Presentation on theme: "Bronchoscopic Anatomy Hold the scope in your left hand. Views are from the ‘head end’ The aim is to allow you to find the correct lobe - segmental anatomy."— Presentation transcript:
Bronchoscopic Anatomy Hold the scope in your left hand. Views are from the ‘head end’ The aim is to allow you to find the correct lobe - segmental anatomy is something you don’t need.
Note semicircular lumen with sharp bifurcation
Rotate 90 degrees to the clockwise (that’s why the scope is in your left hand) and advance a little RULBronchus Intermedius
Pull your thumb down to look up A bit more ….
Right Upper Lobe Note the 3 segments (clover appearance) – this is the only lube that has this appearance
Come back out of the RUL, straighten up your hand again and look down the bronchus intermedius
Right Middle Lobe Segments not visible yet Smaller orifice than RLL On the medial side Right Lower Lobe Multiple segments (usually 5) Variable anatomy
Right upper lobe collapse
Right middle lobe collapse (indistinct Rt heart border, slight raise right hemidiaphragm)
Right Lower Lobe Collapse
Come back to the trachea
The left main bronchus is fairly long, with no RUL equivalent.
The left upper lobe sits superior to the left lower lobe. The thick muscular strands that form the base of the trachea extend into the left lober lobe
Look up into the Left Upper
Left Upper Proper Left Lingular The left lingular: Is on the right hand side Has segments visible from further away than the left upper proper.
Left upper lobe collapse Collapses anteriorally giving an opacity that extends from the hilum. Reverses the normal increase in opacity from superior to inferior. Difficult to interpret on AP CXR
Left lower lobe collapse (Double heart border, loss of cardiac contour and hemidiaphragm)