ANA 202

Gross Anatomy of the Thorax

{2 Units}

Complete Lecture Note

 REGIONS OF THE THORAX
Boundaries
•Superiorly－jugular notch,
sternoclavicular joint, superior
border of clavicle, acromion,
spinous processes of C7
•Inferiorly－xiphoid process,
costal arch, 12th and 11th ribs,
vertebra T12
Regions
•Thoracic wall
•Thoracic cavity
 THE THORACIC WALL
Superficial structures
•Skin
•Superficial fascia
– Superficial a
– Superficial v.
• Thoracoepigastric v.
• Lateral thoracic v.
– Superficial n.
• Supraclavicular n.
• Anterior and lateral
cutaneous branches
of intercostal n.
Deep structures
•Deep fascia
– Superficial layer
– Deep layer—clavipectoral
fascia
•Muscles of thorax
– Subclavius
– Pectoralis major
– Pectoralis minor
– Serratus anterior
– Intercostales externi
– Intercostales interni
– Intercostales intimi
•Endothoracic fascia
 STERNUM
• MANUBRIUM
• JUGULAR (STERNAL)NOTCH
• ARTICULATION WITH RIB #1 & 2
• CLAVICULAR ARTICULAR FACETS
• STERNAL ANGLE – 2 ND RIB
• BODY (GLADIOLUS)
• ARTICULATES W/RIBS 2 - 7
• XIPHOSTERNAL JOINT
• XIPHOID PROCESS
• CARTILAGE-CALCIFIES THROUGH TIME
• PARTIAL ATTACHMENT OF MANY MUSCLES
 The Ribs
• Usually, 12 pairs
– 7 True ribs-direct attachment to sternum
– 5 False ribs-indirect or no attachment to
sternum
– Floating ribs-make up 2 of 5 False ribs, no
ventral attachment
• Typical Ribs
– Ribs # 2-9
• Atypical Ribs
– Ribs #1, 10, 11, 12
• TYPICAL RIBS
• HEAD
• NECK
• TUBERCLE
• ANGLE
• SHAFT
• SUBCOSTAL GROOVE
 TYPICAL RIB
ARTICULATION
• Dorsal (P) Attachment Thoracic Vertebrae
– Head of Rib  2 costal facets
» Superior costal facet
» Inferior costal facet of vertebra above it
» Intervertebral disc
– Tubercle of Rib  Transverse Costal Facet
– e.g. Rib #4 articulates with Superior Costal Facet
and Transverse Costal Facet of T4 & Inferior Costal
Facet of T3
• Ventral (A) Attachment to Sternum
– Via costal cartilage
• ATYPICAL RIBS
• #1-SHORT, FLAT (S-I), WIDE,
SUPPORTS SUBCLAVIAN VESSELS
• #1, 10-12 ARTICULATE WITH ONLY =
# VERTEBRA
• #11, 12 DON’T ARTICULATE WITH
TRANSVERSE PROCESSES, OR
ANTERIORLY AT ALL
 POSTERIOR JOINTS
• Superior costal facet with inferior
articular facet of T vertebrae above
• Inferior costal facet with superior facet
of rib with same number
• Facet on tubercle with transverse
process of T vertebrae of same
number
• Radiate ligaments (head)
• Costotransverse ligaments (tubercle
with transverse process)
 MUSCLES ASSOCIATE WITH THE RIBS

• INTERCOSTALS
• EXTERNAL
• INTERNAL
• INNERMOST

• TRANSVERSUS THORACICIS
• LEVATORES COSTARUM
MUSCLES
MUSCLES
 INTERCOSTAL MUSCLES
• EXTERNAL INTERCOSTALS

• O: INFERIOR BORDER OF RIB ABOVE

• I: SUPERIOR BORDER OF RIB BELOW

• FIBERS RUN OBLIQUE (DOWN AND

FORWARD)

• AID IN INSPIRATION (LIFT RIBCAGE,

INCREASE DIMENSIONS)
 INTERNAL INTERCOSTALS

• O: SUPERIOR BORDER OF RIB BELOW

• I: INFERIOR BORDER OF RIB ABOVE

• FIBERS RUN AT RIGHT ANGLES TO EXTERNAL

INTERCOSTALS

• AID IN FORCED EXPIRATION (DEPRESS

RIBCAGE, DECREASE DIMENSIONS)

 INNERMOST INTERCOSTALS

• O: INFERIOR BORDER OF RIB ABOVE

• I: SUPERIOR BORDER OF RIB BELOW

• SMALL, VARIABLE, FUNCTION UNCLEAR

MUSCLES
 TRANSVERSUS THORACIS

• ORIGIN - COSTAL CARTILAGES OF LAST 3-4 TRUE RIBS,

BODY OF STERNUM AND XIPHOID PROCESS

• INSERTION - RIBS/COSTAL CARTILAGES 2-6

• ACTION - DEPRESSES RIBS
MUSCLES
NEUROVASCULAR
BUNDLE OF INTERCOSTAL
MUSCLES
• VAN (VEIN, ARTERY, NERVE)
• INTERCOSTAL VEIN
• INTERCOSTAL ARTERY
• INTERCOSTAL NERVE

• SIT IN SUBCOSTAL GROOVE

• BETWEEN INTERNAL INTERCOSTAL
AND INNERMOST INTERCOSTAL LAYER
 MUSCLES OF THORAX
Muscle Origin Insertion Action Innervation
Pectoralis Sternum, Inter- Adduct, M&L
major Ribs 2-6 tubercular Flex, Med pectorals
groove of Rotate
humerus Arm
Pectoralis Ribs 3-5 Coracoid Depress, M&L
minor process of Rotate pectorals
scapula scapula
Serratus Ribs 1-9 Scapula Protract, Long
anterior Rotate Thoracic
(ventralis) scapula
 Muscles of Thorax
Muscle Origin Insertion Action Innervation
Trapezius Ligamentum Clavicle, Elevate, Accessory
nuchae, Spine & Adduct,
C7-T12 acromion Rotate,
of scapula Depress
Levator C1-C4 Medial Elevate D. Scapular
Scapulae border of scapula
scapula
Rhomboids C7-T5 Medial Adduct, D. Scapular
border of Elevate,
scapula Rotate
 MUSCLES OF THORAX
Muscle Origin Insertion Action Innervation
Deltoids Clavicle, Deltoid Flex, Axillary
Spin & tuberosityAbduct,
acromion of Extend, Lat
of scapula humerus & med.
rotate arm
Latissimus Iliac crest, Inter- Extend, Thoraco-
dorsi Sacrum, tubercular Adduct, dorsal
T7-12, groove of Med. rotate
Lumbar humerus arm
fascia
INNERVATION/BLOOD SUPPLY
INNERVATION/BLOOD SUPPLY
MUSCLES/NERVES
 DIAPHRAGM

• ORIGIN
• INSERTION
• NERVE SUPPLY (PHRENIC C3, C4 BILATERALLY)
DIAPHRAG
M
DIAPHRAG
M
DIAPHRAG
M
DIAPHRAG
M
PHRENIC NERVE
ACTIONS OF THE MUSCLES OF
RESPIRATION
• INSPIRATION
• DIAPHRAGM
• EXTERNAL INTERCOSTALS
• LEVATORES COSTORUM
• ACCESSORY – SCM, SCALENES
• EXPIRATION
• MOSTLY PASSIVE
• ABDOMINALS
• INTERNAL INTERCOSTALS
M OF RESPIRATION
 THE MEDIASTINUM
CONCEPT
•ALL OF ORGANS BETWEEN
THE LEFT AND RIGHT
MEDIASTINAL PLEURAE IS
CALLED MEDIASTINUM.
•IT EXTENDS FROM THE
STERNUM IN FRONT TO THE
VERTEBRAL COLUMN BEHIND,
AND FROM THE THORACIC
INLET ABOVE TO THE
DIAPHRAGM BELOW.
 SUBDIVISIONS OF
MEDIASTINUM
• SUPERIOR
MEDIASTINUM

• INFERIOR
MEDIASTINUM

• ANTERIOR MEDIASTINUM

• MIDDLE MEDIASTINUM

• POSTERIOR MEDIASTINUM
LEFT SIDE OF MEDIASTINUM
Thoracic duct
Left vagus n. Aortic arch
Left
recurrent n. Thoracic aorta
Phrenic n. &
pericardiaco Sympathetic trunk
Root of lung
phrenic a.

Pericardium

Esophagus Greater splanchnic n

RIGHT SIDE OF MEDIASTNUM
• Trachea
• Right vagus n. Superior vena cava
Arch of azygos Phrenic n. &
v. pericardiacophrenic a.
Root of lung
• Azygos v.
• Sympathetic Pericardium
trunk

• Esophagus

• Inferior vena
cava
SUPERIOR MEDIASTINUM
 SUPERIOR MEDIASTINUM
LOCATING-FROM INLET OF
THORAX TO PLANE EXTENDING
FROM LEVEL OF STERNAL ANGLE
ANTERIORLY TO LOWER BORDER
OF T4 VERTEBRA POSTERIOLY

CONTENTS
• SUPERFICIAL LAYER
• THYMUS
• THREE VEINS
• LEFT BRACHIOCEPHELIC V.
• RIGHT BRACHIOCEPHELIC
V.
• SUPERIOR VENA CAVA
 SUPERIOR MEDIASTINUM

CONTENTS
• MIDDLE LAYER
• AOTIC ARCH AND ITS
THREE BRANCHES
• PHRENIC N.
• VAGUS N.
 SUPERIOR MEDIASTINUM
CONTENTS
• POSTERIOR LAYER
• TRACHEA
• ESOPHAGUS
• THORACIC DUCT
 RELATIONS OF AORTIC ARCH
• ANTERIORLY AND TO THE
LEFT
• PLEURA
• LUNG
• PHRENIC N.
• PERICARDIACOPHRENIC
VESSELS
• VAGUS N.
• POSTERIORLY AND TO THE
RIGHT
• TRACHEA
• ESOPHAGUS
• LEFT RECURRENT N.
• THORACIC DUCT
• DEEP CARDIAC PLEXUS
 RELATIONS OF AORTIC ARCH
• SUPERIORLY
• ITS THREE
BRANCHES
• LEFT
BRACHIOCEPHALIC
V.
• THYMUS

• INFERIORLY
• PULMONARY A.
• ARTERIAL LIGAMENT
• LEFT RECURRENT N.
• LEFT PRINCIPAL
BRONCHUS
• SUPERFICIAL CARDIAC
 TRIANGLE OF DUCTUS ARTERIOSUS

• BOUNDARIES
• PHRENIC N.
• LEFT VAGUS N.
• LEFT PULMONARY A.

• CONTENTS
• ARTERIAL LIGAMENT
• LEFT RECURRENT N.
• SUPERFICIAL CARDIAC
PLEXUSES
TRIANGLE OF DUCTUS
ARTERIOSUS
INFERIOR MEDIASTINUM
 INFERIOR
MEDIASTINUM
ANTERIOR MEDIASTINUM
•LOCATION－POSTERIOR TO
BODY OF STERNUM AND
ATTACHED COSTAL
CARTILAGES, ANTERIOR TO
HEART AND PERICARDIUM

•CONTENTS
• FAT
• REMNANTS OF THYMUS GLAND
• ANTERIOR MEDIASTINAL LYMPH
NODES
 INFERIOR
MEDIASTINUM
MIDDLE MEDIASTINUM
•LOCATION－BETWEEN ANTERIOR
MEDIASTINUM AND POSTERIOR
MEDIASTINUM

•CONTENTS
• HEART AND PERICARDIUM
• BEGINNING OR
TERMINATION
OF GREAT VESSELS
• PHRENIC NERVES
• PERICARDIACOPHRENIC
VESSELS
• LYMPH NODES
 INFERIOR MEDIASTINUM
POSTERIOR MEDIASTINUM
•LOCATION－POSTERIOR TO
HEART AND PERICARDIUM,
ANTERIOR TO VERTEBRAE T5－
T12
 INFERIOR
MEDIASTINUM
POSTERIOR MEDIASTINUM
•CONTENTS:
• ESOPHAGUS
• VAGUS N.
• THORACIC AORTA
• AZYGOS SYSTEM OF VEINS
• THORACIC DUCT
• THORACIC SYMPATHETIC
TRUNK
• POSTERIOR MEDIASTINAL
LYMPH NODES
 RELATIONS OF
ESOPHAGUS
• ANTERIORLY
• TRACHEA
• BIFURCATION OF
TRACHEA
• LEFT PRINCIPAL
BRANCHUS
• LEFT RECURRENT N.
• RIGHT PULMONARY A.
• ANTERIOR ESOPHAGEAL
PLEXUS
• PERICARDIUM
• LEFT ATRIUM
• DIAPHRAGM
 RELATIONS OF
ESOPHAGUS
• POSTERIORLY
• POSTERIOR ESOPHAGEAL
PLEXUS
• THORACIC AORTA
• THORACIC DUCT
• AZYGOS V.
• HEMIAZYGOS V.
• ACCESSORY HEMIAZYGOS
V.
• RIGHT POSTERIOR
INTERCOSTAL V.
 RELATIONS OF
ESOPHAGUS
• LEFT
• LEFT COMMON CAROTID A.
• LEFT SUBCLAVIAN A.
• AORTIC ARCH
• THORACIC AORTA
• SUPERIOR PART OF
THORACIC DUCT

• RIGHT
• ARCH OF AZYGOS V.
 RELATIONS OF THORACIC
AORTA
• ANTERIORLY
• LEFT ROOT OF LUNG
• PERICARDIUM
• ESOPHAGUS
• POSTERIOR
• HEMIAZYGOS V.
• ACCESSORY HEMIAZYGOS
V.

• RIGHT
• AZYGOS V.
• THORACIC DUCT

• LEFT－MEDIASTINAL PLEURA
THE HEART

68
 HEART ANATOMY

Approximately the size of your fist

Location
Superior surface of diaphragm Left of
the midline
Anterior to the vertebral column,
posterior to the sternum

69
HEART ANATOMY

70
 COVERINGS OF THE HEART: ANATOMY
Pericardium – a double-walled sac around the
heart composed of:
1. A superficial fibrous pericardium
2. A deep two-layer serous pericardium
a. The parietal layer lines the internal
surface of the fibrous pericardium
b. The visceral layer or epicardium lines
the surface of the heart
They are separated by the fluid-filled
pericardial cavity
71
 COVERINGS OF THE HEART: PHYSIOLOGY

The Function of the Pericardium: Protects

and anchors the heart Prevents
overfilling of the heart with blood
Allows for the heart to work in a relatively
friction-free environment
72
PERICARDIAL LAYERS OF THE HEART

73
 HEART WALL
Epicardium – visceral layer of the serous
pericardium
Myocardium – cardiac muscle layer
forming the bulk of the heart Fibrous
skeleton of the heart – crisscrossing,
interlacing layer of connective tissue
Endocardium – endothelial layer of the
inner myocardial surface
74
EXTERNAL HEART: MAJOR
VESSELS OF THE HEART
(ANTERIOR VIEW)
• VESSELS RETURNING BLOOD TO THE HEART INCLUDE:
1. SUPERIOR AND INFERIOR VENAE CAVAE
2. RIGHT AND LEFT PULMONARY VEINS
• VESSELS CONVEYING BLOOD AWAY FROM THE HEART INCLUD
1. PULMONARY TRUNK, WHICH SPLITS INTO RIGHT AND LE
PULMONARY ARTERIES
2. ASCENDING AORTA (THREE BRANCHES) –
a. BRACHIOCEPHALIC

75

b. LEFT COMMON CAROTID

c. SUBCLAVIAN ARTERIES
 EXTERNAL HEART: VESSELS THAT
SUPPLY/DRAIN THE HEART (ANTERIOR VIEW)

Arteries – right and left coronary (in

atrioventricular groove), marginal, circumflex, and
anterior interventricular arteries
Veins – small cardiac, anterior cardiac, and great
cardiac veins

76
 EXTERNAL HEART: ANTERIOR VIEW

Chapter 18, Cardiovascular System 77

Figure 18.4b
EXTERNAL HEART: MAJOR VESSELS OF THE HEART

• VESSELS RETURNING BLOOD TO THE HEART INCLUDE:

1. RIGHT AND LEFT PULMONARY VEINS
2. SUPERIOR AND INFERIOR VENAE CAVAE

• VESSELS CONVEYING BLOOD AWAY FROM THE HEART INCLUDE:

1. AORTA
2. RIGHT AND LEFT PULMONARY ARTERIES

78
 EXTERNAL HEART: VESSELS THAT
SUPPLY/DRAIN THE HEART (POSTERIOR VIEW)

Arteries – right coronary artery (in

atrioventricular groove) and the posterior
interventricular artery (in interventricular
groove)
Veins – great cardiac vein, posterior vein to
left ventricle, coronary sinus, and middle
cardiac vein

79
 EXTERNAL HEART: POSTERIOR VIEW

Chapter 18, Cardiovascular System 80

Figure 18.4d
 GROSS ANATOMY OF HEART: FRONTAL
SECTION

Chapter 18, Cardiovascular System 81

Figure 18.4e
 ATRIA OF THE HEART
Atria are the receiving chambers of the heart
Each atrium has a protruding auricle Pectinate
muscles mark atrial walls
Blood enters right atria from superior and
inferior venae cavae and coronary sinus Blood
enters left atria from pulmonary veins

82
 VENTRICLES OF THE HEART
• VENTRICLES ARE THE DISCHARGING CHAMBERS OF THE
HEART
• PAPILLARY MUSCLES AND TRABECULAE CARNEAE MUSCLES
MARK VENTRICULAR WALLS

• RIGHT VENTRICLE PUMPS BLOOD INTO THE PULMONARY

TRUNK
• LEFT VENTRICLE PUMPS BLOOD INTO THE AORTA

Chapter 18, Cardiovascular System 83

 MYOCARDIAL THICKNESS AND FUNCTION

THICKNESS OF MYOCARDIUM VARIES ACCORDING TO

THE FUNCTION OF THE CHAMBER
ATRIA ARE THIN WALLED, DELIVER BLOOD TO ADJACENT
VENTRICLES
VENTRICLE WALLS ARE MUCH THICKER AND STRONGER
• RIGHT VENTRICLE SUPPLIES BLOOD TO THE LUNGS
• LEFT VENTRICLE WALL IS THE THICKEST TO SUPPLY
Chapter 18, CardiovSasYculSarTSyEsteMm IC CIRCULATION 84
 THICKNESS OF CARDIAC WALLS

Myocardium of left ventricle is much thicker than the right.

Chapter 18, Cardiovascular System 85
 PATHWAY OF BLOOD THROUGH THE HEART
AND LUNGS

Chapter 18, Cardiovascular System 86

Figure 18.5
 CORONARY CIRCULATION

Coronary circulation is the functional blood

supply to the heart muscle itself Collateral
routes ensure blood delivery to heart even if
major vessels are occluded

87
 CORONARY CIRCULATION: ARTERIAL
SUPPLY

Chapter 18, Cardiovascular System 88

Figure 18.7a
 CORONARY CIRCULATION: VENOUS SUPP

Chapter 18, Cardiovascular System 89

Figure 18.7b
 HEART VALVES
• HEART VALVES ENSURE UNIDIRECTIONAL BLOOD
FLOW
THROUGH THE HEART
• ATRIOVENTRICULAR (AV) VALVES LIE BETWEEN THE
ATRIA AND THE VENTRICLES
• AV VALVES PREVENT BACKFLOW INTO THE ATRIA WHEN
VENTRICLES CONTRACT
• CHORDAE TENDINEAE ANCHOR AV VALVES TO
PAPILLARY MUSCLES

90
 HEART VALVES
• Semilunar valves prevent backflow of blood into the ventricles
• Aortic semilunar valve lies between the left ventricle and the a
• Pulmonary semilunar valve lies between the right ventricle an
pulmonary trunk

91
HEART VALVES

92

Figure 18.8a, b
HEART VALVES

93

Figure 18.8c, d
 ATRIOVENTRICULAR VALVE FUNCTION

Chapter 18, Cardiovascular System 94

Figure 18.9
SEMILUNAR VALVE FUNCTION

95

Figure 18.10
HEART PHYSIOLOGY: SEQUENCE OF
EXCITATION

96

Figure 18.14a
HEART EXCITATION RELATED TO ECG

97

Figure 18.17
 EXTRINSIC INNERVATION
HEART
OF THE

• HEART IS STIMULATED
BY THE SYMPATHETIC
CARDIOACCELERATORY
CENTER
• HEART IS INHIBITED BY
THE PARASYMPATHETIC
CARDIOINHIBITORY
CENTER

98

Figure 18.15
 ELECTROCARDIOGRAPHY

Chapter 18, Cardiovascular System 99

Figure 18.16
 HEART SOUNDS
Heart sounds (lub-dup) are associated with closing of heart valves
First sound occurs as AV valves close and signifies beginning of
systole (contraction)
Second sound occurs when SL valves close at the beginning
of ventricular diastole (relaxation)

100
 PHASES OF THE CARDIAC CYCLE

Chapter 18, Cardiovascular System 101

Figure 18.20
LUNGS AND PLEURA
 RIGHT AND LEFT PLEURAL CAVITIES

Parietal Pleura
Visceral (Pulmonary) Pleura
Parietal
Costal Mediastinal
Diaphragmatic clavicular
Connecting Pleura
PLEURAL CAVITIES
PLEURAL CAVITIES
 LUNGS
Light, soft, spongy
Conical in shape, apex, base, costal surface,
medial surface, hilus. Note various impressions
Right lung
Three lobes; superior, middle and inferior Oblique and
horizontal fissure
Left Lung
Two lobes; superior and inferior also Lingula and
Cardiac notch, oblique fissure
RIGHT LUNG
RIGHT LUNG
RIGHT LUNG
RIGHT LUNG
LEFT LUNG
LEFT LUNG
LEFT LUNG
SURFACE ANATOMY
SURFACE ANATOMY
 AIRWAYS
• TRACHEA, PRIMARY BRONCHI, SECONDARY
BRONCHI, TERTIARY BRONCHI OUT TO 25
GENERATIONS
• ALL COMPRISED OF HYALINE CARTILAGE
• TRACHEA
• BEGINS WHERE LARYNX ENDS (ABOUT C6)
• 10 CM LONG, HALF IN NECK, HALF IN MEDIASTINUM
• 20 U-SHAPED RINGS OF HYALINE CARTILAGE – KEEPS
LUMEN INTACT BUT NOT AS BRITTLE AS BONE
• LINED WITH EPITHELIUM AND CILIA WHICH WORK TO
KEEP FOREIGN BODIES/IRRITANTS AWAY FROM LUNGS
AIRWAYS
AIRWAYS
TRACHEA
AIRWAYS
 AIRWAYS
• PRIMARY BROCHI
• ONE TO EACH LUNG – CONTINUATION OF
TRACHEA
• RIGHT BRONCHUS IS WIDER AND SHORTER
AND BRANCHES FROM THE TRACHEA AT A
GREATER ANGLE
• SECONDARY BRONCHI – ONE TO EACH
LOBE, THREE IN RIGHT, TWO IN LEFT
• TERTIARY – ONE TO EACH
BRONCHOPULMONARY SEGMENT –
APPROXIMATELY 10 PER LUNG
• ALL OF THE ABOVE ARE HYALINE
BRONCHOSCOPE
IN AND
OUT
BRONCHOPULMONARY SEGMENTS
BRONCHOPULMONARY SEGMENTS
 RIGHT LUNG

• RIGHT UPPER LOBE • RIGHT LOWER LOBE

• APICAL SEGMENT (B1) • SUPERIOR SEGMENT
• POSTERIOR SEGMENT (B6)
(B2) • MEDIAL SEGMENT (B7)
• ANTERIOR SEGMENT • ANTERIOR SEGMENT
(B3) (B8)
• RIGHT MIDDLE LOBE (OR • LATERAL SEGMENT (B9)
MORE CORRECTLY - JUST • POSTERIOR SEGMENT
MIDDLE LOBE) (B10)
• LATERAL SEGMENT (B4)
• MEDIAL SEGMENT (B5)
 LEFT LUNG

• LEFT UPPER LOBE • LEFT LOWER LOBE

• APICOPOSTERIOR • SUPERIOR SEGMENT
SEGMENT (B1/2) (B6)
• ANTERIOR SEGMENT • ANTEROMEDIAL
(B3) SEGMENT (B8)
• SUPERIOR LINGULAR • LATERAL SEGMENT (B9)
SEGMENT (B4) • POSTERIOR SEGMENT
• INFERIOR LINGULAR (B10)
SEGMENT (B5)
BRONCHOPULMONARY SEGMENTS
 BRONCHIOLES

First level of airway surrounded by smooth

muscle; therefore can change diameter as in
brocho-constriction and broncho-dilation
Terminal
Respiratory 3-8 orders alveoli
BRONCHIOLES
 BRONCHIOLES
Gas Exchange
Pulmonary arteries carry deoxygenated
blood to aleoli
Gas exchange occurs via diffusion
through the capillary beds
Returned to heart via pulmonary veins
GAS EXCHANGE
 INNERVATION
• PLEURA VIA INTERCOSTAL (THORACIC) NERVES
• TRACHEOBRONCHIAL TREE
• PARASYMPATHETIC VIA CN X EFFERENT
FUNCTION
= BRONCHO-CONSTRICTION VIA SMOOTH MM., ALSO
TO EPITHELIAL CELLS IN TRACHEA; AFFERENT =
RESPONSIBLE FOR COUGH REFLEX
• SYMPATHETIC FROM T1-T5 EFFERENT =
BROCHO-
DILATION
INTERCOSTAL TO PLEURA
INNERVATION
 BLOOD SUPPLY

Lungs do not receive any vascular supply from

the pulmonary vessels (pulmonary aa. or veins)
Blood delivered to lung tissue via the bronchiole
arteries
Vessels evolve from aortic arch Travel along the
bronchial tree
BLOOD SUPPLY
BLOOD SUPPLY
 BRANCHES OFAORTA

Pericardial. Intercostal.
Bronchial. Subcostal.
Esophageal. Superior Phrenic.

Mediastinal.
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