USLS COLLEGE OF MEDICINE L.

Embryology Notes

ANATOMY ● one lung lies on each side of the mediastinum

Lungs ○ heart and great vessels and other structures in
DATE: 11/16,18/20 mediastinum separate them from each other
● each lung is conical, covered with visceral pleura
LECTURER: Masa, MD ● attached to the mediastinum only by its root
(asynchronous) ● suspended free in its own pleural cavity

1. Apex - ​projects upward into the neck for about 1 in. (2.5 cm)
I. LUNGS above the clavicle
A. Parts and Surfaces ○ can be mapped out on the anterior surface of the body by
1. Apex drawing a curved line, convex upward, from the
2. Base sternoclavicular joint to a point 1 in. (2.5 cm) above the
3. Costal Surface junction of the medial and intermediate thirds of the
4. Medial Surface clavicle
5. Hilum ○ protrudes above the thoracic inlet where it contacts the
B. Impressions cervical pleura
1. Right lung ○ rises 3-4 cm above the first costal cartilage (anteriorly)
2. Left lung although level with the neck of the first rib (posteriorly)
C. Borders ○ relations to other intrathoracic structures:
1. Inferior ■ Anterior ​– Subclavian artery
2. Anterior ■ Posterior – Cervicothoracic (stellate) ganglion, ventral
3. Posterior ramus of T1 spinal nerves, superior intercostal artery
D. Fissures and Lobes ■ Lateral ​– Scalenus medius muscle
1. Oblique fissures ■ Right​ – Right brachiocephalic artery and vein
2. Horizontal fissures ■ Left – Left subclavian artery and Left brachiocephalic
E. Broncho-pulmonary segments vein
1. Main characteristics 2. Base ​- concave and sits on the diaphragm
2. Functional flow pattern ○ semilunar
3. Main bronchopulmonary segments ○ concavity is deeper on the base of right lung
F. Root of the Lungs ○ posterolaterally: has a sharp margin which projects into
G. Blood Supply the costodiaphragmatic recess
1. Bronchial arteries and veins 3. Costal Surface ​- convex and corresponds to concave chest wall
2. Pulmonary arteries and veins ○ smooth, in contact with costal pleura
H. Nerve Supply 4. Medial Surface - ​concave and is molded to the pericardium and
1. Sympathetic efferent fibers other mediastinal structures
2. Parasympathetic efferent fibers ○ Anterior (mediastinal)​ – deeply concave
3. Visceral afferent fibers ■ adapted to the heart (cardiac impression = larger and
I. Lymph Drainage deeper to the left
1. Superficial (subpleural) plexus ○ Posterior (vertebral) – in contact with sides of thoracic
2. Deep Plexus vertebrae, posterior intercostal vessels, splanchnic nerves
J. Mechanics of Respiration 5. Hilum - at about middle of lung surface, a depression in which
1. Types of Respiration the root of the lung attaches
2. Inspiration ○ posterosuperior to the cardiac impression
a) Quiet inspiration
(1) Vertical diameter
(2) Anteroposterior diameter
(3) Transverse diameter
b) Forced Inspiration
3. Expiration
a) Quiet Expiration
b) Forced Expiration
4. Lung Changes in Inspiration vs Expiration
K. Clinical Notes

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
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R​EFERENCES​: S​NELL​’​S​ C​LINICAL​ A​NATOMY​ B​Y​ R​EGIONS​ 10​TH​, N​ETTER​’​S​ A​TLAS​ ​OF​ H​UMAN​ A​NATOMY​ 7​TH​ (​FIGURES​)
 ○ left lung ​- ​“cardiac notch” (area of dullness)
● Right lung ■ has a similar course
○ cardiac impression: right atrium ■ but at level of ​4th costal cartilage​: deviates laterally
○ anterior: groove for SVC and extends for a variable distance beyond the lateral
○ posterior: grooves for azygos vein and esophagus margin of the sternum to form the ​cardiac notch
○ postero-inferior: groove for IVC ● cardiac notch - produced by the heart displacing
● Left lung the lung to the left
○ cardiac impression: left ventricle and atrium 3. Posterior Border
○ supero-posterior: groove for aorta ○ extends downward from spinous process of C7 to T10
○ superior: grooves for left subclavian artery and left ○ lies about 1.5 in. (4 cm) from the midline
brachiocephalic vein ○ separates costal surface from mediastinal surface
○ rounded junction of costal and mediastinal surfaces

1. Inferior Border - ​thin and sharp

○ laterally: separates base from costal surface
○ medially: separates base from mediastinal surface
○ quiet respiration​: inferior border corresponds to a line
■ 6th rib at MCL
■ 8th rib at MAL
■ 10th thoracic spine
■ level of inferior border of lung changes during
inspiration and expiration
2. Anterior Border -​ thin and sharp, overlaps the pericardium
○ right lung​ - ​almost vertical
■ begins behind the sternoclavicular joint
■ runs downward, almost reaching the midline behind
the sternal angle
■ continues downward until it reaches the xiphisternal
joint

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
2
R​EFERENCES​: S​NELL​’​S​ C​LINICAL​ A​NATOMY​ B​Y​ R​EGIONS​ 10​TH​, N​ETTER​’​S​ A​TLAS​ ​OF​ H​UMAN​ A​NATOMY​ 7​TH​ (​FIGURES​)
 ● each segmental bronchus - passes to a structurally and
● Oblique fissure ​(​both lungs​) ​- ​runs from the inferior border functionally independent unit of a lung lobe
upward and backward across the medial and costal surfaces bronchopulmonary segment (bounded by connective tissue
○ cuts the posterior border up to 2.5 in (6.25 cm) below apex walls)
○ indicated on the surface by a line drawn from the root of ○ right lung​ - 10 bronchopulmonary segments
spine of scapula obliquely downward, laterally and ○ left lung​ - 8 to 10
anteriorly
○ following course of 6th rib to the 6th costochondral 1. segmental bronchus divides repeatedly
junction 2. bronchi become smaller -> irregular plates of cartilage become
● Horizontal fissure ​(​right lung only) ​- runs horizontally across the smaller and fewer in number -> replace the tracheal rings
costal surface at the level of the 4th costal cartilage to meet the 3. smallest bronchi divide -> give rise to ​bronchioles (<1 mm in
oblique fissure in the mid axillary lobe diameter)
● bronchioles - possess no cartilage in their walls and are
● slightly larger than the left lined with columnar ciliated epithelium
● divided into 3 lobes: ● submucosa - ​possesses a complete layer of circularly
○ upper lobe arranged smooth muscle fibers
○ middle lobe​ - triangular lobe bounded by the 2 fissures 4. bronchioles then divide -> give rise to ​terminal bronchioles
○ lower lobe (show delicate outpouchings from their walls)
● gaseous exchange between blood and air takes place in
the walls of these outpouchings ​respiratory bronchiole
● divided by a similar oblique fissure into 2 lobes: (diameter of about 0.5mm)
○ upper lobe 5. respiratory bronchioles end by branching into alveolar ducts ->
○ lower lobe lead into tubular passages with numerous thin walled
● no horizontal fissure outpouchings called​ alveolar sac
● alveolar sacs
consist of several
alveoli opening into
a single chamber
● rich network of
blood capillaries
surrounds each
alveolus
● gaseous exchange
takes place
between the air in
the alveolar lumen
and the alveolar
wall into the blood
within the
surrounding
capillaries

● subdivision of a lung lobe

● pyramid shaped​, with its ​apex directed toward the lung root
● surrounded by connective tissue
● has ​3 defining components​:
○ segmental (tertiary) bronchus​ - centrally located
○ segmental artery​ - accompanies segmental bronchus
○ intersegmental veins - ​located in the connective tissue
walls between adjacent bronchopulmonary segments
● has its own lymph vessels and autonomic nerves
Figures Lungs viewed from the right and left. A. Lobes. B. Bronchopulmonary
segments.
● because it is a structural unit -> diseased segment can be
removed surgically

● anatomic, functional, and surgical units of the lungs ● air enters and leaves the center of each bronchopulmonary
● each lobar (secondary) bronchus - passes to a lobe of the lung segment via the segmental bronchus
gives off branches called​ segmental (tertiary) bronchi

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
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 ○ deoxygenated blood - enters the center of each ● common relations to other structures:
bronchopulmonary segment via the segmental artery (a ○ anterior: phrenic nerve, pericardiophrenic artery and vein,
branch of the pulmonary artery) anterior pulmonary plexus
○ oxygenated blood - leaves the bronchopulmonary segment ○ posterior: vagus nerve, posterior pulmonary plexus.
via the intersegmental veins located around the periphery ○ inferior: pulmonary ligament
of each segment ○ right root
■ veins drain into the pulmonary veins ■ posterior to SVC and right atrium
■ inferior to azygos vein
● Right Lung: ○ left root
○ Superior lobe: ■ anterior to descending thoracic aorta
■ apical ■ inferior to aortic arch
■ posterior ● anatomical arrangement of structures:
■ anterior ○ anterior: pulmonary veins
○ Middle lobe: ○ posterior: pulmonary artery, principal bronchus, bronchial
■ lateral vessels
■ medial ○ superior to inferior
○ Inferior lobe: ■ right: superior lobar bronchus, pulmonary artery,
■ superior principal bronchus, lower pulmonary vein
(apical) ■ left: pulmonary artery, principal bronchus, lower
■ medial pulmonary vein
basal
■ anterior
basal
■ lateral 1. Bronchial Arteries ​(branches of ​descending aorta
basal ○ supplies:
■ posterior ■ bronchi
basal ■ connective tissue of the lung
● Left Lung: ■ visceral pleura
○ Superior lobe: ○ right: branch of 3rd ​ ​ posterior intercostal artery
■ apical ○ left: branch of descending thoracic aorta
posterior 2. Bronchial Veins ​(communicate with pulmonary veins​) ​drain
■ anterior into:
■ superior ○ right: azygos veins
lingular ○ left: hemiazygos veins
■ inferior
lingular 1. Segmental Arteries ​(terminal branches of ​pulmonary arteries​)
○ Inferior lobe: ○ carry ​deoxygenated blood into the bronchopulmonary
■ superior segments and to the alveoli
(apical) ○ course​: pulmonary trunk -> left and right pulmonary artery
■ medial basal -> hilum -> branches that accompany segmental and
■ anterior subsegmental bronchi (dorsolateral)
basal 2. Intersegmental Veins
■ lateral basal ○ carry ​oxygenated​ blood from the alveolar capillaries
■ posterior ○ follow the connective tissue septa bounding the
basal bronchopulmonary segments to the pulmonary veins and
to the lung root
○ 2 pulmonary veins leave each lung root to empty into the
left atrium of the heart
○ course​: drains pulmonary capillaries -> coalescing into
larger branches (ventromedial) -> hilum -> left atrium
■ Pulmonary Capillaries - forms plexuses in the
● formed by the structures that enter or leave the lung interalveolar septum
● made of bronchi, pulmonary artery and veins, lymph vessels, ■ Arteriovenous Shunts​ - have been documented
bronchial vessels, and nerves in terminal bronchioles
● surrounded by a tubular sheath of pleura which joins the
mediastinal parietal pleura to the visceral pleura covering the
lungs

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
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 ○ Thoracic type
1. Sympathetic nerve fibers ​(derived from sympathetic chains) - ■ after second year of life: ribs become more oblique,
bronchodilation and adult form of respiration is established
2. Parasympathetic nerve fibers ​(derived from the vagus nerve) - ■ adult: sexual difference exists in the type of
bronchoconstriction respiratory movements
3. Visceral afferent fibers ● females: rely mainly on the movement of the
● intermingle at the root of each lung and form the ​pulmonary ribs rather than the descent of the diaphragm on
plexuses inspiration
○ branches of the pulmonary plexuses follow the bronchi ● males: use both thoracic and abdominal forms,
into and within the lungs but mainly the abdominal form

● lymph vessels originate in Quiet Inspiration

the superficial and deep ● compare thoracic cavity to a box with a single entrance at the
plexuses top, which is a tube ​“trachea”
● not present in the alveolar ● elongating all its diameters -> increases capacity of the box = air
walls under atmospheric pressure entering the box through the tube
1. Superficial (subpleural)
Plexus
Now consider the 3
○ lies beneath the
diameters of the thoracic
visceral pleura cavity and how they may
○ drains over the surface be increased
of the lung toward the
hilum, where the lymph
vessels enter the 1. Vertical Diameter
bronchopulmonary ● roof could be raised and the floor lowered
nodes ○ formed by the ​suprapleural membrane​ and is fixed
2. Deep Plexus ● mobile diaphragm forms the floor
○ travels along the bronchi and pulmonary vessels toward ● when diaphragm contracts:
the hilum ○ domes flatten
○ passing through ​pulmonary nodes ​located within the lung ○ level of diaphragm lowers
substance ○ increased vertical diameter
○ lymph then enters the bronchopulmonary nodes in the of thoracic cavity
hilum of the lung 2. Anteroposterior Diameter
○ all the lymph from the lung leaves the hilum and drains ● if downward-sloping ribs were raised at their sternal ends:
into the ​tracheobronchial node​s and then into the ○ anteroposterior
bronchomediastinal lymph trunks diameter of the
thoracic cavity
● respiration consists of 2 alternating phases: would increased
○ inspiration and expiration ○ lower end of
● accomplished by increasing and decreasing the capacity of the sternum would
thoracic cavity thrust forward
● mechanics of each phase differ depending if respiration occurs ■ happens when first rib is fixed by the contraction
under quiet or forced conditions of scalene muscles of the neck and intercostal
● rate of respiration (normal resting patients): muscles contract
○ 16 - 20 per minute ■ stabilizes sizes of the intercostal spaces and
■ faster in children raises ribs toward the first rib
■ slower in older adults 3. Transverse Diameter
● types of respiration: ● ribs articulation:
○ Abdominal type ○ anterior - sternum
■ babies and young children: ribs are nearly horizontal (via their costal
● babies: rely mainly on the descent of the cartilages)
diaphragm to increase their thoracic capacity on ○ posterior - vertebral
inspiration column
● accompanied by a marked inward and outward ● ribs curve downward and
excursion of the anterior abdominal wall, which forward around the chest
is easily seen wall -> resemble ​bucket
handles

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
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R​EFERENCES​: S​NELL​’​S​ C​LINICAL​ A​NATOMY​ B​Y​ R​EGIONS​ 10​TH​, N​ETTER​’​S​ A​TLAS​ ​OF​ H​UMAN​ A​NATOMY​ 7​TH​ (​FIGURES​)
 ○ if ribs are raised (like bucket handles) -> transverse ○ forcible contraction of musculature of the anterior
diameter of thoracic cavity will be increased abdominal wall
○ occurs by fixing the first rib and raising other ribs to it ○ quadratus lumborum​ - contracts and pulls down 12th rib
by contracting the intercostal muscles ○ some of the ​intercostal muscles - may contract, pull the
● additional factor: ribs together, and depress them to the lowered 12th rib
effect of descent of ○ serratus posterior inferior and ​latissimus dorsi - play a
the diaphragm on minor role
the abdominal
viscera and tone of ​ ​Lung Changes on Inspiration ​ ​ ​Lung Changes on Expiration
the muscles of the
anterior abdominal ● root of the lung descends ● roots of the lungs ascend along
wall ● level of the bifurcation of the the bifurcation of the trachea
○ as diaphragm trachea may lower by as much ● bronchi shorten and contract
descends on inspiration -> intra-abdominal pressure as 2 vertebrae ● elastic tissue of the lungs recoils
rises ● bronchi elongate and dilate and and the lungs reduce in size
○ accommodated by reciprocal relaxation of abdominal the alveolar capillaries dilate -> ● with the upward movement of the
assisting the pulmonary diaphragm, increasing areas of
wall musculature
circulation the diaphragmatic and costal
○ point is reached when no further abdominal
● air is drawn into the bronchial parietal pleura come into
relaxation is possible, and liver and other upper tree as the result of: apposition, and the
abdominal viscera act as a platform that resists ○ positive atmospheric costodiaphragmatic recess
further diaphragmatic descent pressure exerted through becomes reduced in size
● further contraction​: ​diaphragm will have its central tendon the upper part of the ● lower margins of the lungs shrink
supported from below respiratory tract and rise to a higher level
○ its shortening muscle fibers will assist ​intercostal ○ negative pressure on the
muscles in raising lower ribs outer surface of the lungs
○ other less important muscles also contract on brought about by the
inspiration and assist in elevating ribs: increased capacity of the
■ levatores costarum thoracic cavity
■ serratus posterior superior ● with expansion of the lungs ->
Forced Inspiration elastic tissue in the bronchial
● maximum increase in the capacity of the thoracic cavity occurs walls and connective tissue are
in forced deep inspiration stretched
● muscle that can raise ribs: ● as diaphragm descends:
○ costodiaphragmatic recess
○ scalenus anterior
of the pleural cavity opens
○ scalenus medius
○ expanding sharp lower
○ sternocleidomastoid edges of the lungs descend
● respiratory distress​: action of all muscles already engaged to a lower level
becomes more violent
○ scapulae are fixed by trapezius, levator scapulae, and
rhomboid muscles Clinical Notes
○ enabling ​serratus anterior and ​pectoralis minor to pull up Physical Examination of the Lungs
the ribs ● upper lobes of the lungs - most easily examined from front of the chest
○ grasping a chair back or table can support upper limbs -> ● lower lobes - from the back
allowing ​sternal heads of pectoralis major muscles to also ● areas of all lobes - in the axillae
assist the process Lung Trauma
● apex of the lung - projects up into the neck (1 in. [2.5 cm] above the clavicle)
○ can be damaged by stab or bullet wounds in this area
Quiet Expiration ● although lungs are well protected by bony thoracic cage -> splinter from a
● passive​ phenomenon fractured rib can nevertheless penetrate the lung -> air can escape into the
● brought about by: pleural cavity = ​pneumothorax​ and ​collapse of the lung
○ elastic recoil of the lungs ○ also find its way into the lung connective tissue
○ relaxation of intercostal muscles and diaphragm ○ air moves under the visceral pleura until it reaches the lung root
○ passes into the mediastinum and up to the neck
○ increase in tone of muscles of the anterior abdominal wall
○ may distend the subcutaneous tissue ​“subcutaneous emphysema”
-> forces diaphragm upward ● changes in the position of the thoracic and upper abdominal viscera and the
○ serratus posterior inferior - play a minor role in pulling level of the diaphragm during different phases of respiration relative to the
down lower ribs chest wall - considerable clinical importance
Forced Expiration ○ penetrating wound in the lower part of the chest - may or may not
● active​ process damage the abdominal viscera
● brought about by: ■ depending on the phase of respiration at the time of injury

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
6
R​EFERENCES​: S​NELL​’​S​ C​LINICAL​ A​NATOMY​ B​Y​ R​EGIONS​ 10​TH​, N​ETTER​’​S​ A​TLAS​ ​OF​ H​UMAN​ A​NATOMY​ 7​TH​ (​FIGURES​)
Pain and Lung Disease Loss of Lung Distensibility
● lung tissue and visceral pleura - devoid of pain-sensitive nerve endings -> ● diseases (eg. ​silicosis​, ​asbestosis​, ​cancer​, and ​pneumonia​) - interfere with
pain in the chest is always the result of conditions affecting the surrounding process of ​expanding the lung in inspiration
structures ○ decrease in compliance of the lungs and chest wall -> greater effort has
○ tuberculosis​ or ​pneumonia​: pain may never be experienced to be undertaken by ​inspiratory muscles​ to ​inflate lungs
● once lung disease crosses the visceral pleura and the pleural cavity to involve Postural Drainage
the parietal pleura - pain becomes a prominent feature ● excessive accumulation of bronchial secretions in a lobe or segment of a lung
○ lobar pneumonia with pleurisy​: severe tearing pain, accentuated by - can seriously interfere with normal flow of air into the alveoli
deep inspiration or coughing ○ stagnation of such secretions is often quickly followed by infection
○ lower part of the costal parietal pleura - sensory innervation from the ● to aid in the normal drainage of a bronchial segment: physiotherapist often
lower five intercostal nerves alters the position of the patient so that gravity assists in the process of
■ also innervate the skin of the ​anterior abdominal wall drainage
● pleurisy in this area - commonly produces pain that is ○ sound knowledge of the bronchial tree is necessary to determine the
referred to the abdomen optimum position of the patient for good postural drainage
● could result in a mistaken diagnosis of an acute abdominal
lesion
○ pleurisy of the ​central part of the diaphragmatic pleura - sensory
innervation from the ​phrenic nerve (C3 to 5)
Embryology Notes
■ lead to referred ​pain over the shoulder - ​supraclavicular nerves
Development of the Lungs and Pleura
(C3 and 4)​ supply the skin of this region
● lower respiratory tract
Surgical Access to the Lungs
develops from
● surgical access to the lung or mediastinum - commonly undertaken through
embryonic foregut
an intercostal space (see Chapter 4: Thoracotomy)
● longitudinal groove
○ special rib retractors allow wide separation of the ribs
“​laryngotracheal
○ costal cartilages are sufficiently elastic to permit considerable bending
groove​” - develops in
○ permits good exposure of the lungs
endodermal lining of
Segmental Resection of the Lung (Segmental Pulmonary Resection)
floor of the pharynx
● localized chronic lesion (eg. ​tuberculosis or ​benign neoplasm​) - may require
○ gives rise to
surgical removal
laryngotracheal
● if disease is ​restricted to a bronchopulmonary segment​: ​possible to dissect
tube (respiratory
out that particular segment and remove it​ -> surrounding lung intact
diverticulum, lung
● requires radiologist and thoracic surgeon to have a sound knowledge of the
bud)
bronchopulmonary segments and to cooperate fully to localize the lesion
● tracheoesophageal
accurately before operation
septum - partitions
Bronchogenic Carcinoma
laryngotracheal tube
● 1/3 of all cancer deaths in men
from foregut, forming 2
● becoming increasingly common in women
structures:
● commences in most patients in the mucous membrane lining the ​larger
○ more dorsal
bronchi​ -> situated close to the hilum of the lung
esophagus
● neoplasm rapidly spreads to the ​tracheobronchial ​and bronchomediastinal
○ more ventral (anterior) ​respiratory primordium
nodes
● laryngotracheal tube - grows caudally into splanchnic mesoderm and divides
○ may involve the recurrent laryngeal nerves -> ​hoarseness of the voice
distally into ​right​ and ​left lung buds
● lymphatic spread via the ​bronchomediastinal trunks
○ cartilage develops in mesenchyme surrounding the tube
○ may result in early involvement in the ​lower deep cervical nodes just
■ upper part of tube - larynx
above the level of the clavicle
■ lower part - trachea
● hematogenous spread to the bones and brain commonly occurs
● each lung bud consists of an endodermal tube surrounded by splanchnic
Bronchial Constriction (Bronchial Asthma) mesoderm
● one of the problems associated with ​bronchial asthma - spasm of the ○ all tissues of the corresponding lung are derived from this
smooth muscle in the wall of the bronchioles ○ each bud grows laterally and projects into the pleural part of
○ reduces diameter of the bronchioles during expiration -> asthmatic embryonic coelom
patient experience great difficulty in expiring, although inspiration is
● lung bud divides into 2 or 3 lobes
accomplished normally
○ corresponding to number of main bronchi and lobes found in fully
○ lungs consequently become greatly distended
developed lung
○ thoracic cage becomes permanently enlarged​ ​“barrel chest”
● each main bronchus then divides repeatedly in a dichotomous manner
○ airflow through the bronchioles is further impeded by the presence of
○ until terminal bronchioles and alveoli form
excess mucus -> patient is unable to clear because an effective cough
● division of terminal bronchioles, with formation of additional bronchioles
cannot be produced
and alveoli, continues for some time after birth
Loss of Lung Elasticity
○ splanchnic mesoderm - forms visceral pleura
● many diseases of the lungs (eg. ​emphysema and ​pulmonary fibrosis​) -
○ somatic mesoderm - forms parietal pleura
destroy elasticity of lungs -> lungs are unable to recoil adequately =
● 7th month​: capillary loops connected with pulmonary circulation are
incomplete expiration
sufficiently well developed to support life, should premature birth take place
○ respiratory muscles in these patients have to ​assist in expiration, which
● onset of ​respiration at birth​: lungs expand and alveoli dilate
no longer is a passive phenomenon
● after ​3 or 4 days of postnatal life​: alveoli in the periphery of each lung
become fully expanded

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
7
R​EFERENCES​: S​NELL​’​S​ C​LINICAL​ A​NATOMY​ B​Y​ R​EGIONS​ 10​TH​, N​ETTER​’​S​ A​TLAS​ ​OF​ H​UMAN​ A​NATOMY​ 7​TH​ (​FIGURES​)
Congenital Anomalies: Esophageal Atresia and Tracheoesophageal Fistula
● if margins of laryngotracheal groove fail to fuse properly -> abnormal
connection (a fistula) may be left between laryngotracheal tube and
esophagus
● if tracheoesophageal septum formed by fusion of margins of laryngotracheal
groove should be deviated posteriorly -> lumen of esophagus would be much
reduced in diameter
● obstruction of esophagus prevents child from swallowing saliva and milk ->
aspiration into the larynx and trachea = pneumonia

End of Transcription

T​RANSCRIBER​: A​NTOLO​, P., A​RDIENTE​, J., C​ARAM​, M., E​STANOL​, A., G​ONZAGA​, E., K​RAFT​, R., T​ABABA​, R.
8
R​EFERENCES​: S​NELL​’​S​ C​LINICAL​ A​NATOMY​ B​Y​ R​EGIONS​ 10​TH​, N​ETTER​’​S​ A​TLAS​ ​OF​ H​UMAN​ A​NATOMY​ 7​TH​ (​FIGURES​)