c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Tracheobronchial Relationships: 4

A D V E R T I S E M E N T

   
 

The pulmonary trunk takes an almost horizontal course posteriorly and bifurcates in front of the left main stem bronchus. The right pulmonary artery is longer than the left, passing across the carina before giving off its first branch, the truncus anterior to the right upper lobe. It then arches over the bronchus intermedius, giving off one of more small branches to the posterior segment of the right upper lobe. It passes lateral to the right middle lobe bronchus, giving off the artery to that lobe. The continuation of the artery immediately divides into branches supplying the lower lobe segments. The left pulmonary artery gives off branches to the upper lobe segments before arching over the left upper lobe bronchus. Its continuation immediately divides into branches to the lower lobe segments. The termination of the azygous vein is seen peeking over the right main stem bronchus.    

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Tracheobronchial Relationships: 5

A D V E R T I S E M E N T

   
 

The pulmonary veins drain into the left atrium situated posteriorly in the heart, just below the pulmonary trunk. The superior pulmonary veins are the most anterior of the pulmonary hilar structures, while the inferior pulmonary veins lie in posterior positions. These vessels lie at the separation of the leaves of the inferior pulmonary ligaments as they reflect onto the hilar structures (see pulmonary sequestration), and are at risk when the inferior pulmonary ligaments are divided.     

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Tracheobronchial Relationships: 6

A D V E R T I S E M E N T

   
 

The aorta arches over the pulmonary artery and left main stem bronchus. The arch vessels diverge around the trachea, and the subclavian arteries cross the apices of the lungs. The inferior border of the arch is tethered to the pulmonary trunk by the ligamentum arteriosum. This point of fixation is thought to be part of the mechanism of aortic tears which frequently occur at this location in deceleration injury.      

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This page was last modified on 11/21/2001.