Lung: middle lobe syndrome: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Lung: middle lobe syndrome

Sample item

A 9-year-old boy has recurrent cough and a persistent right paracardiac opacity that obscures the right heart border. CT shows collapse of the middle lobe with enlarged hilar nodes compressing its bronchus. Which anatomical features predispose this lobe to collapse?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. A long, narrow bronchus surrounded by lymph nodes, in a lobe with poor collateral ventilation

The right middle lobe bronchus is relatively long and narrow and leaves the intermediate bronchus at an acute angle, surrounded by a ring of nodes. The lobe is usually well separated by the fissures, so collateral air drift is poor. Nodal enlargement or mucus plugging leads to collapse and recurrent infection.

Option by option

  • A. A short, wide bronchus arising directly from the trachea

    The tracheal bronchus is a rare anomaly that supplies the apical segment, not the middle lobe.

  • B. A bronchus supplied by a single large artery that is easily compressed

    Airways are not collapsed by a single supplying artery; bronchial arteries simply run alongside the airway.

  • C. A long, narrow bronchus surrounded by lymph nodes, in a lobe with poor collateral ventilation (correct)

    Correct. Narrow calibre, surrounding nodes and poor collateral ventilation make collapse likely.

  • D. A posterior position behind the oblique fissure, compressed by the diaphragm

    The middle lobe lies anteriorly in front of the oblique fissure, not behind it.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, A long, narrow bronchus surrounded by lymph nodes, in a lobe with poor collateral ventilation. The right middle lobe bronchus is relatively long and narrow and leaves the intermediate bronchus at an acute angle, surrounded by a ring of nodes.

Why is "A short, wide bronchus arising directly from the trachea" not the answer?

The tracheal bronchus is a rare anomaly that supplies the apical segment, not the middle lobe.

Why is "A bronchus supplied by a single large artery that is easily compressed" not the answer?

Airways are not collapsed by a single supplying artery; bronchial arteries simply run alongside the airway.

Why is "A posterior position behind the oblique fissure, compressed by the di…" not the answer?

The middle lobe lies anteriorly in front of the oblique fissure, not behind it.

What concept does this question test?

It tests Lung: middle lobe syndrome in Anatomy. The lobe is usually well separated by the fissures, so collateral air drift is poor. Nodal enlargement or mucus plugging leads to collapse and recurrent infection.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lung: middle lobe syndrome?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.