Chest X-ray Interpretation胸部X射线解释.ppt

Chest X-rayInterpretation Bucky Boaz, ARNP-C Introduction Routinely obtained Pulmonary specialist consultation Inherent physical exam limitations Chest x-ray limitations Physical exam and chest x-ray provide compliment Essentials Before Getting Started Exposure Overexposure Underexposure Sex of Patient Male Female Essentials Before Getting Started Path of x-ray beam PA AP Patient Position Upright Supine Essentials Before Getting Started Breath Inspiration Expiration Systematic Approach Bony Framework Soft Tissues Lung Fields and Hila Diaphragm and Pleural Spaces Mediastinum and Heart Abdomen and Neck Systematic Approach Bony Fragments Ribs Sternum Spine Shoulder girdle Clavicles Systematic Approach Soft Tissues Breast shadows Supraclavicular areas Axillae Tissues along side of breasts Systematic Approach Lung Fields and Hila Hilum Pulmonary arteries Pulmonary veins Lungs Linear and fine nodular shadows of pulmonary vessels Blood vessels 40% obscured by other tissue Systematic Approach Diaphragm and Pleural Surfaces Diaphragm Dome-shaped Costophrenic angles Normal pleural is not visible Interlobar fissures Systematic Approach Mediastinum and Heart Heart size on PA Right side Inferior vena cava Right atrium Ascending aorta Superior vena cava Systematic Approach Mediastinum and Heart Left side Left ventricle Left atrium Pulmonary artery Aortic arch Subclavian artery and vein Systematic Approach Abdomen and Neck Abdomen Gastric bubble Air under diaphragm Neck Soft tissue mass Air bronchogram Summary of Density Air Water Bone Tissue Pitfalls to Chest X-ray Interpretation Poor inspiration Over or under penetration Rotation Forgetting the path of the x-ray beam Lung Anatomy Trachea Carina Right and Left Pulmonary Bronchi Secondary Bronchi Tertiary Bronchi Bronchioles Alveolar Duct Alveoli Lung Anatomy Right Lung Superior lobe Middle lobe Inferior lobe Left Lung Superior lobe Inferior lobe Lung Anatomy on Chest X-ray PA View: Extensive overlap Lower lobes extend high La