A : A irways- Initially check tracheal deviation, and then check for hilar adenopathy or enlargement. Save my name, email, and website in this browser for the next time I comment. Sign in Join. Sign in. Log into your account. Sign up. Password recovery.
Anemia: Understanding The Concepts. Goodman and Gilman Pharmacology Pdf Download. Friday, January 14, Forgot your password? Get help. Create an account. Contents hide. Atelectasis- collapse of lung. Consolidation- replacement of air. Pleural effusion-accumulation of fluid.
Read more- Auscultation of Lungs under Respiratory examination. Very helpful information……Good explanation…. Well done. We appreciate your response and will keep updating this Xray guide as much as we can.
Please enter your comment! Please enter your name here. You have entered an incorrect email address! Follow us on:. Editor's Pick. All Courses and Careers options April 2, Read our list of Emergency drugs used in Casualty wards. The list is made according to India with detailed drug class and uses. On the AP film, the chest has a different appearance.
The heart and mediastinal shadow are magnified because of anterior structures, mainly sternum. This view is taken mostly at the bedside as portable. Some patients are at semi-erect or supine position. Therefore, mediastinal structures are widened because of gravity. The pulmonary vasculature is altered when patients are examined in the supine position.
The size of the pulmonary vasculature is more homogeneous throughout the upper and the lower lobes. Figure-4 and 5. Supine views are less useful and should be reserved for critical patients who cannot stand erect position. You are able to see all vertebral bodies with obvious intervertebral spaces. The interpretation of a chest X-Ray should be approached systematically. You should also check the side marker, and the film position PA or AP. The trachea, carina and both main bronchi are called the upper airway and should all be visible on an AP view Figure Look for if there is any deviation of the trachea away from the midline.
Introduction of air into one side of the chest cavity will cause that side of the lung to collapse. The collapsed lung will push the trachea to the opposite side and resulting in a deviation that will show up on chest X-Ray.
Figure Airway structures on the chest X-Ray. A chest X-Ray provides a good view to look for ribs and clavicle fractures. Clavicular fractures are usually at the middle 3rd of the clavicle, which is easy to see in chest X-Rays. Rib fractures, however, can sometimes be hard to see. Each rib should be followed across its length to look for fracture lines or step-offs that could indicate a fracture.
Hyperinflated lungs are seen as the result of chronic obstructive pulmonary disease where the patient is unable to fully expel the air that is inhaled with every breath. Because of this, overinflation will result in a greater number of ribs that can be visible on the chest X-Rays.
Normally, ribs are expected to be seen on the chest X-Ray Figure Numbers: ribs, red dashed line and arrows: clavicle, yellow dashed line and arrows: medial border of scapula, green dashed line and arrows: 3rd rib, pink dashed line: vertebras. This part involves the heart and surrounding structures. The silhouette of the heart should be identified, and the heart borders should be clear.
The aortic arch and the left pulmonary artery should be visible as two semi-circles above the left atrium. The left hilar point is slightly higher than the right hilar point. The hilar point should be at the level of the lateral extent of the right 6th rib. The inferior vena cava lies end of the right cardiophrenic angle. The structures should be visible behind the heart especially the spine, paraspinal region and azygoesophageal line.
In ideal circumstances, mediastinum is maximum 6 cm in a PA chest x-ray, and further investigation is considered if it is more than 8 cm. Pink dashed lines and arrows: heart borders, Yellow dashed line and arrow: Aortic Arch, Blue circle, and arrow: Aortopulmonary Window. The outline of the diaphragm should be clear and smooth. Right hemidiaphragm should be higher than the left Figure It has 3 major characteristics that can be found on chest X-Ray:.
Yellow dashed lines and arrows: diaphragm, red arrow: gastric air bubble, pink dashed lines: costophrenic angles. Mostly this means as the lung parenchyma. Lung fields can be divided into zones: upper, middle, and lower zones Figure ;. So you should compare the lung parenchyma left to right in the upper, middle and lower zones and see whether there is a difference.
Look for equal radiolucency between the left and the right lungs zones. The horizontal fissure on the right divides the upper and middle lobes; from the hilum to the 6th rib at the axillary line. You should also check soft tissues outside the thorax for subcutaneous air, foreign body, bizarre density, etc.
You should check lung fields for infiltrates. Identify the location of infiltrates and identify the pattern of infiltration interstitial or alveolar pattern. Look for air bronchograms, nodules, Kerley B lines. Pay attention to the apices. You should also check for masses, consolidation, pneumothorax and vascular markings. Vessels should be almost invisible at the lung periphery.
Finally, you should evaluate the major and minor fissures for fluid collection Figure Please visit our Flickr channel to see various chest x-ray pathologies.
Skip to content by Ozlem Koksal Introduction Chest X-ray interpretation is one of the fundamental skills of every doctor. There are 3 types of chest films; AnteroPosterior AP PosteroAnterior PA Lateral The ideal timing can be defined as the end of inspiration , and the patient should hold his breath at that time.
Rotation : The clavicles should appear symmetrical and be seen as equal length.
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