• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content

Loading…

Flash Player 9 (or above) is needed to view presentations.
We have detected that you do not have it on your computer. To install it, go here.

Like this document? Why not share!

Microsoft PowerPoint - a.Thoracic_Anatomy_05

on

  • 1,317 views

 

Statistics

Views

Total Views
1,317
Views on SlideShare
1,317
Embed Views
0

Actions

Likes
1
Downloads
39
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Microsoft PowerPoint - a.Thoracic_Anatomy_05 Microsoft PowerPoint - a.Thoracic_Anatomy_05 Document Transcript

    • CVM 6101 ???? Radiographic Anatomy of the Thorax Daniel A. Feeney DVM, MS Professor of Veterinary Radiology College of Veterinary Medicine University of Minnesota UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical Center CVM 6101 [Imaging Anatomy] CVM 6101 [Imaging Anatomy]• Goals & Expectations: • Approach: – Identify specific structures or parts thereof – Introductory lectures defining the important structures – Understand why the views (projections) look as they do and how they are viewed radiographically – Keep in mind that the items listed in the “to know” lists – Open session, instructor proctored group laboratory are from the perspective of practicing radiologists exercises wherein actual radiographs of the anatomic – If asked, be able to describe what soft-tissue (muscle, structures are viewed and understood tendon, ligament, vessel, or alimentary/parenchymal) – Web-based self-study sets both available on CD and structure(s) attach to, pass through, or lie in contact from the web site http://www.academic- with a given anatomic landmark or region server.cvm.umn.edu/radiology// UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical Center Normal Thoracic Architecture CVM 6101 [Imaging Anatomy] [lateral perspective]• Sources of Information: – Anatomy Textbooks – Radiographic Anatomy Textbooks – General Veterinary Imaging Textbooks – U-MN Medical Imaging web site http://www.academic- server.cvm.umn.edu/radiology// UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical Center
    • Normal Lateral View: Normal Ventrodorsal View: inspiration/expiration inspiration/expiration Normal Cat Normal “FAT” Cat KEYMediastinal Lymph Nodes [for dorsal perspectives] UNIVERSITY OF MINNESOTA Veterinary Medical Center
    • Normal Thoracic Architecture Normal Thoracic Architecture [dorsal perspective (high)] [dorsal perspective (mid)] UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical Center Normal Thoracic Architecture [dorsal perspective (low)] Interpretive Background: THORAX • Pleural space: “potential” space between the visceral pleura (directly surrounding the lungs) and the parietal pleura (lining the thoracic cavity and reflecting over the mediastinum) [not normally visible] • Mediastinal space: “potential” space between the right and left mediastinal (parietal) pleural reflection [not normally visible] • Pericardial sac: sac that directly surrounds the heart [not normally visible] UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical CenterInterpretive Background: THORAX Interpretive Background: THORAX• Pleural space: contains NOTHING• Mediastinal space: contains EVERYTHING except the lungs and the caudal vena cava with • Mediastinal Space its accompanying right phrenic nerve• Pericardial sac: contains only the heart UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical Center
    • Normal Dog Lateral View Normal Dog VD ViewCross-section of Thorax @ Heart Thymic “Sail” Sign (VD) Anterior Mediastinal Mass Interpretive Background: THORAX • Pleural Space UNIVERSITY OF MINNESOTA Veterinary Medical Center
    • Cross-section of Thorax @ Heart Normal Dog Thorax (solid lines are pleura) Concept of Fluid/Air Shift Concept of Fluid/Air Shift [DV]: Air/Fluid [VD]: Air/FluidDiagnostic Pleurogram Pleural Disease Classification (From Bhargava)
    • Pleural Fluid Interpretive Background: THORAX • Pericardial Sac UNIVERSITY OF MINNESOTA Veterinary Medical Center Cross-section of Thorax @ HeartNormal Dog Thorax (dotted lines are pericardial sac) Pericardial Effusion CVM 6101 [Imaging Anatomy] • Diaphragm: Broad Anatomic Regions – R and L crura – Cupola (dome) UNIVERSITY OF MINNESOTA Veterinary Medical Center
    • Diaphragmatic Anatomy CVM 6101 [Imaging Anatomy] Diagram [From Grandage] • Diaphragm: – V D/D V and R L/L R views – Beware of superimposed structures including vertebrae, ribs, sternebrae, lungs, stomach, nipples, fascial planes, trachea, etc. – Remember, the diaphragm is a sling-like muscle that “actively” contracts (caudally) and “passively” relaxes (cranially) [numerous influences such as lungs, abdominal fat, etc.] UNIVERSITY OF MINNESOTA Veterinary Medical Center Diaphragm Appearance: CVM 6101 [Imaging Anatomy] VD vs. DV (From Grandage)• Diaphragm: – Appearance changes depending on DV vs. VD views (with the X-ray beam is centered on the heart): • On DV views, the diaphragm usually has one broad dome which corresponds to the cupola • On VD views, the diaphragm usually has “3 humps” corresponding to the two crura and the central cupola • Appearance related to beam divergence and diaphragm orientation relative to the diverging beam UNIVERSITY OF MINNESOTA Veterinary Medical Center Diaphragm Appearance: CVM 6101 [Imaging Anatomy] Right vs. Left Lateral (From Grandage)• Diaphragm: – Appearance changes depending on R vs. L recumbent lateral views (with the X-ray beam is centered on the heart): • On R lateral views, the diaphragmatic crura are usually parallel with the R crus more cranial and blending with the caudal vena cava • On L lateral views, the diaphragmatic crura usually cross with the L crus being more cranial, but the R crus still blends with the caudal vena cava • Appearance related to right crus being more cranial, but the down-side crus is forced forward by visceral weight UNIVERSITY OF MINNESOTA Veterinary Medical Center
    • Normal Dog ThoraxNormal Dog Thorax Right/Left lateralNormal Dog Thorax Diaphgram: paralysis VD/DV Extrapleural Lesion Interpretive Background: THORAX(diaphragmatic hernia) • Thoracic Wall UNIVERSITY OF MINNESOTA Veterinary Medical Center
    • Pleural Disease Classification Normal Dog Thorax Thoracic Wall: flail chest Interpretive Background: THORAX • Airways UNIVERSITY OF MINNESOTA Veterinary Medical CenterInterpretive Background: THORAX Pharyngeal Collapse: Diagram• Upper Airways (extrapulmonary): nasal passages, pharynx. larynx• Lower Airways (extrapulmonary): extrathoracic trachea intrathoracic trachea proximal mainstem bronchi• Intrapulmonary Airways: distal mainstem bronchi bronchioles [airways distal to 3rd order bronchi not normally visible] UNIVERSITY OF MINNESOTA Veterinary Medical Center
    • Normal Larynx/Pharynx Normal Dog Lateral ViewDiagram: Airway Subdivisions Extrathoracic Tracheal Collapse: Expiration/Inspiration [dog & cat]Interpretive Background: THORAX Interpretive Background: THORAX • Left Lobes (radiologist’s functional perspective): cranial portion of left cranial (left cranial) caudal portion of left cranial (left middle) • Lungs left caudal (left caudal) • Right Lobes: right cranial right middle right caudal accessory UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical Center
    • Lung Diagram [lateral view] Lung Diagram [VD view] Alveolar Disease: pneumonia Interpretive Background: THORAX • Heart and Vessels UNIVERSITY OF MINNESOTA Veterinary Medical CenterInterpretive Background: THORAX Heart Diagram [lateral view] Cardiac Perspective Lateral Thoracic View• Thoracic Circulatory Pattern: cranial/caudal* vena cava Aorta right atrium* tricuspid valve right ventricle* pulmomary trunk* Trachea lobar pulmonary arteries* 12:00 Caudal Cardiac Waist: Lt. Atrium lobar pulmonary veins* Cranial Cardiac Waist: Caudal Vena Cava left atrium* mitral value Aorta, Rt. Atrium, Pulmonary Trunk 3:00 9:00 HEART left ventricle* aorta*• * sufficiently visible to be survey Right Ventricle radiographically useful 6:00 Left Ventricle UNIVERSITY OF MINNESOTA Veterinary Medical Center
    • Normal Dog Lateral View Heart Diagram [VD view] Cardiac Perspective Ventrodorsal Thoracic View Aorta (hidden in mediastinum) Main Pulmonary Trunk 12:00 Right Atrium Left Auricle R 9:00 HEART 3:00 L Right Ventricle Left Ventricle 6:00 Normal Non-selective Normal Dog VD View Angiocardiogram (dog)Normal Cranial Vena Cavogram Normal Caudal Vena Cavogram (dog) (dog)
    • Pulmonic Stenosis Pulmonic StenosisInterpretive Background: THORAX Lung Vessel Diagram [lateral view]• Intrapulmonary Circulatory Pattern: Lobar Pulmonary Vessels (left lateral view) – ARTERY/BRONCHUS/VEIN TRIAD (one in each major lung lobe) – USED AS INDIRECT INDICATOR OF LEFT HEART FUNCTION (vein) and pulmonary flow resistance (artery)• lobar pulmonary arteries – Dorsal to veins on lateral views artery – Lateral to veins on VD/DV Views• lobar pulmonary veins bronchus – Ventral to veins on lateral views – Medial to veins on VD/DV Views vein UNIVERSITY OF MINNESOTA Veterinary Medical Center Pulmonary Hypertension Pulmonary Hypertension [heartworm disease] [canine heartworm disease]
    • Pulmonary Venous Congestion Pulmonary Venous Congestion [early congestive LEFT heart failure] [early congestive LEFT heart failure] Specific References: THORAX General References: THORAX• Grandage J: Posture, gravity and radiographic • Thrall DE (ed): Textbood of Veterinary interpretation. J Am Vet Radiol Soc 22:80, Diagnostic Radiology. WB Saunders, 1979. Philadelphia, 2002.• Grandage J: Radiology of the dog’s diaphragm. J Small Anim Pract 15:1, 1974. • Burk RL, Feeney DA: Small Animal Radiology and Ultrasonography.• Bhargava AK, Rudy JL, Diesem CD: Radiographic anatomy of the pleura in dogs as Saunders/Elsevier, Philadelphia, 2003 visualized by contrast pleurography. J Am Vet Radiol Soc 10:61, 1969. UNIVERSITY OF MINNESOTA UNIVERSITY OF MINNESOTA Veterinary Medical Center Veterinary Medical Center And you think this is tough??? UNIVERSITY OF MINNESOTA Veterinary Medical Center