Lecture 4: Intro to Thorax

Question 1

what are indications for taking thoracic radiographs?

Answer 1

• mets examniation
• resp dysfunction
• cardiac disease
• esophageal issues
• post surgical complications
• establish a baseline

Question 2

should you take a thoracic radiograph on inspiration or expiration?

Answer 2

inspiration to make the chest bigger

Question 3

list the views you need for the following thoracic radigraphs:
- mets check
- cardiac eval
- heart failure check

Answer 3

• mets: 3 views, both laterals and DV
• cardiac eval: lateral and a VD
• heart failure: lateral and a DV

Question 4

which lateral is better for:
- cardiac assessment and left pulmonary lobes
- assessment of right pulmonary lobes especially aspiration penumonia

Answer 4

right (the left lobes are up and more of the heart is up)
left (right lobes are up)

Question 5

which lateral is this and how can you tell?

Answer 5

this is left lateral because the crura are more divergent rather than parallel, the left crura is more cranial and the cadual vena cava is entering the caudal crura

Question 6

which lateral is this and how do you know?

Answer 6

this is right lateral because the crura are more parallel to each other, the right crura is more cranial and the caudal vena cava enters the cranial crura

Question 7

on a thoracic radiograph, what are the normal structures to evaluate?

Answer 7

• the lungs and trachea
• the heart the vessels
• the pleural space
• mediastinum: LNs, esophagus, trachea, vessels
• extrathoracic structures: ribs, limbs, diaphram, SQ space

Question 8

name the lobes of both sides of lungs

Answer 8

right lung: cranial lobe, middle lobe, caudal lobe, accessory lobe
left lung: cranial lobe (split into a cranial portion and a caudal portion), caudal lobe

Question 9

name some ways in which a VD is the better view of choice, and when DVis the better view of choice:

Answer 9

VD: cranial mediatinum easier to evaluate, pleural effusion easier to see, allows better inflation of the lungs
DV: better to evaluate the caudal lung lobes, less respiratory restriction, better for seeing pulmonary edema

Question 10

in rehards to thorax vessels: veins are ________ and arteries are _______

Answer 10

ventral and central
away

Question 11

which lateral is better for seeing the vessels in the chest?

Answer 11

left lateral due to decreased superimposition

Question 12

which one is the vein and which one is the artery?

Answer 12

the vein is ventral and central so it is the one indicated by the black arrow
the artery is away so it is the one indicated by the white arrows

Question 13

dorsally, the mediastinum space is ______ and ventrally it is _________

Answer 13

wide
thin and filled by the heart

Question 14

on a radiograph, the sternal lymph nodes are______ and the cranial medastinal lymph nodes are ______. The trachealbronchial lymph nodes are _______

Answer 14

cranial to the cardiac silhouette
ventral and parallel to the trachea
around the area of the tracheal bifurcation

Question 15

abdominal pathology drains into the ______ lymph nodes and thoracic pathology drains into the ______ lymph nodes

Answer 15

sternal
cranial mediastinal and trachiobronchial