50. Denotes a pulmonary lesion/consolidation (excludes a pleural or mediastinal lesion)
51.
52.
53.
55.
56.
57.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
Notas del editor
The less dense an object is, the fewer xrays it absorbs, and the blacker it wll appearAir attenuates very little of the xray beam, allowing nearly full force of the beam to blacken the image. Fat, and soft tissues attenuate interediate amounts of the xray beam , resulting in proportional degrees of image blackening (shades of gray) radiation than thin structures iBone, metal, and radiographic contrast agents attenuate a large proportion of the xray beam, allowing very little radiation through to blacken the image. Thus, bone and metallic objects and structures opacified by xray contrast agents appear white on radiographs. Bone is densest naturally occurring tissue. It absorbs the greatest amount of xray and appears white on radiographs.Metal is even denser than bone and essentially absorbs all xrays, but unless you have bullets or artifical hip replacements, metal doesn’t naturally occur in humans
Underpenetration – mimic or hide true disease of left lower lung field (lower lobe pneumonia, left pleural effusion)Overpenetration – mistakenly think patient has emphysema or pneumothorax; pulmonary nodule may be invisible
In an AP film, the heart is farther from the film and is more magnifiedPortable chest x-rays are almost always done AP
In an AP film, the heart is farther from the film and is more magnifiedPortable chest x-rays are almost always done AP
Anterior structures (like the clavicles) will be projected higher on the film than posterior structures
A film which is apical lordotic (beam is angled up toward head) will have an unusually shaped heart and the sharp border of the left hemidiaphragm will be absentAnterior structures (like the clavicles) will be projected higher on the film than posterior structureshis projectionresults in clear visualization of the lung apices because the clavicle and first rib are projected above the pulmonary apex
Right – minor fissure separates upper and middle lobe. Major fissure middle lobe and lower lobeRight upper lobe – anterior apical and posteriorMiddle lobe – medial and lateralRight lower lobe – anterior, lateral, posterior and medialLeft – upper and lower lobes by left major fissure Left upper lobe is analogous to the combined right upper and middle , anterior, apicoposterior, superior and inferior lingular segmentsLeft lower lobe – anteromedial, lateral and posterior
Airways, including hilaradenopathy or enlargementBreast shadowsBones, e.g. rib fractures and lytic bone lesionsCardiac silhoutte, detecting cardiac enlargementCostophrenic angles, including pleural effusionsDiaphragm, e.g. evidence of free airEdges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaquesExtrathoracic tissuesFields (lung parenchyma), being evidence of alveolar fillingFailure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
Airways, including hilaradenopathy or enlargementBreast shadowsBones, e.g. rib fractures and lytic bone lesionsCardiac silhoutte, detecting cardiac enlargementCostophrenic angles, including pleural effusionsDiaphragm, e.g. evidence of free airEdges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaquesExtrathoracic tissuesFields (lung parenchyma), being evidence of alveolar fillingFailure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
Airways, including hilaradenopathy or enlargementBreast shadowsBones, e.g. rib fractures and lytic bone lesionsCardiac silhoutte, detecting cardiac enlargementCostophrenic angles, including pleural effusionsDiaphragm, e.g. evidence of free airEdges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaquesExtrathoracic tissuesFields (lung parenchyma), being evidence of alveolar fillingFailure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
DeviationFBET Tube
Airways, including hilaradenopathy or enlargementBreast shadowsBones, e.g. rib fractures and lytic bone lesionsCardiac silhoutte, detecting cardiac enlargementCostophrenic angles, including pleural effusionsDiaphragm, e.g. evidence of free airEdges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaquesExtrathoracic tissuesFields (lung parenchyma), being evidence of alveolar fillingFailure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
Airways, including hilaradenopathy or enlargementBreast shadowsBones, e.g. rib fractures and lytic bone lesionsCardiac silhoutte, detecting cardiac enlargementCostophrenic angles, including pleural effusionsDiaphragm, e.g. evidence of free airEdges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaquesExtrathoracic tissuesFields (lung parenchyma), being evidence of alveolar fillingFailure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
Airways, including hilaradenopathy or enlargementBreast shadowsBones, e.g. rib fractures and lytic bone lesionsCardiac silhoutte, detecting cardiac enlargementCostophrenic angles, including pleural effusionsDiaphragm, e.g. evidence of free airEdges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaquesExtrathoracic tissuesFields (lung parenchyma), being evidence of alveolar fillingFailure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
Airways, including hilaradenopathy or enlargementBreast shadowsBones, e.g. rib fractures and lytic bone lesionsCardiac silhoutte, detecting cardiac enlargementCostophrenic angles, including pleural effusionsDiaphragm, e.g. evidence of free airEdges, e.g. apices for fibrosis, pneumothorax, pleural thickening or plaquesExtrathoracic tissuesFields (lung parenchyma), being evidence of alveolar fillingFailure, e.g. alveolar air space disease with prominent vascularity with or without pleural effusions
Newborn infantAP diameter of the thorax is greater compared with the tranverse diameter than in adultsDiaphragm is higher, vertical diameter of the thoracic cavity relatively less than in the adultWith growth, chest becomes narrower and ribs gradually angulate downward from horizontal position Thymus is often large enough in early infancy to produce widening of the superior mediastinum -bilobed structure located in the anterior mediastinum that can cause considerable confusion simulate cardiomegaly, upper-lobe pneumonia, and atelectasis. Additionally, it can appear as a pathologic mass if it is aberrant in locationHeart is globular and is relatively large in comparison with the diameter of the chest than in adultsLeft ventricle becomes more prominent with age, resulting in downward displacement of the apex, and the relatively heart size gradually decreasesLungs more radiolucent than in the adult because the pulmonary interstitium usually is not visible., tracheal bifurcation gradually descends and reaches the adult level (T5) at about 10 yrs old The hilar shadows are relatively high and usually are situated at the level of the third thoracic vertebra.Diaphragm tends to be higher in infancy and childhood than in adult life; opposite to adult that left hemidiaphragm higher than the right (stomach is distended with air)
Two substances of the same density, in direct contact, cannot be differentiated from each other on x-rayCommon locationsLower lobes-diaphragmsRight heart border – RMLLeft heart border – LingulaLeft diaphragm – Heart (on lateral view)