The superior (upper) lobe of the right lung forms the top part of the right lung, including its apex, which rises into the root of the neck. It is separated from the middle lobe by the horizontal fissure and from the lower lobe by the upper part of the oblique fissure. It has three segments: apical, posterior and anterior.
| Location | Upper part of the right lung, from the apex above the clavicle down to about the 4th rib in front. |
|---|---|
| Parts |
|
| Nerve Supply | Pulmonary plexus; Vagus nerve (parasympathetic, bronchoconstriction and mucus secretion); Sympathetic fibres from T2-T5 ganglia (bronchodilation) |
| Blood Supply | Right pulmonary artery (upper lobe branches); Bronchial arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Contributes to gas exchange; ventilation is relatively lower and perfusion even lower in the upright apices compared with the bases.
The apices are favoured by reactivated tuberculosis and by smoking-related centrilobular emphysema. Tumours at the apex (Pancoast or superior sulcus tumours) can invade the brachial plexus and sympathetic chain, causing shoulder and arm pain and Horner syndrome, sometimes mistaken for a musculoskeletal shoulder problem.
A lung cancer at the lung apex that invades nearby nerves, ribs and vessels. It typically causes shoulder and inner arm pain and hand weakness.
Reactivated tuberculosis that favours the apical and posterior segments of the upper lobes. It causes chronic cough, night sweats, weight loss and cavities on X-ray.
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