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In this video I'm going to talk about how to identify the individual lobes of the lungs on both frontal and lateral chest x-rays well this might seem less practical at first it actually leads into a very clinically relevant topic in future videos and one that you will like surely be asked many times on for that is which lobe is pneumonia it now Before we jump straight into it let's first review the normal lung anatomy I've oriented these two lungs in the same way you would while reading chest x-rays that is the left lung is on the right and the right lung is on the left I do want to stress that the diagrams that you're seeing here are actually lateral views of the lungs not frontal and the reason we're doing this is to give you a better picture what the loads and fissures look like now we call it at the right lung has three lobes the upper the middle and the lower lobes which we're labeling for you here the left lung only has two lobes the upper and the lower technically the left lung does have the lingual which is kind of like the middle lobe Oh — right lung, but a lingual is incorporated into the upper lobe of left lung anyway the right lung has two main lines or divisions, and they are the oblique fissure or the major fissure which is here and a horizontal or minor fissure which is here the left lung has one division and that's this one which is the major or oblique fissure and what these lines and fissures do is that divide the loans into their individual lobes now that's out of way let's go where the money is there first though we're going to talk about is the right upper lobe which is here on the diagram now I know when you look at and x-ray you want to divide it into thirds and call it the upper middle and lower lobes let me tell you that well that makes some intuitive sense it's completely wrong the right upper lobe is actually here on a frontal x-ray and if we draw a line showing the highest and lowest points of the right upper lobe on diagram in the middle this will actually make a lot of sense for the lateral chest x-ray you have to identify the oblique fissure as well as the minor fissure as these are the borders of the right upper lobe and so the right upper lobe is this whole thing here and again if we draw lines from the diagram across this will make sense next up is the right lower lobe which is here in the diagram and here on the front of x-ray, and it's probably surprising how high up the right lower lobe goes but if you draw lines from the highest and lowest points of the right lower lobe on the diagram this makes perfect sense the right low lobe also actually extends below to diaphragm and this is because we're only seeing a dome when the diaphragm here and so there are parts of lung that actually extend below the dome the diaphragm on the lateral the right lower lobe is everything below the oblique fissure which is here and so this would be the right lower lobe, and again it extends the load adult with a diaphragm so if...
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