Bronchoscopy

 

ENT/Pulmonology: Bronchoscopy

High-Yield Revision for NEET PG

Bronchoscopy involves visualization of the tracheobronchial tree. It is a vital tool for both diagnostic (biopsy, lavage) and therapeutic (FB removal) purposes.

1. Rigid vs. Flexible

Type Primary Use
Rigid Gold standard for Foreign Body (FB) removal, managing massive hemoptysis, and airway stenting.
Flexible Diagnostic bronchoscopy (BAL, biopsy, brushing), assessment of difficult airways, and bedside procedures.

2. NEET PG High-Yield Pearls

  • Anatomical Landmark: The Carina (at the level of the T4/T5 vertebrae) is the bifurcation point of the trachea into the right and left main bronchi.
  • Right Main Bronchus: Wider, shorter, and more vertical compared to the left; therefore, inhaled foreign bodies are more common on the right side.
  • Contraindication: Severe hypoxia, unstable cardiac arrhythmias, and uncorrected coagulopathy are relative contraindications for flexible bronchoscopy.
  • Complications: Pneumothorax, bleeding, hypoxemia, and bronchospasm. Always obtain a post-procedural CXR if a biopsy is performed or if pneumothorax is suspected.
  • Therapeutic Tip: For organic FB (e.g., seeds/nuts) in children, bronchoscopy is an urgent procedure due to the risk of mucosal edema and airway obstruction.