This is airway anatomy. In this session, we will focus on the segmental anatomy of the right and left tracheobronchial tree. As we do our airway inspection, we will do repetitive exercises to build muscle memory while focusing on the ergonomics of maneuvering the bronchoscope throughout the airway. I'm Laura Frey, and I'm faculty at the University of Wisconsin and a member of the Bronchoscopy Domain Task Force. Hi, I'm Tim Urgo. I'm the chair of education committee, and I'm faculty of the University of Chicago. Hi, I'm Abdul El-Rais, an innovation subcommittee education committee adjust, and faculty at Roosevelt Franklin University. We will begin with our scope neutral on the trachea and begin navigating from the trachea to the right main stem, withdrawing our scope back to the main carina, and then rotating and navigating our scope into the left main stem. We will now demonstrate an exercise to practice the maneuvering of your bronchoscope from the trachea to the right and left main stem using clockwise and counterclockwise rotation with flexion and extension of the bronchoscope. Carina to the right, back to the main carina, carina to left, back to the main carina. As you're learning to maneuver the bronchoscope, it may be beneficial to practice this multiple times to build muscle memory of how to safely navigate the bronchoscope in the center of the airway, avoiding contact with the airway wall. If we focus on Dr. Mergu's body positioning, we will notice that his arm is tucked at his side to avoid muscle fatigue, especially if you're doing multiple bronchoscopies throughout the day. And our bronchoscope is positioned so that there is not excessive curvature in the length of the scope so we get more efficient movement as we navigate right to left main stem. We will now continue on with our airway inspection, moving systematically to the upper lobes. We will navigate from the trachea into the right main stem and into the right upper lobe. We will withdraw a scope, reversing those movements, coming back to the trachea and moving to the right upper lobe. Coming back to the trachea, navigating down the left main stem and into the left upper lobe, reversing the movements, again returning to the trachea. We will proceed with our airway inspection, now navigating from the trachea to the right main stem into the bronchus intermedius and into the right middle lobe. We will reverse those movements again, coming back to the trachea. We will again drive in from the trachea to the right main stem to the bronchus intermedius and now into the right lower lobe. Reverse those movements and come back to the trachea. We will now drive from the trachea to the left main stem and into the lingula. Reverse those movements, coming back to the trachea and then again drive trachea to the left main stem to the left lower lobe and return to the trachea.

segmental anatomy

tracheobronchial tree

bronchoscope maneuvering

ergonomics

muscle memory