1. Anatomy: Trachea
Chris van Zyl KHC

2. Trachea: Landmarks Begins at lower border of cricoid cartilage / C62
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

3. Trachea 3

4. Trachea Variable shape Very pliable in children4
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.

5. Trachea: Carina Lies at T5 level Normal angle: 65°
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

6. Relations: Cervical Anterior: Posterior: Lateral:6
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

7. Relations: Thoracic Anterior: Brachiocephalic a.7
Anterior:
Brachiocephalic a.
Left common carotid a.
Left brachiocephalic v.

8. Relations: Thoracic Posterior: Oesophagus Left recurrent laryngeal n.8
Posterior:
Oesophagus
Left recurrent laryngeal n.

9. Relations: Thoracic Left lateral: Right lateral: Arch of the aorta9
Left lateral:
Arch of the aorta
Left common carotid
Left subclavian arteries
Right lateral:
Right vagus nerve
Arch of the azygos vein
Pleura

10. Blood supply Upper trachea Lower part Venous drainage10
Upper trachea
Inferior thyroid artery
Lower part
Branches of the bronchial artery
Venous drainage
Inferior thyroid venous plexus

11. Right Paratracheal Stripe11
Interface between trachea and right upper lobe
Max normal thickness 4 mm

12. Left Paratracheal Stripe12
Left upper lobe and trachea
Less common (only on 21 %- 31% of films

13. Posterior Tracheal Stripe13
Interface between trachea and right lung
Normal max diameter 2.5 mm

14. Tracheoesophageal Stripe14
Interface between esophagus and trachea
Normal max diameter 5.5 mm

15. References Lines and Stripes: Where Did They Go?15
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