Bronchopulmonary Segments by Dr Rajitha Vanga

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#lymphaticdrainageoflung #lungsbloodsupply #emphysema #surgicalsegments •  The bronchopulmonary segment is the anatomical, functional, and surgical unit of the lungs. •  Each segment contains a segmental (tertiary or lobular) bronchus, a branch of the pulmonary artery, and a branch of the bronchial artery, which run together through the central part of the segment, surrounded by a delicate connective tissue (intersegmental) septum. •  The tributaries of pulmonary veins are intersegmental and lie at the margins of bronchopulmonary segments. They create surgical planes, which a surgeon can follow for segmental resection, with minimal tissue damage. • Characteristic features: • 1. It is pyramidal or wedge shaped with apex directed towards the hilum and base towards the surface of the lung. • 2. It is the largest subdivision of a lobe, named according to the segmental bronchus supplying it, and is surgically resectable • 3. It is aerated by the segmental (tertiary) bronchus. • 4. It is surrounded by the connective tissue. • 5. Each segment has its own artery, a segmental branch of the pulmonary artery. • 6. Each segment has its own lymphatic drainage and autonomic supply. • Thus, bronchopulmonary segments are the well-defined anatomical, functional, and surgical units of the lungs. • The segmental veins (the tributaries of pulmonary veins) run in the intersegmental planes of the connective tissue. • Bronchopulmonary segments • Right lung •  Superior lobe- 1. Apical, 2. Posterior, 3. Anterior •  Middle lobe- 4. Lateral, 5. Medial •  Inferior lobe- 6. Superior (apical), 7. Medial basal, 8. Anterior basal, 9. Lateral basal, 10. Posterior basal • Left lung •  Superior lobe- 1. Apical, 2. Posterior, 3. Anterior, 4. Superior lingular, 5.Inferior lingular •  Inferior lobe- 6. Superior (apical), 7. Medial basal, 8. Anterior basal, 9. Lateral basal, 10. Posterior basal. • Segmental resection of the lung: The knowledge of the bronchopulmonary segments has led to the advancement in conservation lung surgery. Since each segment is an independent functional unit having its own bronchovascular supply and potential planes of separation exist between the segments. •  Localized chronic disease, such as tuberculosis, bronchiectasis (lung’s airways become damaged, making it hard to clear mucous) or benign neoplasm (non-malignant tumour) is restricted to one segment; it is, therefore, possible to dissect out and remove the diseased segment leaving the surrounding tissue intact. This procedure is called segmental resection. •  During segmental dissection, it is important not to ligate intersegmental veins as they will interfere with the venous drainage of the surrounding healthy segments.

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