Chest X-ray Anatomy - Lung lobes and fissures

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Top Highlights

• right lung has two fissures, oblique fissure and horizontal fissure

• Each lobe has its own visceral pleural covering.

• The left lung is divided into two lobes, upper and lower, by the oblique (major) fissure.

• Only the horizontal fissure is commonly seen on a frontal chest X-ray.

• horizontal fissure (right) is often seen on a normal frontal view

• oblique fissures may be seen on a normal lateral view

• separated by the horizontal and oblique (or major) fissures

• usually no horizontal fissure on the left

• horizontal fissure separates the right upper lobe from the right middle lobe

• as a thin line running roughly horizontally from the edge of the lung towards the right hilum

• oblique (major) fissures overlie each other on a lateral view and are not always seen in entirety

• the lower end is usually seen most clearly

• horizontal fissure is not seen at all on this lateral image

• most common accessory fissure visible on a chest X-ray

• 1-2%

• azygos vein passes horizontally along the right side of the mediastinum

• azygos vein appears to pass through the lung and is surrounded by both parietal and visceral pleura

• azygos fissure therefore consists of four layers of pleura, two parietal layers and two visceral layers

• the head is the azygos vein and the tail the azygos fissure

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