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Ch. 22 The Respiratory System
Marieb - Human Anatomy & Physiology 7th Edition
Marieb, Hoehn7th EditionHuman Anatomy & PhysiologyISBN: 9780805359091Not the one you use?Change textbook
All textbooksMarieb, Hoehn 7th EditionCh. 22 The Respiratory SystemProblem 23
Chapter 21, Problem 23

A surgeon removed three adjacent bronchopulmonary segments from the left lung of a patient with TB. Almost half of the lung was removed, yet there was no severe bleeding, and relatively few blood vessels had to be cauterized (closed off). Why was the surgery so easy to perform?

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1
Understand the anatomy of the lung: The lungs are divided into lobes, and each lobe is further subdivided into bronchopulmonary segments. These segments are functionally and anatomically independent units, each with its own bronchus, artery, vein, and connective tissue boundaries.
Recognize the significance of bronchopulmonary segments: Because these segments are separated by connective tissue, they can be surgically removed without affecting the surrounding segments. This makes surgeries involving the removal of specific segments relatively straightforward.
Consider the vascular arrangement: Each bronchopulmonary segment has its own blood supply and drainage system. This segmentation minimizes the risk of severe bleeding during surgery, as only the vessels supplying the affected segments need to be cauterized.
Analyze the left lung's structure: The left lung has two lobes (superior and inferior) and fewer bronchopulmonary segments compared to the right lung. Removing three adjacent segments from the left lung could account for nearly half of its volume, explaining the extent of the removal.
Conclude why the surgery was easy: The independent nature of bronchopulmonary segments, their distinct vascular supply, and the connective tissue boundaries make it possible to remove specific segments with minimal impact on the rest of the lung and reduced risk of complications like severe bleeding.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Bronchopulmonary Segments

Bronchopulmonary segments are distinct regions of the lung, each supplied by its own bronchus and blood vessels. The left lung typically has eight segments, allowing for surgical removal of specific areas without affecting the entire lung. This segmentation facilitates targeted surgeries, as surgeons can isolate and remove diseased tissue while minimizing damage to surrounding healthy structures.
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Pulmonary Blood Supply

The pulmonary blood supply consists of the pulmonary arteries and veins that transport blood to and from the lungs. Each bronchopulmonary segment has its own vascular supply, which means that during surgery, only the blood vessels associated with the removed segments need to be cauterized. This localized vascular anatomy reduces the risk of severe bleeding during lung surgeries.
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Surgical Techniques in Pulmonology

Surgical techniques in pulmonology, such as segmentectomy, involve the precise removal of lung segments while preserving as much healthy lung tissue as possible. Advances in minimally invasive techniques, such as video-assisted thoracoscopic surgery (VATS), allow for better visualization and control during procedures, contributing to reduced complications and easier surgeries, as seen in this case.
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Textbook Question

Daniel, the swimmer with the fastest time on the Springfield College swim team, routinely hyperventilates before a meet, as he says, 'to sock some more oxygen into my lungs so I can swim longer without having to breathe.' First of all, what basic fact about oxygen loading has Daniel forgotten (a lapse leading to false thinking)? Second, how is Daniel jeopardizing not only his time but his life?

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Textbook Question

Describe the functional relationships between volume changes and gas flow into and out of the lungs.

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Textbook Question

A member of the 'Blues' gang was rushed into an emergency room after receiving a knife wound in the left side of his thorax. The diagnosis was pneumothorax and a collapsed lung. Explain exactly

Why the lung collapsed?

Why only one lung (not both) collapsed?

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