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The settings dialog is divided in 3 main parts:
Used to navigate through all the available settings pages. Click on the + signs to see child pages, and click on the page names to open the corresponding page. The list may change depending on what extensions are loaded, and in what context you are.
The title of the active page and an icon are displayed at the top of the panel, and the rest of the panel contains the available settings. Some of these settings may be unavailable in some contexts.
Since settings have different contexts or levels, this panel is there to display the current level, and to allow a level change. If this panel is not visible, just click on the splitter bar under the dialog's title bar to display it.
Click here for more information on the settings level, or check the settings integration in the solution explorer.