*Cardiothoracic anatomy
*CT anatomy
*Overview mediastinum
Layer Zone 1 (T1 – T4) Zone 2 (T5 – T8)
Zone 3 (T9 – T12)
1 – Posterior channels
Only thoracic duct •Thoracic duct •Azygos vein •Descending thoracic aorta
•Thoracic duct •Azygos vein •Descending thoracic aorta
2 – Tubular viscera
Trachea Oesophagus
Oesophagus Main bronchi
Oesophagus
3 – Heart and arteries
•Arch of the aorta•3 main branches off aortic arch
•Ascending aorta•Pulmonary trunk
•Heart
4 – Veins •Brachiocephalic veins
•SVC Heart (no actual veins)
5 – Anterior mediastinal structures and fat
•Thymus •Anterior mediastinal fat
•Anterior mediastinal fat •?Thymus
Anterior mediastinal fat
* Superior mediastinum
* Superior mediastinum
* Superior mediastinum
* Superior mediastinum
* Superior mediastinum
* Middle zone
* Middle zone
* Middle zone
* Middle zone
* Middle zone
* Middle zone
* Middle zone
* Lower zone
* Lower zone
* Lower zone
* Lower zone
* Lower zone
* Lower zone
*Approach to Chest CT
*5 point checklist
*Mediastinum *Lungs *Pleura *MSK *Chest wall
*Checklist of pathologies to check
Trauma Chest pain / SOB Neoplasm
Mediastinum • Vascular injury • Oesophageal injury • Injury to Bronchus• Pneumomediastinum • Tracheal deviation• Pericardial fluids
• Cardiomegaly • Pulmonary embolus • Aortic dissection• Tracheal deviation
• Lymph nodes • Mediastinal nodes• Pericardial effusions
Lungs • Pulmonary contusions • Pulmonary consolidation
• Pulmonary collapse• Pulmonary mass• Hilar shadowing
• Pulmonary mass – Primary, secondary
Pleura • Pneumothorax • Haemothorax
• Pneumothorax • Pleural effusions
• Pleural effusions
MSK • Fracture – Sternum, Ribs, Vertebrae
• Rib fractures • Kyphoscoliosis
• Bone mets
Chest wall • Haematoma • NA • Previous evidence mastectomy
• Axillary lymphadenopathy