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Lung Surgery Operation

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Lung Surgery Operation

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Lung

The lung or pulmonary system is the essential respiration organ in air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located in the chest on either side of the heart. Their principal function is to transport oxygen from the atmosphere into the bloodstream, and to release carbon dioxide from the bloodstream into the atmosphere. This exchange of gases is accomplished in the mosaic of specialized cells that form millions of tiny, exceptionally thin-walled air sacs called alveoli.

In order to completely explain the anatomy of the lungs, it is necessary to discuss the passage of air through the mouth to the alveoli. Once air progresses through the mouth or nose, it travels through the oropharynx, nasopharynx, the larynx, the trachea, and a progressively subdividing system of bronchi and bronchioles until it finally reaches the alveoli where the gas exchange of carbon dioxide and oxygen takes place.^]

The drawing and expulsion of air (ventilation) is driven by muscular action; in early tetrapods, air was driven into the lungs by the pharyngeal muscles, whereas in reptiles, birds and mammals a more complicated musculoskeletal system is used.

Medical terms related to the lung often begin with pulmo-, from the Latin pulmonarius (“of the lungs”), or with pneumo- (from Greek πνεύμων “lung”).

Anatomy

In humans, the trachea divides into the two main bronchi that enter the roots of the lungs. The bronchi continue to divide within the lung, and after multiple divisions, give rise to bronchioles. The bronchial tree continues branching until it reaches the level of terminal bronchioles, which lead to alveolar sacs. Alveolar sacs are made up of clusters of alveoli, like individual grapes within a bunch. The individual alveoli are tightly wrapped in blood vessels and it is here that gas exchange actually occurs. Deoxygenated blood from the heart is pumped through the pulmonary artery to the lungs, where oxygen diffuses into blood and is exchanged for carbon dioxide in the hemoglobin of the erythrocytes. The oxygen-rich blood returns to the heart via the pulmonary veins to be pumped back into systemic circulation.

Human lungs are located in two cavities on either side of the heart. Though similar in appearance, the two are not identical. Both are separated into lobes by fissures, with three lobes on the right and two on the left. The lobes are further divided into segments and then into lobules, hexagonal divisions of the lungs that are the smallest subdivision visible to the naked eye. The connective tissue that divides lobules is often blackened in smokers and city dwellers. The medial border of the right lung is nearly vertical, while the left lung contains a cardiac notch. The cardiac notch is a concave impression molded to accommodate the shape of the heart. Lungs are to a certain extent ‘overbuilt’ and have a tremendous reserve volume as compared to the oxygen exchange requirements when at rest. Such excess capacity is one of the reasons that individuals can smoke for years without having a noticeable decrease in lung function while still or moving slowly; in situations like these only a small portion of the lungs are actually perfused with blood for gas exchange. As oxygen requirements increase due to exercise, a greater volume of the lungs is perfused, allowing the body to match its CO₂/O₂ exchange requirements.

The environment of the lung is very moist, which makes it hospitable for bacteria. Many respiratory illnesses are the result of bacterial or viral infection of the lungs. Inflammation of the lungs is known as pneumonia; inflammation of the pleura surrounding the lungs is known as pleurisy.

Vital capacity is the maximum volume of air that a person can exhale after maximum inhalation; it can be measured with a spirometer. In combination with other physiological measurements, the vital capacity can help make a diagnosis of underlying lung disease.

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Beyond the Brain

Electrodes measure a Tibetan monk’s brain activity.

The ancient Egyptians thought so little of brain matter they made a practice of scooping it out through the nose of a dead leader before packing the skull with cloth before burial. They believed consciousness resided in the heart, a view shared by Aristotle and a legacy of medieval thinkers. Even when consensus for the locus of thought moved northward into the head, it was not the brain that was believed to be the sine qua non, but the empty spaces within it, called ventricles, where ephemeral spirits swirled about. As late as 1662, philosopher Henry More scoffed that the brain showed “no more capacity for thought than a cake of suet, or a bowl of curds.”

Around the same time, French philosopher René Descartes codified the separation of conscious thought from the physical flesh of the brain. Cartesian “dualism” exerted a powerful influence over Western science for centuries, and while dismissed by most neuroscientists today, still feeds the popular belief in mind as a magical, transcendent quality.

A contemporary of Descartes named Thomas Willis—often referred to as the father of neurology—was the first to suggest that not only was the brain itself the locus of the mind, but that different parts of the brain give rise to specific cognitive functions. Early 19th-century phrenologists pushed this notion in a quaint direction, proposing that personality proclivities could be deduced by feeling the bumps on a person’s skull, which were caused by the brain “pushing out” in places where it was particularly well developed. Plaster casts of the heads of executed criminals were examined and compared to a reference head to determine whether any particular protuberances could be reliably associated with criminal behavior.

Though absurdly unscientific even for its time, phrenology was remarkably prescient—up to a point. In the past decade especially, advanced technologies for capturing a snapshot of the brain in action have confirmed that discrete functions occur in specific locations. The neural “address” where you remember a phone number, for instance, is different from the one where you remember a face, and recalling a famous face involves different circuits than remembering your best friend’s.

Yet it is increasingly clear that cognitive functions cannot be pinned to spots on the brain like towns on a map. A given mental task may involve a complicated web of circuits, which interact in varying degrees with others throughout the brain—not like the parts in a machine, but like the instruments in a symphony orchestra combining their tenor, volume, and resonance to create a particular musical effect.

Corina’s brain all she is…is here

Corina Alamillo is lying on her right side in an operating room in the UCLA Medical Center. There is a pillow tucked beneath her cheek and a steel scaffold screwed into her forehead to keep her head perfectly still. A medical assistant in her late 20s, she has dark brown eyes, full eyebrows, and a round, open face.

Median Sternotomy

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Median Sternotomy

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Median sternotomy is a type of surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided, or “cracked”. This procedure provides access to the heart and lungs for surgical procedures such as heart transplant, corrective surgery for congenital heart defects (CHDs), or coronary artery bypass surgery.

Median sternotomy is often mistakenly referred to as open heart surgery; however, open heart involves incision of the pericardium, and many median sternotomy procedures do not require this. Open heart usually involves the use of a cardiopulmonary bypass, also known as a heart-lung machine.

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