Anatomy III: Blood and the Cardiovascular and Respiratory Systems

Lung Anatomy Overview

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Anatomy III: Blood and the
Cardiovascular and Respiratory
Systems
Dr. José Luis Monroy Antón
6 CMLesson 9
Lung in situ: fissures and lobes

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2Heart and lungs in situ. The pericardium is opened. This left lung has no lingula, and it is retracted for
show the phrenic nerve (anterior to the hilum) and the X Vagus nerve (posterior to the hilum)

Trachea
Right vagus nerve
Apex of left lung
Left vagus nerve
Superior lobe
of right lung
Phrenic nerve
Origin of left recurrent
laryngeal nerve
Superior lobe of left lung
Costal surface
of right lung
Root of lung
Horizontal-
fissure
Parietal layer of
sērous pericardium
Middle lobe
of right lung
Fibrous pericardium
Mediastinal surface
of lung
Oblique fissure
Oblique fissure
Inferior lobe
of right lung
Inferior lobe of left lung
Costal part of
parietal pleura
Costodiaphragmatic
recess
Diaphragm

Lung Characteristics

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3Lungs
· Organs of respiration
· They oxygenate the blood bringing inspired air
to the alveoli
. They are elastic and during the opening of the
thoracic cavity (pulmonary collapse) they can
reduce their size to a third
· The lungs are separated from each other by the
mediastinum

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4Lungs
· We have seen the
cadaveric lungs:
- Small, firm, hard and
grey
. But in the living people,
lungs are:
- Spongy, light, soft and
pink-colored

Components of a Lung

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5Apex
Anterior border
Superior lobe
Oblique
fissure
Horizontal
Right lung
fissure
Middle
lobe
Inferior
lobe
Inferior border
Components of a lung
Every lung has:
· An apex
· A base
· Two or three lobes, separated by one or two fissures
· Three surfaces: costal, mediastinal, and diaphragmatic
· Three borders: anterior, inferior, and posterior

Apex and Base of the Lung

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6Components of a lung
· Apex, the superior end of the lung
ascending above the level of the
1st rib into the root of the neck.
Here is where we can find the
cervical pleura
•
Base, the inferior surface of the
lung, lying on the dome of the
diaphragm, which prints its surface
- Right dome: liver
- Left dome: spleen
Anterior border
Apex
Superior
lobe
Oblique
fissure
Inferior
lobe
Cardiac
notch
Inferior border
Left lung

Right Lung Features

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7Right lung
•
It has two fissures:
- Oblique fissure
- Horizontal fissure
· The fissures divide the lung
into three lobes:
- Superior
- Middle
- Inferior
Horizontal
fissure
Oblique
fissure
Superior
lobe
Superior
lobe
Middle
lobe
Cardiac
notch
Inferior
lobe
Inferior
lobe
Oblique
fissure
Lingula

Right vs. Left Lung Comparison

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8Right lung vs. Left lung
•
Right lung is larger in size than the
left lung
· Right lung is heavier in weight than
the left lung
· But
- Shorter in height due to the right
dome of the diaphragm, which is
higher because it is over the liver
- Wider because the heart and
pericardium are shifted to the left
Horizontal
fissure
Oblique
fissure
Superior
lobe
Superior
lobe
Middle
lobe
Cardiac
notch
Inferior
lobe
Inferior
lobe
Oblique
fissure
Lingula

Left Lung Features

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9Left lung
•
It has only one fissure:
- Oblique fissure
. The fissure divides the lung
into two lobes:
- Superior
- Inferior
Horizontal
fissure
Oblique
fissure
Superior
lobe
Superior
lobe
Middle
lobe
Cardiac
notch
Inferior
lobe
Inferior
lobe
Oblique
fissure
Lingula

Lung Impressions

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10Prints of the lung
· Impressions formed by structures adjacent to the lungs:
. These marks make easier understand the relationships of the
lungs
· In the living people, the most evident during surgery is the
cardiac impression

Right Lung Impressions

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11Prints of the lung
Right lung:
•
Azygos arch
•
Small cardiac impression
· Esophagus and trachea
•
1 st rib
•
Brachiocephalic vein
· Both venae cavae
Tracheal
area
Apex
Groove for
brachiocephalic
vein
Esophageal area
Groove for arch
of azygos vein
Groove for 1st rib
Anterior border
Oblique fissure
Posterior border
Groove for
superior
vena cava
Pleural sleeve
Cardiac
impression
Horizontal
fissure
Groove for
esophagus
Groove for
inferior
vena cava
Pulmonary
ligament
Oblique fissure
Diaphragmatic surface
Inferior border

Left Lung Impressions

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12Prints of the lung
Left lung:
•
Aorta and its arch
· Very big cardiac impression
· Esophagus and trachea
· 1st rib
Area for trachea
and esophagus
Apex
Groove for
arch of aorta
Groove for 1st rib
Oblique fissure
Anterior
border
Pleural sleeve
Cardiac
impression
Groove for
descending
aorta
Pulmonary
ligament
Cardiac
notch
Area for
esophagus
Lingula
Inferior border
Diaphragmatic
surface (forms
base of lung)
Oblique fissure

Lung Surfaces

Costal Surface of the Lungs

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13Costal surface of the lungs
Costal surface:
· Large, smooth, and convex
· The costal pleura separates it from:
- Ribs
- Costal cartilages
- Innermost intercostal muscles
Apex
Anterior border
Superior lobe
Oblique
fissure
Horizontal
fissure
Middle
lobe
Inferior
lobe
Inferior border
· Vertebral part of the costal surface: it is the posterior part, related to the
bodies of the thoracic vertebrae

Mediastinal Surface of the Lungs

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14Mediastinal surface of the lungs
Mediastinal surface
· Concave
. It is related to the middle mediastinum, which
contains the pericardium and heart
•
Content of the mediastinal surface:
- Hilum: the root of the lung
- Groove for the esophagus
- Cardiac impression: larger in the left side
- Groove for the arch of the aorta on the left lung
- Groove for the arch of the azygos on the right
lung, etc ...

Diaphragmatic Surface of the Lungs

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15Ant.
Med.
Lat.
Post.
Diaphragmatic surface of the lungs
Diaphragmatic surface
•
Concave
. It forms the base of the lung, lying on the dome of the diaphragm
· The concavity is deeper in the right lung because of the higher position of the
right dome due to the liver
. Latero-posteriorly, the diaphragmatic surface is bounded by a thin, sharp
border that projects into the costodiaphragmatic recess of the pleura

Lung Borders

Anterior Border of the Lung

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16Borders of the lung
Anterior border:
· Right lung: relatively straight
· Left lung: has two structures that does not have the
right:
· Cardiac notch: deep print due to the deviation
of the apex of the heart to the left side
. Lingula: thin process of the superior lobe at its
inferio-anterior part. It extends below the
cardiac notch and slides in and out of the
costo-mediastinal recess during respiration

Posterior and Inferior Borders

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17Borders of the lung
Anterior border:
. Border between the costal surface and mediastinal surface
. This border overlaps the heart, and in the left lung it is notched by
the cardiac impression and forms the lingula
Posterior border:
. Also between the costal and mediastinal surfaces, but in the
posterior aspect
. It is a rounded border next to the vertebral column
Inferior border:
•
Border between the diaphragmatic surface and the costal and
mediastinal surfaces
. It surrounds completely the diaphragmatic surface of the lung
Ant.
Med.
Lat
Post.

Lung Hilum and Attachment

Hilum Location and Structure

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18Hilum
. Located at the mediastinal surface of each lung
. The hilum is enclosed within an area of continuity
between the parietal pleura and visceral pleura
. This continuity between both pleura forms the
pulmonary ligament:
- Double layer of pleura with connective tissue in the
middle
- Visually is comparable to the double sleeve that
t hangs from your forearm
- Located inferior to the root of the lung
- Located between the lung and the mediastinum
- Located anterior to the esophagus
Hilum of left lung
Pulmonary
artery
Superior lobar
bronchus
Bronchial
vessel
Pleural
sleeve
Left main
bronchus
Inferior lobar
bronchus
Broncho-
pulmonary
lymph node
Pulmonary
veins
Pulmonary
ligament

Hilum Content and Vessels

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19Attachment of the lungs
•
Remember that the heart was only attached by
the great vessels
•
In a similar way, the lungs are attached to the
mediastinum by the hilum
· Content of the hilum:
- Bronchi: at the posterior border of the hilum
- Bronchial artery/vein: in the posterior aspect of the bronchi
- Pulmonary arteries: the most superior structure of the hilum
- Pulmonary veins: the most anterior/inferior structure of the hilum
- Pulmonary nervous plexus
- Lymphatic vessels
Hilum of
right lung
Bronchial
vessels
Superior lobar
bronchus
Right main
bronchus
Pleural
sleeve
Inferior lobar
bronchus
Pulmonary
veins
Broncho-
pulmonary
lymph node
Middle lobar
bronchus
Pulmonary
ligament

Lung Lobe Variations

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20Variations in lobes of the lungs
•
The oblique and horizontal fissures may be
incomplete or absent in some specimens
- This causes reductions in the number of lobes
•
We can also find an extra fissures, for example
dividing the left lung into three lobes
· Not always the left superior lobe has a lingula (check
the drawing at the beginning of the presentation)
· Azygos lobe: appears in the right lung in 1% of the
people
Pulmonary lobe of Azygos vein
Superior lobe
Azygos lobe
Azygos V.
Middle lobe
Interlobar
Incisures
Inferior lobe

Bibliography for Lung Anatomy

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21Bibliography
. Moore Clinically oriented anatomy 8th edition / Moore, Keith L.
Published 2018
. Moore Essential Cllinical anatomy 6th edition. Published 2019
. Gray's Anatomy for students / Drake, Richard L. 4th Edition
Published 2019
. Color atlas of anatomy 7h edition, Rohen, Yokochi
· Manual de embriología y anatomía general. V Smith Agreda
· Anatomía: estructura y morfología del cuerpo humano, 4ª
Edición, Lippert

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22