Test Taking Tip
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.
The thorax, showing rib cage, pleura, and lung fields. (Reproduced from Doherty GM. Current Diagnosis and Treatment: Surgery. 13th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
Which ribs are true ribs (directly articulate with the sternum by means of cartilages)?
Which ribs are false ribs (no direct connection with sternum anteriorly; usually connect with the costocartilage above)?
Which ribs are floating ribs (articulate only with thoracic spine)?
What structure perforates and connects the alveoli?
What type of epithelium lines the larger upper airways as a single layer?
What are type I pneumocytes?
What are type II pneumocytes?
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 from Brunicardi FC, Andersen DK, Billiar TR, et al. Schwartz's Principles of Surgery. 9th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
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?