On an axial CT of the thorax at the level of the carina (T4-T5), which structure lies immediately to the right of the descending aorta and posterior to the right main bronchus?

• A Superior vena cava
• B Azygos vein ✓
• C Right pulmonary artery
• D Thoracic duct

Explanation

At the level of the carina, the azygos vein arches over the right main bronchus to drain into the superior vena cava, making it the structure posterolateral to the right main bronchus. The azygos lies in the right paravertebral gutter. The SVC is located anteriorly and to the right. The right pulmonary artery courses anterior and inferior to the carina toward the right lung. The thoracic duct ascends in the posterior mediastinum, typically slightly left of midline.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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