Trachea

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Trachea

The trachea is a mobile cartilaginous and membranous


tube.
It begins in the neck as a continuation of the larynx at the
lower border of the cricoid cartilage at the level of the 6th
cervical vertebra.
It descends in the midline of the neck.
In the thorax, the trachea ends (at Carina) by dividing into
right and left principal (main) bronchi at the level of the
sternal angle (opposite to the disc between the 4th and 5th
thoracic vertebrae).
During expiration, the bifurcation rises by about one
vertebral level, and during deep inspiration may be lowered
as far as the 6th thoracic vertebra.
The internal surface is lined by ciliated, pseudo stratified
Size of trachea
In adults, the trachea is about 4.5 inches (11.25 cm) long
and 1 inch (2.5 cm) in diameter.
The fibroelastic tube is kept patent by the presence of U-
shaped rings of hyaline cartilage embedded in its wall.
These cartilages are connected with each other by Annular
ligament.
The posterior free ends of the cartilage are connected by
smooth muscles (trachealis muscle).

Relations of trachea
The relations of the trachea in the superior mediastinum
of the thorax are:
Anteriorly:
(1) Sternum (Menubrium)
(2) Thymus
(3) Left brachiocephalic vein
(4) Origins of the brachiocephalic and left common
carotid arteries
(5) Arch of the aorta

Posteriorly:
(1) Esophagus
(2) Left recurrent laryngeal nerve
Right side:
(1) Azygos vein
(2) Vagus nerve
(3) Pleura

Left side:
(1) Arch of aorta
(2) Left common carotid artery
(3) Left subclavian artery
(4) Vagus nerve
(5) Left phrenic nerve
(6) Pleura
Blood Supply of the Trachea
The upper two thirds are supplied by the Inferior Thyroid
arteries and the lower third is supplied by the Bronchial
arteries.

Lymph Drainage of the Trachea


The lymph drains into the pretracheal and paratracheal
lymph nodes and the deep cervical nodes.

Nerve Supply of the Trachea


The sensory nerve supply is from the vagi and the
recurrent laryngeal nerves.
Sympathetic nerves supply the trachealis muscle.
Bronchi
The trachea is divided into right and left principal bronchus just behind the arch of aorta
at the level between
T4 and T5. Each bronchus is further divided into lobar bronchi which is further divided into
many more bronchioles. Each bronchiole ends in 2 to 11 alveolar ducts which inters into
alveolar sacs.
The part of the bronchi which is out of the hilum of the lung at mediastinum is called extra
pulmonary part while the part which is inside the hilum of the lung before the division into
lobar branches is called intrapulmonary part.
Right principal Bronchus
It is wider, shorter and more vertical.
It is 2-2.5 cm (1 inch) long.
After entering into the hilum of the right lung it gives three main branches,
(a) Superior lobar bronchus
Branch to the upper lobe of the right lung.
(b) Middle lobar bronchus
Branch to the middle lobe of the right lung.
(c) inferior lobar bronchus
Branch to the lower lobe of the right lung.
Left principal Bronchus
It passes to the left and goes below the arch of aorta in
the front of esophagus.
It is narrower, longer and more horizontal than the right
principal bronchus.
It is up to 5 cm (2 inches) long.
After entering into the hilum of the left lung it is divided
into,
(a) Superior lobar bronchus
Which enters into upper lobe of the lung.
(b) Inferior lobar bronchus
Which enters into lower lobe of the lung.
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