[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Chest](https://durgical.com/en/anatomy/region/chest/) › Right upper lobe [Respiratory system](https://durgical.com/en/anatomy/system/respiratory-system/) · [Chest](https://durgical.com/en/anatomy/region/chest/) # Right upper lobe The right upper lobe is the top part of the right lung, in the upper right [chest](https://durgical.com/en/anatomy/region/chest/); it is a common site for tuberculosis and lung cancer. Official name: Superior lobe of right lung [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=thorax&select=right_upper_lobe&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The top lobe of the right lung, above the horizontal fissure. ## What it does Fills the upper right chest; a common site for tuberculosis and lung cancer. ## Key points - Classic site of reactivation tuberculosis, in the apical and posterior segments, where oxygen tension is highest - Its apex rises above the [clavicle](https://durgical.com/en/anatomy/clavicle/) into the root of the neck; a Pancoast tumour there can involve the brachial plexus, the sympathetic chain and the upper [ribs](https://durgical.com/en/anatomy/ribs/) - Collapse pulls the horizontal fissure up and in; with a central mass the edge forms a reversed S (Golden S sign) ## Key facts **Where** Above horizontal and oblique fissures; segments apical, posterior, anterior **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; posterior segment is a classic aspiration site when supine ## Relations **Above** Cervical [pleura](https://durgical.com/en/anatomy/pleura/) and suprapleural membrane; above them the [subclavian artery](https://durgical.com/en/anatomy/right-subclavian-artery/), the lower trunk of the [brachial plexus](https://durgical.com/en/anatomy/roots-of-brachial-plexus/) and the stellate ganglion **Medial** [Superior vena cava](https://durgical.com/en/anatomy/superior-vena-cava/), right [brachiocephalic vein](https://durgical.com/en/anatomy/brachiocephalic-vein/), [trachea](https://durgical.com/en/anatomy/trachea/), right [vagus nerve](https://durgical.com/en/anatomy/vagus-nerve/) and the arch of the [azygos vein](https://durgical.com/en/anatomy/azygos-vein/), which grooves the lobe above the hilum **Below** [Right middle lobe](https://durgical.com/en/anatomy/middle-lobe-of-right-lung/) across the horizontal fissure in front; [right lower lobe](https://durgical.com/en/anatomy/inferior-lobe-of-right-lung/) across the oblique fissure behind ## How to find it The apex is heard above the medial third of the clavicle. In front, the lobe lies above the 4th [costal cartilage](https://durgical.com/en/anatomy/costal-cartilage/) (horizontal fissure); behind, only above about the T3 spinous process, where the oblique fissure begins. Its sounds are best heard on the upper front of the chest and high in the axilla. ## On imaging Consolidation is bounded below by a sharp horizontal fissure. Collapse lifts the fissure and the right hilum. Apical lesions can hide behind the clavicle and [first rib](https://durgical.com/en/anatomy/first-rib/); an apical (lordotic) view or CT shows them. Cavities with upper lobe nodules suggest active tuberculosis. ## 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 - Tuberculosis remains a public health problem in Colombia, which keeps upper lobe cavitation high on the list of causes - Pancoast (superior sulcus) tumour: shoulder and ulnar-side arm pain and hand weakness from the brachial plexus, and Horner syndrome from the sympathetic chain - Aspiration while lying on the right side tends to reach the posterior segment of this lobe ## Anatomical variants - Azygos lobe: the azygos vein runs through the apex inside a fold of pleura, creating an extra fissure; uncommon, seen as a fine curved line at the right apex on X-ray ## 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 upper of the three buds forms this lobe. ## Related conditions - [Tuberculosis](https://durgical.com/en/conditions/tuberculosis/) - [Lambert-Eaton myasthenic syndrome](https://durgical.com/en/conditions/lambert-eaton-myasthenic-syndrome/) - [Cystic fibrosis](https://durgical.com/en/conditions/cystic-fibrosis/) - [Sarcoidosis](https://durgical.com/en/conditions/sarcoidosis/) - [Pneumoconioses (silicosis, asbestosis, coal workers' pneumoconiosis)](https://durgical.com/en/conditions/pneumoconioses/) - [Solitary pulmonary nodule](https://durgical.com/en/conditions/solitary-pulmonary-nodule/) - [Hypersensitivity pneumonitis](https://durgical.com/en/conditions/hypersensitivity-pneumonitis/) - [Eosinophilic pneumonias (including Löffler syndrome)](https://durgical.com/en/conditions/eosinophilic-pneumonias/) - [Chronic obstructive pulmonary disease (COPD)](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/) - [Pneumothorax](https://durgical.com/en/conditions/pneumothorax/) - [Pulmonary tuberculosis](https://durgical.com/en/conditions/pulmonary-tuberculosis/) - [Lung cancer](https://durgical.com/en/conditions/lung-cancer/) ## Test yourself Think of the answer, then tap the question to see it. ## Where in the right upper lobe does reactivation tuberculosis classically occur, and why? In the apical and posterior segments, where oxygen tension is highest. ## What are the features of a Pancoast tumour at the apex of the right upper lobe? Shoulder and ulnar-side arm pain and hand weakness from the brachial plexus, and Horner syndrome from the sympathetic chain. ## What is the Golden S sign? Right upper lobe collapse with a central mass: the horizontal fissure is pulled up and in, and its edge forms a reversed S. ## What is an azygos lobe? An uncommon variant: the azygos vein runs through the right apex inside a fold of pleura, seen as a fine curved line on X-ray. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/superior-lobe-of-right-lung/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** lobus superior pulmonis dextri TA2 3284 **Official Spanish (DeCS)** Lóbulo superior del pulmón derecho DeCS D008168 **English (TA2)** Superior lobe of right lung **Also called** upper lobe of right lung · lobus ventrocranialis Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=8345); [Anatomy, Thorax, Lungs](https://www.ncbi.nlm.nih.gov/books/NBK470197/); [22.7 Embryonic Development of the Respiratory System](https://openstax.org/books/anatomy-and-physiology-2e/pages/22-7-embryonic-development-of-the-respiratory-system) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/); Anatomy of the Human Body (20th ed.): The Respiratory Apparatus (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/superior-lobe-of-right-lung/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/superior-lobe-of-right-lung/