How to read CXR continued

Air Broncho gram : are filling bronchi which is made visible by the opacification of the surrounding alveoli

disease of Lung apex Pneumothorax Pan coast tumor bullae Pulmonary TB Upper lobe blood diversion reaching lung apices ( pulmonary plethora ) Massive pleural effusion reaching lung apices.

Pneumothorax ..sudden onset dyspnea, .chest pain Causes Chest trauma Rupture air blister (bleb) …Tension pneumothorax lung disease .pneumonia , cystic fibrosis ,chronic interstitial lung disease Risks factors :male , smoker , age , genetics, mechanical ventilation ,previous pneumothorax

Pan coast tumor ( sup. Sulcus tumor) Un common situation of primary bronchogenic carcinoma arising in the lung apex Presenting as arm pain, shoulder pain , Horner syndrome, chest symptoms , wt. loss.

Pan coast tumor

Hilar lung disease Enlargement : bilateral ..both are enlarged and denser than normal …ex: primary TB , sarcoidosis , Mets. ( ca. breast ) , lymphoma , infection , pulmonary arterial hypertension . ..When asymmetric, one hilum appears larger than the other . Displaced hilum : abnormal positioned , pulled to one side . Indicating loss off volume in the affected side ..or pushed to the other side : ex.. Massive pleural effusion, emphysema or pneumothorax of the contra lateral side Normal positioned …it is formed by vessels and end on bronchi

hilum

Non symmetric hilar enlargement

The diaphragm

Diaphragm

Phrenic nerve pulsy

Event ration of the diaphragm Abnormal contour of the diaphragmatic dome, it affect a segment of the hemi diaphragm