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Normal ChestX Ray

Ina Edwina

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Basic anatomy

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Lobes

Segmen

Lobules

Acinus

Alveoli

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Right Left

Upper Lobe

Middle Lobe

Lower Lobe

Apical

Anterior

Posterior

Lateral

Medial

Superior Lingula

Inferior Lingula

Upper Lobe

Lingula

Anterior

Apicoposterior

Apical

Anterior

Posterior

Medial

Lateral

Lower Lobe

Apicobasal

Anterobasal

Posterobasal

Lateral

Lungs

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Radiographic anatomy

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AscendenAorta

Aortic Knob Left Pulmonary

Artery + LeftAtrium Auricle Heart waist

DescendenAorta

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CTR

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L

Lung zonesApex

Upper

MiddleLower

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Indications of CXR Screening

Cough > 2 weeks

Haemoptoe Fever

Dyspnea

Chest pain

Trauma Metastases

Symptoms of Lung TB/Malignancy

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Before reading CXR

1. Identity

2. Marker (R/L)3. Exposure dose (kV, mAs)

4. Position (PA/AP/Lateral/Oblique)

5. Film qualities (asymmetric, shaken,

inspiration/expiration)

6. Artifacts

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IDR

kV V Th. 3

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PA or AP ?

1

2

PA AP

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Maximuminspiration

1

2

3

4

5

6

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Retrosternal space

Retrocardial space

Anterior sinus

Posteriorsinus

Trachea

R

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PA view1.

Position? enoughinspiration?

2. Soft tissue

3. Skeletal

4. Trachea (deviation?)

5. Sinuses andDiaphragms

6. Mediastinum Heart (position, size,

configuration) Great vessels

7. Lungs Hila Vascular patterns Lung apices, pleural

line and fissures

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Lateral view

Anterior andposterior sinuses

Retro sternaland retrocardiac spaces

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Thank You

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Radiographic anatomy Trachea (midline) Carina level at V. Thoracic 5-

6

Heart Position Size PA view 50%, AP view

55% Configuration (apex, aortic

knob, pulmonary trunk, auricleof left atrial, right atrial, SVC)

Diaphragms Right diaphragm level at V.

thoracic 6-7 Left diaphragm level at V.

thoracic 7-8 Right is higher than left (2,5 cm)

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Radiographic anatomy Right hilum: formed by the right main

bronchus and right

pulmonary artery, lobardivisions

Between the diaphragmand lung apex

V. thoracic 5-6 Content: artery, vein,

bronchus, lymph

Left hilum: V. thoracic 4-5 Content: artery, vein,

bronchus, lymph

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Radiographic anatomy Lungs Vascular pattern

Lung apices Lung contours:

cardiac borders,mediastinal margin

Normal pleural lineand fissures are notvisible

Normal minor fissures

PA: level at V Th. 5/Anterior ribs 4th

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Pulmonary Vascular Patterns

Normal: Right

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Radiographic anatomy Skeletal Clavicles, Scapulae,

Costae, Vertebrae

Fractures Scoliosis Osteoporosis Lytic/blast lesions

metastases/malignancy

Soft Tissues Mass Subcutaneous

Emphysema

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