The document discusses endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). It provides anatomical diagrams and descriptions of lymph node stations that can be sampled by EBUS-TBNA, including stations 4R, 7, 11R, and 12R. Performing EBUS-TBNA requires knowledge of airway and vascular anatomy to properly target lymph nodes and avoid inadvertent vessel puncture.
The document discusses endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). It provides anatomical diagrams and descriptions of lymph node stations that can be sampled by EBUS-TBNA, including stations 4R, 7, 11R, and 12R. Performing EBUS-TBNA requires knowledge of airway and vascular anatomy to properly target lymph nodes and avoid inadvertent vessel puncture.
The document discusses endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). It provides anatomical diagrams and descriptions of lymph node stations that can be sampled by EBUS-TBNA, including stations 4R, 7, 11R, and 12R. Performing EBUS-TBNA requires knowledge of airway and vascular anatomy to properly target lymph nodes and avoid inadvertent vessel puncture.
The document discusses endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). It provides anatomical diagrams and descriptions of lymph node stations that can be sampled by EBUS-TBNA, including stations 4R, 7, 11R, and 12R. Performing EBUS-TBNA requires knowledge of airway and vascular anatomy to properly target lymph nodes and avoid inadvertent vessel puncture.
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EBUS TBNA
Vascular Navigation
Dicky Soehardiman Interventional Pulmonology and Respiratory Care Division Respiratory Medicine Department University of Indonesia/Persahabatan Hospital Jakarta Relations: Airways - Lymphnodes - Vessels • Anatomic knowledge: – facilitate to localize lympnode and lesion – avoid inadvertent access to vascular structure Front cross section of tracheobronchial tree (anterior view)
Front cross section of tracheobronchial tree (posterior view)
AORTA V. Azygos Ant-left 1/3 distal trachea Ant-right 1/3 distal trachea Above the aortic arch Ant-right 1/3 distal trachea Ant-left 1/3 distal trachea Superior vena cava AORTA
Right pulmonary artery
Left pulmonary artery
Left carotid artery
Right innominate vein
Right innominate artery
Left innominate vein At aortic arch level
AORTA
Superior vena cava
Left pulmonary artery
V. Azygos
Right pulmonary artery
Below the carina
Superior vena cava
Left pulmonary artery AORTA
AORT A Right pulmonary artery Right main bronchus
Right upper pulmonary vein
Right pulmonary artery
Right upper lobe bronchus
Right upper pulmonary vein
Right pulmonary artery
Right middle and lower lobe bronchus
Right lower pulmonary vein
Right upper pulmonary vein Right pulmonary artery
Left main bronchus
Left upper pulmonary vein
Left pulmonary artery
Left upper lobe bronchus
Left pulmonary artery
Left upper pulmonary vein
Left lower lobe bronchus
Left lower pulmonary vein
Left pulmonary artery
Cavaliere S, Beamis J. Atlas of therapeutic bronchoscopy laser – stents. Brescia: RIB; 1991 Lympnode Station
4R
11R 7
12R ? 12L ? Lymphnode 4R Station Lymphnode 4R Station • 1 or 2 tracheal rings above the main Carina • Before the bifurcation on the right posterolateral aspect Lymphnode 7 Station Lymphnode 7 Station • 3-5 cm below on either side of the main Carina • Lateral to inferomedial entry Lymphnode 11R Station Lymphnode 11R Station • Right second Carina: right upper lobe bifurcate from bronchus intermedius • Left second Carina: left upper lobe bifurcates from the left main bronchus Lymphnode 12R Station ? Lymphnode 5 or 6 Station? Lymphnode 5 or 6 Station? • Difficult • Anchored at lateral tracheal wall of distal trachea • At the level of Carina • Subsequent downward or inferior movement of the entire bronchoscopy • Facilitate the needle laterally Lymphnode 11L Station? Yurigaoka, September 22, 2010
Flexible Bronchoscopy
Ko Pen Wang Atul Mehta J Francis Turner Baltimore: Blackwell Publishing; 2004
