Carina of trachea

In anatomy, the carina is a ridge of cartilage in the trachea that occurs between the division of the two main bronchi.[1][2]

Carina of trachea
Cartilages of larynx, trachea and bronchi. (Carina is at the point of bifurcation.)
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
SystemRespiratory system
Identifiers
LatinCarina tracheae, bifurcatio tracheae
TA98A06.3.01.009
TA23225
FMA7465
Anatomical terminology

Structure

The carina occurs at the lower end of the trachea (usually at the level of the 4th to 5th thoracic vertebra).[1][3] 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).

The bronchial arteries supply the carina and the rest of the lower trachea.[4]

The carina is around the area posterior to where the aortic arch crosses to the left of the trachea.[3] The azygos vein crosses right to the trachea above the carina.[5]

Clinical significance

Foreign bodies that fall down the trachea are more likely to enter the right bronchus.

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

Widening and distortion of the carina is a serious sign because it usually indicates carcinoma of the lymph nodes around the region where the trachea divides.

Tracheobronchial injury, an injury to the airways, occurs within 2.5 cm of the carina 60% of the time.[6]

Additional images
  • Anatomical dissection of trachea and main bronchi showing the carina
  • Anatomy of the trachea

References
  1. 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
  2. Reynolds, Susan D.; Pinkerton, Kent E.; Mariassy, Andrew T. (2015-01-01), Parent, Richard A. (ed.), "Chapter 6 - Epithelial Cells of Trachea and Bronchi", Comparative Biology of the Normal Lung (Second Edition), San Diego: Academic Press, pp. 61–81, doi:10.1016/b978-0-12-404577-4.00006-0, ISBN 978-0-12-404577-4, retrieved 2020-11-17
  3. 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
  4. 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
  5. 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
  6. 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.
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 This article incorporates public domain material from Dictionary of Cancer Terms. U.S. National Cancer Institute.

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