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Lungs
Assistant Professor
Muhammad Arif Afridi | Sonologist
BS (Radiology), MPH, MS Ultrasound
Email: drarifafridi@gmail.com
“ in the name of Allah the most beneficent the most merciful. ”
1
Introduction
Assistant Professor Muhammad Arif Afridi | Radiology 2
Lungs are a pair of respiratory organs
situated in the thoracic cavity.
Each lung innervates the corresponding
pleural cavity
ln the young, lungs are brown or grey in
color. Gradually, they become mottled
black because of the deposition of
inhaled carbon particles
Features
• Each lung is conical in shape
apex at the upper end
• Base resting on the diaphragm
• Three borders, i.e., anterior,
posterior, and inferior
• Two surfaces, i.e., costal and
medial
Assistant Professor Muhammad Arif Afridi | Radiology 3
Assistant Professor Muhammad Arif Afridi | Radiology 4
The apex lies above the level of first rib. It
reaches 2.5 cm above the medial third of
clavicle, just medial to supraclavicular fossa.
The base rests on the diaphragm.
Which separates the right lung from the right
lobe of the liver.
The left lung from the left lobe of the liver,
fundus of stomach and the spleen.
The anterior border of the left lung shows a
wide cardiac notch below the level of the
fourth costal cartilage.
The heart and pericardium are uncovered by
the lung in the region of this notch.
Assistant Professor Muhammad Arif Afridi | Radiology 5
The posterior border extends from the
level of 7th cervical spine to the 10th
thoracic spine.
The medial surface is divided into a
vertebral part and mediastinal part. The
mediastinal part shows a cardiac
impression, the hilum
Inferior border separates the base from
costal and medial surfaces.
The costal surface is large and convex. It
is in contact with the costal pleura and the
overlying thoracic wall.
Fissures and lobes
Assistant Professor Muhammad Arif Afridi | Radiology 6
The right lung is divided into three lobes by two
fissures oblique and one horizontal.
The left lung is divided into two lobes by oblique
Assistant Professor Muhammad Arif Afridi | Radiology 7
1) In the left lung, oblique fissure cuts into
whole thickness of the lung, except at the hilum.
2) Due to the oblique plane of the fissure ,the
lower lobe is more posterior and the upper and
the middle lobe more anterior
3) In the right lung, the horizontal fissure
passes from the anterior border upto the
oblique fissure and separates a wedge
shaped middle lobe from the upper lobe.
Assistant Professor Muhammad Arif Afridi | Radiology 8
4) The tongue shaped projection of the left lung
below the cardiac notch is called lingula. It
corresponds to middle lobe of the right lung.
6)The presence of the oblique fissure of the
each lung allows a more uniform expansion of
the whole lung
5)The lungs expand maximally in the inferior
direction because movements of the thoracic
wall and diaphragm are maximal toward the
base of the lung
Assistant Professor Muhammad Arif Afridi | Radiology 9
Lateral and medial surfaces of the lungs. A. Right lung. B.
Left lung.
Assistant Professor Muhammad Arif Afridi | Radiology 10
Lungs viewed from the right. A. Lobes. B. Bronchopulmonary
segments
Assistant Professor Muhammad Arif Afridi | Radiology 11
Lung Lobes and Fissures
Assistant Professor Muhammad Arif Afridi | Radiology 12
Root of the Lung
Assistant Professor Muhammad Arif Afridi | Radiology 13
2) It is formed by the structures which either enter or
come out of the lung at the hilum
1) The root of the lung is a short ,broad pedicle which
connects the medial surface of the lung to the
mediastinum
3)The roots of lungs lie opposite the bodies of fifth,
sixth and seventh thoracic vertebra
CONTENTS OF ROOT OFTHE LUNG
1)Principal bronchus on the left side, and eparterial and hyparterial bronchi
on right side
2)One pulmonary artery
3)Two pulmonary veins, superior and inferior
4)Bronchial arteries ,one on the right side and two on the left side
5)Bronchial veins
6)Anterior and posterior pulmonary plexuses of nerves
7)Lymphatics of lung
8)Bronchopulmonary lymph nodes
9)Areolar tissue
Assistant Professor Muhammad Arif Afridi | Radiology 14
Broncho Pulmonary Segments
Assistant Professor Muhammad Arif Afridi | Radiology 15
3) These bronchopulmonary segments are
independent respiratory units
1) These are well defined sectors of the lung
each one of which is aerated by a tertiary or
segmental bronchus
2) Each segment is pyramidal in shape with its
apex directed towards the root of the lung
Assistant Professor Muhammad Arif Afridi | Radiology 16
Assistant Professor Muhammad Arif Afridi | Radiology 17
Assistant Professor Muhammad Arif Afridi | Radiology 18
Assistant Professor Muhammad Arif Afridi | Radiology 19
Assistant Professor Muhammad Arif Afridi | Radiology 20
1) The branches of the pulmonary artery
accompany the bronchi, the artery lies
dorsolateral to the bronchus, thus each
segment has its own separate artery
2)The pulmonary veins do not
accompany the bronchi or the pulmonary
artery ,they run in inter segmental planes
3)Thus teach segment has more than one
vein and each vein drains more than one
segment
Assistant Professor Muhammad Arif Afridi | Radiology 21
Usually the infection of a segment remains
restricted to it although some infections like
tuberculosis may spread from one segment to
the other
However, the segments are no barriers to
the spread of bronchogenic carcinoma.
Arterial Supply
Assistant Professor Muhammad Arif Afridi | Radiology 22
3)There are pre capillary anastomoses between
bronchial and pulmonary arteries. These
connections enlarge when any one of them is
obstructed in disease
1) on the right side there is one bronchial artery
which arises from either the third posterior
intercostal artery or from the upper left
bronchial artery.
2)On the left side there are two bronchial
arteries both of which arise from the descending
thoracic aorta
Venous Drainage
Assistant Professor Muhammad Arif Afridi | Radiology 23
3) The greater part of the venous blood from the
lung is drained by the pulmonary veins.
1) Usually there are two bronchial veins on each
side, the right bronchial vein drain into the
azygous vein
2) The left bronchial vein drains either into the left
superior intercostal vein or into the hemi azygous
vein
Nerve Supply
Assistant Professor Muhammad Arif Afridi | Radiology 24
1) Para sympathetic nerves are derived from
the vagus . These fibres are:
a) motor to the bronchial muscles and on
stimulation cause bronchospasm.
b) secretomotor to the mucous glands of
the bronchial tree
c) the sensory fibres are responsible for
stretch reflex of the lungs and for the
cough
Assistant Professor Muhammad Arif Afridi | Radiology 25
2) The sympathetic nerves are derived from
second to fifth spinal segments. These are
inhibitory to the smooth muscles and glands of
bronchial tree.
3)This is how sympathomimetic drugs like
adrenaline cause brochodilatation and relieve
symptoms of bronchial asthma.
Thank You!
26

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Lungs.pptx

  • 1. Lungs Assistant Professor Muhammad Arif Afridi | Sonologist BS (Radiology), MPH, MS Ultrasound Email: drarifafridi@gmail.com “ in the name of Allah the most beneficent the most merciful. ” 1
  • 2. Introduction Assistant Professor Muhammad Arif Afridi | Radiology 2 Lungs are a pair of respiratory organs situated in the thoracic cavity. Each lung innervates the corresponding pleural cavity ln the young, lungs are brown or grey in color. Gradually, they become mottled black because of the deposition of inhaled carbon particles
  • 3. Features • Each lung is conical in shape apex at the upper end • Base resting on the diaphragm • Three borders, i.e., anterior, posterior, and inferior • Two surfaces, i.e., costal and medial Assistant Professor Muhammad Arif Afridi | Radiology 3
  • 4. Assistant Professor Muhammad Arif Afridi | Radiology 4 The apex lies above the level of first rib. It reaches 2.5 cm above the medial third of clavicle, just medial to supraclavicular fossa. The base rests on the diaphragm. Which separates the right lung from the right lobe of the liver. The left lung from the left lobe of the liver, fundus of stomach and the spleen. The anterior border of the left lung shows a wide cardiac notch below the level of the fourth costal cartilage. The heart and pericardium are uncovered by the lung in the region of this notch.
  • 5. Assistant Professor Muhammad Arif Afridi | Radiology 5 The posterior border extends from the level of 7th cervical spine to the 10th thoracic spine. The medial surface is divided into a vertebral part and mediastinal part. The mediastinal part shows a cardiac impression, the hilum Inferior border separates the base from costal and medial surfaces. The costal surface is large and convex. It is in contact with the costal pleura and the overlying thoracic wall.
  • 6. Fissures and lobes Assistant Professor Muhammad Arif Afridi | Radiology 6 The right lung is divided into three lobes by two fissures oblique and one horizontal. The left lung is divided into two lobes by oblique
  • 7. Assistant Professor Muhammad Arif Afridi | Radiology 7 1) In the left lung, oblique fissure cuts into whole thickness of the lung, except at the hilum. 2) Due to the oblique plane of the fissure ,the lower lobe is more posterior and the upper and the middle lobe more anterior 3) In the right lung, the horizontal fissure passes from the anterior border upto the oblique fissure and separates a wedge shaped middle lobe from the upper lobe.
  • 8. Assistant Professor Muhammad Arif Afridi | Radiology 8 4) The tongue shaped projection of the left lung below the cardiac notch is called lingula. It corresponds to middle lobe of the right lung. 6)The presence of the oblique fissure of the each lung allows a more uniform expansion of the whole lung 5)The lungs expand maximally in the inferior direction because movements of the thoracic wall and diaphragm are maximal toward the base of the lung
  • 9. Assistant Professor Muhammad Arif Afridi | Radiology 9 Lateral and medial surfaces of the lungs. A. Right lung. B. Left lung.
  • 10. Assistant Professor Muhammad Arif Afridi | Radiology 10 Lungs viewed from the right. A. Lobes. B. Bronchopulmonary segments
  • 11. Assistant Professor Muhammad Arif Afridi | Radiology 11
  • 12. Lung Lobes and Fissures Assistant Professor Muhammad Arif Afridi | Radiology 12
  • 13. Root of the Lung Assistant Professor Muhammad Arif Afridi | Radiology 13 2) It is formed by the structures which either enter or come out of the lung at the hilum 1) The root of the lung is a short ,broad pedicle which connects the medial surface of the lung to the mediastinum 3)The roots of lungs lie opposite the bodies of fifth, sixth and seventh thoracic vertebra
  • 14. CONTENTS OF ROOT OFTHE LUNG 1)Principal bronchus on the left side, and eparterial and hyparterial bronchi on right side 2)One pulmonary artery 3)Two pulmonary veins, superior and inferior 4)Bronchial arteries ,one on the right side and two on the left side 5)Bronchial veins 6)Anterior and posterior pulmonary plexuses of nerves 7)Lymphatics of lung 8)Bronchopulmonary lymph nodes 9)Areolar tissue Assistant Professor Muhammad Arif Afridi | Radiology 14
  • 15. Broncho Pulmonary Segments Assistant Professor Muhammad Arif Afridi | Radiology 15 3) These bronchopulmonary segments are independent respiratory units 1) These are well defined sectors of the lung each one of which is aerated by a tertiary or segmental bronchus 2) Each segment is pyramidal in shape with its apex directed towards the root of the lung
  • 16. Assistant Professor Muhammad Arif Afridi | Radiology 16
  • 17. Assistant Professor Muhammad Arif Afridi | Radiology 17
  • 18. Assistant Professor Muhammad Arif Afridi | Radiology 18
  • 19. Assistant Professor Muhammad Arif Afridi | Radiology 19
  • 20. Assistant Professor Muhammad Arif Afridi | Radiology 20 1) The branches of the pulmonary artery accompany the bronchi, the artery lies dorsolateral to the bronchus, thus each segment has its own separate artery 2)The pulmonary veins do not accompany the bronchi or the pulmonary artery ,they run in inter segmental planes 3)Thus teach segment has more than one vein and each vein drains more than one segment
  • 21. Assistant Professor Muhammad Arif Afridi | Radiology 21 Usually the infection of a segment remains restricted to it although some infections like tuberculosis may spread from one segment to the other However, the segments are no barriers to the spread of bronchogenic carcinoma.
  • 22. Arterial Supply Assistant Professor Muhammad Arif Afridi | Radiology 22 3)There are pre capillary anastomoses between bronchial and pulmonary arteries. These connections enlarge when any one of them is obstructed in disease 1) on the right side there is one bronchial artery which arises from either the third posterior intercostal artery or from the upper left bronchial artery. 2)On the left side there are two bronchial arteries both of which arise from the descending thoracic aorta
  • 23. Venous Drainage Assistant Professor Muhammad Arif Afridi | Radiology 23 3) The greater part of the venous blood from the lung is drained by the pulmonary veins. 1) Usually there are two bronchial veins on each side, the right bronchial vein drain into the azygous vein 2) The left bronchial vein drains either into the left superior intercostal vein or into the hemi azygous vein
  • 24. Nerve Supply Assistant Professor Muhammad Arif Afridi | Radiology 24 1) Para sympathetic nerves are derived from the vagus . These fibres are: a) motor to the bronchial muscles and on stimulation cause bronchospasm. b) secretomotor to the mucous glands of the bronchial tree c) the sensory fibres are responsible for stretch reflex of the lungs and for the cough
  • 25. Assistant Professor Muhammad Arif Afridi | Radiology 25 2) The sympathetic nerves are derived from second to fifth spinal segments. These are inhibitory to the smooth muscles and glands of bronchial tree. 3)This is how sympathomimetic drugs like adrenaline cause brochodilatation and relieve symptoms of bronchial asthma.