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Korenkov Topographic Anatomy (1)

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 


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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 


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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. 


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