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The Chest X-Ray

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The Chest X-Ray For: Nottingham SCRUBS 26th August 2006 Presented by: Matthew Aims: Basics Best exam results Appreciate the role radiology plays ? – PowerPoint PPT presentation

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Title: The Chest X-Ray


1
The Chest X-Ray
  • For Nottingham SCRUBS 26th August 2006
  • Presented by Matthew

2
Aims
  • Basics
  • Best exam results
  • Appreciate the role radiology plays
  • ? Instil an interest in radiology

3
Contents
  • Densities
  • Techniques
  • Anatomy
  • CXR Interpretation
  • Common Pathologies
  • Questions

4
Densities
  • The big two densities are
  • (1) WHITE - Bone
  • (2) BLACK - Air
  • The others are
  • (3) DARK GREY- Fat
  • (4) GREY- Soft tissue/water
  • And if anything Man-made is on the film, it is
  • (5) BRIGHT WHITE - Man-made

5
Techniques - Projection
  • P-A (relation of x-ray beam to patient)

6
Techniques - Projection (continued)
  • A-P Supine/Erect

7
Techniques - Projection (continued)
  • Lateral

8
Techniques - Projection (continued)
  • Lateral Decubitus

9
Techniques - Projection (continued)
  • Oblique

10
Orientation
  • Orientation

11
Rotation
12
Rotation (continued)
13
Penetration
14
Inspiration/Expiration
15
Anatomy
16
Anatomy
17
Anatomy
18
Lobes
  • Right upper lobe

19
Lobes (continued)
  • Right middle lobe

20
Lobes (continued)
  • Right lower lobe

21
Lobes (continued)
  • Left lower lobe

22
Lobes (continued)
  • Left upper lobe with Lingula

23
Lobes (continued)
  • Lingula

24
Lobes (continued)
  • Left upper lobe - upper division

25
Pleura
  • Layers

26
Heart
  • Right border Edge of (r) Atrium
  • 3. Left border (l) Ventricle Atrium
  • 4. Posterior border Reft Ventricle
  • 5. Anterior border Right Ventricle

27
Heart (continued)
28
Heart (continued)
29
Heart (continued)
  • Valves

30
Mediastinum
31
Hilum
  • Made of
  • 1. Pulmonary Art.Veins
  • 2. The Bronchi
  • Left Hilus higher (max 1-2,5 cm)
  • Identical size, shape, density

32
Hilum
33
Ribs
34
Soft tissue bones
35
Lateral CXR
36
Lateral CXR (continued)
37
Lateral CXR (continued)
38
Lateral CXR (continued)
39
Lateral CXR (continued)
40
CXR Interpretation
41
Technical Details
  • Type
  • Orientation
  • Rotation
  • Inspiration/expiration
  • Penetration

42
Lungs
  • Lungs
  • Density
  • Symmetry
  • Lesions

43
Heart
  • Size

44
Heart
  • Size of heart
  • Size of individual chambers of heart
  • Size of pulmonary vessels
  • Evidence of stents, clips, wires and valves
  • Outline of aorta and IVC and SVC

45
Mediastinum
  • Width
  • Contour
  • AP window

Hila
  • Size
  • Location

46
Review areas
  • Apices
  • Behind the heart
  • CP angles
  • Below the diaphragm
  • Soft tissues ( breast, surgical emphysema)
  • Ribs clavicle
  • Vertebrae

47
Identify the lesion ? localise the lesion ?
describe the lesion ? give DDNever stop
looking, carry on with your systematic approach!!
48
Pathology
49
  • RUL pneumonia

50
  • RML pneumonia

51
  • RLL pneumonia

52
  • LUL pneumonia

53
  • LLL pneumonia

54
  • Consolidation on CT

55
  • Hilar m l

56
The Enlarged Hila
  • Causes1. Adenopathies (neoplasia,
    infection)2. Primary Tumor3. Vascular4.
    Sarcoidosis

57
  • Multiple Masses

58
  • Hilar Lymphadenopathy - BL

59
(No Transcript)
60
  • Pleural Effusion

61
  • Pulmonary Fibrosis

62
  • ?

63
  • Heart failure

64
  • Pneumothorax

65
  • RUL collapse

66
  • LLL collapse

67
  • Air under the diaphragm

68
  • Emphysema

69
  • Cervical Rib

70
  • Cavitating lesion

71
  • Hiatus hernia

72
  • Miliary shadowing

73
  • Chest Tube, NG Tube, Pulm. artery cath

74
  • Dextrocardia
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