Carina of trachea

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.

The carina occurs at the lower end of the trachea - usually at the level of the 4th to 5th thoracic vertebra.{{Citation |last1=Fernandez |first1=Luis G. |title=Tracheal, Laryngeal, and Oropharyngeal Injuries |date=2008-01-01 |url=http://www.sciencedirect.com/science/article/pii/B9780323044189500369 |work=Current Therapy of Trauma and Surgical Critical Care |pages=215–226 |editor-last=Asensio |editor-first=JUAN A. |place=Philadelphia |publisher=Mosby |language=en |doi=10.1016/b978-0-323-04418-9.50036-9 |isbn=978-0-323-04418-9 |access-date=2020-11-17 |last2=Norwood |first2=Scott H. |last3=Berne |first3=John D. |editor2-last=Trunkey |editor2-first=DONALD D.|url-access=subscription }}{{Citation|last1=Schipper|first1=Paul|date=2008-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780323044189500370|work=Current Therapy of Trauma and Surgical Critical Care|pages=227–251|editor-last=Asensio|editor-first=JUAN A.|place=Philadelphia|publisher=Mosby|language=en|doi=10.1016/b978-0-323-04418-9.50037-0|isbn=978-0-323-04418-9|access-date=2020-11-17|last2=Sukumar|first2=Mithran|last3=Mayberry|first3=John C.|title=Pertinent Surgical Anatomy of the Thorax and Mediastinum|editor2-last=Trunkey|editor2-first=DONALD D.|url-access=subscription}} 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|date=December 2022}}

The bronchial arteries supply the carina and the rest of the lower trachea.{{Citation|last1=Acocella|first1=F.|title=12 - Tracheal tissue regeneration|date=2011-01-01|url=http://www.sciencedirect.com/science/article/pii/B9781845697419500124|work=Electrospinning for Tissue Regeneration|pages=242–279|editor-last=Bosworth|editor-first=Lucy A.|series=Woodhead Publishing Series in Biomaterials|publisher=Woodhead Publishing|language=en|doi=10.1533/9780857092915.2.242|isbn=978-1-84569-741-9|access-date=2020-11-17|last2=Brizzola|first2=S.|editor2-last=Downes|editor2-first=Sandra|url-access=subscription}}

The carina is around the area posterior to where the aortic arch crosses to the left of the trachea. The azygos vein crosses right to the trachea above the carina.{{Citation|last=Hardie|first=E.|title=Chapter 46 - Trachea and bronchus|date=2014-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780702043369000469|work=Feline Soft Tissue and General Surgery|pages=531–540|editor-last=Langley-Hobbs|editor-first=Sorrel J.|publisher=W.B. Saunders|language=en|doi=10.1016/b978-0-7020-4336-9.00046-9|isbn=978-0-7020-4336-9|access-date=2020-11-17|editor2-last=Demetriou|editor2-first=Jackie L.|editor3-last=Ladlow|editor3-first=Jane F.|url-access=subscription}}

The mucous membrane of the carina is the most sensitive area of the trachea and larynx for triggering a cough reflex.{{Citation needed|date=December 2022}}

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

{{cite journal |author=Chu CP, Chen PP |date=April 2002 |title=Tracheobronchial injury secondary to blunt chest trauma: Diagnosis and management |url= |journal=Anaesth Intensive Care |volume=30 |issue=2 |pages=145–52 |doi=10.1177/0310057X0203000204 |pmid=12002920 |doi-access=free}}

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|date=December 2022}}

File:Primary bronchi cross-sectional posterior view.PNG|Anatomical dissection of trachea and main bronchi showing the carina

File:Blausen 0865 TracheaAnatomy.png|Anatomy of the trachea

{{Wiktionary|carina}}

• {{UMichAtlas|lung_carina}} - "Cast of trachea and bronchi, anterior view" (#2) {{dead link|date=January 2012}}
• [http://ect.downstate.edu/courseware/rad-atlas/Thorax/3tomogrm.html "Trachea and carina — tomogram, coronal plane" at SUNY Downstate Medical Center] {{Webarchive|url=https://web.archive.org/web/20160303183643/http://ect.downstate.edu/courseware/rad-atlas/Thorax/3tomogrm.html |date=2016-03-03 }}
• [http://www.cancer.gov/dictionary?CdrID=482344 Carina tracheae] entry in the public domain NCI Dictionary of Cancer Terms

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Category:Respiratory system anatomy

Category:Trachea