Lungs s3. Rights and liva legend

Segment S1 (apikalny or upper) right legacy. To be carried to the upper part of the right legacy. Topographically, it is designed on the chest plate along the anterior surface of 2 ribs, through the apex of the lung to the back of the scapula of the cyst.

S2 segment (rear) right leg. To be carried to the upper part of the right legacy. Topographically, it is designed on the sternum along the posterior surface, paravertebrally, from the upper edge of the scapula to the middle.

S3 segment (front) right leg. To be carried to the upper part of the right legacy. Topographically, it is designed on the sternum in front of 2 to 4 ribs.

Segment S4 (lateral) of the right leg. To be carried up to the middle part of the right legend. Topographically, it is designed for the breast bone in the anterior groin area between 4 and 6 ribs.

Segment S5 (medial) right leg. To be carried up to the middle part of the right legend. Topographically, it is designed on the sternum between 4 and 6 ribs closer to the sternum.

Segment S6 (upper basal) right leg. Brought to the bottom of the right legacy. Topographically designed for the sternum in the paravertebral region from the middle of the scapula to the lower cut.

Segment S7 (medial basal) of the right leg. Brought to the bottom of the right legacy. Topographically, it is localized from the inner surface of the right legend, and grows below the root of the right legend. It is designed on the sternum from 6 ribs to the diaphragms between the sternum and midclavicular lines.

Segment S8 (anterior basal) right leg. Brought to the bottom of the right legacy. Topographically, there are intervals in front of the cephalic interlobar furrow, below the diaphragm, and behind - the posterior line.

Segment S9 (lateral basal) of the right leg. Brought to the bottom of the right legacy. Topographically, it should be designed on the sternum between the scapula and the back-lining lines from the middle of the scapula to the diaphragms.

Segment S10 (posterior basal) right leg. Brought to the bottom of the right legacy. Topographically, it is designed on the sternum from the lower kuta of the scapula to the diaphragms, from the sides of the paravertebral and scapula segments with lines.

Segment S1 + 2 (upper-back) of the same leg. It represents a combination of C1 and C2 segments, which is accompanied by the presence of the posterior bronchus. To be carried up to the upper part of the legends. Topographically, it is designed on the sternum along the front surface of the 2 ribs and up, through the top to the middle of the scapula.

Segment S3 (front) of the left leg. To be carried up to the upper part of the legends. Topographically, it is designed on the sternum from the front from 2 to 4 ribs.

Segment S4 (upper lingual) of the left leg. To be carried up to the upper part of the legends. Topographically, it is designed on the sternum along the anterior surface from 4 to 5 ribs.

Segment S5 (lower lingual) of the left leg. To be carried up to the upper part of the legends. Topographically, it is designed on the sternum along the anterior surface from 5 ribs to diaphragms.

Segment S6 (upper basal) of the left leg. Carry on to the bottom of the legacy. Topographically designed for the sternum in the paravertebral region from the middle of the scapula to the lower cut.

Segment S8 (anterior basal) of the left leg. Carry on to the bottom of the legacy. Topographically, there are intervals in front of the cephalic interlobar furrow, below the diaphragm, and behind - the posterior line.

Segment S9 (lateral basal) of the left leg. Carry on to the bottom of the legacy. Topographically, it is designed on the sternum between the scapula and the posterior lining from the middle of the scapula to the diaphragms.

Segment S10 (posterior basal) of the left leg. Carry on to the bottom of the legacy. Topographically, it is designed on the sternum from the lower kuta of the scapula to the diaphragms, from the sides of the paravertebral and scapula segments with lines.

Viyaviti new foundations in the legends, and in fact it can be, it is possible with a detailed situation. Until the end of the lapse of time, the people of raznogo viku are in good health. Check out the insights into the damage to the process of differentiation of clients, which can be witnessed by internal and external officials.

New satisfaction in the lungs - there is a large group of children in the area of ​​the lungs, which is characteristic of Budov, growth and the nature of walking.

New satisfaction in the legends can be good and evil nature.

good guys May the development of the genesis, Budova, the development and development of the clinical manifest. Good chicks are growing older than bad ones, and they store close to 10% of the number. The stench may seem to be powerfully developing, not to ruin the fabric, since for them infiltrating growth is not characteristic. Deyakі goodyakіsnі poohlini may the power of transforming into evil.

Regularly from the miscellaneous development:

1. Central - swellings from the head, segmental, partial bronchial tubes. The stench can germinate in the middle of the bronchus and the nascent tissue of the lung.
2. Peripheral - swelling from navkolishny tissues and stinoks of other bronchial tubes. Grow superficially or intrapulmonary.

See the good-natured pukhlin

Razr_znyayut such good pukhlini legends:

Briefly about evil affirmation

Cancer of legends (bronchogenic carcinoma) - pukhlina, epithelial fabrics... Chvoroba tends to metastasize in іnshі organisms. It can grow in the periphery, in the head bronchi, and grow in the lumen of the bronchus, in the tissue of the organ.

To the evil ones, the new ones are given:

1. Lung cancer can be seen as: epidermoid, adenocarcinoma, dibnoclitin pukhlina.
2. Lymphome is a pukhlin who is hostile to the lower sides of the dickheads. It may be primarily in the lungs, or in the case of metastases.
3. Sarcoma is a malignant affirmation, with good fabrics... The symptomatology is similar to the signs of cancer, however, there is more rapid development.
4. Pleural cancer - pukhlin, which grows in the epithelial tissue of the pleura. It may be a primary cause, as the result of metastases from other organs.

Riziku factories

The reasons for the accusation of evil and good pukhlin are rich in something similar. Factors that provoke the growth of fabrics:

• Courinnya is more active and passive. 90% of men and 70% of females, in some boules, malignant new ones are found in the legends, є in chickens.
• Contact with not safe chemical and radioactive conversations through the professional activity and through the obstruction of the midst of the region of residence. Prior to such words, radon, asbestos, vinyl chloride, formaldehyde, chromium, mish'yak, radioactive saw are introduced.
• Chronic ailment of dickhead nobles. A boom of good-natured chicks should be knitted with such ailments: chronic bronchitis, Chronic obstructive ailments, pneumonia, tuberculosis. Rizik Viniknennya evil new creatures growth, with history of chronic tuberculosis and fibrosis.

The peculiarity of the field is in the fact that good approval can be caused not by specific factors, but by genetic mutations and genetic instinct. It is also often seen as a little ignorance, and the transformation of chubby into malignancy.

Be-like the establishment of the lungs can be wicked by viruses. Rozpodil clitin can be susceptible to cytomegalovirus, human papiloma virus, multifocal leukoencephalopathy, maternal virus SV-40, human poliomavirus.

Symptoms of swelling in the lung

Good lungs illumination may be signs that lie in the form of swelling of the puffiness, of the growth, of the apparent acceleration, in the activity of hormones, in view of the growth of swelling, impaired bronchial congestion.

To accelerate delivery:

• abscess pneumonia;
• malignancy;
• bronchiectasis;
• atelectasis;
• bleeding;
• metastasis;
• pneumofibrosis;
• compression syndrome.

Bronchial passage has three stages of damage:

• 1 step - part of the bronchus ulceration.
• 2 steps - bronchus ulceration valve.
• 3 steps - occlusion (broken passage) of the bronchus.

Stretching out for a trivial hour, symptoms of puffiness may not be spared. The prevalence of symptoms is the most significant with peripheral fluff. Regardless of the turn, there is a sign of seeing a few stages of overcoming pathology.

stages of approval

1 stage. The contraction is asymptomatic. At the stage of the stage, bronchus ulceration is observed. Ailments may have a cough with a small amount of phlegm. Hemoptysis is spontaneous. If the X-ray sign is not observable, anomalies are not detected. Pukhlin's indications can be as follows: bronchography, bronchoscopy, computer tomography.

Stage 2. Stimulation of ventral (valve) bronchial ulceration. Till the moment of the lumen of the building is practically closed with the light, the proteelasticity of the walls is not damaged. When you inhale, you will be enlightened in a small way, and when you see it, you will be curled up like a chubby. In the area of ​​the lung, the yak is ventilated by the bronchus, and the expiratory emphysema develops. As a result of the presence of bloody houses in the sputum, the clotting of the mucous membrane can lead to obstruction of the lung. The fabrics of the legends can have the development of ignition processes. For the other stage, cough with the appearance of mucous phlegm (often the presence of mucus), hemoptysis, sluggishness, swelling, weakness, pain in the breasts is characteristic, temperature adjusted(Through the ignition process). The other stage is characterized by an alternation of symptoms and time periods of time (in case of lykuvannya). X-ray signs show impaired ventilation, the presence of an ignition process in a segment, a part of the lung, or a whole organ.

To zoom in, make an accurate diagnosis of the need for bronchography, computer tomography, line tomography.

3 stages. Obturation of the bronchus occurs, suppuration develops, and non-emitting tissue changes and lesions develop. At the first stage of ailment, such a manifestation of a broken dichanna (zadishka, poison), abnormal weakness, overwhelming fatigue, chest pains, increased temperature, coughing with gnarious sputum (often with bloody parts). Inodi can winicati Legeneva bleeding. If the X-ray is circumscribed, it is possible to show atelectasis (partial abnormal), ignition processes with gnіyno-destructive snakes, bronchiectatic ailments, about'єmne adopted in the legends. To clarify the diagnosis, it is necessary to carry out more detailed information.

symptomatology

Symptoms of unkind puffins can also be found in the presence of debris, localization of puffin, size of bronchial space, manifestations of early ages, metastases. Until the most widespread acceleration of atelectasis, pneumonia.

At the cob stages, the development of ill-pooled approval, which has become visible in the lungs, shows little sign. The sick person may have the following symptoms:

• zagalnaya weakness, yak will be able to cope with the recession of ailments;
• the tila temperature has been adjusted;
• shvidka stomlyuvanism;
• zagalne nezduzhannya.

Symptoms of the cob stage of development are similar to signs of pneumonia, respiratory infections, bronchitis.

Progression of malignant approval is accompanied by such symptoms as a cough with phlegm, pus, hemoptysis, bad breath, poison. With the germination of a new solution in the judgment, the vinikє legeneva is bleeding.

Peripheral lung illumination may not show signs, as long as it does not germinate in the pleura or the chest wall. Seeing as the head symptom of pain in the legends, which is diagnosed with inhalation.

on in different stages evil chicks appear:

• post-gradual weakness;
• lower vagi;
• cachexia (visnazhennyam organizmu);
• viniknennyam hemorrhagic pleurisy.

diagnostics

To develop a new solution, use the following methods of cleaning:

1. Fluorography. A prophylactic diagnostic method of X-ray diagnostics, which allows for the development of pathological statements in the legends. read in the tsy statty.
2. Oglyadova roentgenography of legends. Allows the visibility of the illumination in the legends, like a round outline. On the X-ray, there are signs of changes in the parenchyma of the lungs from the right, left or both sides.
3. Computer tomography... The parenchyma of legends can be seen behind the additional diagnostic method, pathological changes lungs, skin intrathoracic lymfovuzole. dane doslіdzhennya to recognize, if a differential diagnosis is required for metastases, vertebral puffins, peripheral cancers. Computer tomography is allowed to deliver more correct diagnosis, Ніж X-ray doslіdzhennya.
4. Bronchoscopia. The whole method allows you to inspect the pudding, and to conduct a biopsy for a further cytological dosage.
5. Angiopulmonography. It is possible to carry out an invasive X-ray of the sudinus due to the detection of contrasting speech for the detection of the verrucous fluff of the leg.
6. Magnetic resonance tomography. The Danish diagnostic method is used for important diagnostics.
7. pleural puncture... Pre-treatment in pleural emptying with peripheral growth of fluff.
8. Cytological dosage of phlegm. It helps to increase the appearance of the primary swelling, as well as the appearance of metastases in the legends.
9. Thoracoscopy. To be carried out for the purpose of the operability of the malignant approval.

Fluorography.

Bronchoscopia.

Angiopulmonography.

Magnetic resonance tomography.

Pleural puncture.

Cytological dosage of phlegm.

Thoracoscopy.

It is important to think that good middle-aged illumination of the lungs may not be larger than 4 cm, it is more important to speak about evil.

lykuvannya

All new solutions are used for the operative method of treatment. Good chickens give a secret vision for the diagnosis, in order to eliminate the increased areas of tissue damage, injuries from the operation, the development of accelerated disease, metastases and malignancies. With evil puffins and with accelerated good ones, it is possible to carry out a lobectomy, or a bilobectomy for a visible part of the legacy. When progression of non-vascular processes, pneumonectomy is violated - a visible legacy and lymph nodes.

Central empty illumination, localized in the lungs, is seen as a way of resection of the bronchus without damaging the leg tissue. With such a localization, it is possible to rotate the endoscopic path. For a vivid new establishment with a university department, to complete the resection of the bronchus wall, and for chin with a wide base - a circular resection of the bronchus.

In case of peripheral puffins, such methods of operative treatment as enucleation, edge or segmental resection should be used. With significant razmіrah, the newly established lobectomy is stagnant.

Osvit in the lungs are seen by methods of thoracoscopy, thoracotomy and videothoracoscopy. During the operation, a biopsy is carried out, and material is taken out of the material to be sent to the histological report.

In case of malignant puffs, it is not promptly involved in such cases:

• if we do not seem to be able to see the new satisfaction;
• metastases are found in the distance;
• the function of the stove, nirok, heart, legends is ruined;
• vіk paciєnta over 75 years.

When the patient is seen to be maliciously approved of undergoing chemotherapy or exchange therapy. At the same time, there are various methods of combining.

Segments - morphofunctional elements of the leg tissue, which include the bronchus, artery and vein. The stench of acini is found in a functional unit of the parenchyma (close to 1.5 mm in diameter). Alveolar acini are ventilated by bronchioles - other bronchial malignancies. These structures will provide gas exchange between navkolishnim povtryam and blood capillaries.

The skin of them has its own segmental budovu.

Segments of the upper part of the right legend:

1. Verhivkovy (S1).
2. Back (S2).
3. Front (S3).

The middle part has 2 structural segments:

1. Zovnishniy (S4).
2. Internal (S5).

The lower part of the right legacy has 5 segments:

1. Upper (S6).
2. Nіzhnevnutrennіm (S7).
3. Lower front (S8).
4. Outside (S9).
5. Lower back (S10).

There are two parts to the legends of the legends, to that the structure of the Budova legendary parenchyma is often seen. The middle part of the left legacy consists of the advanced segments:

1. Upper ovarian (S4).
2. Lower ovarian (S5).

The lower part of the segment may be 4-5 segments (among the older authors, there are thoughts):

1. Upper (S6).
2. Nіzhnevnutrennіm (S7), which can be connected to Nіzhne-front (S8).
3. Outside (S9).
4. Lower back (S10).

It is more correct to see 4 segments in the lower part of the left leg, so as S7 and S8 may cause the posterior bronchus.

Pidvodyachi pidsouk: liva legend is stored in 9 segments, and the right - in 10.

Topographic growth of segments of the lungs on the roentgenogram

X-rays, passing through the parenchyma of the Legenev, clearly do not see the topographic orintiri, but allow the localization of the segmental structure of the lungs. The sign is on the way to the beginning of the development of pathological darkening in the legends, likar-roentgenologists are reprimanding with mits.

The upper part is from the lower (or middle right-handed) spit between the lobe split. Vona clearly does not quilt on the roentgenogram. For її vіdіlennya reproach with such terms:

1. On the direct sign of repaired on the edge of the spinous outgrowth Th3 (3rd thoracic ridge).
2. Go horizontally along the last part of the 4th rib.
3. Then we go to the other point with diaphragms in the projection of the middle part.
4. on bichnuyu sign the horizontal pleura is repaired from the top to Th3.
5. Pass through the root of the lung.
6. End up in the best points of diaphragms.

The horizontal gap between the lobes is towards the Kremlin, the upper part is towards the middle in the right leg. Vaughn pass:

1. On a straight roentgenogram along the lateral edge of the 4th rib - right up to the root.
2. In a child's projection, start from the root and go horizontally to the sternum.

Topography of lung segments:

• upper (S1) pass along the 2nd rib to the scapula;
• posterior - from the middle of the scapula to the upper edge;
• front - in front of the 2nd and 4th ribs;
• lateral (upper lingual) - between the 4th and 6th ribs along the anterior groin line;
• medial (lower lingual) - between the 4th and 6th ribs closer to the sternum;
• upper basal (S6) - from the middle of the scapula to the lower kut in the paravertebral region;
• medial basal - from the 6th rib to the diaphragms between the midclavicular line and sternum;
• anterior basal (S8) - between the interlobar fissure in front and groin line behind;
• lateral basal (S9) is designed between the middle of the scapula of the cyst and the posterior lining of the cyst;
• posterior basal (S10) - from the lower cut of the scapula to the diaphragms between the scapula and paravertebral lines.

Malice segmented Budov does not appear, so that the doctor-radiologist allows the doctor-radiologist in direct and general projections to accurately locate the pathological conditions in the parenchyma of the disease.

Rіdkіsni features of the topography of the lungs

Doyak people, through the abnormal position of the unpaired vein, pretend to be lobus venae azygos. It is not necessary to respect pathological assumptions, but it is necessary to take care when reading X-ray evidence of the organs of the breast.

In most people, venae azygos flows into the upper empty vein up to the middle of the mediastinal surface of the right leg, which cannot be seen on radiographs.

When a part of an unpaired veni is revealed, it is obvious that people have a place where a given vessel is reduced to the right in the projection of the upper part.

If the unpaired vein is located lower than the normal position, and if the stravohid is hindered, it will be difficult to deal with it. At the same time, there is a folding when passing through - dysphagialusoria ("heat of nature"). On the roentgenogram, the pathology is manifested by an edge defect similar to that of the familiar cancer. For the sake of the test (CT) the diagnosis is made.

Інші рідкісні lungs:

1. The pericardial is formed by the wrong course of the medial viddil of the interlobar fissure.
2. Yazichkova - quilting on the marks, if the interlobular cleavage is stitched in the projection of the 4th rib. Vaughn is a morphological analogue of the middle part on the right in 1-2% of people.
3. The back - to be seen with the presence of an additional gap, as the upper part of the lower part is seen asleep. See both sides.

Topography and segmentally Budova legend is to blame for the nobility of the skin likar-radiologist. Without it, it is unwise to correctly read the signs of the organs of the breast.

Pulmones

The skin is lighter (pulmo) at the top, front and bottom edges, rib, diaphragmatic and medial surfaces. On the left side, the middle and the ridge part and the heart are depressed. On the medial surface, the gates (hilus pulmonis) grow, through the lungs and through the lungs, the bronchi, nerves and nerves penetrate to form the roots of the lungs of the human (radix pulmonis). The gates are funnel-shaped, irregularly oval-shaped (1.5-2 cm). New Klitkovin's fluff is roasted lymphatic universities, And the head of the bronchi and the judgment of the head here are parts of the head. To that, the gate of the lung can be seen as the top of the skin of the legacy.

right easier people fold from the upper (lobus superior), middle (lobus medius) and lower (lobus inferior) part, divided by the oblique (fissura obliqua) and horizontally (fissura horizontalis) with the slits. Liva legend is made up of the upper and lower parts, torn apart by a slanting crack. The braid of the grain, increasing the size of the part, is on the right in 55-68%, the grain - in 66-74% of the total. In іnshih vipadki, the gap is not perfect, or navіt dividing, і parts of the lung on the edges of the dіlyankas are welded together. The horizontal width is in 17.5% of the population, in the latter - it is either part of the street, or it is more frequent, or (in 5.5% of the population) it will increase in the daytime. In addition to the main shields, they are often developed in addition to them. The presence of additional parts is constantly being adjusted to increase the number of parts (right-handed up to 5, up to 3), or until the change (right-handed up to 2) or until the rest of the time.

Between the legends during the first year of the excursion, they are not stable, and between the parietal pleurisy, they fall less in the area of ​​the top of the legends and often in front and behind. The lower boundary of the lung grows in the form of a pleural appearance.

Small. 85. The rights of the legend. View of the lateral surface.
With a cut in the sagittal area, the lateral right part of the chest wall was seen at once from the upper edge.

In front of the lung border, it repeats in the main outline of the pleural cord, spreading out from the rest more laterally, especially in the area of ​​the heart line, it develops to the parasternal line. From the point of attachment to the sternum of the cartilage, the VI ribs are right-handed and from the parasternal line on the VI ribs, the front line of the lung passes into the lower. Remaining with a small burrow backwards і downwards horizontally іde up to the point where the XI ribs іn the XI thoracic ridge і peremetinaє: along the midclavicular line shoost between the ribs or the upper edge of the VII rib, along the middle edge of the groin - the ribs line on the scapula line - IX rib of the ninth mid-rib. The posterior boundary of the leg is directed along the ridge lines on the protrusions from I to XI of the thoracic ridge.

Payowa i segmentally budovu bronchus and legends... In 1933, B.E.Linberg Bula was proponated with a four-lobe structure of the lungs, the basis of which, at the bottom of the lung, by the interlobar fissures, was laid on the four-lobe of the second bronchus. Right and left easy, skin folds from 4 zones (parts) and і according to the number of zones, symmetric. Adjustment of the classic lung growth into parts (3 right-handed, 2 PLN) with a four-zone structure showing, on the right, the upper part shows the upper zone, the middle part - the middle zone, and the lower part folds into two zones - the rear. The evil upper part is stored in the upper and middle zones, and the lower part - in the rear and lower.

The further development of the legacy surgery led to the establishment of the segmental anatomy of the legends, the basis of which was laid down the bronchial tubes of the third order. Bronchus of the third order is formed by the broncholegenic segment.

Parts and segmental bronchi and segments of the right leg. From the upper outer surface of the right head bronchus at the exit of 2-3 cm from the bifurcation of the trachea enter the bronchus lobaris superior dexter, which after 1-1.5 cm extends into three segmental bronchi: bronchus segmentalis apicalis to segmentum apicale anus, bronchus segmental bronchus to segmentus segus segus segmentalis posterior to segmentum poste-rius. The lower part of the anterior surface of the head bronchus is called forward and downward, the bronchus lobaris me-dius dexter is straightened, which after 1.5-2 cm, having penetrated into the Legenev tissue, extends into the bronchus segmentalis lateralis to segmentum late-rale medial bronchus segment segmentalis ... The bronchus segmentalis apicalis (superior) to segmentum apicale (superius) go from the head bronchus to the ear of the middle lobe bronchus to the lower part. Lower by 0.5-1 cm from the LOWER LEFT bronchus, bronchus segmentalis subapicalis can enter to a single segment. The injury of the last segment leads to the posterior zones in case of four-zone pulmonary growth. When the middle lobe bronchus appears, the head bronchus is trivial downward at the viewer bronchus lobaris inferior dexter, as seen bronchi segmen-tales basales medialis (cardiacus), anterior, lateralis and posterior, as seen before the segle-menta basale basale posterius.

Small. 86. The rights of the legend. The topography of the bronchial tubes, the legacy of the artery and the glock from the side obliquely and horizontally. View from the lateral side.

The same as in fig. 85. Besides, the upper part of the right leg is pulled up the hill and forward, the middle part is brought forward.

Particles and segmental bronchi and segments of the left leg. The malignant bronchus extends into 2 portions of the bronchi - upper and lower. Bronchus lobaris superior sinister upright forward і name і through 0.5-1 cm to extend upward and downward. There is a drop out of the way і named і after 1-1.5 cm from bronchus segmentalis apicoposterior to segmentum apicoposterius і bronchus segmentalis anterior to segmentum anterius. The lower head is straight down, forward and named trochus and through 1.5-2 cm to extend into the bronchus lingularis superior to segmentum lingulare superius and bronchus lingularis inferior to segmentum lingulare inferius. Bronchus lobaris inferior sinister go down і a spike named і after 1 cm from the cob from the back surface to the bronchus segmentalis apicalis (superior) to one segment of the lower part. Lower (by 0.5-1 cm) the upper segmental bronchus emerged from the LOWER LEFT bronchus, possibly from bronchus segmentalis subapicalis to segmentum subapicale. Even after 1.5 cm, more often in the parenchyma of the leg, the bronchus extends into 3 or 4 segmental bronchi: bronchi segmentales basales mediaiis (cardiacus), anterior, lateralis and posterior, up to segmenta basale mediale (cardiacum), basale anterius, basale laterale basale posterius. Heart basal segmental bronchus non-perishable. In such a rank, which is vrahuvati, how evil is at the top of the myazovy and heart segmental bronchi, and the right-handed supra-upper bronchus can be visible, right to the legend ma 10-11 bronchogenic segments, liv - 8-10. Placed segments of the rosette on the surface of the lung, the tops - at the legenevoe vort. The form of presentation of the segments and the volumetric form of the segments are up to individual smallness.

Legeneviy stovbur (truncus pulmonalis, being extended to the arterial cone of the right lumberjack, going up the back, trochi lіvoruch, crossing the upper aorta in front, and at the same time, thrashing malice from her. 3.8 cm. From the arcuate aorta of the legenevius stovbur from the cut from 95 to 125 °. Legeneviy stovbur covered with an epicardium from the sides, behind a vignette, mice, de vin prilyagє to the upper aorta.

Small. 87. Liva is a legend. View of the lateral surface.
With a cut in the sagittal area, the lateral part of the chest wall was seen at once from the upper end.

A. pulmonalis dextra may be more often from 3.1 to 4.5 cm, diameter from 1.3 to 3.2 cm. ... The right head bronchus is located behind the artery, lower - in front of the heart, And laterally, the upper right of the Legenevian vein, which then crosses the artery in front. The position of emptying the pericardium from the arm of the upper empty vein to the right Legendary artery yde a sailing ring, like two leaves circularly looking for the right Legendary artery and mintly tying the artery through the vein. Tsei zyvyazy two posad is a transition from the anterior access to the right legacy artery, the empty position of the pericardium. Having entered the gate of the lung, the Legendary artery passes in front of the head bronchus, into the middle of the upper and middle pyovny bronchi, and, having skirted the middle lateral bronchus from the lateral side, at the pars basalis view of the lower part of the upper arm of the anterior part of the legend. The first step in the roots of the legend from the upper surface of the right legendary artery is to go to the upper part. It grows anteriorly to the upper part of the bronchus and posteriorly to the trochus of the upper segmental veins (the right upper leg veins). The head of the upper part extends for 2-3 heads (rr. Apicalis, anterior descendens, anterior ascendens, posterior descendens) up to the upper, anterior and posterior segments. Gilki ci in the vicinity of the drop can be repaired right from the legendary artery. In addition to the rear lower head, which can be seen, 85-94% of the back segment penetrates into the rear upper head (m posterior ascendens), as well as it can be seen from the side of the interlobar space. Tsia gilka to reclaim from the upper pivkola of the legendary artery, there, de von, to cross over through the middle podvzhny bronchus and straight down. Zvidsi gilka ede up behind the upper part of the bronchus. R. lobi medii to repair from the anterior surface of the leg artery at the middle part of the bronchus and go forward and the spike laterally to the upper outer surface of the middle part of the bronchus. Before penetration into the part, or in the n_y artery, it spreads to the p mediaiis and the lateralis. In 41.7% of the media and lateral types, they self-repair themselves from the legendary artery. At the bottom or at the bottom of the middle part of the rear periphery of the Legendary artery, there should be apicalis (superior) lobi inferioris. Won straight back udovzh upper lateral surface upper segmental bronchus і before penetration into the upper segment of the lower part of the subapicalis (subsuperior) for the same segment. In some case, the sub-top head is repaired as a pars basalis of the legendary artery independently. Going down to the middle part and the upper segment of the lower part of the Legeny artery, it goes down yak pars basalis, as it lasts for 2-3 heads, which penetrates the viewer rr. basales medialis, anterior, lateralis and posterior in the same basal segment of the right leg.

A. pulmonalis sinistra has a larger short stem, lower right artery, and small diameter. From the moment the artery is seen going backwards, up and down and criss-crossing the head bronchus in front. The arch and the right-handed person from the artery rots the aortic arch, behind - the cob breastfeeding lower aorta, lower - lva upper Legeny vein. In front of the cob are seen arteries of the pericardium. Having penetrated into the gates of the leg, the artery of the frog on the upper half of the head bronchus and, bending around the back of the left upper podovzhny bronchus, turned downwards, lagging along the posterolateral surface of the lower limb bronchus. The upper part of the part should be repaired from the upper surface of the legacy artery and straight up and laterally, spreading in front or back of the left upper part of the bronchus. Before joining the parenchyma of the part, or in the new artery, last for rr. apicalis, anterior descendens, posterior and anterior ascendens. The two backs, especially the back, can come in independently. From the anterior surface of the lateral upper lobe artery of the lateral upper lobe bronchus, enter the lingularis, extending to the upper (m lingularis superior) and lower (m lingularis inferior) lingual limbs. In 15% of cases, the problem is repaired on its own. On the edge, and on the bottom of the tongue, from the rear surface of the Legendary artery, the apicalis (superior) lobi inferioris should be repaired. Remain nezbarom viddaє p subapicalis. The sub-apical head in 50% of the cases comes independently from the legendary artery. Yak and right-handed, pars basalis of the left legendary artery to be extended to rr. basales medialis (non-post), anterior, lateralis and posterior.

From both legends, the arterial roof comes up at the front of the heart along the upper and lower legene veins.

V. pulmonalis superior dext g and to form from zlittya (2-4) pp. apicalis, anterior і posterior і m lobi medii. Most of the right upper Legendary Vienna is established from 3 veins of the upper part and one vein of the middle part. Remaining (m lobi medii) is formed from pars lateralis and pars medialis from the leading segments of the middle part. A day from the middle part of the city there can be one (in 24.3%), two (in 63.1%) or three (in 12.6%) stovburs, as it is one for one, or the skin spontaneously merges into the upper right legeneva a vein abo bezposeredno in the left atrium (in 17.7% of vipads). When the evil is set, they converge to the medial side of the veins, the right upper Legendary vein lies in the middle of the root of the lung in front of the other elements and spontaneously with their little heads curls the front of the Legendary artery and bronchi. Straight medially, the vein grows behind the upper arm of the upper arm and falls into the upper right cut of the left atrium by 2-13 mm lower than the arm of the right lower leg artery and 8-11 mm arm of the right lower arm.

Small. 88. Liva is a legend. Topography of the bronchial tubes, the Legendary artery of the Legendary veins from the side of the oblique slit. View from the lateral side.
The same, in fig. 87. In addition, the upper part of the left leg is pulled forward and as a result of the preparation of the leg and bronchus.

V. pulmonalis inferior dextra to bring shelter from the lower part of the right legacy and to establish itself from the zlity of 2-5 veins (m apicalis, v. Basalis communis, which is formed from the bottom of the vv. Basales superior and inferior, but also carries the segment of the blood from the bases). Most often, the lower right vein of the Leheneva is established from 3 (in 43.2%) or 4 (in 41.6%) veins. From the upper and sub-apical segments of the lower part, blow 2 veins. During the day, the basal segments are directed uphill, medially from forward, spreading backward and medially from the lower part of the bronchus. In 13.2% of cases of the lower segmental veins, in quiet days two or three times, they fall independently into the left front of the heart. Right lower legeneva vein in the roots of the legacy upper veniі, straight medially, trochi uphill і forward, close to the front we right the edge of the pericardium and heart, falling into the right lower cut of the left atrium.

V. pulmonalis superior sinistra to form from rr. apicoposterior, anterior and lingularis. Most often, 3 (in 45%) or 4 (in 40.3%) veins will close a vein. From the upper-posterior and anterior segments, blow 2 or 3 veins. 2 veins (pars superior and pars inferior) go from the ovarian segments, as they get angry more often in the middle segments. In a large number of patients (89%), veins get angry immediately and fix the upper left vein. Straight medially, the vein flows into the upper left side of the frontal front. At the root of the legacy, the vein lies in the anterior-lower part of the lower left legacy artery and in front of the lower legacy legionary vein. The viscera and the back of the vein grow out of the head bronchus.

V. pulmonalis inferior sinistra is quietly named as veins, right. Most often, a burrow of veins is formed in 3 (in 48%) or 4 (in 30.9%) veins, more than in 2 (in 17.7%). 5 (3.3%) veins. During the day, the kut of the left front of the heart flows into the lower livy with the upper leg of the vein.

Correcting the Budovian veins on the right and showing evilly, how do you think about the two Legendary veins on the right and evilly accepting only 63.2% of the veins. In those cases, there is a larger and smaller number of veins that flow into the left atrium, and on the right, the number of cyx veins can grow up to 6-7, which, on the other hand, changes to one (in 3.5%). It’s still going to get angry, if the upper and lower legends get angry, they’re getting v. pulmonalis sinistra. The increase in the number of veins in evil is more than two, it is highly susceptible.
The magnitude of the intrapericardial veins in the leg veins is not the same and changes throughout the day of the serous cover on the vein (the vein falls into the left in front of the heart, the empty pericardial position) to values, if 1 is the serous membrane of the pericardium. Intra-cardiac articulations of the right and lenevic veins are designed on the ledge edge of the sternum on the equal attachment of the cartilage of the third ribs and third of the mid-ribs.

root of the lungs... Head bronchi, legends and bronchial arteries and veins, lymphatic universities and judges and nerves of legendary gossip, which go from the middle in the lungs and backwards, in essence lay the root of the legend. Root elements grow in cells. The very root of the pleuroy covers, yak below pass into the Legendary sound. As a result of the abducted position of the roots of the lung, the upper edge of the root was expanded closer to the anterior surface of the chest wall, lower than the lower. The right root is better than the left.

The projection of the upper edge of the root of the right leg is varied from the edge of the first mid-rib to the edge of the third costal cartilage, most often (in 79.8% of the ribs) they grow on the edge of the second rib and the other mid-rib. The projection of the upper edge of the root of the left leg grows out from the first to the third intercostal space, with the most frequent position from the second to the third rib (in 91.7% of cases). Back to the chest, the upper edge of the roots of the lungs is designed most often on the V-VI chest ridge and іх mid-spine discs... The projections of the lower edges of the roots of both legs grow out at the bottom of the upper edges by approximately two segments, i.e., the backward is two ridges lower, in front - on one edge and mid-ribs. Topography of the main elements roots of legends, The right-hander and the lіvoruch are not the same. On the right in the middle and in the front lies the upper Legeny Vienna. The Legendary artery grows lower and rearward - the lower Legendary Vienna. Behind the legendary artery, there is the right cephalic bronchus, the upper pivkolo which rises above the artery from 2 to 11 mm. In 20% of all types of bronchial tubes, they grow at one level from the artery, and in 10% of the cases, they can be moved 2-6 mm below the level of the leg artery.

Small. 89. Broncholegenic segments of the right and left lungs (corrosive drugs, styracril, photography).
1 bronchus segmentalis lateralis; 2 - bronchus segmentalis medialis; 3 - bronchus lobaris medius dexter; 4, 22 - bronchus segmentalis anterior; 5 - bronchus segmentalis posterior; 6 - bronchus segmentalis apicalis; 7 - bronchus lobaris superior dexter; 8 - trachea; 9 - bifurcatio tracheae; 10 - bronchus principalis dexter; 11 - bronchus lobaris inferior dexter; 12, 18 - bronchus segmentalis apicalis (superior); 139 17 - bronchus segmentalis basalis posterior; 14 - bronchus segmentalis basalis medialis; 16, 27 - bronchus segmentalis basalis lateralis; 16, 26 - bronchus segmentalis basalis anterior; 19 - bronchus lobaris inferior sinister; 20 - bronchus principalis sinister; 21 - bronchus segmentalis apicoposterior; 23 - bronchus lobaris superior sinister; 24 - bronchus lingularis superior; 25 -bronchus lingularis inferior.

The rear surface of the root of the right legacy is stored: in the mountains - the head bronchus, the lower surface - the lower legene vein and the gilts. The upper edge is in front of the statements of the legacy vein, behind the head bronchi. The lower edge of the roots of both legends, as well as the rear lower edges of the roots, form the lower Legendary Vienna and the lower part of the roots.

Evil the front surface of the root is set: from above - the left legeneva artery, the cleared from it, and the bottom - the upper legeneva vein. Remain in the big chi menshy world, or you can raise the artery in front of you. Lower and behind the upper Legendary vein, the lower Legeny vein grows. The head bronchus is located below and behind the Legendary artery, and the last one until the Upper Legendary vein is located behind her, or it is possible to lie on one line, or to move below the Veni. The back surface of the root of the left legacy is set up: above - the Legendary artery, below it - the head bronchus, and below the rest surface, the lower Legeny vein grows. Lymphatic universities (1-5), which grow in the roots of the legacy, are most often found in the middle between the upper and lower legacy veins.

a - front view; b - kind of grace; 1 - segmentum, ipit ale; 2 - segmentum poster] us; 3 -segmentum anterius; 4 - segmentum lalerale; 5 - seamen linn modi ale; 6 - xim-nlum apicale (superius); 7 - segmentum subapicale (subsuperius); 8 - segmentum basale mediale (tardiacum); 9 - seamen 11tin basale anterius; 10 - segmentum basale laterale; 11 - segmentum basale posterius; 12 - segmentum apicoposterius; 13 - segmentum lingulare superius; 14 - segmentum lingulare inferius.

Small. 90. Diseases of bronchogenic segments.
c - lateral surface view; g - type of medial surface; 1 - segmentum apicale; 2 - segmentum poste-rius; 3 - segmentum anterius; 4 - segmentum laterale; 5 - segmentum mediale; 6 - segmentum apicale (superius); 7 - segmentum subapicale (subsuperius); 8 - segmentum basale mediale (cardiacum); 9 -segmentum basale anterius; 10 - segmentum basale laterale; 11 - segmentum basale posterius; 12 - segmentum apicoposterius; 13 - segmentum lingulare superius; 14 - segmentum lingulare inferius.

Syntopy. In front of the root of the right legends, it grows: viscid aorta, upper empty vein, pericardial sac and partly to the right of the anterior; above and behind - an unpaired vein. The root of the lung is in front of it. From top to new reclining aortic arch, behind, from the side rear center, - stravohid, and behind the new one - the aorta is spasmodic. The offense of the root is in front of meteinayut diaphragmatic nerves, behind - blukayuchi.

Arterial lesion of the tissue, the edge of the alveoli, appears as bronchial arteries, which in the lung follow the course of the bronchi (from 1 to 4, partly 2-3). Blood posture of the legacy pleura is formed by the capillaries of the bronchial and legenevic vessels. Venous roof from fabrics and legends The bronchial tubes and the great sudins are seen through the bronchial veins, which flow into the system of the upper empty veins, as well as in the veins.

Lymphatic and lymphatic cannulae from the lung and leg pleuria ede along the superficial and glyphoid lymphatic vessels. Introduce lymphatic vessels from the superficial hedge is formed on the medial, diaphragmatic and interlobar surfaces and in the area of ​​the posterior part of the costal surface of the lung and go to the regional nodi lymphatici bronchopal. So, when inhaling the lymph from the cortical balls of the lung, it moves into the surface lymph hemisphere, which is also why the lymph valve is sucked out, the surface way towards the lymph from the lung inflator more important... glibokі lymphatic judge the lung to be formed from lymph capillary hems of legeneous patches, bronchial tubes, sudinum and semi-tissue partitions. Gliboki lead lymphatic vessels, direct vdovzh bronchial tubes and sudines to regional lymphatic universities, along the way they pass in nodi lymphatici pulmo-nales, lie at the forks of bronchial tubes, lymphatic bronchi in nod bronchopathies

Lymphoma of the lungs in particular and segments of the lungs go up to the first regional lymph nodes. From the upper part of the right leg, the lymph appears in the right lateotracheal and upper tracheobronchial lymphatic nodes, from the middle part - in the laterotracheal and upper and lower tracheobronchial parts From the upper-posterior and anterior segments of the upper part of the left leg, the lymphatic growth in some laterotracheal and upper tracheobronchial nodes and in the vertical lantry of the anterior mediastinal from ovarian segments - to laterotracheal universities and in both upper and lower tracheobronchial universities and anterior medical universities; from the lower part - in the lower tracheobronchial university. From the lower part of both the pathway, the pathway is also seen in the back of the medical institution, in the morning, in the university, where you lie behind the stravohode on the diaphragm. The grape of the judges of the university penetrates through the diaphragm and pours into the upper aortoabdominal lymph nodes. From the lower tracheobronchial nodes and all upper tracheobronchial nodes, the lymphadenopathy is important in the right upper tracheobronchial and laterotracheal nodes, and from them - right to the right to the right.

The innervations of the lungs get rid of the bloody, sympathetic, spinal and diaphragmatic nerves, making the plexus pulmonalis. From the flaccid nerves directly from the cob of the vertebral laryngeal nerves to the anterior surface of the root of the lung, enter (1-6) the anterior leg. Up to the posterior surface of the root of the lung, along the entire protrusion of the remaining protuberance of the bloating nerve, go from 5 to 18 (partly 8-11) of the posterior legenevia. Straight ligaments between the nerves of the heart and lung are established with the help of the heart gossip, which is straight up to root of the lung... Nice nerves to the anterior roots of the lungs are seen from the heart-legendary gossip Gilka gossip invokes the heart, so the lungs do not provide a strong functional interconnection with them. Up to the rear of the roots of the lungs from the pretty stubs, go to the back of the head: the right-hander goes from the fastest to the IV breast, the evil is from the fast or the first breast. gilki spinal nerves to the lungs they penetrate from Cv to Thv. The tips of the phrenic nerves go up to the mediastinal pleura and tissue, and also penetrate into the walls of the interlobar furrow between the lower and middle parts. On the roots of the legs, the nerves of the legendary gossip, like quilting in the walls of the arteries and veins to the parietal vertebrae, far to the periphery on the arterioles and venules, there are no more single nerve bundles and fibers that can resemble gossip. At the walls Legendary arteries and veins є the most common purchase of nerve ends (reflexogenic zones). They are є the ring of the Legendary veins and the cob part of the Legendary stovbur, the surface of its connection to the aorta and the area of ​​bifurcation.

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Broncholegenic segments.

lungs p_drozd_lyayutsya on the broncholegenic segment, segmenta bronchopulmonalia.

Broncholegenic segment is a segment of the leg part, ventilation with one segmental bronchus and living with one artery. During the day, it is necessary to provide shelter from the segment, to pass through the intermediate partitions, and most often the back walls for two suspended segments. Segments emerge one from the other with semi-fabric partitions and may form irregular cones and pyramids, the top of the beasts to the gates, and then to the surface of the legends. According to the International Anatomical Nomenclature, which is right, it is even easier to divide into 10 segments. The broncholegenic segment is not only a morphological, but a functional unit of the lung, as well as pathological processes in the legs are repaired in the boundaries of one segment.

V right legend developed ten bronchogenic segments, segmenta bronchopulmonalia.

The upper part of the right side of the leg should be placed in three segments, up to which go the segmental bronchi, which go out from the right upper pain bronchus, bronchus lobaris superior dexter, subdivided into three segmental bronchi:

1) upper segment (СI), segmentum apicale (SI), loan of the upper medial segment of the part, behind the dome of the pleura;

2) the posterior segment (CII), segmentum rosterius (SII), occupying the dorsal part of the upper part, adhering to the dorsolateral surface of the thoracic cell on the edges of the II-IV ribs;

3) the anterior segment (CIII), segmentum anterius (SIII), to become a part of the ventral surface of the upper part and the anterior part of the thorax (between the cartilages of the I and IV ribs).

The middle part of the right leg is folded into two segments, up to which there are segmental bronchi from the right middle lobe bronchus, bronchus lobaris medius dexter, which takes the ear from the anterior surface of the head bronchus; Straight forward, from bottom to bottom, the bronchus is divided into two segmental bronchi:

1) the lateral segment (CIV), segmentum laterale (SIV), of the incisions before the anterolateral costal surface (on the IV-VI ribs), and at the top - burn down, backwards and medially;

2) the medial segment (CV), segmentum mediale (SV), to become parts of the costal (at the level of IV-VI ribs), medial and diaphragmatic surfaces of the middle part.

The lower part of the right leg is folded into five segments and ventilated by the lower portion of the bronchus, bronchus lobaris interior dexter, which is one segmental bronchus on its way і, reach the basal arteries, for the duration of the lower part of the bronchus:

1) upper (upper) segment (CVI), segmentum apicale (superior) (SVI), borrowing the upper part of the lower part and up to the posterior chest wall (at the level of V-VII ribs) and up to the ridge;

2) the medial (heart) basal segment (CVII), segmentum basale mediale (cardiacum) (SVII), borrowing the lower medial parts of the lower part, going to the medial and diaphragmatic surface;

3) the anterior basal segment (CVIII), segmentum basale anterius (SVIII), occupy the anterolateral part of the lower part, go to the її rib (at the іvnі VI-VIII ribs) and the diaphragmatic surface;

4) the lateral basal segment (CIX), segmentum basale laterale (SIX), occupying the middle-lateral part of the lower part, the beruch part of the part in the illumination of the diaphragmatic and costal (on the level of the VII-IX ribs) and the surface;

5) the posterior basal segment (CX), segmentum basale posterius (SX), occupying a part of the lower part of the lower part, ma costal (at the level of VIII-X ribs), diaphragmatic and medial surface.

V liviy legend razr_znyayut nine bronchogenevic segments, segmenta bronchopulmonalia.

The upper part of the lobaris superior sinister, which can be divided into two arms - the upper and the linguistic ones, are responsible for the bronchus of the upper part of the bronchus.

1) the upper-posterior segment (СI + II), segmentum apicoposterius (SI + II), according to the topography, approximately resembled the upper and posterior segments in the upper part of the right leg;

2) anterior segment (CIII). segmentіm anterius (SIII), є the largest segment of the legends, іn borrowing the middle part of the upper part;

3) the upper ovarian segment (CIV), segmentum lingulare superius (SIV), occupying the upper part of the testicle of the lung and middle viddiliv of the upper part;

4) the lower ovarian segment (CV), segmentum lingulare inferius (SV), borrowed from the lower anterior part of the lower part.


The lower part of the left leg is composed of five segments, up to which there are segmental bronchi from the left lower part of the bronchus, bronchus lobaris inferior sinister, which, for its direct fact, is actually advanced to the left head bronchus.