2. Descriptive anatomy based on three-dimensional imaging of the body, organs, and structures using a series of computer multiplane sections, displayed by transverse, coronal, and sagittal analyses. It is essential to accurate interpretation by the radiologist of such techniques as ultrasonic diagnosis, magnetic resonance imaging, and computed tomography. (From Lane & Sharfaei, Modern Sectional Anatomy, 1992, Preface)

4. Planes of Section Transverse Plane (axial) – run top to bottom, superior to inferior. Cranial to caudal

5. Planes of Section Coronal Follow front to back, anterior to posterior, or ventral to dorsal.

6. Planes of Section Sagittal One side of the body to the other, right to left, left to right, lateral to medial

7. Axial CT Axial MRI Axial PET

8. Coronal CTCoronal MR Coronal PET

9. Sagittal CTSagittal MR Sagittal PET

10. COMPARRISONS

11. THORACIC APERTURES Superior Aperture Thoracic Inlet Formed by first thoracic vert. First pair of ribs w/ costal cartilage Manubrium Functions: Passage way for nerves, vessels and viscera from the neck into the thoracic cavity

12. THORACIC APERTURES Inferior Aperture Thoracic Outlet Much larger 12th. thoracic vert. 12th. pair of ribs and costal margins Xiphoid Sternal junction

13. THORACIC APERTURES Inferior Aperture Thoracic Outlet

14. THORACIC APERTURES Superior Aperture Thoracic Inlet

15. BONY THORAX Protects the lungs and aids in respiration….

16. BONY THORAX Consists of; Vertebrae (12) Sternum (1) Ribs (12) pairs Costal cartilages

17. BONY THORAX Consists of; Vertebrae (12) Sternum (1) Ribs (12) pairs Costal cartilages

18. BONY THORAX Vertebrae (12) (7) Cervical (12) Thoracic (5) Lumbar (5) Sacral Vertebrae (3) (5) usually (4) Coccyx

19. BONY THORAX Cervical (7)

20. BONY THORAX Thoracic (12)

21. BONY THORAX Lumbar (5)

22. BONY THORAX Sacrum (5)

23. BONY THORAX Coccyx (3) (5)

24. STERNUM (3) Components: -Manubrium -Body -Xiphoid process -Sternoclavicular joints -Jugular notch - Sternal angle (T4-T5)

25. STERNUM

27. RIBS -Form the lateral borders of the thoracic cage - all (12) pairs articulate post. With T spine -First (7) pairs are TRUE -Lower (5) pairs FALSE

28. LUNGS - Organs of respiration - Large conical shaped -Apex - Diaphragm - Medial angle “Cardiophrenic sulcus” - Lateral angle “ Costophrenic sulcus” - Fissures -Cardiac notch -Hilum - Roots

29. LUNGS CT FACTS REGARDING THE THORASIC CAVITY -Contrast is normally used - If a nodule is seen, finer cuts may be indicated -Patient should hold breathe during exposure, however, not full inspiration -Usually start at level of shoulders and scan down -Patient must be centered to the middle of the table - Continuing scanning until you are out of both lungs, stop scanning at kidneys -Must include multiple windows; lung, mediastinum, bone, soft tissue and liver -evaluate all pathology - Carefully take your scout or Delta scan

30. THORACIC CONTENTS 1.Lungs (-) 2.Trachea (-) 3.Esophagus (+) 4.Thymus (+) 5.Aorta (ascending, descending, arch) (+) 6.IVC (+) 7.SVC (+) 8.Phrenic and Vagus nerves (+) 9.Heart (+) 10.Main bronchus (+) 11.Pulmonary artery (+) 12.Pulmonary veins (+) 13.Bronchial veins (+) 14.Lymph nodes (+)

31. LUNGS 1

33. LUNGS 3

35. SECTIONS 1.Pleural Space (sac) 2.Mediastinum (space between lungs) 3.Heart

36. SECTIONS Pleural Space

37. SECTIONS Heart

38. Components 1. Lungs (2) - Lt. and Rt. - Lt. is more concave (?) - Hilums (slits) (roots) - base, apex, costal surface and costophrenic angles - Lobes, Rt. (3) Lt. (2) - Fissures

39. Lobes of lungs

40. Fissures of lungs Separate lobes

41. COMPONENTS 2. Trachea - Passageway for air - 11cm long - splits into rt. and lt. stem bronchus between 2 nd and 3 rd rib CARINA -Rt. Bronchi’s is larger and more vertical than the lt. bronchi's. - Both divide into secondary and primary bronchioles

42. 2. Trachea Bifurcation (Carina)

43. 2. Trachea - After bronchioles an additional separation occurs where the alveoli exchange gas with capillaries….CO2 – O2

44. Capillary exchange -

47. COMPONENTS 3. Esophagus -Extends from pharynx to stomach. - Anterior to spine & posterior to trachea - Passes through the esophageal hiatus (opening)

48. COMPONENTS ESOPHAGUS

49. COMPONENTS ESOPHAGUS Axial CT

50. COMPONENTS ESOPHAGUS Sagittal MR

51. COMPONENTS 4. Thymus -(2) glands in the upper anterior chest wall - behind sternum - above the heart - large at birth, shrinks with age - STIMULATES GROWTH

52. COMPONENTS THYMUS GLAND Axial CT

53. COMPONENTS THYMUS GLAND PET

54. 5 AORTA - Main trunk - Begins at lt. ventricle - passes behind sternum - behind sternum – ascending aorta - at sternal angle (left) - at thoracic vert. becomes descending aorta

55. AORTA

56. Multiple imaging

57. 6 IVC - large trunk vein - enters from lower abdomen - enters right atrium

58. 6 IVC CT/PET Fusion

59. 7 SVC - Large trunk vein - receives branches from all of the body above the diaphragm except the lungs - Lies behind sternum

60. 7 SVC AXIAL CT

61. 8 Phrenic Nerve& Vagus Nerve Phrenic Vagus