PULMONES - ANATOMÍA DE TORAX.

Anatomy of the Lungs: Right vs. Left

Overview of Lung Anatomy

• The presentation takes place at the National University of San Antonio Abad del Cusco, focusing on lung anatomy, particularly differences between the right and left lungs.

• The lungs are preserved using plastination techniques for anatomical study, with a focus on their structure and surgical relevance.

Structural Characteristics

• Lungs are located in pleural cavities, lateral to the mediastinum, above the diaphragm; each lung has a base (diaphragmatic surface), apex (vértice), and three surfaces: mediastinal, costal, and diaphragmatic.

• The left lung has two lobes separated by an oblique fissure while the right lung has three lobes divided by both oblique and horizontal fissures.

Borders of the Lungs

• Each lung features three borders: anterior (sharp), posterior (blunt), and inferior (also sharp); these characteristics help differentiate between right and left lungs.

Mediastinal Surface Relations

• The mediastinal surface is crucial as it interacts with structures in the mediastinum; notable impressions from surrounding organs can be observed here.

• The hilum is where structures such as bronchi, pulmonary arteries, veins, and plexus enter or exit; its central location is consistent across both lungs.

Impressions on Mediastinal Surface

• Differences exist in impressions found on the right versus left lungs due to adjacent organ relationships; for instance, notable impressions include those from major veins like superior vena cava and azygos vein.

• Other significant impressions include esophageal impressions behind the hilum and cardiac impression below it; these highlight how closely related lung anatomy is to other thoracic structures.

Pulmonary Pedicle Structures

• Understanding how structures within the pulmonary pedicle are arranged is essential for recognizing their entry/exit points through the hilum.

• In detail:

• Right main bronchus positioned anteriorly to pulmonary artery,

• Followed by superior pulmonary vein above,

• Inferior pulmonary vein located below.

Pulmonary Anatomy and Structure

Overview of the Left Lung

• The left lung's anatomical structures differ from those of the right lung, particularly in the arrangement at the hilum.

• Notable impressions on the left lung include a significant indentation from the thoracic aorta, especially its descending portion.

• The cardiac impression is more pronounced on the left lung compared to the right, along with impressions from the first rib and subclavian veins and arteries.

Key Impressions on Left Lung

• Major impressions identified include:

• Aortic impression

• Arch of aorta impression

• Cardiac impression

• First rib impression

• Subclavian vein and artery impressions

Pulmonary Vascular Structures

• The left pulmonary artery is positioned above the main bronchus, with specific relationships to pulmonary veins:

• Superior pulmonary vein located anteriorly to the bronchus.

• Inferior pulmonary vein situated below it.

Differences Between Lungs

• The primary distinction in structure between lungs lies in vascular positioning relative to bronchi; this affects surgical approaches and anatomical understanding.

Costal and Diaphragmatic Surfaces

• Costal surfaces are oriented obliquely due to their relationship with ribs, while diaphragmatic surfaces are concave, conforming to diaphragm curvature.

• The apex of each lung extends slightly above the clavicle, indicating potential injury risks during neck trauma.

Importance of Pulmonary Segmentation

• Pulmonary segmentation is crucial for surgical procedures as it allows targeted interventions within specific segments based on bronchial branching patterns.

Blood Supply Considerations

• Functional blood supply comes from pulmonary arteries while nutritional support is provided by bronchial arteries.