CASE 2

A 55 year old man states that he has

noticed an alteration in his voice. He has
lost 40 lb (18 kg) and has a persistent cough
with blood-stained sputum. He smokes 50
cigarettes a day. On examination, the left
vocal fold is immobile and lies in the
adducted position. A posteroanterior chest
radiograph reveals a large mass in the upper
lobe of the left lung with an increase in
width of the mediastinal shadow on the left
side.
 LUNGS
A. Parts:
1. apex – projects into the neck from the sternoclavicular
joint to a point 1 inch above the junction of the medial
and intermediate thirds of the clavicle
2. base (diaphragmatic surface) – rests on the
diaphragm; crosses the 6th, 8th and 10th ribs at the
midclavicular line, midaxillary line, and adjacent to the
vertebral column, respectively
3. costal surface – related to the chest wall
4. mediastinal surface – molded to the pericardium and
other mediastinal structures.
 B. Lobes and Fissures
1. Right lung
2. Left lung
Right lung
Left lung
 C. Bronchopulmonary segments
- the anatomical, functional, and surgical units of
the lungs
- pyramidal in shape with its apex directed towards
the lung root
- each bronchopulmonary segment contains:
1. segmental bronchus – branch of the lobar
bronchus
2. segmental artery
3. lymph vessels
4. autonomic nerves
C. Bronchopulmonary segments
 D. Root of the Lung
- formed of structures entering or leaving
the lung: the bronchi, pulmonary artery and
veins, lymph vessels, bronchial vessels and
nerves
 E. Blood supply of the Lungs
1. bronchial arteries
2. pulmonary arteries
 F. Lymph Drainage of the Lungs
1. superficial (subpleural) plexus
2. deep plexus