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The Chest X-Ray For: Nottingham SCRUBS 26 th August 2006 Presented by: Matthew.

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Presentation on theme: "The Chest X-Ray For: Nottingham SCRUBS 26 th August 2006 Presented by: Matthew."— Presentation transcript:

1 The Chest X-Ray For: Nottingham SCRUBS 26 th 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

11 Rotation

12 Rotation (continued)

13 Penetration

14 Inspiration/Expiration

15 Anatomy

16

17

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

29 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

38

39

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 DD Never 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 Causes: 1. Adenopathies (neoplasia, infection) 2. Primary Tumor 3. Vascular 4. Sarcoidosis

57 Multiple Masses

58 Hilar Lymphadenopathy - BL

59

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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