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How to read X’Ray chest

Dr. S. Parthasarathy MD., DA., DNB, MD ( Acu ), Dip. Diab . DCA, Dip. Software statistics Ph d (physiology) Mahatma Gandhi medical college and research institute , puducherry – India . How to read X’Ray chest. Preliminary check up . Is it the right patient ?

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How to read X’Ray chest

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  1. Dr. S. Parthasarathy MD., DA., DNB, MD (Acu), Dip. Diab. DCA, Dip. Software statistics Ph d (physiology) Mahatma Gandhi medical college and research institute , puducherry – India How to readX’Raychest

  2. Preliminary check up • Is it the right patient ? • Is it the right position ? • Overall patient ? Gopal or ramu

  3. XRay interprétation

  4. Rotation • Medial end of the clavicle – equidistantfromvertebra – • closerlungappearswhiter Clavicle Clavicle vertebra

  5. Left rotation

  6. Exposure • Check at the lower part of the cardiacshadow • Spinesjust visible – normal • Cleardemarcation of spines – overpenetration • Spines not visible – underpenetration

  7. Over and under penetration

  8. Or demarcation at T4

  9. Apex missed

  10. Rt CP angle ??

  11. Inspiration • 6th rib anterior • 9th rib posterior • If no – • Heart larger • Basal shadows • Trachea to right

  12. Things to see • Soft tissue • Bones • Mediastinum • Angles • Heart and vessels • Lungs • Go methodical

  13. Soft tissue Emphysema

  14. bones - Scapula

  15. Bones – ribs

  16. Scoliosis

  17. Costophrenic angles • Rt diaphragm lower • 1 inch • Highest point – rt – middle of the lung field • Lt – slightly lateral • Smooth contour

  18. CP angles which is low and why?

  19. Mediastinum- fuzziness Aorta Pulm. art LA LV

  20. CT ratio 50 %

  21. Prominent aortic knuckle

  22. Pulmonary hypertension

  23. Left atrial and LV enlargement

  24. SVC and rt atrium enlarged

  25. Where is the trachea ?

  26. MEDIASTINUM

  27. Lung parenchyma • Rotation • Exposure • Soft tissue • Bones • Mediastinum • Trachea • Angles

  28. Pneumonia

  29. Pneumothorax - markings ??

  30. Collapse • Upper zone- from 2nd costal cartilage to axilla • Middle zone- between 2nd and 4th costal cartilage. • Lower zone- below 4th costal cartilage

  31. Active PT ?

  32. Silicosis

  33. Perforation

  34. Emphysema

  35. Pneumonectomy

  36. Some life lines can be assessed • Central line • Tracheostomy • Nasogastric tube • ET tube

  37. Tracheal tube position

  38. Central lines

  39. Nasogastric tube

  40. Pacing wires

  41. Reading an X-ray

  42. How to read

  43. Rt sided chest pain and cough

  44. Cough fever

  45. Two X rays

  46. Students turn

  47. Post op laparotomy

  48. Silhoute sign ??

  49. What is it??

  50. Smoker for years dry cough wheezing

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