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Anatomy for Dental Students$
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Martin E. Atkinson

Print publication date: 2013

Print ISBN-13: 9780199234462

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199234462.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 21 January 2022

The lower respiratory tract and its role in ventilation

The lower respiratory tract and its role in ventilation

(p.78) 11 The lower respiratory tract and its role in ventilation
Anatomy for Dental Students

Martin E. Atkinson

Oxford University Press

The two lungs occupy the right and left pleural cavities in the thoracic cavity. They are separated by the central mediastinum containing the heart and the great vessels, the trachea, and other structures passing through the thorax to the abdomen. The left and right pleural cavities are entirely separate from each other. Figure 11.1 shows how they are formed as the developing lung buds invade part of the coelomic cavity by pushing a layer of the wall before it. This is analogous to pushing your finger into a partially inflated balloon. Your finger is the equivalent of the lung bud, the wall of the balloon it is pushing into is the inner layer of pleura, and the far wall of balloon is the outer layer of pleura. The pleura are thus divided into outer and inner layers. As outlined in Figure 11.1D, the outer parietal layer lines the inner surface of the thoracic wall, the thoracic surface of the diaphragm, and the medial wall of the mediastinum. The inner visceral layer closely covers all surfaces of the lungs. The pleural cuff is formed where the two layers become continuous at the junctional region, surrounding the root (hilus) of the lung. A fold in the pleural cuff called the pulmonary ligament allows some space for movement of the lungs relative to the mediastinum during ventilation. The pleural cavity separates the two layers of pleura, but is normally a potential space over most of the lung surface. The visceral and parietal pleurae are in virtual contact, separated by only a thin layer of pleural fluid. Pleural fluid has two important functions. • It lubricates movement of the lungs and their attached visceral pleurae against the parietal pleurae. • It also adheres the two pleural layers to each other, thus maintaining the inflation of the lungs. The parietal pleura is often described as having costal, diaphragmatic, and mediastinal surfaces; this is useful when considering their nerve supply. The costal pleura is supplied segmentally by intercostal nerves, the mediastinal pleura by the phrenic nerves, and the diaphragmatic pleura centrally by the phrenic and peripherally by the lower five intercostal nerves.

Keywords:   abdominal muscles, bronchi, chemoreceptors, diaphragm, forced inspiration, hilus, lung cancer

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