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SURGICAL ANATOMY OF THE ROOT OF LUNG
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Korenkov Topographic Anatomy (1)
| SURGICAL ANATOMY OF THE ROOT OF LUNG
The complex of anatomical formations which are located in the hilum pulmonis are the root of the lung (radix pulmonis). The elements of root of the lung are located in the cellular tissue. The root is covered with mediastinal pleura. On the edge of hilum pulmonis the pulmonary pleura passes into pericardium and esophagus as two layers of serous membrane which anastomose and create triangular pulmonary ligament (lig. pulmonale). It is located in the frontal surface and stretches between the root of the lung on the top and diaphragm from below. The width of the root of lung is 6 – 8 cm. Hilum pulmonis is located at the level of the 5th – 7th sternal cartilages posteriorly and anteriorly – at the level of the 2nd – 4th 28 sternal cartilages. There is v. pulmonalis superior in the root of the right lung which is located anteriorly. There is a. pulmonalis from above and behind v. pulmonalis superior, and v. pulmonalis inferior passes lower and behind it. There is right primary bronchus behind pulmonary artery which protrudes the artery 2 – 11 mm above (Fig. A.9 (a)). There is left pulmonary artery in the root of the left lung on the top. The superior pulmonary vein is located anteriorly and below from it. Bronchus is located below and behind pulmonary artery and superior pulmonary vein (Fig. A.9 (b)). There is bronchus it the hilum of the right lung which is located on the top; the pulmonary artery is located anteriorly and below; and the pulmonary vein is located below. There is an artery it the hilum of the left lung. The bronchus is located below and there is inferior pulmonary vein below from it. The veins are located anteriorly in the horizontal plane in the hilum of the lung; the pulmonary vein is located behind the veins and the primary bronchus – behind the pulmonary vein. Bronchial arteries (a. bronchiales) attach to the inferior semicircle of primary bronchi. There are ascending part of aorta, precava, pericardium and the part of the right atrium in front of the root of the lung. There is azygos vein from above and behind the root of the lung. The arch of aorta attaches to the root of the lung from above, esophagus and descending part of aorta – behind. The both roots (of right and left lungs) are crossed anteriorly with phrenic nerve which is accompanied by a. et vv. pericardiacophrenicae. There is n. vagus behind the root. Each lung is divided into lobes due to interpaticle fissurae. Oblique fissure of the left lung (fissura obliqua) divides it into 29 superior and inferior portions. The projection line of this fissure onto thoracic cage passes from the 3rd thoracic vertebra acantha to the junction of the bone and costal cartilage of the 6th rib. If to lift the hand, the medial border of scapula will show the direction of the fissure. There is also horizontal fissure (fissura horizontalis) in the right lung, which passes along IV costal cartilage from sternum to the projection line of the oblique fissure on the midaxillary line. The middle part is limited from superior part with horizontal fissure. The lobes of lungs consist of segments. A segment is the жүктеу/скачать 2,76 Mb. Достарыңызбен бөлісу:
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