The trachea, trachea (from the Greek trachus - rough), being a continuation of the larynx, begins at the level of the lower edge of the VI cervical vertebra and ends at the level of the upper edge of the V thoracic vertebra, where it is divided into two bronchi - right and left. The place of division of the trachea is called bifurcatio tracheae. The length of the trachea ranges from 9 to 11 cm, the transverse diameter is on average 15 - 18 mm.
Trachea topography.
The cervical region is covered at the top by the thyroid gland, behind the trachea is adjacent to the esophagus, and the common carotid arteries are located on the sides of it. In addition to the isthmus of the thyroid gland, mm is also covered in front of the trachea. sternohyoideus and sternothyroideus, with the exception of the midline, where the inner edges of these muscles diverge. The space between the posterior surface of the named muscles with the fascia covering them and the anterior surface of the trachea, spatium pretracheale, is filled with loose tissue and blood vessels of the thyroid gland (a. Thyroidea ima and venous plexus). The thoracic trachea is covered in front by the sternum handle, thymus gland, and vessels. The position of the trachea in front of the esophagus is associated with its development from the ventral wall of the anterior intestine.
The structure of the trachea.
The wall of the trachea consists of 16 - 20 incomplete cartilaginous rings, cartilagines tracheales, connected by fibrous ligaments - ligg. annularia; each ring extends only two thirds of the circle. The posterior membranous wall of the trachea, paries membranaceus, is flattened and contains bundles of unmarked muscle tissue that run transversely and longitudinally and provide active tracheal movements during breathing, coughing and m. n. The mucous membrane of the larynx and trachea is covered with ciliated epithelium (with the exception of the vocal cords and part of the epiglottis) and is rich in lymphoid tissue and mucous glands.
Vessels and nerves.
The trachea receives arteries from aa. thyroidea inferior, thoracica interna, and also from rami bronchiales aortae thoracicae. Venous outflow is carried out into the venous plexus surrounding the trachea, and also (and especially) into the veins of the thyroid gland. The lymphatic vessels of the trachea along its entire length go to two chains of nodes located on the sides of it (peri-tracheal nodes). In addition, from the upper segment they go to the prelaryngeal and upper deep cervical, from the middle to the last and supraclavicular, from the lower to the anterior mediastinal nodes.
Tracheal nerves come from truncus sympathicus and n. vagus, as well as from the latter's vegvi - n. laryngeus inferior.
The main bronchi, right and left, bronchi principales (bronchus, Greek - respiratory tube) dexter et sinister, depart at the site of bifurcatio tracheae almost at a right angle and go to the gate of the corresponding lung. The right bronchus is somewhat wider than the left, since the volume of the right lung is larger than that of the left. At the same time, the left bronchus is almost twice as long as the right, the cartilaginous rings in the right 6 - 8, and in the left 9-12. The right bronchus is located more vertically than the left, and, thus, is, as it were, a continuation of the trachea. Through the right bronchus, v is thrown in an arcuate manner from back to front. azygos, heading towards v. cava superior, the aortic arch lies above the left bronchus. The mucous membrane of the bronchi is the same in structure as the mucous membrane of the trachea.
In a living person, during bronchoscopy (that is, when examining the trachea and bronchi by introducing a bronchoscope through the larynx and trachea), the mucous membrane has a grayish color; the cartilaginous rings are clearly visible. The angle at the site of the division of the trachea into bronchi, which looks like a ridge protruding between them, crista, should normally be located along the midline and move freely during breathing.
Trachea, trachea(from the Greek trachus - rough), being a continuation of the larynx, begins at the level of the lower edge of the VI cervical vertebra and ends at the level of the upper edge of the V thoracic vertebra, where it is divided into two bronchi - right and left. The place of division of the trachea is called bifurcatio tracheae. The length of the trachea ranges from 9 to 11 cm, the transverse diameter is on average 15 - 18 mm. Trachea topography... The cervical region is covered at the top by the thyroid gland, behind the trachea is adjacent to the esophagus, and the common carotid arteries are located on the sides of it. In addition to the isthmus of the thyroid gland, mm is also covered in front of the trachea. sternohyoideus and sternothyroideus, with the exception of the midline, where the inner edges of these muscles diverge. The space between the posterior surface of the named muscles with the fascia covering them and the anterior surface of the trachea, spatium pretracheale, is filled with loose tissue and blood vessels of the thyroid gland (a. Thyroidea ima and venous plexus). The thoracic trachea is covered in front by the sternum handle, thymus gland, and vessels. The position of the trachea in front of the esophagus is associated with its development from the ventral wall of the anterior intestine. The structure of the trachea... The wall of the trachea consists of 16 - 20 incomplete cartilaginous rings, cartilagines tracheales, connected by fibrous ligaments - ligg. annularia; each ring extends only two thirds of the circle. The posterior membranous wall of the trachea, paries membranaceus, is flattened and contains bundles of non-striated muscle tissue that run transversely and longitudinally and provide active movements of the trachea during breathing, coughing, etc. ) and is rich in lymphoid tissue and mucous glands. The trachea has: - cervical part(pars cervicalis; pars colli); - chest part(pars thoracica). The cervical part of the trachea in front is covered with muscles that lie below the hyoid bone (oshyoideum), as well as the thyroid isthmus, which corresponds to the level of the second-third semi-ring of the trachea. Behind the trachea (trachea) is the esophagus (oesophagus) .The chest part of the trachea (pars thoracica tracheae) is located in the upper mediastinum (mediastinum superius) Main bronchi, right and left, bronchi principales (bronchus, Greek - breathing tube) dexter et sinister, depart in place of bifurcatio tracheae almost at a right angle and go to the gate of the corresponding lung. The right bronchus is somewhat wider than the left, since the volume of the right lung is greater than that of the left. At the same time, the left bronchus is almost twice as long as the right, the cartilaginous rings in the right 6 - 8, and in the left 9-12. The right bronchus is located more vertically than the left, and, thus, is, as it were, a continuation of the trachea. Through the right bronchus, v is thrown in an arcuate manner from back to front. azygos, heading towards v. cava superior, the aortic arch lies above the left bronchus. The mucous membrane of the bronchi is similar in structure to the mucous membrane of the trachea. In a living person, during bronchoscopy (that is, when examining the trachea and bronchi by introducing a bronchoscope through the larynx and trachea), the mucous membrane has a grayish color; the cartilaginous rings are clearly visible. The angle at the site of the division of the trachea into bronchi, which looks like a ridge protruding between them, carina, should normally be located along the midline and move freely during breathing. Main bronchi(bronchi principales) are bronchi first order , the bronchial tree (arbor bronchialis) begins from them. The main bronchi (bronchi principales), entering the gate of the lungs (hilum pulmonum), branch out into bronchi of the second order , which ventilate the corresponding lobes of the lungs and are therefore called lobar bronchi ((bronchi lobares) .In the left lung (pulmo sinister) there are two lobar bronchi, and in the right - three lobar bronchi. The lobar bronchi (bronchi lobares) forks into third order bronchi that ventilate areas of the lungs that are separated by layers of connective tissue - segments of the lungs(segmenta pulmonalia) .All segmental bronchi (bronchі segmentalеs) branch dichotomously (that is, each into two) to lobular bronchi(bronchi lobulares) that ventilate the lobules of the lungs. This area is called lobule of lung (lobulus pulmonis), and the bronchi that ventilate it are called lobular bronchi(bronchioli lobulares). The lobular bronchus (bronchus lobularis) has a diameter of about 1 mm and goes into the apex of the lobule (apex lobuli), where it branches into 12 - 18 terminal bronchioles (bronchioli terminales), which have a diameter of 0.3 - 0.5 mmB their wall already lacks cartilaginous tissue, and the middle layer of the wall is represented only by smooth muscle tissue (textus musculаris glaber). Therefore, the small bronchi and terminal bronchioles (bronchioli terminales) perform the function of not only conducting, but also regulating the flow of air into certain parts of the lungs. terminal | bronchioli terminales ends bronchial tree (arbor bronchialis) and a functional unit of the lungs begins, which is called pulmonary acinus ((acinus pulmonalis), which translates as a bunch, or aalveolar tree(arbor alveolaris), there are up to 30,000 of them in the lungs.
64. Trachea and bronchi: topography, structure, functions, blood supply, innervation, regional lymph nodes.
Bronchi Trachea (trachea) (windpipe) - an unpaired organ (10-13 cm), which serves for the passage of air into the lungs and back, begins at the lower edge of the cricoid cartilage of the larynx. The trachea is formed by 16-20 semi-rings of hyaline cartilage. The first semicircle is connected to the cricoid cartilage by means of the cricoid-tracheal ligament. Cartilaginous half-rings are interconnected by dense connective tissue. Behind the rings is a connective tissue with an admixture of smooth muscle fibers, a membrane (membrane). Thus, the trachea is cartilaginous in front and sides, and connective tissue behind. The upper end of the tube is located at the level of the 6th cervical vertebra. The lower one is at the level of 4-5 thoracic vertebrae. The lower end of the trachea is divided into two main primary bronchi, the place of division is called the tracheal bifurcation. Due to the presence of elastic fibers in the connective tissue between the half rings, the trachea can lengthen when the larynx moves up and shorten when it is lowered. Numerous small mucous glands are located in the submucosal layer.
Bronchi are a continuation of the windpipe both functionally and morphologically. The walls of the main bronchi consist of cartilaginous semirings, the ends of which are connected by a connective tissue membrane. The right main bronchus is shorter and wider. Its length is about 3 cm, it consists of 6-8 semirings. The left main bronchus is longer (4-5 cm) and narrower, consists of 7-12 semirings. The main bronchi enter the gate of the corresponding lung. The main bronchi are first-order bronchi. Bronchi of the 2nd order depart from them - lobar (3 in the right lung and 2 in the left), which give segmental bronchi (3 orders), and the latter branch dichotomously. In the segmental bronchi, there are no cartilaginous semirings, the cartilage splits into separate plates. The segments are formed by pulmonary lobules (up to 80 pieces in 1 segment), which include the lobular bronchus (8th order). In small bronchi (bronchioles) with a diameter of 1-2 mm, cartilaginous plates and glands gradually disappear. Intralobular bronchioles disintegrate into 18-20 terminal (terminal) bronchioles with a diameter of about 0.5 mm. In the ciliated epithelium of the terminal bronchioles, there are separate secretory cells (Clarke) that produce enzymes that break down sur-factant. These cells are also a source of restoration of the epithelium of the terminal bronchioles. All bronchi, starting from the main ones and including the terminal bronchioles, make up the bronchial tree, which serves to conduct a stream of air during inhalation and exhalation; respiratory gas exchange between air and blood does not occur in them.
65. Lungs: borders, structure, blood supply, innervation, regional lymph nodes.
The branching of the terminal bronchiole is the structural unit of the lung acinus. Terminal bronchioles give rise to 2-8 respiratory (respiratory) bronchioles, pulmonary (alveolar) vesicles already appear on their walls. From each respiratory bronchiole radially depart alveolar passages, blindly ending with alveolar sacs (alveoli). In the walls of the alveolar passages and alveoli, the epithelium becomes monolayer flat. In the cells of the alveolar epithelium, a factor that lowers the surface tension of the alveoli is formed - a surfactant. This substance is composed of phospholipids and lipoproteins. The surfactant prevents the lungs from collapsing during exhalation, and the surface tension of the alveolar walls prevents excessive stretching of the lungs during inhalation. With forced inhalation, the elastic structures of the lungs also prevent overstretching of the pulmonary alveoli. The alveoli are surrounded by a dense network of capillaries, where gas exchange takes place. Respiratory bronchioles, alveolar passages and sacs make up the alveolar tree, or respiratory parenchyma of the lungs. In man 2 lungs (pulmones) - left and right. These are rather voluminous organs, occupying almost the entire volume of the chest, with the exception of its middle part. The lungs are cone-shaped. The lower expanded part - the base - is adjacent to the diaphragm and is called the diaphragmatic surface. Corresponding to the dome of the diaphragm, there is a depression at the base of the lung. The tapered, rounded upper portion — the apex of the lung — extends through the upper opening of the chest and into the neck. In front, it is located 3 cm above 1 rib, behind its level corresponds to the neck of 1 rib. On the lung, in addition to the diaphragmatic surface, there is an external convex - costal. There are rib prints on this surface of the lung. The medial surfaces face the mediastinum and are called mediastinal. In the central part of the mediastinal surface of the lung, its gate is located. The gates of each lung include the primary (main) bronchus, a branch of the pulmonary artery that carries venous blood into the lung, and a small bronchial artery (a branch of the thoracic aorta) that carries arterial blood to supply the lung. In addition, with the vessels are nerves that innervate the lungs. From the gate of each lung, two pulmonary veins exit, which carry arterial blood to the heart, and lymphatic vessels. Bifurcation of the trachea, all structural formations passing through the gate of the lungs, and lymph nodes together form the root of the lung. At the place of transition of the costal surface of the lung into the diaphragmatic, a sharp lower edge is formed. Between the costal and mediastinal surfaces in front there is a sharp edge, behind it is blunt, rounded. The lung has deep grooves dividing it into lobes. On the right lung there are two grooves that divide it into three lobes: upper, middle and lower; on the left - one, dividing the lung into two lobes: upper and lower. According to the nature of the branching of the bronchi and blood vessels, segments are distinguished in each lobe. In the right lung, 3 segments are distinguished in the upper lobe, 2 segments in the middle lobe, and 5-6 segments in the lower lobe. In the left lung in the upper lobe - 4 segments, in the lower lobe 5-6 segments. Thus, in the right lung 10-11, in the left 9-10 segments. The left lung is narrower, but longer than the right, the right lung is wider, but shorter than the left, which corresponds to the higher standing of the right dome of the diaphragm due to the liver located in the right hypochondrium.
Blood circulation in the lungs has its own characteristics. Due to the function of gas exchange, the lungs receive not only arterial, but also venous blood. Venous blood enters the branches of the pulmonary arteries, each of which enters the gate of the lung and divides up to the capillaries, where gas exchange between the blood and the air of the alveoli occurs: oxygen enters the blood, and from it carbon dioxide enters the alveoli. From the capillaries, the pulmonary veins are formed, which carry arterial blood to the heart. Arterial blood enters the lungs through the bronchial arteries (from the aorta, posterior intercostal and subclavian arteries). They nourish the bronchial wall and lung tissue. From the capillary network, which is formed by the branching of these arteries, bronchial veins are collected, which flow into the azygos and semi-unpaired veins, partly into the pulmonary veins from small bronchioles. Thus, the systems of the pulmonary and bronchial veins anastomose with each other.
The upper parts of the respiratory system are supplied with blood by the branches of the external carotid artery (facial, upper thyroid artery, lingual). The nerves of the lungs come from the pulmonary plexus, formed by the branches of the vagus nerves and sympathetic trunks.
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Bronchi Trachea (trachea)(windpipe) - an unpaired organ (10-13 cm), which serves for the passage of air into the lungs and back, begins at the lower edge of the cricoid cartilage of the larynx. The trachea is formed by 16-20 semi-rings of hyaline cartilage. The first semicircle is connected to the cricoid cartilage by means of the cricoid-tracheal ligament. Cartilaginous half-rings are interconnected by dense connective tissue. Behind the rings is a connective tissue with an admixture of smooth muscle fibers, a membrane (membrane). Thus, the trachea is cartilaginous in front and sides, and connective tissue behind. The upper end of the tube is located at the level of the 6th cervical vertebra. The lower one is at the level of 4-5 thoracic vertebrae. The lower end of the trachea is divided into two main primary bronchi, the place of division is called the tracheal bifurcation. Due to the presence of elastic fibers in the connective tissue between the half rings, the trachea can lengthen when the larynx moves up and shorten when it is lowered. Numerous small mucous glands are located in the submucosal layer.
Bronchi are a continuation of the windpipe both functionally and morphologically. The walls of the main bronchi consist of cartilaginous semirings, the ends of which are connected by a connective tissue membrane. The right main bronchus is shorter and wider. Its length is about 3 cm, it consists of 6-8 semirings. The left main bronchus is longer (4-5 cm) and narrower, consists of 7-12 semirings. The main bronchi enter the gate of the corresponding lung. The main bronchi are first-order bronchi. Bronchi of the 2nd order depart from them - lobar (3 in the right lung and 2 in the left), which give segmental bronchi (3 orders), and the latter branch dichotomously. In the segmental bronchi, there are no cartilaginous semirings, the cartilage splits into separate plates. The segments are formed by pulmonary lobules (up to 80 pieces in 1 segment), which include the lobular bronchus (8th order). In small bronchi (bronchioles) with a diameter of 1-2 mm, cartilaginous plates and glands gradually disappear. Intralobular bronchioles disintegrate into 18-20 terminal (terminal) bronchioles with a diameter of about 0.5 mm. In the ciliated epithelium of the terminal bronchioles, there are separate secretory cells (Clarke) that produce enzymes that break down sur-factant. These cells are also a source of restoration of the epithelium of the terminal bronchioles. All bronchi, starting from the main ones and including the terminal bronchioles, make up the bronchial tree, which serves to conduct a stream of air during inhalation and exhalation; respiratory gas exchange between air and blood does not occur in them.
Skeletotopy. The projection of the lungs onto the ribs constitutes their boundaries, which are determined by percussion (percussion) or radiographically. The tops of the lungs are 3-4 cm above the clavicle, and from behind they reach the level of the spinous process of the VII cervical vertebra.
The anterior border of the right lung runs from the apex to the II rib along the linea parasternalis and further along the same line to the VI rib, where it passes into the lower border. The anterior border of the left lung in the III rib runs in the same way as the anterior border of the right one, and in the IV intercostal space it deviates to the linea medioclaricularis, from where it descends to the VI rib and also passes into the lower border.
The lower border of the right lung crosses the 6th rib linea parasternalis 7 linea medioclavicularis 8 - linea axillaris media 9 linea axillaris posterior, 10 - along line a scapularis, XI - along linea paravertebral. The lower border of the left lung is located 1-1.5 cm below the right.
The posterior border of the right and left lung runs from the apex to the XI rib along the linea paravertebrals.
Syntopy. The subclavian artery is adjacent to the apex of the lung from the medial side. The costal surface, being covered by the parietal pleura, is separated from the intercostal vessels and nerves behind the intrathoracic fascia. The basis of the lungs lies on the diaphragm. In this case, the diaphragm separates the right lung from the liver, and the left one from the spleen, left kidney and adrenal glands, stomach, transverse colon and liver.
The medial surface of the right lung in front of the hilum is adjacent to the right atrium; above - to the right brachiocephalic and superior vena cava; behind the gate - to the esophagus. The medial surface of the left lung in front of the hilum is adjacent to the left ventricle; above - to the arch of the aorta and the left brachiocephalic vein; behind the gate - to the thoracic aorta.
The topography of the elements of the root of the right and left lungs is not exactly the same. On the right, the main bronchus is located on top; below is the pulmonary artery; in front and below from which are the pulmonary veins. At the root of the left lung, the pulmonary artery lies on top, below and behind it is the main bronchus, in front and below of which are the pulmonary veins.
In front of the root of the right lung are the ascending aorta, the superior vena cava, the pericardium and part of the right atrium, above and behind - the azygos vein. The arch of the aorta is adjacent to the root of the left lung in front, and the esophagus is behind. The phrenic nerves run in front of both roots, and the vagus nerves run in the back.
In newborns, the lungs expand on the first breath. At the end of the 1st year of life, their volume increases by 4 times; at the end of the 8th year - 8 times; at 12 years old - 10 times. The tops of the lungs in newborns reach only the first rib, and the lower border is higher than in adults.
Blood supply lungs has its own characteristics. Arterial blood enters the lungs through the bronchial arteries, and venous blood flows through the veins of the same name. In addition, venous blood enters the lungs through the pulmonary arteries. The pulmonary arteries are divided into lobar and segmental arteries, which further branch out according to the structure of the bronchial tree. The capillaries, formed, surround the alveoli. This ensures gas exchange between the air in the alveoli and the blood. From the capillaries, venous vessels are formed, carrying arterial blood to the pulmonary veins. The systems of the pulmonary and bronchial vessels are not completely isolated - there are anastomoses between their terminal branches.
Lymphatic
vessels and nodes of the lungs. In the lungs, superficial and deep lymphatic vessels are distinguished. Superficial are formed from pleural lymphatic capillaries. Deep ones are formed from capillary networks around the terminal bronchioles, inter-acynary and interlobular spaces. The drainage lymphatic vessels pass in the regional lymph nodes, which are subdivided into:
1) pulmonary, nodi lymphoidei pulmonales, located in the parenchyma of the lungs, mainly at the sites of division of the bronchi;
2) bronchopulmonary, nodi lymphoidei bronchopulmonales, located in the area of the gate of the lungs;
3) upper tracheobronchial, nodi lymphoidei tracheohronchiales sup., Lying along the trachea and the upper surface of the main bronchi;
4) lower tracheobronchial or bifurcation, nodi lymphoidei tracheobronchiales inf., Located on the lower surface of the bifurcation of the trachea and main bronchi;
5) tracheal, nodi lymphoidei paratracheales, placed along the trachea.
Innervation the lungs are provided by the branches of the vagus nerve, the branches of the nodes of the sympathetic trunk, as well as the branches of the phrenic nerve, which form the pulmonary plexus at the gate of the lungs, pl. pulmonalis. The pulmonary plexus is divided into anterior and posterior, its branches form the parabronchial and perivascular plexuses. Sensitive innervation of the lungs is carried out by the cells of the lower node of the vagus nerve and cells of the lower cervical and upper thoracic spinal nodes. Nerve impulses from the bronchi are conducted mainly along the ferrous fibers of the vagus nerves, and from the visceral pleura - along the ferrous spinal fibers.
The sympathetic innervation of the lungs is carried out from the cells of the lateral horns along the Th II-V segments of the spinal cord. Parasympathetic innervation - from the cells of the posterior nucleus of the vagus nerve. The axons of these cells reach the lungs as part of the branches of the vagus nerve.
Pleura, pleura, is the serous membrane of the lungs, which consists of a connective tissue base covered with mesothelium. In the pleura, two sheets are distinguished: the visceral (pulmonary) and parietal pleura, pleura visceralis (pulmonalis) et parietalis. The latter is subdivided into the mediastinal part, pars mediastinalis, which limits the mediastinum on the sides; costal, pars costalis, covering the inside of the chest wall, and diaphragmatic, pars diaphragmatica. At the lower edge of the lung root, the visceral pleura passes into the parietal pleura and forms a fold - the pulmonary ligament, ligamentum pulmonale.
The slit space between the parietal and visceral pleura is called the pleural cavity, cavitas pleuralis. In a healthy person, this cavity is filled with 1-2 ml of serous fluid. In pathological conditions (pleurisy), the amount of fluid increases significantly. The latter is secreted by the free surface of mesothelium cells (mesothelial cells). Under normal conditions, mesotheliocytes also provide the absorption of this fluid. In pathological conditions (pleurisy), the amount of fluid increases significantly, since the processes of excretion prevail over the processes of absorption. Three slit-like spaces are formed between different parts of the parietal pleura - pleural sinuses, recessus pleurales. The largest of them passes between the costal and diaphragmatic pleura - costophrenic sinus, recessus costodiaphragmaticus. The second lies sagittally between the diaphragmatic and mediastinal pleura - the diaphragmatic-mediastinal sinus, recessus phrenicomediastinalis. The third is located vertically between the costal and mediastinal pleura - costal-mediastinal sinus, recessus costo-mediastinalis. The pleural sinuses constitute the reserve spaces that the lungs enter during maximum inspiration. With pleurisy, fluid accumulates primarily in the pleural sinuses, and later in the pleural cavity.
The level of the tops of the pleural sacs (dome of the pleura, cupula pleurae) coincides with the level of the tops of the lungs.
The anterior border of the pleural sacs runs from the apex to the sternoclavicular joint. Further to the right, it passes to the midline at the level of the sternum angle, from where it descends to the level of the VI-VII ribs and passes into the lower border. On the left, at the level of the VI rib, the anterior border deviates laterally, then descends to the VI rib, where it passes into the lower border.
The lower border on the right along the linea medioclavicularis crosses the VII rib, along the linea axillaris media - IX, along the linea scapularis - XI, no linea paravertebral - XII. On the left, the bottom border runs slightly below.
The posterior border of the pleural sacs runs from the dome to the XII rib along the linea paravertebral.
Mediastinum, mediastinum, is a complex of organs located between the mediastinal pleura. In front, it is bounded by the anterior chest wall; behind - the spine, rib necks and anterior vertebral fascia; from below - with a diaphragm. The mediastinum is divided into: upper, mediastinum superius, and lower, mediastinum imferius, which in turn includes the anterior mediastinum, mediastinum anterius; middle, mediastinum medium, and posterior, mediastinum posterius. The border between the upper and lower runs along a conventional horizontal plane, which is drawn through the upper edge of the roots of the lungs. In the upper mediastinum lies the thymus or its remnants, the ascending aorta and the aortic arch with its branches, the superior vena cava with its tributaries, the trachea, esophagus, thoracic duct, sympathetic trunks, vagus nerves, trachea, phrenic nerves, lymph nodes.
The anterior mediastinum is located between the body of the sternum and the pericardium. It includes in its composition fiber and processes of the intrathoracic fascia, in the leaves of which are located the internal thoracic arteries and veins, the retrosternal and anterior mediastinal lymph nodes. The middle mediastinum contains the pericardium with the heart, tracheal bifurcation and main bronchi, pulmonary trunk, pulmonary arteries and veins, phrenic nerves with accompanying phrenic-pericardial vessels, lymph nodes. The posterior mediastinum is located between the pericardium and the bifurcation of the trachea in front and the back of the spine. It includes the descending aorta, vagus nerves, sympathetic trunks, esophagus, thoracic duct, lymph nodes, and more.
1. The muscle is, on the one hand, the abdominal obstruction, and on the other hand, the respiratory muscle:
A) diaphragm;
C) rectus abdominis muscle;
C) the external oblique muscle;
D) transverse abdominal muscle;
E) dentate muscle.
2. Holes leading from the nasal cavity to the pharynx:
B) pharyngeal;
D) upper nasal passage;
E) sinus of the sphenoid bone.
3. The smallest branches of the bronchial "tree":
A) lobar bronchi;
C) lobular bronchi;
C) terminal bronchioles;
D) segmental bronchi;
E) respiratory (respiratory) bronchioles.
4. Body for coarse and fine air purification:
A) nasopharynx;
C) trachea;
C) bronchi;
D) the nasal cavity;
E) larynx;
5. Opening from the mouth to the pharynx:
C) Eustachian Trumpet;
C) maxillary sinus;
D) jugular;
6. The part of the nasal cavity, which is called the olfactory:
A) the middle nasal passage;
B) top;
C) lower;
E) external nose.
7. The main organs of the respiratory system:
A) bronchi;
B) pulmonary artery;
C) acicus;
D) lungs;
E) alveoli.
8. Pressure in the pleural fissure:
A) 760 mm Hg;
B) - 9 mm Hg;
C) 510 mm Hg;
D) above atmospheric;
E) - 19 mm Hg. Art.
9. The organ where the respiratory and digestive tracts intersect:
A) larynx;
C) pharynx;
C) the esophagus;
10. The main respiratory muscles of a woman:
A) abdominal muscles;
B) diaphragm;
C) intercostal;
D) staircase;
E) serrated.
11. A distinctive feature of the human external nose in comparison with other vertebrates:
A) flattened;
B) protruding on the face;
C) depressed;
D) bifurcated;
E) having two halves.
12. Average length of the trachea:
A) 25 - 30 cm;
B) 40 - 41 cm;
C) 6 - 8 cm;
D) 5 - 10 cm;
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