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The Chest X-Ray

The Chest X-Ray. For: Nottingham SCRUBS 26 th August 2006 Presented by: Matthew. Objectives:. Basic Radiology 101 Film Interpretation Appreciate the role radiology plays Artifacts in X-Rays. Contents:. Densities Techniques Anatomy CXR Interpretation Common Pathologies Questions.

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The Chest X-Ray

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

  2. Objectives: Basic Radiology 101 Film Interpretation Appreciate the role radiology plays Artifacts in X-Rays

  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 Orientation

  11. Rotation

  12. Rotation (continued)

  13. Penetration

  14. Inspiration/Expiration

  15. Anatomy

  16. Anatomy

  17. Anatomy

  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. Heart (continued)

  29. Heart (continued) 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. Lateral CXR (continued)

  38. Lateral CXR (continued)

  39. Lateral CXR (continued)

  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 DDNever stop looking, carry on with your systematic approach!!

  48. Pathology

  49. RUL pneumonia

  50. RML pneumonia

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