THE LUNGS The Huffing Puffing Organs that keep the Oxygen Flowing and ridding the Body of Toxic Carbon Dioxide by Ashley Davidoff MD
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Dyspnea and COPD Ashley Davidoff
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Lungs – Collage Anatomy This image takes you from the person (1) to the alveolus (8,9)- a continuum of structure – each element an individual unit, which in concert work for the harmony of health. Image 2 is a post mortem specimen showing trachea and proximal bronchi entering the lung. The chest X-ray showing the lungs in black within the thoracic cavity (3) is followed by a diagram of the same structure(4), secondary lobule(5), acinus (6), connective support tissues (7), and then the alveoli (8.9). Courtesy Ashley Davidoff MD. code normal anatomy lung pulmonary trachea bronchus bronchi CXR plain film lobes secondary lobules respiratory bronchioles terminal bronchioles alveolus alveoli capillary drawing collage Ashley Davidoff MD
CHEST of FRUIT Talking about grapes This artistic rendition of the heart and lungs uses the shape of fruit and vegetables to create an image of the chest. The lungs are made of grapes, the pulmonary arteries are made of carrots, the ribs are made of banana peel and the heat is made of a red pepper. aka 02032p Davidoff art by Ashley Davidoff MD
The Alveolus
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Alveolus Parts and Bonds Ashley Davidoff MD
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Type I Pneumocyte – Squamous Cell Ashley Davidoff MD
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Type II Pneumocyte Ashley Davidoff MD
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Macrophage Ashley Davidoff MD
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The alveolus ? the center of the pulmonary universe The five major layers that keep the air moving include the outer bony cage, the muscular layer represented in maroon, the pleural complex (orange yellow orange) the lung (blue) and surfactant within the alveolus. (pink) 42530b05b09b01a08 Ashley Davidoff art by Ashley Davidoff MD
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CELLS OF THE ALVEOLI There are two types of cells lining the alveoli: Type I alveolar cells (pneumocytes) are squamous cells. They enable gas exchange. Type 2 alveolar cells ,are cuboidal in shape and they secrete surfactant. by Ashley Davidoff MD
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Alveolus Cells and Capillaries of the Lung ?Alveolus Cells and Capillaries of the Lung? shows an alveolus with single cell lining and associated arteriole, capillary and venous circulation. The cool fresh air flows into the alveolus, and oxygen flows into the blue blooded arteriole converting into a red blooded venule. A breeze of carbon dioxide flows through the single celled alveolus and into the airways for expiration by Ashley Davidoff MD
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Alveolus Cells and Capillaries of the Lung ?Alveolus Cells and Capillaries of the Lung? shows an alveolus with single cell lining and associated arteriole, capillary and venous circulation. The cool fresh air flows into the alveolus, and oxygen flows into the blue blooded arteriole converting into a red blooded venule. A breeze of carbon dioxide flows through the single celled alveolus and into the airways for expiration by Ashley Davidoff MD
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Alveolus Cells and Capillaries of the Lung ?Alveolus Cells and Capillaries of the Lung? shows an alveolus with single cell lining and associated arteriole, capillary and venous circulation. The cool fresh air flows into the alveolus, and oxygen flows into the blue blooded arteriole converting into a red blooded venule. A breeze of carbon dioxide flows through the single celled alveolus and into the airways for expiration by Ashley Davidoff MD by Ashley Davidoff MD
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Alveolus at a Cytologic Level
The diagram shows an alveolus (a) above, lined by a single layer of squamous cells, surrounded by a capillary with red cells which is also lined by a single layer of squamous endothelial cells . The images below show progressive magnification of the alveolar wall demonstrating the two thin layer of the alveolar membrane .
Courtesy Ashley Davidoff 2019
lungs-0028-low res
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Microscopic view of Alveoli
The low magnification at the periphery of the normal lung shows normal lining of the alveoli surrounding the air spaces (alveoli).
The layer of visceral pleura is shown to the right of the image
Small airways and accompanying blood vessels (with clotted blood)
Ashley Davidoff MD
lungs-0031-hi-res
Cluster of Alveoli
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CLUSTER OF ALVEOLI This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. key words RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing Ashley Davidoff MD 32164
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ALVEOLITIS This is a drawing of a cluster of inflamed alveoli surrounded by the capillary network, Ashley Davidoff MD 32164
Acinus
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THE ACINUS 3000-4,000 acini unite to form the acinus. The acini are formed by the respiratory bronchioles and the alveolar ducts, and the alveoli Ashley Davidoff MD
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Acinus From Latin: grape, berry. An acinus with similar morphology to a bunch of grapes Ashley Davidoff MD
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Acinus From Latin: grape, berry. Top images show a an acinus and a raspberry Bottom image an acinus and a blackberry Ashley Davidoff MD Image of raspberry courtesy Brave New World and image of blackberry courtesy Beko
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The Acinus, The Duct, and the Artery The pulmonary arteriole (pa) accompanies the lobular bronchiole (lb). The arteriole transports deoxygenated blood and the bronchiole carries oxygen from the trachea to the alveoli. They part ways at the alveoli Ashley Davidoff MD
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Multiple Acini This diagram illustrates the branching pattern of the tracheobronchial tree that extends from the bronchi to the terminal bronchioles transitioning into the alveoli via the alveolar sacs. Courtesy Ashley Davidoff MD 32645b04b04 lung Davidoff tree branching alveolus alveoli normal drawing Davidoff art 32645a10.800 by Ashley Davidoff MD
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The Acinus, The Duct, and the Artery The pulmonary arteriole accompanies the airway as it carries oxygen from the trachea to the alveoli. They part ways at the alveoli where the pulmonary venule then takes the oxygenated blood from capillary network around the alveoli back to the left atrium. The intimate relationship of the airways and the pulmonary artery and their close approximation in size, is helpful in radiology, firstly to identify theese structures and secondly to define disease such as heart failure and bronchiectasis. The acinus as shown in this image is defined as a unit of lung consisting of a single first order respiratory bronchiole that subtending a cluster of alveoli reminiscent of a bunch of grapes or berries (acinus in Latin means berry) . The lobular bronchiole (lb) branches into the terminal bronchiole (tb), which then branches into the first order respiratory bronchiole (rb). Subsequent branching after the respiratory bronchiole, includes in order, the alveolar duct (ad), alveolar sac (as), and then finally the berry like alveoli. Courtesy Ashley Davidoff 2019 lungs-0033-low res
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The Ductal System of the Acinus The diagram shows the ductal system of the acinus, starting with the tick walled terminal bronchiole (tb) that is the last duct of the conducting system of the airways. The respiratory bronchiole (rb) enters the secondary lobule and is the first duct to have diffusion capability. There can be 3 orders of rb’s, and they branch into alveolar ducts, which branch in turn to alveolar sacs until they reach the alveoli, which is the final destination. Courtesy Ashley DAvidoff MD 2019 lungs-0032-low res
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ACINUS Acinus with terminal bronchiole, respiratory bronchiole and alveolar ducts. by Ashley Davidoff MD
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The Secondary Lobule Between 10 and 30 acini combine to form a secondary lobule which is between .5- 2 cms in diameter. It is subtended by a single lobar bronchiole (lb), and is accompanied by arterioles, venules, lymphatics and connective tissue. It is important in clinical radiology since many of the structures can be identified in health, and more particularly in disease, enabling the identification and characterization of many disease processes. Courtesy Ashley Davidoff MD lungs-0035-low res
The Secondary Lobule
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The Secondary Lobule The secondary lobule is housed in a connective tissue framework in which run the lymphatic and venular tributaries . Together these 3 structures form the interlobular septum. The lobar arteriole enters the framework, accompanied by the lobar bronchiole, and they all run together and form the interlobular septa. This structure measures between .5cms and 2cms and is visible on CT scan. It is important in clinical radiology since many of the structures can be identified in health, and more particularly in disease, enabling the identification and characterization of many pathological processes. Courtesy Ashley Davidoff MD lungs-0036-low res
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This image is a panoramic view of the lung showing in this case almost rectangular secondary lobules surrounded by interlobular septa (cream borders) The distal bronchioles (teal) and pulmonary arteriole (royal blue are shown in the centre of a lobule in the right lower corner. The branches of these two structures are shown in the secondary lobule with the acinar airways shown in teal and the presumed course artistically inferred in royal blue. Within the interlobular septa (light pink) remnants of the pulmonary venules (red – inferred) and lymphatics (yellow inferred) course going in the opposite direction to the arteriole and the airways. Courtesy Armando Fraire MD. code lung pulmonary alveoli alveolus secondary lobule interlobular septa vein lymphatic histology interstitium interstitial normal copyright 2009 all rights reserved
The Secondary Lobule Secondary lobule Here is a picture of the outside of the polyhedral pulmonary lobule from the side. Courtesy Ashley Davidoff MD 42449b02
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SEGMENTS OF THE LUNGS The secondary lobules, connect, and unite, linked through the airways, blood vessels, lymphatics and nerves, to form segments in the lungs There are ten bronchopulmonary segments in the right lung: three in the upper lobe, two in the middle lobe, and five in the lower lobe. Some of the segments may fuse in the left lung to form usually eight to nine segments (four to five in the upper lobe and four to five in the lower lobe. Ashley Davidoff MD
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ASYMMETRIC BRANCHING PATTERN – RIGHT SHORT AND STOUT AND THE LEFT LONG AND THIN WITH SEGMENTS OF THE LUNG The classical branching pattern of many trees Ashley Davidoff MD
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LOBES OF THE LUNGS The right lung has an upper middle and lower lobe, and the left lung has a left upper lobe that incorporates the lingula segment and and the left lower lobe Ashley Davidoff MD
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THE LUNGS AND THE RIBS Ashley Davidoff MD
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THE LUNGS AND THE PROXIMAL TRACHEOBRONCHIAL TREE by Ashley Davidoff MD
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LUNGS INSIDE THE CHEST CAVITY by Ashley Davidoff MD
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THE LUNGS IN THE CHEST (3D) by Ashley Davidoff MD
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THE LUNGS IN THE CHEST (3D) by Ashley Davidoff MD
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THE LUNGS IN THE CHEST (3D) by Ashley Davidoff MD
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Gingko Chest Tracheobronchial Tree Tree, flower, tracheobronchial tree, trachea bronchi lung Ashley Davidoff Art 32620b14.800b02p by Ashley Davidoff MD
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DERIVATION OF THE GINGKO LUNGS of the Gingko Chest Tracheobronchial Tree lung bronchus tracheobronchial tree airway tree the common vein applied biology Davidoff tree Ashley Davidoff art 32620c02.800 by Ashley Davidoff MD
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Pulmonary Artery Tree Art image derived from a parasagittal view of a reconstructed CT scan – CTA of the chest Ashley Davidoff MD Copyright 2018 46649b04b.800
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Pulmonary Tree and a Summer Sky Art image derived from a parasagittal view of a reconstructed CT scan – CTA of the chest Ashley Davidoff MD Copyright 2018 46649b11.800b01
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Derivation of the Pulmonary Tree Art image derived from a parasagittal view of a reconstructed CT scan – CTA of the chest Ashley Davidoff MD Copyright 2018 46649c01.800
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ARTERIES AND VEINS by Ashley Davidoff MD
Imaging the Lungs
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Lungs and the X-Ray 42444b18.8 lungs anatomy X-ray Davidoff art Medical Art copyright 2008
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Talking about grapes This artistic rendition of the heart and lungs uses the shape of fruit and vegetables to create an image of the chest. The lungs are made of grapes, the pulmonary arteries are made of carrots, the ribs are made of banana peel and the heat is made of a red pepper. 02032p Ashley Davidoff MD TTagsheCommonVein.net
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Parts of the lungs 82738p chest lung connective tissue pulmonary artery pulmonary vein axial interstitial tissue secondary lobule lobes segments trachea bronchi interlobular septa polygonal Ashley Davidoff MD TheCommonVein.net
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The Alveolus – The Centre of the Pulmonary Universe The five major layers that keep the air moving include the outer bony cage, the muscular layer represented in maroon, the pleural complex (orange yellow orange) the lung (blue) and surfactant within the alveolus. (pink) 42530b05b09b01a08 Ashley Davidoff MD TheCommonVein.net
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The lungs ? as they live and breathe The chest is surrounded by a ring of muscle (maroon) made up of a various groups which work in concert. The diaphragm is the workhorse of the respiratory muscles and is shown as a thick maroon band inferiorly. 42530b05b09b14 Ashley Davidoff MD TheCommonVein.net
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Gingko Chest Tracheobronchial Tree Tree, flower, tracheobronchial tree, trachea bronchi lung Ashley Davidoff Art 32620b14.800b02p Ashley Davidoff MD TheCommonVein.net
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Evolution of the Gingko Chest Tracheobronchial Tree lung bronchus tracheobronchial tree airway tree the common vein applied biology Ashley Davidoff MD TheCommonVein.net 32620c02.800
This collage reflects the range of the respiratory system from the macroscopic and anatomic to the microscopic – a continuum of structure. Image 2 is a post-mortem specimen taken from the front and slightly above. It shows the trachea and bronchi supplying the two lungs above, with the aortic arch and cardiac structures in the middle and below. Note how pink the lungs are in this specimen from an unfortunate baby with congenital heart disease. Image 3, the chest X-ray, shows the lucent lungs within the thoracic cavity while image 4 is a diagram of the trilobed right lung and the bilobed left lung. Two respiratory units of the lung are shown in the next image each called a pulmonary lobule (5). The lobule consists of a central bronchiole (light blue) and pulmonary arteriole (dark blue), surrounded by the air filled acinus (teal) with its peripheral venules. (red) The acinus is magnified in the next image (6), showing first the tubular terminal bronchiole branching into the respiratory bronchioles, alveolar sacs, and finally the grape like alveoli. The organization of the connective tissues of the lung is shown in image 7. Finally we get down to the grapes or alveoli of the lung with surrounding vessels (8), and a single alveolus is seen in 9. It seems a long way for the air to travel but the system can deliver the air to and from the outside in a single breath, and exchange the gases at the capillary level even more rapidly. It is a remarkable system. 42651c keywords lung chest Ashley Davidoff TheCommonVein.net
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Hearing with your eyes 32647 Davidoff Ashley Davidoff MD TheCommonVein.net
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Normal Alveoli or Grapes of the lung This diagram illustrates the branching pattern of the tracheobronchial tree that extends from the bronchi to the terminal bronchioles transitioning into the alveoli via the alveolar sacs. 32645b04b04 lung D Ashley Davidoff MD TheCommonVein.net 32645a10.800
Tree in Bud Tree in bud nociceptors free nerve endings trees in the body Ashley Davidoff MD TheCommonVein.net87559pb04b07b.8s
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The Shape of the Grape Snow covered red berries ? the contrast between the cherry red and the snow white make them look delicious. Ashley Davidoff MD TheCommonVein.net 02160p
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Alveoli of the Lung ? Factory Workers This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity ? carbon dioxide Ashley Davidoff MD TheCommonVein.net 32165c
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Tracheobronchial Tree 42474b18.800 lung trachea bronchi tracheobronchial tree Ashley Davidoff MD TheCommonVein.net
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Derivation of the Pulmonary Tree Art image derived from a parasagittal view of a reconstructed CT scan – CTA of the chest Ashley Davidoff MD Copyright 2018 46649c01.800
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Lungs and the Heart – Intimate Buddies Forever For more medical art see TheCommonVein.net at https://medicalart.thecommonvein.net/ Courtesy of the Free Museums In and Around Us Ashley Davidoff MD Ashley Davidoff MD
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The shape of the corona virus causing COVID-19 bears similarity with the flower of the Buttonbush pictured above
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Perhaps from a Bat?
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POTENTIALLY A FATAL MOVE A mere scratching of your chin could be fatal. One of the best reasons to wear a mask is to remind you: hands off. Please keep your hands off your face! Ashley Davidoff MD
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TWO POTENTIALLY FATAL ERRORS 1 – Hand to Mouth (No No) 2 – Close Contact (No No) Ashley Davidoff
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CONTACT and CONTAMINATION Man buys meat at the wet market and corona virus spreads to his hands during the purchase or during food preparation. Ashley Davidoff MD
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INHALATION His hands go to his mouth and he inhales the virus. The virus does not proliferate if it is ingested, only if inhaled. Ashley Davidoff
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BMC Radiology and Covid 19 Ashley Davidoff
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Smoking Kick the Habit in the Butt Ashley Davidoff MD
