• R: 2 fissures (oblique, transverse)
• L: 1 fissure (oblique)
• R: 3 lobes (sup., middle, inf.)
• L: 2 lobes (sup., inf.)
• R: Middle lobe
• L: lingula on ant./inf. aspect of sup. lobe
• L: cardiac notch
• R: heavier, larger
• L: smaller, lighter
• R: shorter, wider, dome of diaphragm placed higher (due to liver)
• L: narrow, longer; dome lower

R-veins

• Azygos V.
• Arch of Azygos V.
• SVC
• IVC
• R. brachiocephalic V.

L-arteries

• Arch of aorta
• Thoracic aorta
• L. Common Carotid
• L. Subclavian

R- Superior lobar/eparterial bronchus

L- Pulmonary A.

• Apex- superior to medial 1/3 of clavicle (and & post)
• Sup. lobe- 2nd IC space (ant & post)
• Aortic and pulmonic valve too
• Middle lobe- R 4th IC space
• Inf. lobe
• Anteriorly- 6th/7th IC space
• Posteriorly- triangle of auscultation (Rhomboid M, medial of scapula, Latissimus Dorsi)

Listen to bronchiolar and vesicular sounds

Describe pneumothorax and different types

• Air in pleural space
• Open penumothorax- (stab wound) hole in chest wall
• No negative pressure
• Lung collapses-atelectasis
• Mediastinal and tracheal shift toward affected side
• Tension pneumothorax- valvelike opening (ruptured bleb)- one way opening
• Mediastinal and tracheal shift toward unaffected side
• Widening of IC spaces
• Diaphragm displaced inferiorly (affected side)
• Spontaneous pneumothorax
• Primary- non-existing lung disease (Bleb)- thin, tall, young man
• Secondary- associated with existing lung disease (COPD)

Lung collapse

Atelectasis

Open pneumothorax- deviates to affected side

Tension pneumothorax- deviates to unaffected side