE ANATOMY OF PLEURA
6
4
6
Parietal Pleura
• Cervical PleuraCervical Pleura:• Projects up into the
neck about one inch above the medial1/3rd of clavicle.
• It lines the under surface of the suprapleural membrane.
• Costal pleuraCostal pleura::• lines, the back of the:• Sternum,• Ribs & costal
cartilages,• Intercostal spaces & • Sides of vertebral
bodies
Parietal Pleura
Mediastinal Mediastinal pleurapleura: covers the mediastinum.
At the hilum, it is reflected on to the vessels and bronchi, and continuous with the visceral pleura.
Diaphragmatic Diaphragmatic pleurapleura: : covers the thoracic (upper) surface of the diaphragm.
Pleural Recesses
Costodiaphragmatic: Slit like space
between costal and diaphragmatic pleurae, along the inferior border of the lung which enters through it in deep inspiration.
Costomediastinal: Slit like space
between costal and mediastinal pleurae, along the anterior border of the lung which enters through it in deep inspiration.
Pleural Cavities
• The potential space between the serous
membrane layers is a pleural cavity.
• The pleural membranes produce a thin, serous
pleural fluid that circulates in the pleural
cavity and acts as a lubricant, ensuring
minimal friction during breathing.
Pleural Pleural Effusion Effusion
It is an abnormal accumulation of pleural fluid about 300 ml, in the Costodiaphragmatic pleural recess , (normally 5-10 ml fluid)
Causes: inflammation, TB, congestive heart disease and malignancy.
The lung is compressed & the bronchi are narrowed.
Auscultation would reveal only faint & decreased breathing sounds over compressed or collapsed lung lobe.
Dullness on percussion over the effusion.
Nerve supply of the pleura
Parietal pleura:1. Costal pleura and peripheral diaphragmatic pleura:
Intercostal nerves
2. Mediastinal and central diaphragmatic pleura :
Phrenic nerves
3. Diaphragmatic pleura is supplied over the domes by phrenic nerves, around the periphery by lower 6 intercostal nerves.
Visceral pleura:
Not sensitive (has autonomic nerve supply).
Arterial supply of the pleura
Partial Pleura:
1. Intercostal arteries.
2. Internal thoracic artery.
3. Musculo-phrenic artery.
Visceral Pleura:
Bronchial arteries.
Thank you