1 / 43

Anatomy Of Tracheo -Bronchial Tree

Anatomy Of Tracheo -Bronchial Tree. Dr. Supreet Singh N ayyar, AFMC f or more presentations, visit www.nayyarENT.com. Layout. Embryology Respiratory Tree Trachea and main bronchi Segmental Bronchi Bronchopulmonary Segments Structure Vasculature , Lymphatic and Nerve Supply

delano
Download Presentation

Anatomy Of Tracheo -Bronchial Tree

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Anatomy Of Tracheo-Bronchial Tree Dr. Supreet Singh Nayyar, AFMC for more presentations, visit www.nayyarENT.com www.nayyarENT.com

  2. www.nayyarENT.com Layout • Embryology • Respiratory Tree • Trachea and main bronchi • Segmental Bronchi • Bronchopulmonary Segments • Structure • Vasculature , Lymphatic and Nerve Supply • Applied Anatomy

  3. www.nayyarENT.com EMBRYOLOGY • Tracheobronchial Diverticulum below Hypobranchial Eminence – 4th wk IUL • edges – oesophagotracheal septum • fuses caudally • endoderm lining • cranial – Trachea / Larynx • caudal – Bronchi / Lungs

  4. www.nayyarENT.com EMBRYOLOGY

  5. www.nayyarENT.com EMBRYOLOGY

  6. www.nayyarENT.com The Respiratory Tree

  7. www.nayyarENT.com The Trachea • Cartilaginous and Membranous tube • Dimensions • Length -10- 12 cm • Ext Dia – 2.0 cm ( 1.5 cm) • Extent – C6 – T4 • Incomplete rings

  8. www.nayyarENT.com

  9. www.nayyarENT.com Relations • Cervical • Anteriorly • Isthmus of thyroid with inf thyroid vessels • Pretracheal fascia • Sternothyroid & Sternohyoid • Investing layer of Deep Cervical Fascia • Skin & superficial fascia • Posteriorly • Oesophagus; longus colli; RLN • On each side • Thyroid • Common Carotid Artery

  10. www.nayyarENT.com

  11. Relation o cervical trachea at C 7 www.nayyarENT.com

  12. www.nayyarENT.com Relations • Thoracic • Anterior • ManubriumSterni • Sternothyroid • Thymus • Lt Brachiocephalic V • Aorta & Lt CCA • Deep Cardiac Plexus • Posterior • Oesophagus • Vertebral Column • Rt Side • Right Lung & Pleura • RtVagus • Azygous V • Lt Side • Arch of Aorta • Lt Common Carotid • Lt Subclavian A • Lt RLN

  13. www.nayyarENT.com

  14. www.nayyarENT.com

  15. www.nayyarENT.com The main Bronchi and Branches • Rt and Lt Main Bronchi – T4 level • Carina • The Right Bronchus (bronchus dexter), wider, shorter, and more vertical • 5 cm. long • Enters right lung opposite fifth thoracic vertebra • Azygos vein arches over it from behind • Right pulmonary artery lies at first below and then in front • 2.5 cm along course- Rt Upper Lobe Bronchus • At Hilum of Lung – Middle & Lower Lobe Bronchi

  16. Bronchi, Bronchioles, & Alveoli www.nayyarENT.com • Tracheadivides into • Primary bronchiidivide into • Secondary bronchidivide into • Tertiary bronchidivide into • Bronchiolesdivide into • Terminal bronchiolesdivide into • Respiratory bronchioles divide into • Alveolar ductsend in • Alveoli

  17. www.nayyarENT.com The Respiratory Tree

  18. www.nayyarENT.com The Respiratory Tree Structure through the airways 1.Trachea  2. Bronchus (Right- or Left- Primary Bronchus)  3. Lobar Bronchus  4. Segmental Bronchus  5. Bronchus  6. Bronchiole  7. Terminal Bronchiole  8. Respiratory Bronchiole  9. Alveolar Duct  10. Alveolar Sac / Alveolus

  19. www.nayyarENT.com

  20. www.nayyarENT.com The Respiratory Tree • Rt Upper Lobe Bronchus • Rt lat aspect of bronchus • Superolaterally • 3 segmental Bronchi ( Apical; Post; Ant ) • Apical Segmental – Apical & Ant. Subsegmental Br • Post Segmental – Lateral & Ant. Subsegmental Br • Ant. Segmental – Lateral & Ant. Subsegmental Br • Rt Middle Lobe Bronchus • 2.5 cm beyond Rt Upper Lobe Bronchus • Ant aspect • Forwards Downwards and Laterally • Lateral and Medial Subsegments

  21. www.nayyarENT.com The Respiratory Tree • Rt lower lobe bronchus • Apical Segmental – post aspect Medial ; Sup ; Lat subsegmentalbr • Medial Basal ( Cardiac ) – Rt Border of heart • Ant Basal • Lateral Basal • Post Basal

  22. www.nayyarENT.com

  23. www.nayyarENT.com The Respiratory Tree

  24. www.nayyarENT.com The Respiratory Tree

  25. www.nayyarENT.com The Respiratory Tree • Left Bronchus (bronchus sinister) smaller in calibre but longer than the right • 5.5 cm long • Enters root of the left lung opposite sixth thoracic vertebra • Passes beneath Aortic arch, • crosses in front of oesophagus, thoracic duct, descending aorta • Left pulmonary artery lies at first above then in front

  26. www.nayyarENT.com The Respiratory Tree • Lt upper Lobe Bronchus • Anterolateral aspect 5.5cm from carina • Curves laterally then divides • Cranial divisions: Apico posterior and Anterior • Caudal divisions : anterolaterallyLingular area of lung Sup and Inf segmental • Lt Lower Lobe Bronchus • Apical segmental • Originates posteriorly 1cm below upper lobe orifice • Anteromedial (Anterior Basal and Medial Basal ) • PosterolateralLateral Basal and Post Basal)

  27. www.nayyarENT.com

  28. The Lungs www.nayyarENT.com • Soft, spongy, cone-shaped • Right lung • 3 lobes • Left lung • 2 lobes

  29. www.nayyarENT.com Bronchopulmonary segments • Independent respiratory units • Sectors of lung with tertiary/ segmental bronchus ;separate Br of Pulmonary A • Pyramidal with apex to root of lung • Clinical Significance • Restriction of infections • Segmental resection • Bronchoscopy

  30. www.nayyarENT.com

  31. www.nayyarENT.com Structure of Trachea andMajor Bronchi • Cartilages • 16-20 • Incomplete Rings (4 mm vertically and 1 mm thick) • Union of 2 or more rings partially or completely • Highly elastic • 1st Tracheal Cartilage • Fibrous Membrane • Perichondrium of cartilages • Collgen with elastic fibres • Non striated musfibres

  32. www.nayyarENT.com

  33. Changes as the Respiratory Tree Branches www.nayyarENT.com • As branching of bronchi becomes more extensive • Rings of cartilage become plates • Smooth muscle increases • Columnar epithelium becomes cuboidal, then squamous (in alveoli

  34. www.nayyarENT.com

  35. www.nayyarENT.com • Mucous Membrane • Epith lining – thins and single layered • Tubulo-racemose glands • Not present in bronchioles

  36. www.nayyarENT.com Vasculature and lymphatics • Blood Supply • Inf Thyroid A • Bronchial A – 1 for Rt lung ;2 for Lt • Lie against post wall of Bronchi • 2 Bronchial Veins • Rt – Azygous V • Lt – Lt Sup Intercostal V or HemiazygousV • Pulmonary V

  37. www.nayyarENT.com Vasculature and lymphatics • Lymphatic Drainage • Pretracheal and Paratracheal groups • Superficial System- Tissue beneath pleura vessels round lung borders and fissures to reach hilum numerous Valves • Deep System- Bronchial Tree; Pulm Vessels hilum- drain into Bronchopulmonary Nodes less no. of Valves • Rt and Lt Paratracheal LN unite with Internal Thoracic and Brachiocephalic LN

  38. www.nayyarENT.com

  39. www.nayyarENT.com Nerve Supply • Parasympathetic ( Vagus) • Motor to bronchial muscle – bronchospasm • Secretomotor to mucous gland • Sensory- stretch and Cough Reflex • Sympathetic • Cervical Ganglion and Spinal N. T2 – T5 • Inhibitory to smooth muscle and glands

  40. www.nayyarENT.com Applied Anatomy • Tracheostomy • Bronchoscopy • Foreign Body In Respi Tract

  41. www.nayyarENT.com

  42. www.nayyarENT.com

  43. www.nayyarENT.com Thank youfor more presentations, visit www.nayyarENT.com

More Related