Chest X-Ray Anna

Slide 1 © 2003 By Default!
CHEST X-RAY
.Anna Ben Ely M.D
A Free sample background from www.powerpointbackgrounds.com

Willhem Konrad Roentgen

1895

Effective dose equivalent

from diagnostic medical exposures


Positioning
The standard chest examination :
PA (posterioranterior) + lateral chest x-ray.

Positioning
left chest against the cassette

AP supine film
magnification of the heart and widening

of the mediastinum
Lateral decubitus position
pleural effusion
pneumothorax
air trapping

Technically adequate
 Inspiration
– diaphragm at the level of the 8th - 10th posterior
rib or 5th - 6th anterior rib

 Penetration
PA :
-thoracic spine disc spaces should be visible
through the heart
Lat:
-“More black sign”
-The sternum should be seen edge on
posteriorly you should see two sets of
ribs

underpenetrated normal PA film overpenetrated normal PA film

Chest X-ray anatomy

Bronchi

Lobes and Fissures

Lobes and Fissures

Lobes and Fissures

Diaphragm

Mediastinum
1 Superior Vena
Cava
2. Right Atrium
3. Aortic Arch
4. Edge of Main
Pulmonary Artery
5. Left Atrial
Appendage
6. Left Ventricle

Mediastinum
1. Trachea
2. Right
Ventricle
3. Left Ventricle
4. Left Atrium
5. Right
Pulmonary
Artery
Pulmonary Vasculature
A = Apical segmental bronchus
B = Posterior segmental bronchus
C = Anterior segmental bronchus
D = Bronchus intermedius
E = Truncus anterior
F = Carina
G = Right main pulmonary artery
H = Left main pulmonary artery

I = Right inferior pulmonary artery
J = Right superior pulmonary vein
K = Right middle lobe bronchus
L = Right lower lobe bronchus
M = Right inferior pulmonary vein
N = Left Atrium
O = Left superior pulmonary vein
P = Apicoposterior segmental bronchus
Q = Left upper lobe bronchus
R = Lingular bronchus
S = Left inferior pulmonary artery

T = Left inferior pulmonary vein
Pulmonary Vasculature
left pulmonary artery passes over RPA passes behind the

the left mainstem bronchus to ascending aorta
descend behind it
Mediastinum and Lungs

Silhouette sign
 loss of lung/soft
tissue interface
 mass or fluid in the

normally air filled lung



Air Bronchogram
 tubular outline of airway
 filling of surrounding
alveoli by fluid
 causes :
– lung consolidation
– pulmonary edema
– nonobstructive pulmonary
atelectasis
– severe interstitial disease
– neoplasm
– normal expiration

Solitary Pulmonary Nodule
 compare with prior

films if available
 nodule unchanged for

two years - almost
certainly benign
 completely calcified-
benign

Solitary Pulmonary Nodule

Atelectasis
 collapse or incomplete expansion of the lung

or part of the lung
– endobronchial lesion
– extrinsic compression
– cicatricial

Atelectasis

Atelectasis

Pulmonary Edema
cephalization of pulmonary veins

indistinctness of the vascular "bat wing" pattern
margins
Kerley B lines
 horizontal
lines
 less than
2cm long
 commonly
found in the
lower zone
periphery
 thickened,
edematous
interlobular
septa

Pneumonia
 Consolidation: air spaces filled with

bacteria or other microorganisms and
pus
 is NOT associated with volume loss
 bacteria, viruses, mycoplasmae, fungi
 x-ray findings :
– airspace opacity,
– lobar consolidation
– interstitial opacities
– may have an associated parapneumonic
effusion.
Pneumonia

Pleural Effusion
 CHF, infection (parapneumonic), trauma,

PE, tumor, autoimmune disease, renal
failure
 200 ml of fluid - frontal film
 75ml – lateral
 Larger unilateral effusions are more likely

malignant

Pleural Effusion

Pneumothorax
 air inside the thoracic cavity but outside the

lung
 spontaneous pneumothorax- without obvious
inciting incident: idiopathic, asthma, COPD,
pulmonary infection, neoplasm, Marfanâs
syndrome, smoking cocaine
 most pneumothoraces are iatrogenic
 trauma
 tension PTX : air enters the pleural cavity and is
trapped during expiration

Pneumothorax

Hydropneumothorax

Emphysema

Anterior Mediastinal Mass
 4 "T's"
– Terrible lymphadenopathy
– Thymic tumors
– Teratoma
– Thyroid mass
 aortic aneurysm
 pericardial cyst
 epicardial fat pad

Anterior Mediastinal Mass

Middle Mediastinal Mass
 The most common cause of a middle

mediastinal mass is lymphadenopathy
 hiatial hernia
 aortic aneurysm
 thyroid mass
 duplication cyst
 bronchogenic cyst

Middle Mediastinal Mass

Posterior Mediastinal Mass
 Neoplasm
 Lymphadenopathy
 aortic aneurysm
 adjacent pleural or lung mass
 neurenteric cyst
 lateral meningocele
 extramedullary hematopoiesis

Posterior Mediastinal Mass

Pericardial Effusion
 400-500 ml of fluid

Pneumomediastinum

Trauma - Rib fracture

Thank you

Chest X-Ray Anna

Încărcat de

Informații document

Descriere originală:

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Chest X-Ray Anna

Încărcat de

Drepturi de autor:

Formate disponibile

Slide 1 © 2003 By Default!

.Anna Ben Ely M.D

A Free sample background from www.powerpointbackgrounds.com

Willhem Konrad Roentgen

A Free sample background from www.powerpointbackgrounds.com

Effective dose equivalent

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

magnification of the heart and widening

Lateral decubitus position

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

underpenetrated normal PA film overpenetrated normal PA film

A Free sample background from www.powerpointbackgrounds.com

Chest X-ray anatomy

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

Lobes and Fissures

A Free sample background from www.powerpointbackgrounds.com

Lobes and Fissures

A Free sample background from www.powerpointbackgrounds.com

Lobes and Fissures

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

H = Left main pulmonary artery

S = Left inferior pulmonary artery

left pulmonary artery passes over RPA passes behind the

Mediastinum and Lungs

A Free sample background from www.powerpointbackgrounds.com

 mass or fluid in the

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

Solitary Pulmonary Nodule

 compare with prior

 nodule unchanged for

A Free sample background from www.powerpointbackgrounds.com

Solitary Pulmonary Nodule

A Free sample background from www.powerpointbackgrounds.com

 collapse or incomplete expansion of the lung

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

cephalization of pulmonary veins

A Free sample background from www.powerpointbackgrounds.com

 Consolidation: air spaces filled with

A Free sample background from www.powerpointbackgrounds.com

 CHF, infection (parapneumonic), trauma,

 200 ml of fluid - frontal film

 Larger unilateral effusions are more likely

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

 air inside the thoracic cavity but outside the

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

A Free sample background from www.powerpointbackgrounds.com

Anterior Mediastinal Mass