Bronchoscopic anatomy of the bronchial tree

 Question 1 from the second paper of 2005 asks the candidate to describe this anatomy: " Describe  the  anatomy   of the  tracheobronchial tree, as  seen  down  a  bronchoscope inserted via an endotracheal tube."

In short, these are the landmarks one encounters when performing a bronchoscopy.

  • Right main bronchus
    • right upper lobe bronchus at 12 o'clock
      • branches to the apical, anterior and posterior segments
    • right bronchus intermedius
      • right middle lobe bronchus
        • 3 branches: to the right middle medial and lateral segments
      • right lower lobe bronchus
        • apical segment of the lower lobe
        • four basal segments: medial, lateral, anterior and posterior
  • Left main bronchus
    • left upper lobe bronchus
      • superior division
        • apicoposterior and anterior segments
      • lingular division
        • superior and anterior segments
    • left lower lobe bronchus
      • apical segment of the lower lobe
      • three basal segments: lateral, anterior, and posterior.

References

LITFL have some excellent bronchoscopy videos.

Educational resources for bronchoscopy are available from the wonderful website of the American Thoracic Society.

Additionally, ThoracicAnaesthesia.com has a full-on virtual bronchoscopy simulator which is essentially a Flash-based game, and which is disturbingly fun to play with.

Lastly, bronchoscopy.org is probably the definitive resource for all this, and represents the pinnacle of bronchoscopic excellence. Their bronchoscopic anatomy poster is the best thing ever.