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Lobar Collapse. Lung Anatomy. (1) aortic arch (2) pulmonary trunk (3) left atrial appendage (4) left ventricle (5) right atrium (6) superior vena cava (7 & 8) diaphragm (9) transverse fissure. Lung Anatomy. (1) oblique fissure (2) transverse fissure (3) retrocardiac space

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Presentation Transcript
lung anatomy
Lung Anatomy

(1) aortic arch

(2) pulmonary trunk

(3) left atrial appendage

(4) left ventricle

(5) right atrium

(6) superior vena cava

(7 & 8) diaphragm

(9) transverse fissure

lung anatomy3
Lung Anatomy

(1) oblique fissure

(2) transverse fissure

(3) retrocardiac space

(4) retrosternal space

silhouette sign
Silhouette Sign
  • If two soft tissue densities lie in apposition, then they will not be visible separately
  • If they are separated by air, the boundaries of both will be seen
uses of silhouette
Uses of Silhouette
  • Localisation without a lateral view
  • Loss of clarity of a structure suggests there is adjacent soft tissue shadowing even when the abnormality itself is not clearly visualised. This is particularly valuable in some cases of lobar collapse.
lobar collapse8
Lobar Collapse
  • Partial or complete loss of lung volume
  • Air resorption
  • Atelectasis
common causes of lobar collapse
Common causes of lobar collapse
  • Proximal stenosing bronchogenic carcinoma.
    • Middle aged or elderly, almost always smokers.
  • Asthma due to mucous plugging
    • Young adult or older child ,responds to physiotherapy.
  • Inhaled foreign body
    • Infants , such as a peanut.
  • Retention of secretions
    • Any age, frequent cause of post operative collapse.
  • Ventilation
    • Endotracheal tube is inserted too far, entering one main bronchus and occluding the other.
signs of lobar collapse
Signs of Lobar Collapse
  • Lobar
    • Shift of fissures
    • Crowding of vessels (increased opacity)
  • Extra lobar
    • Hemi diaphragm elevation
    • Mediastinal shift towards side of collapse
    • Hilar shift and distortion
    • Compensatory hyperinflation
    • Rib approximation
    • Shift of other structures e.g. granuloma
right upper lobe collapse
Right upper lobe collapse
  • Minor fissure pivots and bows
  • Right hilar elevation
  • May simulate mediastinal widening
  • Deviation of trachea
  • Both fissures concave superiorly
right lower lobe collapse
Right Lower lobe collapse
  • Posterior and medial collapse
  • Obliteration of the right hemi diaphragm
  • Heart border clearly seen
  • Transverse fissure pulled inferiorly
right middle lobe collapse
Right Middle Lobe Collapse
  • Right horizontal and oblique fissure move towards each other
  • often subtle
  • blur the normally sharp right-heart border (silhouette sign)
left lower lobe collapse
Left lower lobe collapse
  • Posterior and medial collapse
  • triangular opacity – sail sign
  • hemidiaphragm may be obscured
left upper lobe collapse
Left Upper Lobe Collapse
  • veil like opacity
  • aortic knuckle, left hilum, and left-heart border initially ill defined but may progress to become sharp
  • almost vertical oblique fissure
summary right
Summary Right
  • Right Upper lobe
  • Right middle lobe
  • Right Lower Lobe
summary left
Summary Left
  • Left upper lobe
  • Left lower lobe
ad