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Trachea and Bronchi
Dr.Hassan Shaibah
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Tracheobronchial anatomy
3Tracheal Displacement Due to Goiter
Images downloaded from From www.vh.org
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a mobile cartilaginous and membranous tube
Right bronchs•Wider•Shorter C6C6
T4/5T4/5
Left bronchus•Narrower•Longer•More horizontal
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• C shaped rings of hyaline cartilages
• Free Posteriorly. Cartilages are connected by a muscle
11.25 cm
TrachealisMuscle
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LTMain
bronchus
RTMain
bronchusLT
Upper lobar
bronchus
LTlower lobar
bronchus
RTlower lobar
bronchus
RTUpper lobar
bronchus
RTmiddle lobar
bronchus
Cricoid Cartilage
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Main carina: Concepts of anterior and posterior
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RTSegmantal
bronchiLT
Segmantal bronchi
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Relations of the Trachea
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At Level of superior Mediastinum• Anteriorly: The sternum, thymus, left brachio-
cephalic v., origins of the brachiocephalic and left common carotid a., & arch of the aorta
• Posteriorly: esophagus & left recurrentlaryngeal n.
• Right side: azygos v., right vagus n., & the pleura
• Left side: arch of the aorta, left common carotid &left subclavian a., the left vagus & left phrenic n., & the pleura.
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sternum
thymus
LT brachiocephalic v.
Brachiocephalic truck
LT common carotid a.
Anterior the level of T1
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Posteriorly at level of T1
esophagus
LTRecurrent
laryngeal N
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Right at level of T1
RT vagus n.
Pleura
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Left at level of T1
Pleura
LT common carotid a
LT subclavian a.
left vagus n.
LT phrenic n.
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The sternum
thymus
LT brachiocephalic v.
BrachiocephalicTrunk
LT common carotid a.
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The sternum
thymus
LT brachiocephalic v.
BrachiocephalicTrunk
LT common carotid a.
anterior
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Left at level of T1
Pleura
LT common carotid a
LT subclavian a.
left vagus n.
LT phrenic n.
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Right
RT vagus n.
Pleura
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sternumthymus
Arch of aorta
Anterior at level of T4
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Left at level of T1
Pleura
Arch of aorta
left vagus n.
LT phrenic n.
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Right at level of T1
RT vagus n.
Pleura
Azygos v.
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Posterior at level of T4
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At level T4
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At level T3
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At Level of the neck• Anterior: thyroid gland, inf. Thyroid vein with some neck
muscles• Posterior : right and left recurrent laryngeal nerve• Lateral: lobes of the thyroid gland and carotid sheath
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thyroid gland
inf. Thyroid vein
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Posterior• right and left recurrent laryngeal nerve
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Lateral
Lobes of the thyroid gland & carotid sheath
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48
Intraluminal disease and extrinsic compression
• Tumor invading through posterior wall.
• Tumor invading left and right main bronchi
• Narrowing of lower third of trachea
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BI,
All R
ight
s Re
serv
ed, 2
005
50
Tracheal appearances
A
B
C
D
E
F
Saber sheath Dynamic collapse Crescent shape collapse
Normal shape expansion during inhalation circumferential collapse
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Nerve Supply of the Trachea
• sensory nerve supply is from the vagi and the recurrent laryngeal nerves.
• Sympathetic nerves supply the trachealis muscle
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Blood Supply of the Trachea
• upper 2/3 are supplied by the inferior thyroid arteries • lower 1/3 is supplied by the bronchial arteries.