A 52-year-old male smoker presents with persistent cough and haemoptysis for 3 weeks. Chest X-ray shows a 3 cm mass in the right upper lobe with hilar involvement. CT chest confirms a tumour in the right upper lobe bronchus. During pre-operative staging, the surgeon needs to assess which bronchopulmonary segments are involved to plan segmental resection. Which of the following bronchopulmonary segments comprise the right upper lobe?

Explanation

## Bronchopulmonary Segments of the Right Upper Lobe **Key Point:** The right upper lobe contains exactly **three bronchopulmonary segments**: apical, posterior, and anterior. These are supplied by the three secondary (lobar) bronchi of the right upper lobe bronchus. ### Anatomical Organization **Right Lung Segmentation:** | Lobe | Segments | Number | |------|----------|--------| | **Upper** | Apical, Posterior, Anterior | 3 | | **Middle** | Lateral, Medial | 2 | | **Lower** | Superior, Medial basal, Anterior basal, Lateral basal, Posterior basal | 5 | **High-Yield:** The right lung has **10 segments total** (3 + 2 + 5), while the left lung has **9 segments** (no middle lobe; apical-posterior fused, superior and inferior divisions). ### Clinical Relevance in Lung Cancer **Clinical Pearl:** In upper lobe tumours, segmental resection (segmentectomy) is increasingly preferred over lobectomy in early-stage disease to preserve lung function. Knowing the exact segments involved guides the extent of resection. **Mnemonic for Right Upper Lobe: "APA"** — **A**pical, **P**osterior, **A**nterior. ### Bronchial Anatomy 1. **Apical segment** — supplied by apical secondary bronchus; most superior 2. **Posterior segment** — supplied by posterior secondary bronchus; posterior aspect 3. **Anterior segment** — supplied by anterior secondary bronchus; anteromedial aspect These three segments are supplied by the **right upper lobe bronchus**, which divides into three secondary bronchi after the hilum. **Tip:** On imaging (CT/chest X-ray), upper lobe lesions are localised to one or more of these three segments. The posterior segment is the largest and most commonly involved in apical tuberculosis.