1. 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.

2. Note semicircular lumen with sharp bifurcation

3. Right Lung

4. Rotate 90 degrees to the clockwise (that’s why the scope is in your left hand)
and advance a little
Bronchus Intermedius
RUL

5. Pull your thumb down to look up
A bit more ….

6. Right Upper Lobe
Note the 3 segments (clover appearance) – this is the only lube that has this appearance

7. Come back out of the RUL, straighten up your hand again and look down the bronchus intermedius

8. Right Middle Lobe
Segments not visible yet
Smaller orifice than RLL
On the medial side
Right Lower Lobe
Multiple segments (usually 5)
Variable anatomy

9. Right upper lobe collapse

10. Right middle lobe collapse
(indistinct Rt heart border, slight raise right hemidiaphragm)

11. Right Lower Lobe Collapse

12. Left Lung

13. Come back to the trachea

14. The left main bronchus is fairly long, with no RUL equivalent.

15. 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

16. Look up into the Left Upper

17. 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.

18. 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

19. Left lower lobe collapse
(Double heart border, loss of cardiac contour and hemidiaphragm)