Some presentaion regarding Pulmonology

3. •P-A (relation of x-ray beam to patient)

4. •A-P Supine/Erect

5. •Lateral

6. • Decubitus position

7. THE BIG TWO DENSITIES ARE:
WHITE - Bone
BLACK - Air
THE OTHERS ARE:
DARK GREY- Fat
GREY- Soft tissue/water
And if anything Man-made is on the film, it is:
BRIGHT WHITE - Man-made

9. A well centred x-ray. Medial ends of clavicles are equidistant from
the spinous process.

11. On a high quality radiograph, the vertebral bodies should just
be visible through the heart.

12. •If six complete anterior or ten posterior ribs are visible then the
patient has taken an adequate inspiratory effort.
•Conversely, fewer than six anterior ribs implies a poor inspiratory
effort and more than six anterior ribs implies hyper-expanded lungs.

18. Each of these
zones occupies
approximately
one third of the
height of the
lungs.

19. • Right upper lobe:

20. • Right middle lobe:

21. • Right lower lobe:

22. • Left lower lobe:

23. • Left upper lobe with Lingula:

24. • Lingula:

25. • Left upper lobe - upper division:

26. • Layers:

27. •Peripheral
•Sharp inner
Extrapleural sign
•Indistinct outer
•Concave angles

28. Right border: Edge of (Rt)
Atrium
Left border: (Lt) Ventricle +
Atrium
Posterior border: Lt
Ventricle
Anterior border: Rt Ventricle

37. The main regions where a chest X-ray may identify problems may be
summarized as ABCDEF by their first letters:
• Airways, including hilar adenopathy or enlargement
• Bones, e.g. rib fractures and lytic bone lesions
• Cardiac silhoutte, detecting cardiac enlargement
• Costophrenic angles, including pleural effusions
• Diaphragm, e.g. evidence of free air, indicative of perforation of an
abdominal viscus
• Edges, e.g. apices for fibrosis, pneumothorax, pleural thickening or
plaques
• Extrathoracic tissues
• Fields (lung parenchyma), being evidence of alveolar filling
• Failure, e.g. alveolar air space disease with prominent vascularity
with or without pleural effusions

40. RUL opacity /Consolidation

41. RLL opacity/ consolidation

42. LLL Opacity

43. Air
bronchograms
Lt lung upper + mid zone opacity

44. Consolidation on CT

45. Causes:
1. Vascular
2. Primary Tumor
3. Sarcoidosis
4. Adenopathies (neoplasia, infection)

46. difference between a lung
“nodule” and a lung
“mass” is that of size.
Traditionally, nodules are
soft tissue lesions in the
lung that are smaller
than 3cm, while masses
are lesions that are 3 cm
or greater.
Multiple nodules / Mets

47. Miliary shadowing

48. B/L Hilar Lymphadenopathy

49. Mass Lt mid zone

51.  Bilateral & symmetrical
hilar & mediastinal LAD
 Generalized fibrosis

52. Cavitating lesion

53. A. Generalized interstitial thickening = linear
(“reticular”).
B. Discrete interstitial thickening = nodules.
C. Interstitial & alveolar filling = silhouette.

56. Alveolar-filling, or “airspace” disease:
“Pointillist” patterns.
Air bronchograms.

62. Pleural Effusion

63. Pulmonary oedema

64. Pulmonary Fibrosis

66. A Tension Bulla Mimicking Tension Pneumothorax

68. Emphysema

69.  No ventilation to lobe
beyond the obstruction
 Trapped air absorbed by
pulmonary circulation
 Segmental/lobar density
 Compensatory hyper-
inflation of normal lungs.

70. Air under the diaphragm

72. Hiatus hernia

73. Cervical Rib

74. Dextrocardia