Radiographic Anatomy of the Thorax Flashcards
Dr. Morris
List the radiographic views you must take when doing a thoracic radiograph
left lateral
right lateral
ventrodorsal or dorsoventral (VD, DV)
Why are the 3 views needed for the thorax?
the “down” lung fields are not properly inflated with air, so you can’t evaluate that lung field that’s lying on the table
A right lateral lung field is shown. Which lung is inflated?
left lung
down lung (i.e. right) is not properly inflated
Should you take an xray on inspiration or expiration?
inspiration - lung fields completely expanded allows for good contrast
A good lateral thorax will have what alignment criteria?
- rib heads should overlap
- rib curvature should match
- pull thoracic limbs cranially out of view
This radiograph shows [inspiration/expiration]
inspiration
This radiograph shows [inspiration/expiration]
inspiration
This radiograph shows [inspiration/expiration]
expiration
What makes a good VD thorax projection?
- inspiration still the best
- alignment - define on next card
What makes a good VD thorax projection - alignment-wise?
- equal thorax space on each side of the spine
- alignment of the sternum and vertebral column
- spinous process in a straight line
- thoracic limbs pulled cranially
How do you differentiate DV versus VD?
crus of the diaphragm is different
DV = D for dome?
VD = 3
DV or VD?
DV
DV or VD?
VD
Name this radiographic view
VD
How would you improve this radiograph?
take on inspiration, not expiration
ribs aren’t aligned
pull thoracic limbs out of way
Label where the 4 chambers of the heart are
- right atrium
- right ventricle
- left ventricle
- left atrium
Label 1-5
- main pulmonary artery (2-3 o’clock)
- left auricle (2-3 o’clock)
- left ventricle (3-6 o’clock)
- right ventricle (6-9 o’clock)
- right atrium (9-11 o’clock)
What is the galaxy pattern line a representation of?
the tracking path of the aortic arch
Identify the descending aorta and caudal vena cava on this radiograph
What is the order of vascular anatomy - lateral thoracic projections?
pulmonary artery
bronchus
pulmonary vein (ventral and central)
Can you find where the pulmonary artery, bronchus, and pulmonary vein are?
What structures do you see on a right lateral thorax?
right cranial lobe artery
right cranial lobe vein
left lung field!
What structures do you see on the left lateral thorax?
aorta
left cranial lobe vessels and bronchus
right cranial lobe vessels and bronchus
right middle lobe vessels
caudal vena cava
right lung field!
What structures do you see on VD/DV thorax?
right caudal lobar artery
right caudal lobar vein
left caudal lobar artery
left caudal lobar vein
- can’t see bronchus as well
Normal caudal lobe pulmonary arteries and veins should be the same size as _______
the diameter of the 9th rib
Unless air or foreign material is present within the _______, it is difficult to distinguish
esophagus
How should the trachea be oriented?
should be air-filled and travel at a slight ventral angle as it approaches the cardiac silhouette
If the heart is enlarged, how does the trachea appear?
will be elevated due to left ventricle enlargement
What is this?
redundant tracheal membrane (normal!)
Identify the right cranial lobe
Identify the right cranial bronchus
Identify the pulmonary arteries (1)
Identify the pulmonary arteries (2)
Identify the aorta
Identify the vena cava
Identify the right accessory lobe
Identify the left cranial lung lobe
Look at these lung fields
What would you change about this radiograph?
take on inspiration
rib heads starts to not be symmetrical caudally
overall not bad
What is the mediastinum?
space between the right and left pleural sacs, bounded by mediastinal pleura. Extends from the thoracic inlet to the diaphragm. It is fenestrated and typically cannot contain unilateral pleural disease
lives between the lung lobes
What are the arrows pointing to?
the mediastinum
What are these arrows pointing to?
the mediastinum
What are the lymph nodes of the thorax?
tracheobronchial lymph node
sternal lymph node
craniomediastinal lymph node
What does the tracheobronchial lymph node do?
drains the thorax
What does the sternal lymph node do?
drains thorax and peritoneal cavity
What does the craniomediastinal lymph node do?
drains thorax and cervical region
Label the colors
black: sternal lymph node
green: craniomediastinal lymph node
red: tracheobronchial lymph node
How does the trachea look in this?
it is dorsally deviated
Which lymph node would you expect to be enlarged here?
tracheobronchial lymph node
enlarged heart - left ventricle likes to enlarge and heart looks taller
