Question

The clinical anatomy of bronchus as visualized on bronchoscopy.

Hint:

Bronchoscopy is essential for both diagnostic and therapeutic purposes, allowing visualization of the bronchial tree to manage conditions such as foreign body aspiration, infections, and airway obstructions.

Answer 1

Step 1: Anatomy of the Bronchus:
The bronchus is part of the lower respiratory tract and divides into the left and right main bronchi, which further branch into the secondary (lobar) and tertiary (segmental) bronchi. On bronchoscopy, the bronchial tree can be visualized as a series of progressively smaller airways leading to the alveoli. Key features include:
1. Right Main Bronchus: The right bronchus is wider, shorter, and more vertical than the left, making it more prone to aspiration.
2. Left Main Bronchus: The left bronchus is longer and more horizontal, passing under the aortic arch.
3. Carina: The carina is the ridge where the trachea bifurcates into the left and right bronchi. It is an important landmark during bronchoscopy.
4. Secondary and Tertiary Bronchi: These smaller bronchi supply the lobes and segments of the lungs, respectively.

Step 2: Bronchoscopy Visualization:
Bronchoscopy is used to visualize the bronchial tree and diagnose conditions such as infections, obstructions, tumors, and foreign body aspiration. Key points observed during bronchoscopy include:
1. Normal Appearance: The normal bronchus has a smooth, pink mucosal lining with visible cartilage rings.
2. Infections and Inflammation: Conditions like bronchitis or pneumonia may cause redness, swelling, and purulent secretions in the bronchial tree.
3. Obstructions: Foreign bodies, tumors, or mucus plugs may cause partial or complete obstruction of the bronchus, visible as narrowing or blockage during bronchoscopy.
4. Structural Anomalies: Conditions like bronchomalacia (softening of the bronchial walls) can be diagnosed by bronchoscopy, where the airways may collapse during respiration.