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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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