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Respiratory System. RT 91 Chapter 3. Normal Two View CXR. Mediastinum. Anatomy – Heart, Hilar region, Thyroid &Thymus glands, Nervous & Lymphatic tissues. Inspiration vs. Expiration. Elevated diaphram. Elevated diaphram. What do you think? Dexatracardia.

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respiratory system

Respiratory System

RT 91

Chapter 3

  • Anatomy – Heart, Hilar region, Thyroid &Thymus glands, Nervous & Lymphatic tissues.
  • Correct exposure factors selection is critical
  • Radiologists rely heavily on consistent exposure factors for serial portable radiographs
    • Recording technique selection
  • For CXR maintaining kVp and changing the mAs is the general rule
  • AEC
    • A complete patient hx is very important
  • CR/DR
    • High kVp
technique considerations
Technique Considerations
  • Pathology
    • Overlapping Structures
  • Prior Examinations
  • Lungs/Bony Structures/Line Placement
chest positioning
PA/Lt Lat


72 inches

Upright or Supine

AP or PA Decubitus

Oblique Projections

Lordotic Projections

Chest Positioning
cystic fibrosis
Cystic Fibrosis
  • An accumulation of excessively thick mucous and abnormal secretion of sweat and saliva
hyaline membrane disease
Hyaline Membrane Disease
  • RDS – Respiratory distress syndrome
    • Leading cause of infant death
    • Premature birth before 26 weeks
    • “ground glass” look on the radiograph
sail sign

Sail Sign

Enlarged thymus in an infant

Sail-like appearance

hiatal hernia

Hiatal Hernia

Any structure through the hiatus of the diaphram

  • Soft tissue neck
  • Croup is a syndrome that is produced by an acute infection of the lower air passages and is usually seen in children below age of 3
  • Bark like cough
  • Thumb sign
  • Enlarged heart
  • PA chest – Distance?
  • Collapse of all or part of the lung due to obstruction of bronchus
    • Lung compression/consolidation
    • Air, fluid, tumors, enlarged lymph nodes, ET tube below carina
  • caused by the obstructive effects of carcinoma of the bronchus supplying the upper lobe of the right lung.
pleural effusion
Pleural Effusion
  • Fluid within pleural space
  • Response to inflammation
    • Infection, Trauma
  • Acute infection of lung parenchyma
  • Impairs air exchange
  • Collapse of lung, air in the chest cavity
    • Change in interthoracic pressure
  • Radiographical importance
    • Order: 2V CXR Diag: Post BX/Pneumo
pulmonary embolism infarction
Pulmonary Embolism/Infarction
  • Acute onset of chest pain
lung abscess empyema
Lung Abscess/Empyema
  • Pus formed in a cavity
  • Disintegration of tissue
  • A group of disorders that cause chronic airway obstruction.
  • Chronic, inflammation process involving the lungs
  • Ex: Chronic bronchitis, emphysema, asthma & bronchiectasis.
pulmonary emphysema
pulmonary emphysema
  • Blunting of the costophrenic angles.
  • Barrel chest
  • Trapped air
lung cancer
Lung Cancer
  • Bronchogenic Carcinoma is the most common fatal primary malignancy in the United States.
  • Pulmonary metastases are much more common than primary lung neoplasm.
  • Lymphoma
  • Anatomy – Heart, Hilar region, Thyroid &Thymus glands, Nervous & Lymphatic tissues.
pulmonary metastases
Pulmonary metastases
  • uterine cancer
  • “cotton ball” appearance