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Korenkov Topographic Anatomy (1)
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- LUNGS (pulmones)
| Pleura innervation
The costal pleura is innervated with intercostal nerves. The mediastinal pleura is innervated with phrenic nerves. The diaphragmal pleura is innervated with 6 inferior intercostal nerves and with phrenic nerves. The pulmonary pleura is innervated from pulmonary plexus which is formed of phrenic nerves, sympathetic trunk and pneumogastric (vagus nerve). In disease or injury of pleura what leads to exudation, air or blood accumulation, the thoracocentesis is performed. LUNGS (pulmones) There is paired respiratory system – lungs in the right and left parts of thoracic cavity. Lungs have the irregular conical shape with rounded top (apex pulmonis) and wide basis (basis pulmonis). The lung surface is divided into three surfaces: costal surface (facies costalis), diaphragmal surface (facies diaphramatica) and 26 mediastinal surface (facies mediastinalis). In adult people the apex of the lung protrudes through upper thoracic aperture to the neck, reaches the acantha of the 7th cervical vertebra from behind and 4 – 5 cm the suprasternal notch above – or 2 – 3 cm above the collarbone in front. The subclavian artery attaches to the apex of the lung at medial surface leaving sulcus on the lung (a. subclavia). The lung basis attaches to the diaphragm by its diaphragmal surface (facies diaphramatica). Facies diaphramatica is concave according to the shape of convex diaphragm: more on the right and less on the left. The right lung is limited from the liver with diaphragm, the left one – from the spleen, left kidney and adrenal gland, stomach, transverse colon and left part of the liver which adhere to the diaphragm from below. There is sharp inferior edge which goes into costodiaphragmatic recess between the costal surface (facies costalis) and diaphragmal surface (facies diaphramatica). When breathing the inferior edge of the lung shifts 7 – 8 cm down. The sharp anterior edge of the lung penetrates into costomediastinal recess between the thoracic cage and heart and limits the costal surface (facies costalis) of the lung from the mediastinal surface (facies mediastinalis). The mediastinal surface (facies mediastinalis) is turned to the mediastinum and vertebral spine. There are hila (hilum pulmonis) in the paramedian surface of the lung through which the primary bronchi (bronchi principales) and pulmonary arteries go into the lungs and through which the superior pulmonary vein and lower pulmonary vein go out. Besides primary bronchus, pulmonary artery and pulmonary veins there are lymph nodes (nodi lymphoidei bronchopulmonales), neuroplex and pulmonary 27 arteries and pulmonary veins in the hila of the lung. There is a deep cardiac impression (impressio cardiaca) in the paramedian surface of the lung anteriorly and lower from the hila which is more expressed on the left lung. There is a deep sulcus on the top and behind the root of the left lung due to the arch of aorta and descending part of aorta, in front of which there is esophagus attachment near the inferior edge of the lung. There is a recess of precava on the mediastinal surface of the right lung in front of the hila, and behind – there are sulci due to azygos vein and esophagus. The borders of lungs are as follows: ● anterior and posterior lung borders and pleura coinсide. The inferior edge of the right lung: ● lin. parasternalis – the 6th rib; ● lin. medioclavicularis – the 7th rib; ● lin. axillaris media – the 8th rib; ● lin. scapularis – the 10th rib; ● lin. paravertebralis – the 11th rib. жүктеу/скачать 2,76 Mb. Достарыңызбен бөлісу:
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