Anatomy: Trachea

Chris van Zyl KHC

 Trachea: Landmarks
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 Begins at lower border of cricoid cartilage / C6

 Extends to Carina
 Right of the midline
 Sternal angle
 T4 on inspiration / T6 on expiration

 Lined by ciliated columnar epithelium

 15 cm long / 2cm in diameter

 15 – 20 incomplete rings of cartilage

 Bridged post. by trachealis muscle
 Trachea
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 Trachea
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 Variable shape
 Usually round, oval, oval with flattened post. border
 Square

 Inverted pear

 Horseshoe

 Very pliable in children

 May deviate to the right at almost 90° in normal
expiratory film.
 Trachea: Carina
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 Lies at T5 level
 T4 on expiration
 T6 on inspiration

 Normal angle: 65°

 20° to right of midline
 40° to left of midline

 Angle slightly larger + symmetrical in children

 Angle increases by 10° - 15° in recumbency
 Relations: Cervical
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 Anterior:
 Isthmus anterior to 2nd, 3rd,
4th rings
 Inferior thyroid veins
 Strap muscles: Sternohyoid,
Sternothyroid
 Posterior:
 Oesophagus, recurrent
laryngeal nerves
 Lateral:
 Lobes of thyroid
 Common carotid artery
 Relations: Thoracic
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 Anterior:
 Brachiocephalic a.
 Left common carotid a.

 Left brachiocephalic v.
 Relations: Thoracic
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 Posterior:
 Oesophagus
 Left recurrent laryngeal n.
 Relations: Thoracic
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 Left lateral:
 Arch of the aorta
 Left common carotid

 Left subclavian arteries

 Right lateral:
 Right vagus nerve
 Arch of the azygos vein

 Pleura
 Blood supply
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 Upper trachea
 Inferior thyroid artery
 Lower part
 Branches of the
bronchial artery

 Venous drainage
 Inferior thyroid venous
plexus
 Right Paratracheal Stripe
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 Interface between trachea and right upper lobe

 Max normal thickness 4 mm
 Left Paratracheal Stripe
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 Left upper lobe and trachea

 Less common (only on 21 %- 31% of films
 Posterior Tracheal Stripe
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 Interface between trachea and right lung

 Normal max diameter 2.5 mm
 Tracheoesophageal Stripe
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 Interface between esophagus and trachea

 Normal max diameter 5.5 mm
 References
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 Lines and Stripes: Where Did They Go?

 Jerry M. Gibbs, Chitra A. Chandrasekhar, Emma C. Furgasson,
 Sandra A. A. Oldham
 Applied Radiological Anatomy
 Paul Butler, Adam W. M. Mitchell, Harold Ellis
 Anatomy for Diagnostic Imaging
 Stephanie Ryan, Michelle McNicholas, Stephen Eustace
 Third Edition