bimbingan toraks

8/11/2019 Bimbingan Toraks

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Normal ChestX Ray

Anggreiny


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Basic anatomy


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Lobes

Segmen

Lobules

Acinus

Alveoli


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Right Left

Upper Lobe

Middle Lobe

Lower Lobe

Apical

Anterior

Posterior

Lateral

Medial

Superior Lingula

Inferior Lingula

Upper Lobe

Lingula

Anterior

Apicoposterior

Apical

Anterior

Posterior

Medial

Lateral

Lower Lobe

Apicobasal

Anterobasal

Posterobasal

Lateral

Lungs


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Radiographic anatomy


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AscendenAorta

Aortic Knob Left Pulmonary

Artery + LeftAtrium AuricleHeart waist

DescendenAorta


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CTR


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L

Lung zonesApex

Upper

MiddleLower


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Before reading CXR

1. Identity

2. Marker (R/L)3. Exposure dose (kV, mAs)

4. Position (PA/AP/Lateral/Oblique)

5. Film qualities (asymmetric, shaken,inspiration/expiration)

6. Artifacts


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IDR

kVV Th. 3


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PA or AP ?

1

2

PA AP


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Maximuminspiration

1

2

3

4

5

6


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Retrosternal space

Retrocardial space

Anterior sinus

Posterior

sinus

Trachea

R


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PA view1.

Position? enoughinspiration?2. Soft tissue3. Skeletal4. Trachea (deviation?)

5. Sinuses andDiaphragms6. Mediastinum

Heart (position, size,configuration)

Great vessels

7. Lungs Hila

Vascular patterns

Lung apices, pleuralline and fissures


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Lateral view

Anterior andposterior sinuses

Retro sternaland retrocardiac spaces


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Thank You


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Radiographic anatomy Trachea (midline) Carina level at V. Thoracic 5-

6

Heart Position Size PA view 50%, AP view

55%

Configuration (apex, aorticknob, pulmonary trunk, auricleof left atrial, right atrial, SVC)

Diaphragms Right diaphragm level at V.

thoracic 6-7

Left diaphragm level at V.thoracic 7-8

Right is higher than left (2,5 cm)


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Radiographic anatomy Right hilum: formed by the right main

bronchus and right

pulmonary artery, lobardivisions

Between the diaphragmand lung apex

V. thoracic 5-6

Content: artery, vein,bronchus, lymph

Left hilum: V. thoracic 4-5

Content: artery, vein,bronchus, lymph


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Radiographic anatomy Lungs Vascular pattern

Lung apices Lung contours:

cardiac borders,mediastinal margin

Normal pleural lineand fissures are notvisible

Normal minor fissuresPA: level at V Th. 5/

Anterior ribs 4th


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Pulmonary Vascular Patterns

Normal: Right


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