After a right pneumonectomy, the surgeon notes that the right lung root structures pass anterior and posterior to the right main bronchus. Which structure passes anterior to the right main bronchus at the lung root?

• A Right pulmonary artery ✓
• B Azygos vein arching over the root
• C Right superior pulmonary vein
• D Right phrenic nerve

Explanation

At the right lung root, the right pulmonary artery is the most superior and anterior structure (eparterial bronchus means bronchus below the artery — the right upper lobe bronchus arises above the pulmonary artery, a defining feature of the right side). From anterior to posterior at the right hilum: right pulmonary veins anteriorly, right pulmonary artery in the middle, and right main bronchus posteriorly. On the left, the left pulmonary artery arches over the left main bronchus (hyparterial bronchus). This asymmetry is important for surgical dissection during pneumonectomy and lobectomy.

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

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Written and medically reviewed by the StethoPrep medical team.