Carina of trachea

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Carina of trachea
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Cartilages of larynx, trachea and bronchi. (Carina is at the point of bifurcation.)
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Transverse section of the trachea, just above its bifurcation, with a bird’s-eye view of the interior. (Carina not labeled; the ridge that separates the left and right bronchus.)
Details
System Respiratory system
Identifiers
Latin carina tracheae
TA98 A06.3.01.009
TA2 3225
FMA 7465
Anatomical terminology

The carina of trachea (also: "tracheal carina" [1] ) is a ridge [1] of cartilage [2] at the base of the trachea separating the openings of the left and right main bronchi. [1] [2]

Contents

Structure

The carina is a cartilaginous ridge separating the left and right main bronchi that is formed by the inferior-ward and posterior-ward prolongation of the inferior-most tracheal cartilage. [2]

The carina occurs at the lower end of the trachea - usually at the level of the 4th to 5th thoracic vertebra. [3] [4] This is in line with the sternal angle, but the carina may raise or descend up to two vertebrae higher or lower with breathing. The carina lies to the left of the midline, and runs antero-posteriorly (front to back).[ citation needed ]

Blood supply

The bronchial arteries supply the carina and the rest of the lower trachea. [5]

Relations

The carina is around the area posterior to where the aortic arch crosses to the left of the trachea. [4] The azygos vein crosses right to the trachea above the carina. [6]

Physiology

The mucous membrane of the carina is the most sensitive area of the trachea and larynx for triggering a cough reflex.[ citation needed ]

Clinical significance

Tracheobronchial injury, an injury to the airways, occurs within 2.5 cm of the carina 60% of the time. [7]

Diagnostic radiology

Widening and distortion of the carina is a serious radiological sign that usually indicates carcinoma of the lymph nodes around the region where the trachea divides.[ citation needed ]

Additional images

Related Research Articles

<span class="mw-page-title-main">Trachea</span> Cartilaginous tube that connects the pharynx and larynx to the lungs

The trachea, also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all animals with lungs. The trachea extends from the larynx and branches into the two primary bronchi. At the top of the trachea the cricoid cartilage attaches it to the larynx. The trachea is formed by a number of horseshoe-shaped rings, joined together vertically by overlying ligaments, and by the trachealis muscle at their ends. The epiglottis closes the opening to the larynx during swallowing.

<span class="mw-page-title-main">Tracheal intubation</span> Placement of a tube into the trachea

Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.

<span class="mw-page-title-main">Deep femoral artery</span> Large branch of the femoral artery that supplies the thigh

The deep femoral artery also known as the deep artery of the thigh, or profunda femoris artery, is a large branch of the femoral artery. It travels more deeply ("profoundly") than the rest of the femoral artery. It gives rise to the lateral circumflex femoral artery and medial circumflex femoral artery, and the perforating arteries, terminating within the thigh.

<span class="mw-page-title-main">Respiratory tract</span> Organs involved in transmission of air to and from the point where gases diffuse into tissue

The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa.

<span class="mw-page-title-main">Thoracic duct</span> Lymphatic vessel

In human anatomy, the thoracic duct is the larger of the two lymph ducts of the lymphatic system. The thoracic duct usually begins from the upper aspect of the cisterna chyli, passing out of the abdomen through the aortic hiatus into first the posterior mediastinum and then the superior mediastinum, extending as high up as the root of the neck before descending to drain into the systemic (blood) circulation at the venous angle.

<span class="mw-page-title-main">Bronchus</span> Airway in the respiratory tract

A bronchus is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi to branch from the trachea at the carina are the right main bronchus and the left main bronchus. These are the widest bronchi, and enter the right lung, and the left lung at each hilum. The main bronchi branch into narrower secondary bronchi or lobar bronchi, and these branch into narrower tertiary bronchi or segmental bronchi. Further divisions of the segmental bronchi are known as 4th order, 5th order, and 6th order segmental bronchi, or grouped together as subsegmental bronchi. The bronchi, when too narrow to be supported by cartilage, are known as bronchioles. No gas exchange takes place in the bronchi.

<span class="mw-page-title-main">Epiglottis</span> Leaf-shaped flap in the throat that prevents food from entering the windpipe and the lungs

The epiglottis is a leaf-shaped flap in the throat that prevents food and water from entering the trachea and the lungs. It stays open during breathing, allowing air into the larynx. During swallowing, it closes to prevent aspiration of food into the lungs, forcing the swallowed liquids or food to go along the esophagus toward the stomach instead. It is thus the valve that diverts passage to either the trachea or the esophagus.

<span class="mw-page-title-main">Mediastinum</span> Central part of the thoracic cavity

The mediastinum is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagus, the trachea, the phrenic and cardiac nerves, the thoracic duct, the thymus and the lymph nodes of the central chest.

<span class="mw-page-title-main">Syrinx (bird anatomy)</span> The vocal organ of birds

The syrinx is the vocal organ of birds. Located at the base of a bird's trachea, it produces sounds without the vocal folds of mammals. The sound is produced by vibrations of some or all of the membrana tympaniformis and the pessulus, caused by air flowing through the syrinx. This sets up a self-oscillating system that modulates the airflow creating the sound. The muscles modulate the sound shape by changing the tension of the membranes and the bronchial openings. The syrinx enables some species of birds to mimic human speech.

<span class="mw-page-title-main">Arytenoid cartilage</span> Part of the larynx, to which the vocal folds (vocal cords) are attached

The arytenoid cartilages are a pair of small three-sided pyramids which form part of the larynx. They are the site of attachment of the vocal cords. Each is pyramidal or ladle-shaped and has three surfaces, a base, and an apex. The arytenoid cartilages allow for movement of the vocal cords by articulating with the cricoid cartilage. They may be affected by arthritis, dislocations, or sclerosis.

<span class="mw-page-title-main">Right coronary artery</span> Blood vessel supplying the human heart

In the blood supply of the heart, the right coronary artery (RCA) is an artery originating above the right cusp of the aortic valve, at the right aortic sinus in the heart. It travels down the right coronary sulcus, towards the crux of the heart. It gives off many branches, including the sinoatrial nodal artery, right marginal artery, posterior interventricular artery, conus artery, and atrioventricular nodal branch. It contributes the right side of the heart, and parts of the interventricular septum.

<span class="mw-page-title-main">Cisterna chyli</span>

The cisterna chyli or receptaculum chyli is a dilated sac at the lower end of the thoracic duct in most mammals into which lymph from the intestinal trunk and two lumbar lymphatic trunks flow. It receives fatty chyle from the intestines and thus acts as a conduit for the lipid products of digestion. It is the most common drainage trunk of most of the body's lymphatics. The cisterna chyli is a retroperitoneal structure.

<span class="mw-page-title-main">Anterior jugular vein</span>

The anterior jugular vein is a vein in the neck.

<span class="mw-page-title-main">Bronchopulmonary segment</span>

A bronchopulmonary segment is a portion of lung supplied by a specific segmental bronchus and its vessels. These arteries branch from the pulmonary and bronchial arteries, and run together through the center of the segment. Veins and lymphatic vessels drain along the edges of the segment. The segments are separated from each other by layers of connective tissue that forms them into discrete anatomical and functional units. This separation means that a bronchopulmonary segment can be surgically removed without affecting the function of the others.

The trachealis muscle is a sheet of smooth muscle in the trachea.

<span class="mw-page-title-main">Tracheobronchial injury</span> Damage to the tracheobronchial tree

Tracheobronchial injury is damage to the tracheobronchial tree. It can result from blunt or penetrating trauma to the neck or chest, inhalation of harmful fumes or smoke, or aspiration of liquids or objects.

<span class="mw-page-title-main">Bronchogenic cyst</span> Medical condition

Bronchogenic cysts are small, solitary cysts or sinuses, most typically located in the region of the suprasternal notch or behind the manubrium.

A pericardial window is a cardiac surgical procedure to create a fistula – or "window" – from the pericardial space to the pleural cavity. The purpose of the window is to allow a pericardial effusion or cardiac tamponade to drain from the space surrounding the heart into the chest cavity.

<span class="mw-page-title-main">Advanced airway management</span>

Advanced airway management is the subset of airway management that involves advanced training, skill, and invasiveness. It encompasses various techniques performed to create an open or patent airway – a clear path between a patient's lungs and the outside world.

<span class="mw-page-title-main">Intubation granuloma</span> Medical condition

Intubation granuloma is a benign growth of granulation tissue in the larynx or trachea, which arises from tissue trauma due to endotracheal intubation. This medical condition is described as a common late complication of tracheal intubation, specifically caused by irritation to the mucosal tissue of the airway during insertion or removal of the patient's intubation tube.

References

  1. 1 2 3 "tracheal carina - NCI Dictionary of Cancer Terms". www.cancer.gov. 2011-02-02. Retrieved 2022-12-29.
  2. 1 2 3 "carina tracheae". TheFreeDictionary.com. Retrieved 2022-12-29.
  3. Fernandez, Luis G.; Norwood, Scott H.; Berne, John D. (2008-01-01), Asensio, JUAN A.; Trunkey, DONALD D. (eds.), "Tracheal, Laryngeal, and Oropharyngeal Injuries", Current Therapy of Trauma and Surgical Critical Care, Philadelphia: Mosby, pp. 215–226, doi:10.1016/b978-0-323-04418-9.50036-9, ISBN   978-0-323-04418-9 , retrieved 2020-11-17
  4. 1 2 Schipper, Paul; Sukumar, Mithran; Mayberry, John C. (2008-01-01), Asensio, JUAN A.; Trunkey, DONALD D. (eds.), "Pertinent Surgical Anatomy of the Thorax and Mediastinum", Current Therapy of Trauma and Surgical Critical Care, Philadelphia: Mosby, pp. 227–251, doi:10.1016/b978-0-323-04418-9.50037-0, ISBN   978-0-323-04418-9 , retrieved 2020-11-17
  5. Acocella, F.; Brizzola, S. (2011-01-01), Bosworth, Lucy A.; Downes, Sandra (eds.), "12 - Tracheal tissue regeneration", Electrospinning for Tissue Regeneration, Woodhead Publishing Series in Biomaterials, Woodhead Publishing, pp. 242–279, doi:10.1533/9780857092915.2.242, ISBN   978-1-84569-741-9 , retrieved 2020-11-17
  6. Hardie, E. (2014-01-01), Langley-Hobbs, Sorrel J.; Demetriou, Jackie L.; Ladlow, Jane F. (eds.), "Chapter 46 - Trachea and bronchus", Feline Soft Tissue and General Surgery, W.B. Saunders, pp. 531–540, doi:10.1016/b978-0-7020-4336-9.00046-9, ISBN   978-0-7020-4336-9 , retrieved 2020-11-17
  7. Chu CP, Chen PP (April 2002). "Tracheobronchial injury secondary to blunt chest trauma: Diagnosis and management". Anaesth Intensive Care. 30 (2): 145–52. doi: 10.1177/0310057X0203000204 . PMID   12002920.

PD-icon.svg This article incorporates public domain material from Dictionary of Cancer Terms. U.S. National Cancer Institute.