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The Chest X-Ray

The Chest X-Ray. Dr Mohamed El Safwany, MD. Intended learning outcome. The student should learn at the end of this lecture Clinical aspects of Chest X ray. Aims:. Basics Best exam results Appreciate the role radiology plays. Contents:. Densities Techniques Anatomy CXR Interpretation

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The Chest X-Ray

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  1. The Chest X-Ray Dr Mohamed El Safwany, MD.

  2. Intended learning outcome The student should learn at the end of this lecture Clinical aspects of Chest X ray .

  3. Aims: Basics Best exam results Appreciate the role radiology plays

  4. Contents: Densities Techniques Anatomy CXR Interpretation Common Pathologies Questions

  5. 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

  6. Techniques - Projection P-A (relation of x-ray beam to patient)

  7. Techniques - Projection (continued) A-P Supine/Erect

  8. Techniques - Projection (continued) Lateral

  9. Techniques - Projection (continued) Decubitus

  10. Techniques - Projection (continued) Oblique

  11. Rotation

  12. Rotation (continued)

  13. Penetration

  14. Inspiration/Expiration

  15. Anatomy

  16. Anatomy

  17. Lobes Right upper lobe:

  18. Lobes (continued) Right middle lobe:

  19. Lobes (continued) Right lower lobe:

  20. Lobes (continued) Left lower lobe:

  21. Lobes (continued) Left upper lobe with Lingula:

  22. Lobes (continued) Lingula:

  23. Lobes (continued) Left upper lobe - upper division:

  24. Pleura Parietal , visceral Layers:

  25. Heart Right border: Edge of (r) Atrium 3. Left border: (l) Ventricle + Atrium 4. Posterior border: Reft Ventricle 5. Anterior border: Right Ventricle

  26. Heart (continued)

  27. Heart (continued)

  28. Heart (continued) Valves

  29. Mediastinum

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

  31. Hilum

  32. Ribs

  33. Lateral CXR (continued)

  34. Lateral CXR (continued)

  35. Lateral CXR (continued)

  36. Lateral CXR (continued)

  37. CXR Interpretation

  38. Technical Details Rotation Inspiration/expiration Penetration

  39. Lungs: Lungs Density Symmetry Lesions

  40. Heart Size:

  41. 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

  42. Mediastinum: Width Contour AP window Hila: • Size • Location

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

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

  45. Pathology

  46. RUL pneumonia

  47. RML pneumonia

  48. RLL pneumonia

  49. LUL pneumonia

  50. LLL pneumonia

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