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LECTYRE OF THE CHEST X-RAY

LECTYRE OF THE CHEST X-RAY. A.WEISS M.D D.E.S , Chirurgie Générale, Viscérale et Laparoscopique A.F.S/A.F.S.A/DU - FRANCE. Aims. Basics . Best exam results . Appreciate the role radiology plays . Instil an interest in radiology. Contents. Densities Techniques Anatomy

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LECTYRE OF THE CHEST X-RAY

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  1. LECTYRE OF THE CHEST X-RAY A.WEISS M.D D.E.S ,Chirurgie Générale, Viscérale et Laparoscopique A.F.S/A.F.S.A/DU - FRANCE

  2. Aims • Basics . • Best exam results . • Appreciate the role radiology plays . • Instil an interest in radiology . A.K.WEISS M.D

  3. Contents • Densities • Techniques • Anatomy • CXR Interpretation • Common Pathologies • Questions A.K.WEISS M.D

  4. Densities • The big two densities are: • (1) WHITE - Bone • (2) BLACK - Air • The others are: • (3) DARK GREY- Fat • (4) GREY- Soft tissue/water • And if anything Man-made is on the film, it is: • (5) BRIGHT WHITE - Man-made A.K.WEISS M.D

  5. TECHNIQUEP-A ( relation of x-ray beam to patient ) A.K.WEISS M.D

  6. TECHNIQUELateral A.K.WEISS M.D

  7. TECHNIQUELateral Decubitus A.K.WEISS M.D

  8. I.D A.K.WEISS M.D

  9. ORIENTATION - ROTATION A.K.WEISS M.D

  10. PENETRATION LOW HIGH A.K.WEISS M.D

  11. INSPIRATION - EXPIRATION A.K.WEISS M.D

  12. ORGANS A.K.WEISS M.D

  13. LECTURE OF THE NORMAL CHEST X - RAY A.K.WEISS M.D

  14. ANATOMY A.K.WEISS M.D

  15. Lobes RIGHT UPPER LOBE

  16. Lobes RIGHT MIDDLE LOBE

  17. LOBES RIGHT LOWER LOBE

  18. Lobes LEFT LOWER LOBE

  19. LOBES LEFT UPPER LOBE WITH LINGULA

  20. LOBES LINGULA

  21. LOBES LEFT UPPER LOBE – UPPER DIVISION

  22. Heart - RIGHT BORDER : EDGE OF ( R ) ATRIUM - LEFT BORDER : ( L ) VENTRICLE + ATRIUM - POSTERIOR BORDER : REFT VENTRICLE - ANTERIOR BORDER : RIGHT VENTRICLE

  23. Heart

  24. Heart

  25. Heart A.K.WEISS M.D

  26. LECTURE OF THE NORMAL CHEST X - RAY • Superior vena cava • Inferior vena cava • Right atrium (blue) • Right ventricle (blue) • Left ventricle (red) • Aorta • Pulmonary trunk A.K.WEISS M.D

  27. Mediastinum

  28. Hilum Made of : Pulmonary Art.+Veins The Bronchi Left Hilus higher (max 1-2,5 cm) Identical : size, shape, density

  29. Hilum

  30. Ribs

  31. LECTURE OF THE NORMAL CHEST X - RAY A.K.WEISS M.D

  32. Lateral CXR

  33. Lateral CXR

  34. Lateral CXR

  35. LECTURE OF THE NORMAL CHEST X - RAY A.K.WEISS M.D

  36. LECTURE OF THE NORMAL CHEST X - RAY • Rib • Sternum • Breast • Position of oblique fissure • Position of horizontal fissure A.K.WEISS M.D

  37. LECTURE OF THE NORMAL CHEST X - RAY A.K.WEISS M.D

  38. LECTURE OF THE NORMAL CHEST X - RAY A.K.WEISS M.D

  39. NORMAL POSITION OR NOT ? A.K.WEISS M.D

  40. LECTURE OF THE NORMAL CHEST X - RAY A.K.WEISS M.D

  41. CXR Interpretation A.K.WEISS M.D

  42. Technical Details Type Orientation Rotation Penetration Inspiration - expiration

  43. Lungs Lungs Density Symmetry Lesions

  44. Heart SIZE

  45. Heart Size of heart Size of individual chambers of heart Size of pulmonary vessels Evidence of stents, clips, wires and valves Outline of aorta and IVC and SVC

  46. Mediastinum: Width Contour AP window HILA • Size • Location

  47. Review areas Apices Behind the heart CP angles Below the diaphragm Soft tissues ( breast, surgical emphysema) Ribs & clavicle Vertebrae

  48. Identify the lesion → localise the lesion → describe the lesion → give DDNever stop looking, carry on with your systematic approach!!

  49. Pathology A.K.WEISS M.D

  50. EMPHYSEMA A.K.WEISS M.D

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