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Test Taking Tips

All general surgery residents should have a working knowledge of basic thoracic surgical conditions. Focus on the common problems you may encounter as incidental findings—such as managing a solitary pulmonary nodule or a newly found mediastinal mass. Be familiar with the common surgical approaches such as median sternotomy, posterolateral thoracotomy, etc.


Which ribs are true ribs (directly articulate with the sternum by means of cartilages)?

  • The upper 7 ribs (numbered 1–7)

Which ribs are false ribs (no direct connection with the sternum anteriorly; usually connect with the costocartilage above)?

  • The lower 5 ribs (numbered 8–10)

Which ribs are floating ribs (articulate only with the thoracic spine)?

  • Ribs 11 and 12


The thorax, showing rib cage, pleura, and lung fields. (Reproduced with permission from Doherty GM. CURRENT Diagnosis & Treatment Surgery, 15th ed. New York, NY: McGraw Hill; 2020.)

What structure perforates and connects the alveoli?

  • The pores of Kohn

What type of epithelium lines the larger upper airways as a single layer?

  • Ciliated tall columnar epithelium

What are type I pneumocytes?

  • Gas exchange; constitute ∼40% of the number of cells lining the alveoli and cover >90% of the alveolar lining

What are type II pneumocytes?

  • Granular pneumocytes that contain lipid inclusion bodies and manufacture surfactant, a lipoprotein (dipalmitoyl-lecithin) that decreases surface tension

What are the lobes and fissures of the right lung?

  • The right lung is composed of 3 lobes: the upper, middle, and lower

  • The major (oblique) fissure separates the right lower lobe from the right upper and middle lobes

  • The minor (horizontal) fissure separates the right upper lobe from the right middle lobe


Segmental anatomy of the lungs and bronchi. (Reproduced with permission from Brunicardi FC, Andersen DK, Billiar TR, et al. Schwartz’s Principles of Surgery, 11th ed. New York, NY: McGraw Hill; 2019.)

What are the lobes and fissures of the left lung?

  • The left lung has 2 lobes—the left upper lobe and the left lower lobe

  • The lingula is a portion of the left upper lobe and corresponds embryologically to the right middle lobe

  • A single oblique fissure separates the left upper lobe from the left lower lobe

What is the blood supply to the lung?

  • Unoxygenated blood is pumped to the lung from the right ventricle through ...

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