<?xml version="1.0" encoding="UTF-8"?>
<opml version="2.0">
  <head>
    <title>077-03 Lungs, airways, pulmonary vessels, lymphatics, and thoracic localisation</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Lungs, airways, and thoracic localisation">
      <outline text="Right and left lungs">
        <outline text="Right shorter and wider from liver"/>
        <outline text="Left has cardiac notch and lingula"/>
        <outline text="Right three lobes, left two"/>
        <outline text="Fissures variable or incomplete">
          <outline text="Alter collateral ventilation and spread"/>
        </outline>
        <outline text="Root in pleural sleeve">
          <outline text="Pulmonary ligament below root"/>
        </outline>
        <outline text="Hilar order">
          <outline text="Right upper bronchus above artery"/>
          <outline text="Left artery above bronchus"/>
          <outline text="Front to back: vein, artery, bronchus"/>
        </outline>
      </outline>
      <outline text="Tracheobronchial tree">
        <outline text="Trachea from cricoid near C6">
          <outline text="C-shaped rings, membranous back wall"/>
          <outline text="Carina near sternal-angle plane"/>
        </outline>
        <outline text="Right main bronchus wider, shorter, vertical">
          <outline text="Aspiration favours right, posture decides"/>
        </outline>
        <outline text="Segments: bronchus plus arterial branch">
          <outline text="Veins run between segments"/>
          <outline text="Resectable along connective planes"/>
        </outline>
        <outline text="Right lung ten segments"/>
        <outline text="Bronchioles lack cartilage and glands">
          <outline text="Terminal bronchiole ends conducting zone"/>
        </outline>
        <outline text="Collateral channels bypass obstruction">
          <outline text="Also permit spread"/>
          <outline text="Complete fissures limit interlobar flow"/>
        </outline>
        <outline text="Sequestration: systemic supply, no bronchus"/>
      </outline>
      <outline text="Acini and alveoli">
        <outline text="Acinus distal to terminal bronchiole"/>
        <outline text="Secondary lobule seen on high-resolution CT"/>
        <outline text="Type one cells form gas-exchange surface"/>
        <outline text="Type two cells make surfactant, regenerate"/>
        <outline text="Macrophages clear particles and microbes"/>
        <outline text="Fused basal laminae minimise diffusion"/>
        <outline text="Surfactant lowers surface tension">
          <outline text="Stabilises alveoli, raises compliance"/>
          <outline text="Loss causes collapse and distress"/>
        </outline>
      </outline>
      <outline text="Dual blood supply">
        <outline text="Pulmonary arteries follow bronchi"/>
        <outline text="Pulmonary veins intersegmental to left atrium"/>
        <outline text="Bronchial arteries feed airways and pleura">
          <outline text="Return via pulmonary veins as shunt"/>
        </outline>
        <outline text="Low-pressure, compliant pulmonary circuit">
          <outline text="Emboli often in lower lobes"/>
          <outline text="Dual supply limits infarction"/>
        </outline>
        <outline text="Severe haemoptysis mainly bronchial">
          <outline text="Embolisation needs spinal artery map"/>
        </outline>
      </outline>
      <outline text="Lymphatic drainage">
        <outline text="Subpleural and peribronchial plexuses"/>
        <outline text="Hilar to tracheobronchial to paratracheal"/>
        <outline text="Left lower lobe can drain right">
          <outline text="Affects cancer staging and spread"/>
        </outline>
        <outline text="No lymphatics in alveolar walls"/>
        <outline text="Nodal stations defined anatomically">
          <outline text="Endobronchial ultrasound samples hilar nodes"/>
          <outline text="Oesophageal ultrasound reaches posterior nodes"/>
        </outline>
      </outline>
      <outline text="Autonomic and sensory supply">
        <outline text="Pulmonary plexuses: vagal and sympathetic"/>
        <outline text="Parasympathetic constricts, secretes"/>
        <outline text="Sympathetic dilates via catecholamines"/>
        <outline text="Vagal afferents carry stretch reflexes"/>
        <outline text="Parenchyma insensitive, parietal pleura painful"/>
        <outline text="Cough receptors in larger airways"/>
      </outline>
      <outline text="Localising disease">
        <outline text="Aspiration follows dependent segments">
          <outline text="Upright: basal lower lobe"/>
          <outline text="Supine: superior lower, posterior upper"/>
        </outline>
        <outline text="Collapse pulls structures toward lesion"/>
        <outline text="Consolidation keeps volume, air bronchograms"/>
        <outline text="Pleural disease follows surfaces and fissures">
          <outline text="Loculation constrained by adhesions"/>
          <outline text="Empyema lenticular, abscess in parenchyma"/>
        </outline>
        <outline text="Apical tumour invades plexus, sympathetics">
          <outline text="Hand weakness, pain, Horner syndrome"/>
        </outline>
        <outline text="Central tumours obstruct and invade"/>
      </outline>
      <outline text="Reading thoracic images">
        <outline text="Frontal film: systematic anatomical tour">
          <outline text="Hilar density mainly vascular"/>
          <outline text="Left hilum usually higher"/>
          <outline text="Rotation and low inspiration mimic disease"/>
        </outline>
        <outline text="Silhouette sign localises opacity">
          <outline text="Right border: middle lobe"/>
          <outline text="Left border: lingula"/>
        </outline>
        <outline text="Axial: aorta left, azygos right"/>
        <outline text="Follow findings across planes"/>
        <outline text="Branching and boundaries organise the chest"/>
      </outline>
    </outline>
  </body>
</opml>
