This Presentation is basically image collection from chapter 9 of GRAINGER & ALLISON’S DIAGNOSTIC RADIOLOGY.
This is an effort to present the most authentic images.
Learn Chest X-Ray With Its Normal Positioning & Radio-AnatomyDr.Santosh Atreya
Learn Chest X-Ray With Its Normal Positioning & Radio-Anatomy..For some image description please go through the text book "David Sutton" because i have described these image during my presentation Verbally..There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
Learn Chest X-Ray With Its Normal Positioning & Radio-AnatomyDr.Santosh Atreya
Learn Chest X-Ray With Its Normal Positioning & Radio-Anatomy..For some image description please go through the text book "David Sutton" because i have described these image during my presentation Verbally..There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
Radiology Spotters mixed Bag Collection for post graduates student .PPTDr pradeep Kumar
Radiology Spotters collection by Dr Pradeep. nice collection of radiology spotter made by or collected by Dr. Pradeep, this is a collection of confusing spotter and very important spotter commonly asked in exams, our references is radiopaedia, learning radiology and Aunt Minnie.. Thanks.
The Chest Wall, Pleura,Diaphragm and Intervention 10 Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
This Presentation is basically image collection from chapter 10 of GRAINGER & ALLISON’S DIAGNOSTIC RADIOLOGY.
This is an effort to present the most authentic images.
Dr.Héctor Domínguez Hernández
Residente Imagenología
Platica básica acerca de las estructuras que conforman la silueta cardíaca, mediciones básicas en la placa simple, incluye también mediastina e hilios pulmonares.
Radiology Spotters mixed Bag Collection for post graduates student .PPTDr pradeep Kumar
Radiology Spotters collection by Dr Pradeep. nice collection of radiology spotter made by or collected by Dr. Pradeep, this is a collection of confusing spotter and very important spotter commonly asked in exams, our references is radiopaedia, learning radiology and Aunt Minnie.. Thanks.
The Chest Wall, Pleura,Diaphragm and Intervention 10 Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
This Presentation is basically image collection from chapter 10 of GRAINGER & ALLISON’S DIAGNOSTIC RADIOLOGY.
This is an effort to present the most authentic images.
Dr.Héctor Domínguez Hernández
Residente Imagenología
Platica básica acerca de las estructuras que conforman la silueta cardíaca, mediciones básicas en la placa simple, incluye también mediastina e hilios pulmonares.
This presentation is from 13th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
Role of MDCT MULTISCLICE in coronary artery part 5 (non atherosclerotic coron...AHMED ESAWY
Role of mdc tin coronary artery part 5 (non atherosclerotic coronary abnormalities) dr ahmed esawy
Role of mdc tin coronary artery part 4 (anomalous coronary arteries) dr ahmed esawy
This is a chapter from Grainger and Allison. I have Coolected all images from chapter 20 with caption in this presentation.
In my opinion it will be very benificial to have this in your android. ,
Pulmonary Lobar Collapse:Essential Considerations 14 Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
This presentation is from 15th chapter of Grainger and Allison--Diagnostic Radiology A TEXTBOOK OF MEDICAL IMAGING.
My aim behind all these presentation is to provide authentic images. As our all radiology revolve around images of diseases. We can put these ppts in our androids for study and references.
Imaging for Thoracic Surgeons | IACTS SCORE 2020IACTSWeb
This presentation illustrates the imaging and the modalities involved in a prudent diagnosis in thoracic surgery. It is meant to serve as an introductory guide for beginners to understand the need for imaging referrals, considerations, pre-operative decision making in imaging and post-surgical follow up.
Courtesy of Dr. Srikrishna S.V, MS, MCh, FRCS(Ed.), FIACS. He presently serves as Professor and Senior Consultant of Thoracic Surgery at Narayana Institute of Cardiac Sciences, Bommasandra, Bengaluru.
This presentation is part of a video that belongs to the lecture series of IACTS SCORE 2020 held at the Sri Sathya Sai Institute of Higher Medical Sciences Whitefield, Bengaluru between 7th and 8th March, 2020.
Dislocation of joint is very tricky. In this presentation radiological evaluation of Dislocation of various joints will be discussed.
This is one of the best pictoral review of important joint dislocations
Renal Color Doppler Ultrasound.
After studying this presentation one will be able to perform and interpret ultrasound.
This presntation in my opinion is best short analog to text.
In this presentation we will discuss the bone age assessment mainly focusing wrist radiograph.
we shall also highlights some points in adult bone age
Basically it is an introduction. We shall not discuss its judicial importance
Role of medical imaging in developemental dysplasia of Hip Dr muhammad Bin Zu...Dr. Muhammad Bin Zulfiqar
In this presentation we will discuss the role of medical imaging---plain Radiography, Ultrasound,Arthrography, CT and MRI in the evaluation of Developemental dysplasia of hip. Our main focuss will be on Sonographic evaluation.
In this presentation we will discuss the basic of axial trauma from head to pelvis. We will discuss the important key points that aids in the diagnosis of axial trauma
This is a chapter from Grainger and Allison. I have Coolected all images from chapter 21 with caption in this presentation.
In my opinion it will be very benificial to have this in your android.
This presentation is the first series of the MR imaging of Knee.
In this presentation MRI anatomy has been discussed. As we all know good knowledge of medical imaging three dimensional anatomy is key for good reporting.
Hope we all get benifitted.
Suggestions are most welcome
This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
This is a chapter from Grainger and Allison. I have Coolected all images from chapter 19 with caption in this presentation.
In my opinion it will be very benificial to have this in your android. ,
In this presentation we will dscuss the imp imaging features of Posterior fossa tumors in pediatric age group.
Medulloblastoma
Pilocytic Astrocytoma
Ependymoma
Brainstem Glioma
Schwanoma
Meningioma
Epidermoid Cyst
Arachnoid Cyst
In this presentation we will discuss about the
Anatomy of Prostate
Technique of Transrectal US
Carcinoma Prostate and
Different modes of prostatic biopsy.
In this presentation we shall discuss all fractures with specific names .
This is a pictoral review.
This presentation will be very helpful for radiologist to have in their androids to help them in rapid reporting
In this presentation all images of Chapter 18 from Grainger and Allison have been discussed.
Our aim is to discuss authentic material .
This is only for educational purposes.
In this chapter air space infilteration have been discussed. Ground glass haze and consolidation are discussed in detail.
This presentation is a selection of images from 17th chapter of grainger and allison.
Our aim is to provide standard and proved cases of the disease process.
This all is for educational purpose
Objectives of this presentation are
Introduction to ct
Cross sectional anatomy
Common important pathologies
This presentation is aimed to educate beginers to help in ct interpretetion.
16 High Resolution Computed Tomography of Interstitial and Occupational Lung ...Dr. Muhammad Bin Zulfiqar
This presentation is collection of images from chapter 16 of Grainger and Allison.
Inthis we will discuss the ILD.
This is only for educational purposes.
This Presentation is a collection of chapter 5 images from Grainger and Allison.
Our aim is to study authentic data.
This is only for educational purposes
In this presentation we will discuss role of high resolution in characterizing normal variant and pathologies of spinal pathologies.
This is a pictoral review.
This presentation provides sufficient material for anyone who wants is interested in interventional radiology. Here we will discuss the available facilities, mechanisms and equipments.
In my opinion this presentation will prove a footstep in interventional radiology
Hepatocellular carcinoma—role of interventional radiologist Dr. Muhammad Bin ...Dr. Muhammad Bin Zulfiqar
In these presentation we will discuss the merits, demrits and outcomes of various interventional radiology modalities for the treatment of hepatocellular carcinoma
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
1. 9
The Normal Chest
DR MUHAMMAD BIN ZULFIQAR
PGR III FCPS Services institute of Medical
Sciences/ Services Hospital Lahore
GRAINGER & ALLISON’S DIAGNOSTIC RADIOLOGY
2. • FIGURE 9-1 ■ The position and shape of the major
fissures (arrows) in the lower and the upper zones is
best shown by CT. Note that above the hila, the major
fissures bow backwards (B, C)
• The images are high-resolution 0.625-mm-thin CT
sections from a 64-row multislice CT study.
3. • FIGURE 9-1 ■ The position and shape of the major fissures
(arrows) in the lower and the upper zones is best shown
by CT. Note that above the hila, the major fissures bow
backwards (B, C), whereas below the hila, the major
fissures bow forwards (D to H).
• The images are high-resolution 0.625-mm-thin CT sections
from a 64-row multislice CT study.
4. • FIGURE 9-1 ■ The position and shape of the major fissures (arrows) in
the lower and the upper zones is best shown by CT. Note below the hila,
the major fissures bow forwards (D to H). The minor fissure (F, G) is
apparent as an area of avascularity anterior to the major fissure. In this
example the slightly bowed horizontal fissure undulates through the plane
of the slice (asterisks). The images are high-resolution 0.625-mm-thin CT
sections from a 64-row multislice CT study.
• The images are high-resolution 0.625-mm-thin CT sections from a 64-row
multislice CT study.
5. • FIGURE 9-1 ■ The position and shape of the major fissures
(arrows) in the lower and the upper zones is best shown
by CT. below the hila, the major fissures bow forwards. The
minor fissure (F, G) is apparent as an area of avascularity
anterior to the major fissure. In this example the slightly
bowed horizontal fissure undulates through the plane of
the slice (asterisks). The images are high-resolution 0.625-
mm-thin CT sections from a 64-row multislice CT study.
6. • FIGURE 9-2 ■ The position of fissures is often
best shown in additional sagittal reformats
(arrows) taken of the right lung (A, B) and the
left lung (C, D). Note the course of the major and
minor fissures together with an accessory cardiac
fissure on the right (arrowhead), and the major
fissure on the left (arrows).
7. • FIGURE 9-2 ■ The position of fissures is often
best shown in additional sagittal reformats
(arrows) taken of the right lung (A, B) and the
left lung (C, D). Note the course of the major and
minor fissures together with an accessory cardiac
fissure on the right (arrowhead), and the major
fissure on the left (arrows).
8. • FIGURE 9-3 ■ Azygos lobe fissure (A, C, arrows) and
azygos vein (B to D, asterisk). The azygos vein in the
lower end of the fissure is well seen on the coronal
reformats (C, D). In the early arterial contrast perfusion
phase the vein is not filled with contrast media (D)
displaying a soft-tissue-like attenuation. Occasionally
on conventional plain film radiography (E) the course of
the azygos vein from the mediastinum to the lower end
of the fissure (arrowhead) can be appreciated as a
vascular band (asterisk).
9. • FIGURE 9-3 ■ Azygos lobe fissure (A, C, arrows) and azygos
vein (B to D, asterisk). The azygos vein in the lower end of
the fissure is well seen on the coronal reformats (C, D). In
the early arterial contrast perfusion phase the vein is not
filled with contrast media (D) displaying a soft-tissue-like
attenuation. Occasionally on conventional plain film
radiography (E) the course of the azygos vein from the
mediastinum to the lower end of the fissure (arrowhead)
can be appreciated as a vascular band (asterisk).
10. • FIGURE 9-3 ■ Azygos lobe fissure (A, C, arrows) and azygos vein (B to D, asterisk).
The azygos vein in the lower end of the fissure is well seen on the coronal
reformats (C, D). In the early arterial contrast perfusion phase the vein is not filled
with contrast media (D) displaying a soft-tissue-like attenuation. Occasionally on
conventional plain film radiography (E) the course of the azygos vein from the
mediastinum to the lower end of the fissure (arrowhead) can be appreciated as a
vascular band (asterisk).
11. • FIGURE 9-4 ■ Intersegmental bilateral septa deep to
the inferior pulmonary ligament (A). Note the
bifurcated T-shape of the septum on the right
indicating the boundaries of the segments 9 and 10
(arrowheads). The function of the inferior pulmonary
ligament fixating the lower lobe to the
paraoesophageal mediastinum (asterisk) is well
appreciated in another patient with pneumothorax (B).
12. • FIGURE 9-5 ■ Diagram illustrating the anatomy of the
main bronchi and segmental divisions. The
nomenclature is that approved by the British Thoracic
Society. (Courtesy of the Editors of Thorax.)
13. • FIGURE 9-5 ■ Diagram illustrating the anatomy
of the main bronchi and segmental divisions.
The nomenclature is that approved by the British
Thoracic Society. (Courtesy of the Editors of
Thorax.)
14. • FIGURE 9-6 ■ Ring shadows (arrowheads) due to end-
on bronchial projection as a normal finding on chest
radiography. Note the delicate appearance in a patient
without interstitial oedema.
15. RUL, 4 = lateral segment of right middle lobe (RML), 5 = medial segment of RML, 6 = apical
posterior segment of left upper lobe (LUL), 7 = anterior segment of LUL, 8 = superior segment of
lingula, 9 = inferior segment of lingula, 10 = apical (superior) segment of right lower lobe (RLL),
11 = medial basal segment of RLL, 12 = anterior basal segment of RLL, 13 = lateral basal segment
of RLL, 14 = posterior basal segment of RLL, 15 = apical (superior) segment of left lower lobe
(LLL), 16 = anterior basal segment of LLL, 17 = lateral basal segment of LLL, 18 = posterior basal
segment of LLL.
• FIGURE 9-7 ■ Diagrams of position of segments
seen on plain frontal and lateral chest
radiographs. There is substantial overlap of the
projected images of the segments in both views;
this overlap is worse in the frontal than the
lateral projection. (A) shows only the segments
in the upper lobes and the middle lobe; (B)
shows only the segments in the lower lobes; (C,
D) show all the segments in the right and left
lung, respectively, in the lateral view. H = hila, 1 =
apical segment of right upper lobe (RUL), 2 =
posterior segment of RUL, 3 = anterior segment
of
16. • FIGURE 9-8 ■ Pulmonary angiography. Conventional digital subtraction
angiography using selective right and left injections (A, B). Composed
image obtained during (A) the arterial phase and (B) the venous phase.
Note the difference in arrangement of the central arteries and veins,
whereas anatomic differences are not perceptible in the lung periphery.
Also note the biventricular ICD device overlying the projection in this
patient with cardiac arrhythmia. On CT pulmonary angiography the
anatomical relation of arterial and venous systems can be appreciated
interactively on one image using volume rendering (C) or thick-slab
maximum intensity imaging (D).
17. • FIGURE 9-8 ■ Pulmonary angiography. Conventional digital subtraction
angiography using selective right and left injections (A, B). Composed image
obtained during (A) the arterial phase and (B) the venous phase. Note the
difference in arrangement of the central arteries and veins, whereas anatomic
differences are not perceptible in the lung periphery. Also note the biventricular
ICD device overlying the projection in this patient with cardiac arrhythmia. On CT
pulmonary angiography the anatomical relation of arterial and venous systems can
be appreciated interactively on one image using volume rendering (C) or thick-slab
maximum intensity imaging (D).
18. • FIGURE 9-9 ■ Diagrams of the relationships
between the hilar blood vessels and bronchi.
(A) Frontal view. (B) Right posterior oblique
view of right hilum. (C) Left posterior oblique
view of left hilum.
19. • FIGURE 9-9 ■ Diagrams of the relationships
between the hilar blood vessels and bronchi. (A)
Frontal view. (B) Right posterior oblique view of
right hilum. (C) Left posterior oblique view of left
hilum.
20. Lateral chest radiograph
with major blood vessels
drawn in. IPV = inferior
pulmonary vein—only one
has been drawn in since they
are superimposed, LPA = left
pulmonary artery, LSPV = left
superior pulmonary vein,
RPA = right pulmonary
artery, RSPV = right superior
pulmonary vein. (Diagrams
drawn by Ron Ervin and
reproduced with permission
from Armstrong P (ed) 1983
Critical problems in
diagnostic radiology.
Lippincott, Philadelphia.)
• FIGURE 9-9, Continued ■
21. • FIGURE 9-10 ■ Normal
digital PA chest
radiograph
demonstrating position
and density of the hilar
structures. Arrows
indicate the hilar points
where the superior
pulmonary vein crosses
the descending lower
lobe artery, the left
normally being level with
or slightly higher than
the right.
22. • FIGURE 9-11 ■ Frontal view of the hila in a
plain chest radiograph. The measurement
points for the diameter of the right lower lobe
artery are indicated.
23. • FIGURE 9-12 ■ CT of normal hila. High-resolution CT images (0.625 mm) have
been obtained through the hilar structures during contrast medium injection and
displayed on lung windows (L-500, W 1500). (A) Section just below the tracheal
carina at the origin of the right upper lobe bronchus, immediately posterior to the
upper lobe vein (v). (B) Section through level of right main pulmonary artery (RPA)
and bronchus intermedius (arrowhead). Note the tongue of lung that contacts the
left main bronchus between the aorta (B) and the left lower lobe artery (black
arrowhead). Note also that the right lung contacts the posterior wall of the
bronchus intermedius as it extends into the azygo-oesophageal recess. (C) Section
through the level of the middle lobe bronchus (long arrow) at the point of origin of
the bronchus to the superior segment of the right lower lobe. Note that the
middle lobe bronchus separates the right lower lobe artery from the right superior
pulmonary vein as it enters the left atrium (LA). The lung contacts the posterior
wall of the right lower lobe bronchus as it extends into the azygo-oesophageal
recess. (D) Section through the level of the inferior pulmonary veins (arrows). At
this level the lower lobe arteries have bilaterally divided into basal segmental
divisions; each are less than 10 mm in diameter.
24. • FIGURE 9-12 ■ CT of normal hila. High-resolution CT images (0.625 mm)
have been obtained through the hilar structures during contrast medium
injection and displayed on lung windows (L-500, W 1500). Section through
the level of the middle lobe bronchus (long arrow) at the point of origin of
the bronchus to the superior segment of the right lower lobe. Note that
the middle lobe bronchus separates the right lower lobe artery from the
right superior pulmonary vein as it enters the left atrium (LA). The lung
contacts the posterior wall of the right lower lobe bronchus as it extends
into the azygo-oesophageal recess. (D) Section through the level of the
inferior pulmonary veins (arrows). At this level the lower lobe arteries
have bilaterally divided into basal segmental divisions; each are less than
10 mm in diameter.
25. • FIGURE 9-13 ■ Lateral view of the hila
showing normal thickness of the posterior
wall of the bronchus intermedius (arrows).
26. • FIGURE 9-14 ■ MRI of normal mediastinum and hila. Four transverse and four
coronal sections have been chosen to show the important anatomical features:
(A–D, G, H) gradient echo post gadolinium iv; (E, F) T1-weighted gradient echo
sequence). (A) is 1 cm above the tracheal carina; (B) is just below (A); (C) is at the
level of the right main pulmonary artery; (D) is at the level of the mid left atrium.
A.Ao = ascending aorta; AV = azygos vein; BI = bronchus intermedius; D.Ao =
descending aorta; LA = left atrium; LCA = left carotid artery; LMB = left main
bronchus; LPA = left pulmonary artery; LV = left ventricle; MPA = main pulmonary
artery; Oes = oesophagus; RA = right atrium; RMB = right main bronchus; RSPV =
right superior pulmonary vein; SVC = superior vena cava;
27. • FIGURE 9-14 ■ MRI of normal mediastinum and hila. Four transverse and four
coronal sections have been chosen to show the important anatomical features:
(A–D, G, H) gradient echo post gadolinium iv; (E, F) T1-weighted gradient echo
sequence). (A) is 1 cm above the tracheal carina; (B) is just below (A); (C) is at the
level of the right main pulmonary artery; (D) is at the level of the mid left atrium.
A.Ao = ascending aorta; AV = azygos vein; BI = bronchus intermedius; D.Ao =
descending aorta; LA = left atrium; LCA = left carotid artery; LMB = left main
bronchus; LPA = left pulmonary artery; LV = left ventricle; MPA = main pulmonary
artery; Oes = oesophagus; RA = right atrium; RMB = right main bronchus; RSPV =
right superior pulmonary vein; SVC = superior vena cava; T = trachea.
28. • FIGURE 9-14 ■ MRI of normal mediastinum and hila. Four transverse and
four coronal sections have been chosen to show the important anatomical
features: (A–D, G, H) gradient echo post gadolinium iv; (E, F) T1-weighted
gradient echo sequence). (A) is 1 cm above the tracheal carina; (B) is just
below (A); (C) is at the level of the right main pulmonary artery; (D) is at the
level of the mid left atrium. A.Ao = ascending aorta; AV = azygos vein; BI =
bronchus intermedius; D.Ao = descending aorta; LA = left atrium; LCA = left
carotid artery; LMB = left main bronchus; LPA = left pulmonary artery; LV =
left ventricle; MPA = main pulmonary artery; Oes = oesophagus; RA = right
atrium; RMB = right main bronchus; RSPV = right superior pulmonary vein;
SVC = superior vena cava; T = trachea.
29. • FIGURE 9-14 ■ MRI of normal mediastinum and hila. Four transverse and
four coronal sections have been chosen to show the important anatomical
features: (A–D, G, H) gradient echo post gadolinium iv; (E, F) T1-weighted
gradient echo sequence). (A) is 1 cm above the tracheal carina; (B) is just
below (A); (C) is at the level of the right main pulmonary artery; (D) is at the
level of the mid left atrium. A.Ao = ascending aorta; AV = azygos vein; BI =
bronchus intermedius; D.Ao = descending aorta; LA = left atrium; LCA = left
carotid artery; LMB = left main bronchus; LPA = left pulmonary artery; LV =
left ventricle; MPA = main pulmonary artery; Oes = oesophagus; RA = right
atrium; RMB = right main bronchus; RSPV = right superior pulmonary vein;
SVC = superior vena cava; T = trachea.
30. • FIGURE 9-15 ■ CT of normal mediastinum. (A–I) Five 1-cm-
thick sections have been selected to show the important
anatomical features. The level of each section is illustrated in
the diagram. A.Ao = ascending aorta; AoA = aortic arch; AV =
azygos vein; D.Ao = descending aorta; IA = innominate artery;
LA = left atrium; LCA = left carotid artery; LIV = left innominate
vein; LPA = left pulmonary artery; LSA = left subclavian artery;
MPA = main pulmonary artery; OES = oesophagus; RA = right
atrium; RIV = right innominate vein; RPA = right pulmonary
artery; RVO = right ventricular outflow tract; SPV = superior
pulmonary vein; SVC = superior vena cava; T = trachea.
31. • FIGURE 9-15 ■ CT of normal mediastinum. (A–I) Five 1-cm-thick
sections have been selected to show the important anatomical
features. The level of each section is illustrated in the diagram. A.Ao
= ascending aorta; AoA = aortic arch; AV = azygos vein; D.Ao =
descending aorta; IA = innominate artery; LA = left atrium; LCA =
left carotid artery; LIV = left innominate vein; LPA = left pulmonary
artery; LSA = left subclavian artery; MPA = main pulmonary artery;
OES = oesophagus; RA = right atrium; RIV = right innominate vein;
RPA = right pulmonary artery; RVO = right ventricular outflow tract;
SPV = superior pulmonary vein; SVC = superior vena cava; T =
trachea.
32. • FIGURE 9-15 ■ CT of normal mediastinum. (A–I) Five 1-cm-thick
sections have been selected to show the important anatomical
features. The level of each section is illustrated in the diagram. A.Ao
= ascending aorta; AoA = aortic arch; AV = azygos vein; D.Ao =
descending aorta; IA = innominate artery; LA = left atrium; LCA =
left carotid artery; LIV = left innominate vein; LPA = left pulmonary
artery; LSA = left subclavian artery; MPA = main pulmonary artery;
OES = oesophagus; RA = right atrium; RIV = right innominate vein;
RPA = right pulmonary artery; RVO = right ventricular outflow tract;
SPV = superior pulmonary vein; SVC = superior vena cava; T =
trachea.
33. • FIGURE 9-15 ■ CT of normal mediastinum. (A–I) Five 1-cm-thick
sections have been selected to show the important anatomical
features. The level of each section is illustrated in the diagram.
A.Ao = ascending aorta; AoA = aortic arch; AV = azygos vein; D.Ao
= descending aorta; IA = innominate artery; LA = left atrium; LCA
= left carotid artery; LIV = left innominate vein; LPA = left
pulmonary artery; LSA = left subclavian artery; MPA = main
pulmonary artery; OES = oesophagus; RA = right atrium; RIV =
right innominate vein; RPA = right pulmonary artery; RVO = right
ventricular outflow tract; SPV = superior pulmonary vein; SVC =
superior vena cava; T = trachea.
34. • FIGURE 9-15 ■ CT of normal mediastinum. (A–I) Five 1-cm-thick
sections have been selected to show the important anatomical
features. The level of each section is illustrated in the diagram.
A.Ao = ascending aorta; AoA = aortic arch; AV = azygos vein; D.Ao
= descending aorta; IA = innominate artery; LA = left atrium; LCA
= left carotid artery; LIV = left innominate vein; LPA = left
pulmonary artery; LSA = left subclavian artery; MPA = main
pulmonary artery; OES = oesophagus; RA = right atrium; RIV =
right innominate vein; RPA = right pulmonary artery; RVO = right
ventricular outflow tract; SPV = superior pulmonary vein; SVC =
superior vena cava; T = trachea.
35. • FIGURE 9-16 ■ CT of normal thymus (arrow)
in a young adult man.
37. • FIGURE 9-18 ■ The International Association for the
Study of Lung Cancer (IASLC) lymph node map
grouping the lymph node stations into ‘zones’ for
purpose of prognostic analysis (from:
<http://www.radiologyassistant.nl/en/4646f1278c26f>
). Please see explanations in Table 9-1.
38. • FIGURE 9-18 ■ The International Association for the
Study of Lung Cancer (IASLC) lymph node map
grouping the lymph node stations into ‘zones’ for
purpose of prognostic analysis (from:
<http://www.radiologyassistant.nl/en/4646f1278c26f>
). Please see explanations in Table 9-1.
39. • FIGURE 9-19 ■ The IASLC lymph node map can be applied to clinical staging by
computed tomography in axial (A–C) views. The border between the right and left
paratracheal region is shown in (A) and (B). Ao = aorta; Az = azygos vein; MB =
main bronchus; Eso = oesophagus; IV = innominate vein; LtInV = left innominate
vein; LtSCA = left subclavian artery; PA = pulmonary artery; SPV = superior
pulmonary vein; RtInV = right innominate vein; SVC = superior vena cava; T =
trachea. (With permission from Rusch VW, Asamura H, Watanabe H et al 2009 The
IASLC lung cancer staging project. J Thorac Oncol 4: 568–577.)
40. • FIGURE 9-19 ■ The IASLC lymph node map can be applied to clinical staging by
computed tomography in axial (A–C) views. The border between the right and left
paratracheal region is shown in (A) and (B). Ao = aorta; Az = azygos vein; MB =
main bronchus; Eso = oesophagus; IV = innominate vein; LtInV = left innominate
vein; LtSCA = left subclavian artery; PA = pulmonary artery; SPV = superior
pulmonary vein; RtInV = right innominate vein; SVC = superior vena cava; T =
trachea. (With permission from Rusch VW, Asamura H, Watanabe H et al 2009 The
IASLC lung cancer staging project. J Thorac Oncol 4: 568–577.)
41. • FIGURE 9-20 ■ Diagrams
illustrating the mediastinal
boundaries and junction
lines. The visualisation of the
junction lines on a plain chest
radiograph is variable,
depending on how much fat is
present in the mediastinum
and on how closely the two
lungs approximate to one
another. (A) Section just
above the level of the aortic
arch; (B) section through the
aortic arch; (C) section
through the heart. (D) Axial
CT and (E) chest plain X-ray
showing the anterior junction
line (arrowheads). (F, G) Axial
CT showing the supra-aortic
and lower posterior junction
line (arrows).
42. • FIGURE 9-20 ■ Diagrams illustrating the mediastinal
boundaries and junction lines. The visualisation of the
junction lines on a plain chest radiograph is variable,
depending on how much fat is present in the mediastinum
and on how closely the two lungs approximate to one
another. (A) Section just above the level of the aortic arch;
(B) section through the aortic arch; (C) section through the
heart. (D) Axial CT and (E) chest plain X-ray showing the
anterior junction line (arrowheads). (F, G) Axial CT showing
the supra-aortic and lower posterior junction line (arrows).
43. • FIGURE 9-20 ■ Diagrams illustrating the mediastinal boundaries
and junction lines. The visualisation of the junction lines on a plain
chest radiograph is variable, depending on how much fat is present
in the mediastinum and on how closely the two lungs approximate
to one another. (A) Section just above the level of the aortic arch;
(B) section through the aortic arch; (C) section through the heart.
(D) Axial CT and (E) chest plain X-ray showing the anterior junction
line (arrowheads). (F, G) Axial CT showing the supra-aortic and
lower posterior junction line (arrows).
44. • FIGURE 9-20 ■ Diagrams illustrating the mediastinal boundaries
and junction lines. The visualisation of the junction lines on a plain
chest radiograph is variable, depending on how much fat is present
in the mediastinum and on how closely the two lungs approximate
to one another. (A) Section just above the level of the aortic arch;
(B) section through the aortic arch; (C) section through the heart.
(D) Axial CT and (E) chest plain X-ray showing the anterior junction
line (arrowheads). (F, G) Axial CT showing the supra-aortic and
lower posterior junction line (arrows).
45. • FIGURE 9-21 ■ Right tracheal stripe (straight
arrows) and pleurooesophageal line (curved
arrows) demonstrated on (A) plain radiograph
and (B) unenhanced CT.
46. • FIGURE 9-22 ■ Lateral view of trachea and
major bronchi. (A) In this example, the
posterior wall of the trachea is outlined by
lung posterior to it (arrow). (B) In this
example, the collapsed oesophagus is
between the lung and the trachea (arrow).
47. • FIGURE 9-23 ■ Bulge behind manubrium
representing normal left innominate
(brachiocephalic) vein (arrow).
49. • FIGURE 9-25 ■ Patterns of pleural reflection along the
left border of the great vessels and heart. The heavy
line indicates the visible pleural interface. (Adapted
from Blank N, Castellino R A 1972 Patterns of pleural
reflections of the left superior mediastinum: normal
anatomy and distortions produced by adenopathy.
Radiology 102: 585–589, with permission from the
Radiological Society of North America.)
50. • FIGURE 9-26 ■ Retrosternal stripe
(arrowheads) and inferior vena cava in lateral
projection (arrows).
51. • FIGURE 9-27 ■ (A) Right phrenic nerve as it
passes over the surface of the right
hemidiaphragm (arrows). (B, C) Coronal
secondary reformat and volume rendering
showing the nerve as delicate structure crossing a
lymph node in the mediastino-diaphragmatic
angle (arrowheads).
52. • FIGURE 9-27 ■ (A) Right phrenic nerve as it
passes over the surface of the right
hemidiaphragm (arrows). (B, C) Coronal
secondary reformat and volume rendering
showing the nerve as delicate structure crossing a
lymph node in the mediastino-diaphragmatic
angle (arrowheads).