The document provides information on how to interpret a chest x-ray, including: - The chest x-ray allows visualization of the heart, lungs, airways, blood vessels and chest bones. - Different tissues show up differently on x-rays due to their absorption of the x-rays. - When interpreting a chest x-ray, one should check for positioning, evaluate the lungs and heart size, examine bones and soft tissues, and look for any abnormalities. - Key aspects include assessing lung opacities, fractures, the diaphragm, and using the x-ray to help diagnose various chest pathologies.

1. PRESENTED BY:

2. The chest x-ray is the most commonly
performed diagnostic x-ray examination.A
chest x-ray makes images of the heart, lungs,
airways, blood vessels and the bones of the
spine and chest.
X-rays are the oldest and most frequently
used form of medical imaging.

3. STANDARDVIEWS
 Erect PA
 LATERAL
INDICATIONS:
 For fit and able bodied
persons
 To diagnose any pathology
 To visualize pleural effusion
 To localize opacity

4. VIEWS:
 Supine AP
 Lateral decubitus view
 Expiratory view
 Penetrated PA view
INDICATIONS:
 For ill patients and those
with multiple injuries
 To visualize small effusion
 To visualize pneumothorax
 Useful for cardiac chamber
visualization and left lower
lobe visualization

5.  When you shine a beam of x-ray at a person and put a
film on other side a shadow is produced of the inside
of their body
 Different tissues in our body absorb x-ray at different
extent:
 Bone-high absorption(white)
 Tissue-Somewhere in middle absorption(grey)
 Air-low absorption(black)

6.  Chest x-ray should
include entire
thoracic cage.
 First rib
 Clavicle
 Lateral edges of
ribs
 Costophrenic
angles

7.  Chest x-ray should not be taken with patient
rotated
 Spinous process of thoracic vertebrae should lie
in the midline.
 They should form a vertical line that lies
equidistant from the medial ends of the clavicles
 EFFECTS OF ROTATION ON RADIOGRAPH:
 Become difficult to comment accurately on
heart size.
 Changes in lung density due to asymmetry of
overlying lung tissue

8.  RIGHT LUNG:
 3 LOBES
 Superior
 Middle
 Inferior
 LEFT LUNG:
 2 LOBES:
 Superior lobe
 Lingula
 Superior
 Inferior
 Inferior lobe

9.  The bronchopulmonary segments are the
anatomic, functional, and surgical units of the
lungs
 It has a segmental bronchus, a segmental artery,
lymph vessels, and autonomic nerves
 The segmental vein lies in the connective tissue
between adjacent bronchopulmonary segments
 Because it is a structural unit, a diseased
segment can be removed surgically

10. RUL
RML
LUL
LLL
RLL

16.  On chest x-ray we
consider zones of lungs.
 UPPER ZONE:
 Is present up to 2nd
intercostal space
approximately
 MIDDLE ZONE:
 From 2nd intercostal
space-5th intercostal
space
 LOWER ZONE:
 From 5th intercostals
space to onward

18.  Cardiac size is assessed
as cardiothoracic
ratio(CTR)
 CTR is the transverse
cardiac diameter divided
by the transverse chest
diameter
 NORMAL CTR:
 IN ADULTS:
 Approximately 50 %
 IN NEONATES:
 Approximately 65%

21.  Bones on chest x-ray
involved are:
 Clavicle
 Ribs
 spinous process
 Scapula
 Little part of humerus
IMP POINT:
 Check for any fracture any
lesion or any abnormality

24. sternum
Rt
ventricle
Lft atrium
Lft ventricle
Trachea
Vertebral bod
right
hemidiaphragm
ribs
ANATOMY AND HOWTO ACCESSS

25.  Check patient detail
 Check orientation, position
 Check quality of film
 NOW EITHER START FROM OUTSIDETO INSIDE
OR INSIDETO OUTSIDE:
 Ensure trachea is visible in midline
 Check for widened mediastinum
 Check heart size and borders
 Check aorta
 Check diaphragms
 Check lung fields
 Check bones and soft tissue

26.  Lobar consolidation:
 Alveolar space filled with
inflammatory exudate
 Interstitium and architecture
remain intact
 The airway is patent
 Radiologically:
 A density corresponding to a segment
or lobe
 Airbronchogram, and
 No significant loss of lung volume

27.  Loss of air
 Obstructive atelectasis:
 No ventilation to the lobe
beyond obstruction
 Radiologically:
 Density corresponding to a
segment or lobe
 Significant loss of volume
 Compensatory hyperinflation
of normal lungs

28.  Identification of abnormal shadows
 2. Localization of lesion
 3. Identification of pathological process
 4. Identification of etiology
 5. Confirmation of clinical suspension
 Complex problems
 Introduction of contrast medium
 CT chest
 MRI scan

29. THANKYOU

30.  Look at the diaphram:
for tenting
free air
abnormal elevation
 Margins should be
sharp
(the right hemidiaphram is
usually slightly higher than
the left)