Page 283 - Clinical Application of Mechanical Ventilation

Monitoring in Mechanical Ventilation 249

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Figure 9-4 Anterior positions for chest auscultation.
Figure 9-5 Posterior positions for chest auscultation.

cuff’s location. The cuff is leaking if distinct air movement can be heard toward the
end of a mechanical breath. Uneven bilateral breath sounds in the absence of lung pa-
thology (e.g., atelectasis, tension pneumothorax) may indicate main-stem intubation.
The placement of an endotracheal tube should be confirmed by chest radiograph.

Right Upper Lobe Left Upper Lobe
(RUL) (LUL)
2 1
Right Middle Lobe
(RML)
4 3

Right Lower Lobe 6 5
(RLL) 8
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Left Lower Lobe
(LLL)

Figure 9-6 Anterior surface projection of the lung lobes and segments. Left lung: (1) LUL
apical segment, (3) LUL anterior segment, (5) LUL lingula inferior and superior segments, (7) LLL
anterior segment. Right lung: (2) RUL apical segment, (4) RUL anterior, (6) RML medial and lateral
segments, (8) RLL anterior segment.

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