Download Part 3A - Variant Airway Anatomy

3A: Variant Airway Anatomy
Series of Web-based Bronchoscopic Images
BRONCHATLAS©
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Bronchoscopy International
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Epiglottis
Thin tongue-like
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Thick Omega-shaped
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Cartilage protuberance trachea
Patient without
respiratory symptoms
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Lobar and segmental anatomy
From Oho and
Matsukawa
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Left
Right
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Enlarged arytenoids
Open
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Closed
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Airway secretions

Airway secretions
are usually clear
and frothy.
Cricoid cartilage (superior aspect)
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Small, round cricoid region in
woman of small stature
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Also seen in the airway wall
Anthrocotic pigment
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Bronchial glands/
mucosal pits
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Enlarged bronchial pits
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Mucosal swelling
Anterior swelling
Swelling on spur
Biopsies all normal. No subsequent pathology noted
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Prominent longitudinal elastic bundles
Posterior wall
of bronchus
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Anthrocosis
With hyperemia
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With stenosis and edema
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Tracheal cartilage variants
Saber sheath
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Bony protuberance
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More tracheal variants
V-shaped trachea
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U-shaped trachea
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Cartilaginous spur Left main bronchus
With pale overlying mucosa
The Patient had bronchitis
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Tracheal bronchus
Tracheal bronchus orifice is
almost two centimeters above
the main carina, along Right
lateroposterior tracheal wall.
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Tracheal bronchus
Tracheal bronchus orifice at
level of carina and at entrance
to the Right main bronchus
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Carina shapes
A
B
C
Normal, but different. Note slight infolding
(normal during expiration) in photo B
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Normal variants of Right upper lobe
segmental bronchial anatomy
Box-like
Quadripartite
upper lobe
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Linear quadripartite
configuratlion RUL
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Pyramid-like
Quadripartite
RUL upper lobe
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Right middle lobe bronchus variant
Immediate bipartite
configuration medial
segment of RML bronchus
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Lateral segment
RML bronchus
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Right lower lobe bronchus variant
Small medial basal
segment RB7)
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Bipartite variants
Right upper lobe bronchus
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Right lower lobe bronchus
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Subapical segment of the Right lower
lobe bronchus
Mediobasal segment
Superior segment
Subapical segment
Middle lobe bronchus
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Left lower lobe bronchus with right
sided configuration
Left lower lobe basal pyramid
Medial basal segment LB 7
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Linear configuration of left lower lobe basal
segments
LB 6
LB 10
LB 8
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This presentation is part of a
comprehensive curriculum for
Flexible Bronchoscopy. Our goals are
to help health care workers become
better at what they do, and to
decrease the burden of procedurerelated training on patients.
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BRONCHATLAS©
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to maintain currency of online information. All
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and essays can be cited for reference as:
Bronchoscopy International: BronchAtlas©, an Electronic On-Line
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http://www.Bronchoscopy.org/Bronchatlas/htm. Published 2005
(Please add “Date Accessed”).
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