Right lower lobe !
The right lower lobe is the bottom part of the right lung, filling the lower back of the chest; inhaled material often ends up here.
Official name: Inferior lobe of right lung
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What it is
The largest lobe of the right lung, below the oblique fissure, resting on the diaphragm.
What it does
Fills the lower back of the right chest; inhaled material often ends up here.
Key facts
- Where
- Below oblique fissure, posteroinferior; segments superior, medial, anterior, lateral and posterior basal
- Blood supply
- Pulmonary artery branches (gas exchange); bronchial arteries (nourish lung tissue)
- Nerve
- Pulmonary plexus: vagus (bronchoconstriction, secretion); upper thoracic sympathetic (bronchodilation)
- Function
- Gas exchange; commonest aspiration site when upright (right main bronchus wider and more vertical)
Relations
- Above
- Right upper lobe across the upper, posterior part of the oblique fissure
- In front
- Right middle lobe across the lower part of the oblique fissure
- Below
- Right dome of the diaphragm, with the liver beneath it
- Medial
- Esophagus behind the hilum, inferior vena cava near the diaphragm, the pulmonary ligament and the vertebral bodies
- Behind
- Posterior ribs and intercostal spaces; the costodiaphragmatic recess of the pleura extends below its lower edge
How to find it
Heard over the back from the medial end of the spine of the scapula (about T3) down to about T10, and low in the axilla. Its base moves down in deep inspiration, which is measured by percussing the lower edge in full expiration and full inspiration (diaphragmatic excursion).
On imaging
Consolidation hides the right hemidiaphragm and may show an air bronchogram. On the lateral view the lower vertebrae look denser instead of darker (spine sign). Collapse pulls the oblique fissure back and down, forms a triangle beside the spine and lowers the right hilum.
Common problems
- Pneumonia (infection), asthma and COPD (narrowed airways).
- Lung cancer, often linked to smoking.
- Pulmonary embolism: a clot blocks an artery in the lung.
How it is diagnosed
Listening to the chest, chest X-ray, CT, breathing tests (spirometry), blood oxygen.
Treatment
- Depends on the cause: antibiotics, inhalers, oxygen; surgery removes a lobe or segment for some cancers.
Clinical notes
- Upright aspiration, as in impaired swallowing or reduced consciousness, sends material into the basal segments of this lobe because the right main bronchus is more in line with the trachea
- Basal crackles in heart failure and in pulmonary fibrosis are heard first over the lower lobes
- Pulmonary infarcts from embolism are often peripheral and basal, a wedge with its base on the pleura (Hampton hump)
Anatomical variants
- Inferior accessory fissure, separating the medial basal segment from the rest of the lobe; usually an incidental CT finding
Development
Around week 5 the lung buds split into lobar buds: three on the right and two on the left, which is why the left lung lacks a middle lobe. On the right, the lowest of the three buds forms this lobe.
Related conditions
- α1-antitrypsin deficiency
- Sepsis and septic shock
- Echinococcosis (hydatid disease)
- Legionnaires disease and Pontiac fever
- Neonatal respiratory distress syndrome (hyaline membrane disease)
- Foreign body aspiration in children
- Measles
- Acute respiratory failure (hypoxaemic and hypercapnic)
- Hospital-acquired and ventilator-associated pneumonia
- Aspiration pneumonia and pneumonitis
- Parapneumonic effusion and empyema
- Lung abscess
- Atelectasis
- Pneumoconioses (silicosis, asbestosis, coal workers' pneumoconiosis)
- Community-acquired pneumonia
- Interstitial lung disease
- Acute respiratory distress syndrome (ARDS)
Test yourself
Think of the answer, then tap the question to see it.
Why does upright aspiration most often reach the basal segments of the right lower lobe?
Because the right main bronchus is wider and more in line with the trachea, so aspirated material falls into the right lower lobe.
Which segment of the right lower lobe is the most dependent airway when lying on the back, a frequent site of aspiration pneumonia and abscess?
The superior segment (B6), the first branch of the lower lobe bronchus, directed backward.
On a frontal chest X-ray, which outline does consolidation of the right lower lobe erase?
The right hemidiaphragm, not the right heart border (silhouette sign), because the lobe rests on the diaphragm.
What is the spine sign on a lateral chest X-ray in right lower lobe consolidation?
The lower vertebrae look denser instead of darker, because consolidated lung lies behind the heart over them.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- lobus inferior pulmonis dextri TA2 3293
- Official Spanish (DeCS)
- Lóbulo inferior del pulmón derecho DeCS D008168
- English (TA2)
- Inferior lobe of right lung
- Also called
- lower lobe of right lung · lobus dorsocaudalis
Related
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Thorax, Lungs; 22.7 Embryonic Development of the Respiratory System (OpenStax (Rice University), 2022) · adapted, CC BY 4.0; Anatomy of the Human Body (20th ed.): The Respiratory Apparatus (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.
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Representative model, for educational purposes only.
