Chest X Ray, lung parts and fissures, CXR

Frontal Examination of the Lungs

THE HEART, LUNGS, PLEURA, DIAPHRAGM, ARTERIES, VEINS, PROXIMAL TRACHEOBRONCHIAL TREE and SKELETON
Ashley Davidoff MD
Parts of the Lungs-  Basics

Left Lung – Left Upper Lobe – Frontal Projection

LEFT UPPER LOBE IN THE FRONTAL PROJECTION
Ashley Davidoff MD

Frontal Projection Left Lower Lobe

LEFT LOWER LOBE IN THE FRONTAL PROJECTION
Ashley Davidoff MD

Right Lung – Right Upper Lobe – Frontal Projection
RIGHT UPPER LOBE IN THE FRONTAL PROJECTION
Ashley Davidoff MD
Right Middle Lobe – Frontal Projection

 

RIGHT MIDDLE LOBE IN THE FRONTAL PROJECTION
Ashley Davidoff MD
Right Lower Lobe – Frontal Projection

 

RIGHT MIDDLE LOBE IN THE FRONTAL PROJECTION
Ashley Davidoff MD

Lateral Examination of the Lungs


Major Fissure on the Left 

LATERAL PROJECTION – FISSURE DIVIDES THE LEFT UPPER LOBE (INCLUDING LINGULA) AND LEFT LOWER LOBE
Ashley Davidoff MD
MAJOR FISSURE ON THE LEFT
Ashley Davidoff MD

Lateral Projection – Left Upper Lobe

LATERAL PROJECTION, LEFT UPPER LOBE
Ashley Davidoff MD

Lateral Projection left Lower Lobe

LATERAL CXR SHOWING LEFT LOWER LOBE
Ashley Davidoff MD

 

 

Major and Minor Fissures on the Right

ANATOMIC SPECIMEN SHOWING MAJOR and MINOR FISSURES DIVIDING THE RIGHT LUNG INTO 3 LOBES
The right lung has a small right upper lobe (RUL) separated from the middle lobe (RML) by the minor fissure (pink,lower image) . Both the RUL and RML are anterior and are separated from the lower lobe  by the major fissure (orange line)
Ashley Davidoff MD
LATERAL X-RAY SHOWING MAJOR and MINOR FISSURES DIVIDING THE RIGHT LUNG INTO 3 LOBES
The right lung has a relatively small right upper lobe (RUL) separated from the middle lobe (RML) by the minor fissure (pink,lower image). Both the RUL and RML are anterior and are separated from the lower lobe  by the major fissure (orange line)
Ashley Davidoff MD
Right Upper Lobe – Lateral  Projection
LATERAL CXR SHOWING RIGHT UPPER LOBE
Ashley Davidoff MD
Right Middle Lobe – Lateral Projection

 

LATERAL CXR SHOWING RIGHT MIDDLE LOBE
Ashley Davidoff MD
Right Lower  Lobe – Lateral Projection
LATERAL CXR SHOWING RIGHT LOWER LOBE
Ashley Davidoff MD
Summary

CXR of LEFT LUNG
Ashley Davidoff MD

CXR of RIGHT LUNG
Ashley Davidoff MD

Trachea, Main Stem Bronchi, and Carina

 

NORMAL FRONTAL CXR NORMAL ASYMMETRIC BRANCHING OF MAINSTEM BRONCHI
The normal CXR shows the characteristic asymmetric branching of the main stem bronchi. The right is short and stout and slightly more vertical while the left is long and thin and slightly more obtuse.
The normal carinal angle is between 40-80 degrees.
Ashley Davidoff MD

ASYMMETRIC BRANCHING PATTERN – RIGHT SHORT AND STOUT AND THE LEFT LONG AND THIN
CARINAL ANGLE – 40-80 degrees
Ashley Davidoff MD
THE RIGHT – SHORT STOUT AND CUTE
THE LEFT – TALL THIN AND GRACILE
The carinal angle
OLIVER HARDY AND STAN LAUREL IN THE 1939 FILM – THE FLYING DEUCES
SCREW IN THE RIGHT MAIN STEM
http://www.wikiradiography.net/
N-G TUBE IN RIGHT MAIN STEM BRONCHUS
Courtesy Radiopaedia

ET TUBE IN RIGHT MAIN STEM BRONCHUS
Courtesy Radiopaedia

References and Links

CXR Map