Updated: 7/6/2017

Lung Relationships

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Overview

Lungs

  • Right Lung
    • 3 lobes
      • upper (superior), middle, and lower (inferior) lobes
    • 2 fissures
      • oblique (major) fissure separates upper and lower lobes
      • horizontal (transverse) fissure separates upper and middle lobes
  • Left Lung
    • 2 lobes
      • upper (superior) and lower (inferior) lobes
    • 1 fissure
      • oblique fissure
    • cardiac notch
      • an indentation consequent to the deviation of apex of heart to left side
        • lingula is a flap of lung tissue of the left upper (superior) lobe that lies below cardiac notch
          • homolog of right middle lobe
        • the apex of the heart is covered anteriorly by the left lung
          • lies at the left fifth intercostal space at the midclavicular line
  • Hilum of Lung
    • a wedge-shaped area on mediastinal surface of each lung through which structures forming root of lung pass to enter or to exit lung
    • Relationship of pulmonary artery (PA) to bronchus ("RALS")
      • right lung: anterior to bronchus
      • left lung: superior to bronchus
  • Trachea
    • bifurcates into left and right (primary) main bronchi at level of sternal angle
      • right (primary) main bronchus is shorter, wider, and runs more vertically
        • foreign body is more likely to pass through right (primary) main bronchus and into right lung 
          • upright position
            • inferior (basal) portion of right lower (inferior) lobe
          • supine position
            • posterior portion of the right upper lobe
            • superior portion of right lower (inferior) lobe
High Yield

 

  • Blue - left upper lobe
  • Green - left lower lobe
  • Yellow - right upper lobe
  • Red - right middle lobe
  • Orange - right lower lobe

  1. Coracoid process (scapula)
  2. Clavicle (right)
  3. Right common carotid artery
  4. Thyroid
  5. Internal jugular vein (left)
  6. Clavicle (left)
  7. Subclavian vein (left)
  8. Humeral head (left)
  9. Spine of scapula
  10. Spinous process

  1. Esophagus
  2. Rib
  3. Trachea
  4. Superior vena cava
  5. Brachiocephalic artery
  6. Common carotid (left)
  7. Aorta
  8. Scapula
  9. Vertebral foramen

  1. Lung (right)
  2. Pulmonary artery (right)
  3. Superior vena cava
  4. Ascending thoracic aorta
  5. Pulmonary artery
  6. Pulmonary vein (left)
  7. Pulmonary artery (left)
  8. Rib
  9. Descending thoracic aorta
 

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Questions (2)
Lab Values
Blood, Plasma, Serum Reference Range
ALT 8-20 U/L
Amylase, serum 25-125 U/L
AST 8-20 U/L
Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL
Calcium, serum (Ca2+) 8.4-10.2 mg/dL
Cholesterol, serum Rec: < 200 mg/dL
Cortisol, serum 0800 h: 5-23 μg/dL //1600 h:
3-15 μg/dL
2000 h: ≤ 50% of 0800 h
Creatine kinase, serum Male: 25-90 U/L
Female: 10-70 U/L
Creatinine, serum 0.6-1.2 mg/dL
Electrolytes, serum  
Sodium (Na+) 136-145 mEq/L
Chloride (Cl-) 95-105 mEq/L
Potassium (K+) 3.5-5.0 mEq/L
Bicarbonate (HCO3-) 22-28 mEq/L
Magnesium (Mg2+) 1.5-2.0 mEq/L
Estriol, total, serum (in pregnancy)  
24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL
28-32 wk // 36-40 wks 40-220 ng/mL // 80-350 ng/mL
Ferritin, serum Male: 15-200 ng/mL
Female: 12-150 ng/mL
Follicle-stimulating hormone, serum/plasma Male: 4-25 mIU/mL
Female: premenopause: 4-30 mIU/mL
midcycle peak: 10-90 mIU/mL
postmenopause: 40-250
pH 7.35-7.45
PCO2 33-45 mmHg
PO2 75-105 mmHg
Glucose, serum Fasting: 70-110 mg/dL
2-h postprandial:<120 mg/dL
Growth hormone - arginine stimulation Fasting: <5 ng/mL
Provocative stimuli: > 7ng/mL
Immunoglobulins, serum  
IgA 76-390 mg/dL
IgE 0-380 IU/mL
IgG 650-1500 mg/dL
IgM 40-345 mg/dL
Iron 50-170 μg/dL
Lactate dehydrogenase, serum 45-90 U/L
Luteinizing hormone, serum/plasma Male: 6-23 mIU/mL
Female: follicular phase: 5-30 mIU/mL
midcycle: 75-150 mIU/mL
postmenopause 30-200 mIU/mL
Osmolality, serum 275-295 mOsmol/kd H2O
Parathyroid hormone, serume, N-terminal 230-630 pg/mL
Phosphatase (alkaline), serum (p-NPP at 30° C) 20-70 U/L
Phosphorus (inorganic), serum 3.0-4.5 mg/dL
Prolactin, serum (hPRL) < 20 ng/mL
Proteins, serum  
Total (recumbent) 6.0-7.8 g/dL
Albumin 3.5-5.5 g/dL
Globulin 2.3-3.5 g/dL
Thyroid-stimulating hormone, serum or plasma .5-5.0 μU/mL
Thyroidal iodine (123I) uptake 8%-30% of administered dose/24h
Thyroxine (T4), serum 5-12 μg/dL
Triglycerides, serum 35-160 mg/dL
Triiodothyronine (T3), serum (RIA) 115-190 ng/dL
Triiodothyronine (T3) resin uptake 25%-35%
Urea nitrogen, serum 7-18 mg/dL
Uric acid, serum 3.0-8.2 mg/dL
Hematologic Reference Range
Bleeding time 2-7 minutes
Erythrocyte count Male: 4.3-5.9 million/mm3
Female: 3.5-5.5 million mm3
Erythrocyte sedimentation rate (Westergren) Male: 0-15 mm/h
Female: 0-20 mm/h
Hematocrit Male: 41%-53%
Female: 36%-46%
Hemoglobin A1c ≤ 6 %
Hemoglobin, blood Male: 13.5-17.5 g/dL
Female: 12.0-16.0 g/dL
Hemoglobin, plasma 1-4 mg/dL
Leukocyte count and differential  
Leukocyte count 4,500-11,000/mm3
Segmented neutrophils 54%-62%
Bands 3%-5%
Eosinophils 1%-3%
Basophils 0%-0.75%
Lymphocytes 25%-33%
Monocytes 3%-7%
Mean corpuscular hemoglobin 25.4-34.6 pg/cell
Mean corpuscular hemoglobin concentration 31%-36% Hb/cell
Mean corpuscular volume 80-100 μm3
Partial thromboplastin time (activated) 25-40 seconds
Platelet count 150,000-400,000/mm3
Prothrombin time 11-15 seconds
Reticulocyte count 0.5%-1.5% of red cells
Thrombin time < 2 seconds deviation from control
Volume  
Plasma Male: 25-43 mL/kg
Female: 28-45 mL/kg
Red cell Male: 20-36 mL/kg
Female: 19-31 mL/kg
Cerebrospinal Fluid Reference Range
Cell count 0-5/mm3
Chloride 118-132 mEq/L
Gamma globulin 3%-12% total proteins
Glucose 40-70 mg/dL
Pressure 70-180 mm H2O
Proteins, total < 40 mg/dL
Sweat Reference Range
Chloride 0-35 mmol/L
Urine  
Calcium 100-300 mg/24 h
Chloride Varies with intake
Creatinine clearance Male: 97-137 mL/min
Female: 88-128 mL/min
Estriol, total (in pregnancy)  
30 wks 6-18 mg/24 h
35 wks 9-28 mg/24 h
40 wks 13-42 mg/24 h
17-Hydroxycorticosteroids Male: 3.0-10.0 mg/24 h
Female: 2.0-8.0 mg/24 h
17-Ketosteroids, total Male: 8-20 mg/24 h
Female: 6-15 mg/24 h
Osmolality 50-1400 mOsmol/kg H2O
Oxalate 8-40 μg/mL
Potassium Varies with diet
Proteins, total < 150 mg/24 h
Sodium Varies with diet
Uric acid Varies with diet
Body Mass Index (BMI) Adult: 19-25 kg/m2
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(M1.PL.26) A 27-year-old male is brought to the emergency room following a violent assault in which he was stabbed in the chest. The knife penetrated both the left lung and the left ventricle. Where did the knife most likely enter his chest? Review Topic

QID: 100829
1

Left seventh intercostal space in the midaxillary line

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(0/2)

2

Left seventh intercostal space in the midclavicular line

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3

Left fifth intercostal space just lateral to the sternum

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4

Left fifth intercostal space in the midaxillary line

0%

(0/2)

5

Left fifth intercostal space in the midclavicular line

100%

(2/2)

M1

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