Thoracic anaesthesia: left-sided double-lumen tube: practice question

A Anaesthesia 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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Anaesthesia · Thoracic anaesthesia: left-sided double-lumen tube

Sample item

Why is a left-sided double-lumen tube preferred in most cases of one-lung ventilation?

AThe right upper lobe bronchus arises close to the carina, so a right tube can occlude itBThe left lung is smallerCThe left main bronchus is shorterDRight-sided tubes cannot be fibreoptically checked

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

The answer and the reasoning

A. The right upper lobe bronchus arises close to the carina, so a right tube can occlude it

The left main bronchus is about 5 cm long, which gives space for the endobronchial cuff, while the right upper lobe bronchus arises about 2.5 cm from the carina and can be blocked by a right-sided tube. Right tubes therefore need a slot opposite the upper lobe orifice and are used only when the left bronchus is diseased or distorted. Position is confirmed by fibreoptic bronchoscopy.

Option by option

A. The right upper lobe bronchus arises close to the carina, so a right tube can occlude it (correct)
Correct. The anatomy of the right upper lobe bronchus makes right-sided tubes riskier.
B. The left lung is smaller
The lung size is not the reason.
C. The left main bronchus is shorter
The left main bronchus is longer than the right.
D. Right-sided tubes cannot be fibreoptically checked
Right tubes can be checked with a bronchoscope.

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.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, The right upper lobe bronchus arises close to the carina, so a right tube can occlude it. The left main bronchus is about 5 cm long, which gives space for the endobronchial cuff, while the right upper lobe bronchus arises about 2.

Why is "The left lung is smaller" not the answer?

The lung size is not the reason.

Why is "The left main bronchus is shorter" not the answer?

The left main bronchus is longer than the right.

Why is "Right-sided tubes cannot be fibreoptically checked" not the answer?

Right tubes can be checked with a bronchoscope.

What concept does this question test?

It tests Thoracic anaesthesia: left-sided double-lumen tube in Anaesthesia. 5 cm from the carina and can be blocked by a right-sided tube. Right tubes therefore need a slot opposite the upper lobe orifice and are used only when the left bronchus is diseased or distorted. Position is confirmed by fibreoptic bronchoscopy.

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 Thoracic anaesthesia: left-sided double-lumen tube?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.