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THORAX X-RAYS, ANGIOGRAMS AND BRONCHOGRAMS

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Title: THORAX X-RAYS, ANGIOGRAMS AND BRONCHOGRAMS


1
THORAX X-RAYS, ANGIOGRAMS AND BRONCHOGRAMS
2
Third Rib (posterior)
Clavicle
Fifth Rib (posterior)
Aortic arch
Third Rib (anterior)
Vessels and Bronchi in lungs
Right Atrium
Left ventricle
Shadow of breast
3
Second rib (posterior)
First rib (anterior)
Fourth rib (posterior)
Aortic arch
Seventh rib (posterior)
Fourth rib (anterior)
Left ventricle
Costodiaphragmatic recess
4
Sternal angle
Ascending aorta
Ribs
Left ventricle
Thoracic (descending) aorta
Diaphragm
Costodiaphragmatic recess
5
First rib (posterior)
First rib (anterior)
Surface electrode
Aortic arch
Right atrium
Left ventricle
Gas in intestine
Liver
6
Clavicle
Lateral border of scapula
Second rib
Fourth rib
Left ventricle
Right atrium
Body of T9 Vertebra
Liver
Thumb of hand, holding infant in proper position.
7
Clavicle
Body of vertebra
Transverse process of vertebra
Gas in intestine
Diaphragm
8
2 Normal Chest X-ray Labeled
2 Normal AP chest xray labeled 1- Shadow of
breast (Don't be confused by this) 2- Left 7th
rib (posterior aspect) 3- Right 4th rib
(anterior aspect) 4- Border of right atrium 5-
Aortic arch (called aortic knob by
radiologists) 6- Small pulmonary vessels and
bronchi in lung fields (region of lungs are
called lung fields by radiologists) 7- Spine of
vertebra T2 8- Transverse process of vertebra T1
articulating with rib 1 9- Clavicale 10- Acromion
process of scapula 11 - Coracoid process of
scapula To identify anterior from posterior
aspects of a rib, note that the anterior rib runs
down and medially while the posterior part of the
rib runs down and laterally from the vertebral
column. Compare to the skeleton in the lab.
9
Bronchogram
5 Bronchogram PA Chest file - Radiographic
substance applied to the bronchial tree. This
film is called a bronchogram 1- Trachea 2- Right
Main Bronchus (between two arrows) 3- Left Main
Bronchus 4- Larynx 5- Acromion process of
Scapula 6- Coracoid process of Scapula 7-
Eparterial Bronchus - Lobar bronchus to upper
lobe in right lung 8- Bronchus to middle and
inferior lobe of right lung
10
9 Fluid in Right Pleural Cavity
9- PA chest film denoting pathological
condition 1) Fluid is present in right pleural
cavity. Right Costodiaphragmatic recess is
'obliterated' from view by presence of fluid in
the recess. Fluid level presents as a horizontal
line. Remember, the patient is erect in a PA
film therefore, fluid accumulates inferiorly in
pleural cavity. Compare the height of this fluid
level to normal costodiaphragmatic recess. 2)
Left costodiaphragmatic recess 3) Medial border
of scapula 4) Acromio-clavicular joint 5)
Clavicle 6) Coracoid process of Scapula
11
14 Artificial Aortic Valve
14 - Artificial valve 1- Artificial aortic valve
in heart at aortic orifice. 2- Note the wires
used to close the two halves of the sternum
following the median sternotomy.
12
16 Cardiomegaly
16 - Cardiomegaly Note the large size presented
by the left side of the heart. Left ventricle is
hypertrophied. This condition is called
cardiomegaly. 1- Left ventricle 2- Right
atrium 3- Aortic Knob (arch of aorta)
13
17
17- Positive film of catheterization of arch of
the aorta 1- Catheter (inserted via femoral
artery in thigh) 2- Arch of Aorta 3- Left
Subclavian artery 4- Left Common Carotid
artery 5- Brachiocephalic artery 6- Right Common
Carotid artery 7- Right Subclavian artery 8-
Right Internal Thoracic artery 9- Right axillary
artery (distal continuation of Subclavian artery)
14
12 Pulmonary artery
12 Pulmonary Arterial System 1) Catheter lying
outside of patient on chest wall 2) Catheter
within right atrium 3) Catheter within right
ventricle 4) Catheter within pulmonary trunk 5)
Right pulmonary artery (between arrows) 6)
Pulmonary artery branch to right upper lobe 7)
Pulmonary artery branch to right lower lobe
15
12F
12 - Arteriogram of Branches of Aortic Arch 1.
Aortic Arch 2. Left Subclavian 3. Left Common
Carotid 4. Brachiocephalic 5. Vertebral 6. First
rib 7. Axillary 8. Bifurcation of Common
Carotid 9. Internal Carotid 10. External Carotid
16
18A Ruptured Aorta - only EKG wires labeled
18A
18A Note the excessive width (area between white
arrows) of the mediastiinum. This was due to a
ruptured arch of the aorta. Blood fills the
mediastinum between the mediastinal parietal
pleurae. Aorta visualized by injection of
radiopaque contrast materials seen in Fig.
18B. 1) EKG wires
17
18B TEAR IN DISTAL AORTA
18B same case as 18A 1) Tear in distal part of
Arch of the Aorta (between 1 arrows) due to
a deceleration injury (car accident) 2) Catheter
(2) inserted into femoral artery of thigh and run
superiorly into the aorta to inject radiopaque
dye to visualize the damage to the vessel.
18
19 BARIUM SWALLOW
19 - Chest film - oblique view - Barium was
swallowed by patient 1. Esophagus 2.
Constriction of esophagus by arch of the aorta 3.
Esophagus entering cardiac end of stomach. Site
of passage of esophagus through diaphragm
(approx.) 4. Stomach
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