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Chest Xray
- 4. NORMAL CHEST X-RAY PA LATERAL Two (2) projections are needed for most x-rays to locate structures in 3 planes (1)Right or Left , (2) Anterior or Posterior) or (3) Superior or Inferior.
- 5. NORMAL HEART BORDERS Note cardiac chambers that account for margins on the chest X-ray
- 8. LEFT 4 TH RIB POSTERIOR AND ANTERIOR PORTIONS POSTERIOR ANTERIOR 4 A P
- 9. AORTIC ARCH LT. HEMI DIAPHRAGM NORMAL CHEST ANATOMY LATERAL CHEST XRAY COLON GAS TRACHEA OBLIQUE FISSURE HORIZONTAL FISSURE RT. HEMI DIAPHRAGM Diaphragm-AP view Diaphragm- Lateral view LT. LT. RT. LT.
- 10. CARINA LT. MAIN BRONCHUS RT. MAIN BRONCHUS TRACHEA OBLIQUE FISSURE (major) OBLIQUE FISSURE major HORIZONTAL FISSURE minor BRONCHOGRAM—CONTRAST OUTLINING AIRWAY
- 11. HORIZONTAL FISSURE FISSURES DIVIDE LUNGS INTO LOBES RIGHT lung has: UPPER MIDDLE lobes LOWER LEFT lung has: UPPER lobes LOWER
- 22. TB
- 25. CaVity
- 29. PLEURAL EFFUSION
- 32. PNEUMOTHORAX
- 36. Hyperinflation
- 37. Hemothorax
- 38. Aortic dissection with hemothorax
- 42. Chest mass, emphysema Hilar mass
- 46. Bulla
- 51. NORMAL HEART CARDIOMEGLY
- 54. Cardiomegaly Cardiac silhouette greater than 50% of width of thorax
- 55. CARDIOMEGLY CONGESTIVE HEART FAILURE Evolution of congestive heart failure and pulmonary edema. With Progressive Lt. Ventricular failure blood backs into the left atrium—then to the pulmonary veins (PULMONARY VENOUS HYPERTENSION) then to the pulmonary interstitium (INTERSTITIAL EDEMA) then to the alveoli (ALVEOLAR EDEMA)
- 59. Pulmonary Edema
- 61. Kerley B line
- 62. VSD
- 63. ASD
- 64. Tetrology Of Fallot (Boot Shaped)
- 68. Free air Free air beneath diaphragm
- 70. Empyema after trauma Clavicle fracture Cavitary lesion Opacified hemithorax
- 71. Pneumonectomy
- 72. Pneumonectomy Entire mediastinum shifted left, indicating volume loss Opacified left hemithorax Trachea shifted left, indicating volume loss
- 75. Clavicle dislocation Medial clavicle is displaced inferiorly
- 77. LT. Rib fracture on the left are associated with a small pleural effusion blunting the costophrenic angle. Compare with normal RT. side.
- 78. FRONTAL LATERAL WHAT AND WHERE IS IT? Air stripe Coin in esophagus shows a wider diameter than possible in the trachea and is posterior to the tracheal air stripe on the lateral chest x-ray.
- 80. Smoke inhalation, chronic changes
- 82. Right Lower Lobe Pneumonia
- 83. Right side tension pneumothorax
- 84. Fracture of posterior rib #7
- 85. Right Side Pleural Effusion
Editor's Notes
- Two (2) projections are needed for most x-rays to locate structures in 3 planes (1)Right or Left , (2)Anterior or Posterior) or (3) Superior or Inferior.
- Note cardiac chambers that account for margins on the chest X-ray
- This exam shows barium contrast outlining the bronchial tree. This is an old exam not done now with CT imaging replacing it. It does demonstrate the anatomy of the hila which superimpose over the pulmonary arteries and veins. This is why anatomy here on the chest X-ray is difficult in this region.
- With heart failure edema builds up in lungs and edema along fissures allows them to be seen more easily on chest x-ray
- Pleural effusion developing on the left
- Air in the pleural space separates the visceral and parietal pleura. This limits effective ventilation of the lung.
- Here air has built up under pressure in the pleural space and collapsed the lung severely compromising ventilation. The pressure builds due to a ball valve type leak of air into the pleural space with air going into the space on each inspiration.
- Evolution of congestive heart failure and pulmonary edema. With Progressive Lt. Ventricular failure blood backs into the left atrium—then to the pulmonary veins (PULMONARY VENOUS HYPERTENSION) then to the pulmonary interstitium (INTERSTITIAL EDEMA) then to the alveoli (ALVEOLAR EDEMA)
- Multiple lesions in the chest are typical for metastatic disease since the pulmonary capillary bed is often the first site metastatic lesions appear as they spread and embolize the pulmonary capillaries and grow in the new location.
- Rib fracture on the left are associated with a small pleural effusion blunting the costophrenic angle. Compare with normal RT. side.
- Coin in esophagus shows a wider diameter than possible in the trachea and is posterior to the tracheal air stripe on the lateral chest x-ray.